|
HC DRAINAGE OVARIAN ABSCESS ABDOMINAL APPROACH
|
Facility
|
IP
|
$2,094.48
|
|
|
Service Code
|
CPT 58822
|
| Hospital Charge Code |
36100259
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,319.52 |
| Max. Negotiated Rate |
$1,885.03 |
| Rate for Payer: Aetna Commercial |
$1,780.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,361.41
|
| Rate for Payer: Cash Price |
$1,675.58
|
| Rate for Payer: Cofinity Commercial |
$1,466.14
|
| Rate for Payer: Cofinity Commercial |
$1,801.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,466.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,675.58
|
| Rate for Payer: Healthscope Commercial |
$1,885.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,780.31
|
| Rate for Payer: PHP Commercial |
$1,780.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,361.41
|
| Rate for Payer: Priority Health SBD |
$1,319.52
|
|
|
HC DRAINAGE OVARIAN ABSCESS ABDOMINAL APPROACH
|
Facility
|
OP
|
$2,094.48
|
|
|
Service Code
|
CPT 58822
|
| Hospital Charge Code |
36100259
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$764.84 |
| Max. Negotiated Rate |
$5,811.00 |
| Rate for Payer: Aetna Commercial |
$1,780.31
|
| Rate for Payer: Aetna Medicare |
$1,047.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,361.41
|
| Rate for Payer: BCBS Complete |
$837.79
|
| Rate for Payer: BCBS Trust/PPO |
$1,437.20
|
| Rate for Payer: BCN Commercial |
$1,437.20
|
| Rate for Payer: Cash Price |
$1,675.58
|
| Rate for Payer: Cash Price |
$1,675.58
|
| Rate for Payer: Cash Price |
$1,675.58
|
| Rate for Payer: Cofinity Commercial |
$1,466.14
|
| Rate for Payer: Cofinity Commercial |
$1,801.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,466.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,675.58
|
| Rate for Payer: Healthscope Commercial |
$1,885.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,780.31
|
| Rate for Payer: PHP Commercial |
$1,780.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,361.41
|
| Rate for Payer: Priority Health SBD |
$1,319.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$764.84
|
| Rate for Payer: UHC Core |
$5,427.00
|
| Rate for Payer: UHC Exchange |
$5,811.00
|
|
|
HC DRAINAGE PERITONEAL OR RETROPERITONEAL PERCUTANEOUS
|
Facility
|
OP
|
$4,265.64
|
|
|
Service Code
|
CPT 49406
|
| Hospital Charge Code |
36100433
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$202.64 |
| Max. Negotiated Rate |
$4,989.41 |
| Rate for Payer: Aetna Commercial |
$3,625.79
|
| Rate for Payer: Aetna Medicare |
$1,650.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,772.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,984.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,984.35
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$997.65
|
| Rate for Payer: BCN Commercial |
$997.65
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$3,412.51
|
| Rate for Payer: Cash Price |
$3,412.51
|
| Rate for Payer: Cash Price |
$3,412.51
|
| Rate for Payer: Cofinity Commercial |
$2,985.95
|
| Rate for Payer: Cofinity Commercial |
$3,668.45
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,985.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,412.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$3,839.08
|
| Rate for Payer: Mclaren Medicaid |
$850.89
|
| Rate for Payer: Mclaren Medicare |
$1,587.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,666.85
|
| Rate for Payer: Meridian Medicaid |
$893.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,825.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,625.79
|
| Rate for Payer: Nomi Health Commercial |
$3,333.71
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$3,625.79
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,772.67
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,989.41
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$3,991.53
|
| Rate for Payer: Priority Health SBD |
$2,687.35
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$202.64
|
| Rate for Payer: UHC Core |
$3,138.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$3,362.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$893.75
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
HC DRAINAGE PERITONEAL OR RETROPERITONEAL PERCUTANEOUS
|
Facility
|
IP
|
$4,265.64
|
|
|
Service Code
|
CPT 49406
|
| Hospital Charge Code |
36100433
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,687.35 |
| Max. Negotiated Rate |
$3,839.08 |
| Rate for Payer: Aetna Commercial |
$3,625.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,772.67
|
| Rate for Payer: Cash Price |
$3,412.51
|
| Rate for Payer: Cofinity Commercial |
$2,985.95
|
| Rate for Payer: Cofinity Commercial |
$3,668.45
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,985.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,412.51
|
| Rate for Payer: Healthscope Commercial |
$3,839.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,625.79
|
| Rate for Payer: PHP Commercial |
$3,625.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,772.67
|
| Rate for Payer: Priority Health SBD |
$2,687.35
|
|
|
HC DRAINAGE PERITONEAL OR RETROPERITONEAL TRANSVAG OR TRANSRECTAL
|
Facility
|
IP
|
$3,153.60
|
|
|
Service Code
|
CPT 49407
|
| Hospital Charge Code |
36100434
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,986.77 |
| Max. Negotiated Rate |
$2,838.24 |
| Rate for Payer: Aetna Commercial |
$2,680.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,049.84
|
| Rate for Payer: Cash Price |
$2,522.88
|
| Rate for Payer: Cofinity Commercial |
$2,207.52
|
| Rate for Payer: Cofinity Commercial |
$2,712.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,207.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,522.88
|
| Rate for Payer: Healthscope Commercial |
$2,838.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,680.56
|
| Rate for Payer: PHP Commercial |
$2,680.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,049.84
|
| Rate for Payer: Priority Health SBD |
$1,986.77
|
|
|
HC DRAINAGE PERITONEAL OR RETROPERITONEAL TRANSVAG OR TRANSRECTAL
|
Facility
|
OP
|
$3,153.60
|
|
|
Service Code
|
CPT 49407
|
| Hospital Charge Code |
36100434
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$215.36 |
| Max. Negotiated Rate |
$4,989.41 |
| Rate for Payer: Aetna Commercial |
$2,680.56
|
| Rate for Payer: Aetna Medicare |
$1,650.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,049.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,984.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,984.35
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$543.70
|
| Rate for Payer: BCN Commercial |
$543.70
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$2,522.88
|
| Rate for Payer: Cash Price |
$2,522.88
|
| Rate for Payer: Cash Price |
$2,522.88
|
| Rate for Payer: Cofinity Commercial |
$2,207.52
|
| Rate for Payer: Cofinity Commercial |
$2,712.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,207.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,522.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$2,838.24
|
| Rate for Payer: Mclaren Medicaid |
$850.89
|
| Rate for Payer: Mclaren Medicare |
$1,587.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,666.85
|
| Rate for Payer: Meridian Medicaid |
$893.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,825.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,680.56
|
| Rate for Payer: Nomi Health Commercial |
$3,333.71
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$2,680.56
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,049.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,989.41
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$3,991.53
|
| Rate for Payer: Priority Health SBD |
$1,986.77
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$215.36
|
| Rate for Payer: UHC Core |
$3,138.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$3,362.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$893.75
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
HC DRAINAGE SCROTAL WALL ABSCESS
|
Facility
|
IP
|
$2,142.08
|
|
|
Service Code
|
CPT 55100
|
| Hospital Charge Code |
76100278
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,349.51 |
| Max. Negotiated Rate |
$1,927.87 |
| Rate for Payer: Aetna Commercial |
$1,820.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,392.35
|
| Rate for Payer: Cash Price |
$1,713.66
|
| Rate for Payer: Cofinity Commercial |
$1,499.46
|
| Rate for Payer: Cofinity Commercial |
$1,842.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,499.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,713.66
|
| Rate for Payer: Healthscope Commercial |
$1,927.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,820.77
|
| Rate for Payer: PHP Commercial |
$1,820.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,392.35
|
| Rate for Payer: Priority Health SBD |
$1,349.51
|
|
|
HC DRAINAGE SCROTAL WALL ABSCESS
|
Facility
|
OP
|
$2,142.08
|
|
|
Service Code
|
CPT 55100
|
| Hospital Charge Code |
76100278
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$177.62 |
| Max. Negotiated Rate |
$4,989.41 |
| Rate for Payer: Aetna Commercial |
$1,820.77
|
| Rate for Payer: Aetna Medicare |
$1,650.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,392.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,984.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,984.35
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$466.03
|
| Rate for Payer: BCN Commercial |
$466.03
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$1,713.66
|
| Rate for Payer: Cash Price |
$1,713.66
|
| Rate for Payer: Cash Price |
$1,713.66
|
| Rate for Payer: Cofinity Commercial |
$1,842.19
|
| Rate for Payer: Cofinity Commercial |
$1,499.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,499.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,713.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$1,927.87
|
| Rate for Payer: Mclaren Medicaid |
$850.89
|
| Rate for Payer: Mclaren Medicare |
$1,587.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,666.85
|
| Rate for Payer: Meridian Medicaid |
$893.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,825.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,820.77
|
| Rate for Payer: Nomi Health Commercial |
$3,333.71
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$1,820.77
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,392.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,989.41
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$3,991.53
|
| Rate for Payer: Priority Health SBD |
$1,349.51
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$177.62
|
| Rate for Payer: UHC Core |
$3,138.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$893.75
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
HC DRAINAGE SOFT TISSUE W IMAGE GUIDANCE
|
Facility
|
OP
|
$3,174.66
|
|
|
Service Code
|
CPT 10030
|
| Hospital Charge Code |
36100422
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$142.01 |
| Max. Negotiated Rate |
$2,857.19 |
| Rate for Payer: Aetna Commercial |
$2,698.46
|
| Rate for Payer: Aetna Medicare |
$716.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,063.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$861.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$861.70
|
| Rate for Payer: BCBS Complete |
$387.97
|
| Rate for Payer: BCBS MAPPO |
$689.36
|
| Rate for Payer: BCBS Trust/PPO |
$521.35
|
| Rate for Payer: BCN Commercial |
$521.35
|
| Rate for Payer: BCN Medicare Advantage |
$689.36
|
| Rate for Payer: Cash Price |
$2,539.73
|
| Rate for Payer: Cash Price |
$2,539.73
|
| Rate for Payer: Cash Price |
$2,539.73
|
| Rate for Payer: Cofinity Commercial |
$2,222.26
|
| Rate for Payer: Cofinity Commercial |
$2,730.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,222.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,539.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$689.36
|
| Rate for Payer: Healthscope Commercial |
$2,857.19
|
| Rate for Payer: Mclaren Medicaid |
$369.50
|
| Rate for Payer: Mclaren Medicare |
$689.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$723.83
|
| Rate for Payer: Meridian Medicaid |
$387.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$792.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,698.46
|
| Rate for Payer: Nomi Health Commercial |
$1,447.66
|
| Rate for Payer: PACE Medicare |
$654.89
|
| Rate for Payer: PACE SWMI |
$689.36
|
| Rate for Payer: PHP Commercial |
$2,698.46
|
| Rate for Payer: PHP Medicare Advantage |
$689.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,063.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,166.65
|
| Rate for Payer: Priority Health Medicare |
$689.36
|
| Rate for Payer: Priority Health Narrow Network |
$1,733.32
|
| Rate for Payer: Priority Health SBD |
$2,000.04
|
| Rate for Payer: Railroad Medicare Medicare |
$689.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$142.01
|
| Rate for Payer: UHC Core |
$1,463.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$689.36
|
| Rate for Payer: UHC Exchange |
$1,566.00
|
| Rate for Payer: UHC Medicare Advantage |
$689.36
|
| Rate for Payer: UHCCP Medicaid |
$388.11
|
| Rate for Payer: VA VA |
$689.36
|
|
|
HC DRAINAGE SOFT TISSUE W IMAGE GUIDANCE
|
Facility
|
IP
|
$3,174.66
|
|
|
Service Code
|
CPT 10030
|
| Hospital Charge Code |
36100422
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,000.04 |
| Max. Negotiated Rate |
$2,857.19 |
| Rate for Payer: Aetna Commercial |
$2,698.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,063.53
|
| Rate for Payer: Cash Price |
$2,539.73
|
| Rate for Payer: Cofinity Commercial |
$2,222.26
|
| Rate for Payer: Cofinity Commercial |
$2,730.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,222.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,539.73
|
| Rate for Payer: Healthscope Commercial |
$2,857.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,698.46
|
| Rate for Payer: PHP Commercial |
$2,698.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,063.53
|
| Rate for Payer: Priority Health SBD |
$2,000.04
|
|
|
HC DRAINAGE VISCERAL
|
Facility
|
IP
|
$4,064.42
|
|
|
Service Code
|
CPT 49405
|
| Hospital Charge Code |
36100432
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,560.58 |
| Max. Negotiated Rate |
$3,657.98 |
| Rate for Payer: Aetna Commercial |
$3,454.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,641.87
|
| Rate for Payer: Cash Price |
$3,251.54
|
| Rate for Payer: Cofinity Commercial |
$2,845.09
|
| Rate for Payer: Cofinity Commercial |
$3,495.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,845.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,251.54
|
| Rate for Payer: Healthscope Commercial |
$3,657.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,454.76
|
| Rate for Payer: PHP Commercial |
$3,454.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,641.87
|
| Rate for Payer: Priority Health SBD |
$2,560.58
|
|
|
HC DRAINAGE VISCERAL
|
Facility
|
OP
|
$4,064.42
|
|
|
Service Code
|
CPT 49405
|
| Hospital Charge Code |
36100432
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$202.64 |
| Max. Negotiated Rate |
$4,989.41 |
| Rate for Payer: Aetna Commercial |
$3,454.76
|
| Rate for Payer: Aetna Medicare |
$1,650.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,641.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,984.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,984.35
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$547.00
|
| Rate for Payer: BCN Commercial |
$547.00
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$3,251.54
|
| Rate for Payer: Cash Price |
$3,251.54
|
| Rate for Payer: Cash Price |
$3,251.54
|
| Rate for Payer: Cofinity Commercial |
$2,845.09
|
| Rate for Payer: Cofinity Commercial |
$3,495.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,845.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,251.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$3,657.98
|
| Rate for Payer: Mclaren Medicaid |
$850.89
|
| Rate for Payer: Mclaren Medicare |
$1,587.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,666.85
|
| Rate for Payer: Meridian Medicaid |
$893.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,825.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,454.76
|
| Rate for Payer: Nomi Health Commercial |
$3,333.71
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$3,454.76
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,641.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,989.41
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$3,991.53
|
| Rate for Payer: Priority Health SBD |
$2,560.58
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$202.64
|
| Rate for Payer: UHC Core |
$3,138.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$3,362.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$893.75
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
HC DRAIN EXTERNAL EAR ABSCESS/HEMATOMA CMPLX
|
Facility
|
IP
|
$4,095.00
|
|
|
Service Code
|
CPT 69005
|
| Hospital Charge Code |
76100479
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,579.85 |
| Max. Negotiated Rate |
$3,685.50 |
| Rate for Payer: Aetna Commercial |
$3,480.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,661.75
|
| Rate for Payer: Cash Price |
$3,276.00
|
| Rate for Payer: Cofinity Commercial |
$2,866.50
|
| Rate for Payer: Cofinity Commercial |
$3,521.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,866.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,276.00
|
| Rate for Payer: Healthscope Commercial |
$3,685.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,480.75
|
| Rate for Payer: PHP Commercial |
$3,480.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,661.75
|
| Rate for Payer: Priority Health SBD |
$2,579.85
|
|
|
HC DRAIN EXTERNAL EAR ABSCESS/HEMATOMA CMPLX
|
Facility
|
OP
|
$4,095.00
|
|
|
Service Code
|
CPT 69005
|
| Hospital Charge Code |
76100479
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$98.93 |
| Max. Negotiated Rate |
$4,989.41 |
| Rate for Payer: Aetna Commercial |
$3,480.75
|
| Rate for Payer: Aetna Medicare |
$1,650.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,661.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,984.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,984.35
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$98.93
|
| Rate for Payer: BCN Commercial |
$98.93
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$3,276.00
|
| Rate for Payer: Cash Price |
$3,276.00
|
| Rate for Payer: Cash Price |
$3,276.00
|
| Rate for Payer: Cofinity Commercial |
$3,521.70
|
| Rate for Payer: Cofinity Commercial |
$2,866.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,866.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,276.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$3,685.50
|
| Rate for Payer: Mclaren Medicaid |
$850.89
|
| Rate for Payer: Mclaren Medicare |
$1,587.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,666.85
|
| Rate for Payer: Meridian Medicaid |
$893.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,825.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,480.75
|
| Rate for Payer: Nomi Health Commercial |
$3,333.71
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$3,480.75
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,661.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,989.41
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$3,991.53
|
| Rate for Payer: Priority Health SBD |
$2,579.85
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$170.49
|
| Rate for Payer: UHC Core |
$3,138.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$893.75
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
HC DRAIN EXTERNAL EAR ABSCESS/HEMATOMA SIMPLE
|
Facility
|
OP
|
$970.69
|
|
|
Service Code
|
CPT 69000
|
| Hospital Charge Code |
76100298
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$131.67 |
| Max. Negotiated Rate |
$2,166.65 |
| Rate for Payer: Aetna Commercial |
$825.09
|
| Rate for Payer: Aetna Medicare |
$716.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$630.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$861.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$861.70
|
| Rate for Payer: BCBS Complete |
$387.97
|
| Rate for Payer: BCBS MAPPO |
$689.36
|
| Rate for Payer: BCBS Trust/PPO |
$214.45
|
| Rate for Payer: BCN Commercial |
$214.45
|
| Rate for Payer: BCN Medicare Advantage |
$689.36
|
| Rate for Payer: Cash Price |
$776.55
|
| Rate for Payer: Cash Price |
$776.55
|
| Rate for Payer: Cash Price |
$776.55
|
| Rate for Payer: Cofinity Commercial |
$834.79
|
| Rate for Payer: Cofinity Commercial |
$679.48
|
| Rate for Payer: Cofinity Medicare Advantage |
$679.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$776.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$689.36
|
| Rate for Payer: Healthscope Commercial |
$873.62
|
| Rate for Payer: Mclaren Medicaid |
$369.50
|
| Rate for Payer: Mclaren Medicare |
$689.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$723.83
|
| Rate for Payer: Meridian Medicaid |
$387.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$792.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$825.09
|
| Rate for Payer: Nomi Health Commercial |
$1,447.66
|
| Rate for Payer: PACE Medicare |
$654.89
|
| Rate for Payer: PACE SWMI |
$689.36
|
| Rate for Payer: PHP Commercial |
$825.09
|
| Rate for Payer: PHP Medicare Advantage |
$689.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$630.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,166.65
|
| Rate for Payer: Priority Health Medicare |
$689.36
|
| Rate for Payer: Priority Health Narrow Network |
$1,733.32
|
| Rate for Payer: Priority Health SBD |
$611.53
|
| Rate for Payer: Railroad Medicare Medicare |
$689.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$131.67
|
| Rate for Payer: UHC Core |
$1,463.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$689.36
|
| Rate for Payer: UHC Medicare Advantage |
$689.36
|
| Rate for Payer: UHCCP Medicaid |
$388.11
|
| Rate for Payer: VA VA |
$689.36
|
|
|
HC DRAIN EXTERNAL EAR ABSCESS/HEMATOMA SIMPLE
|
Facility
|
IP
|
$970.69
|
|
|
Service Code
|
CPT 69000
|
| Hospital Charge Code |
76100298
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$611.53 |
| Max. Negotiated Rate |
$873.62 |
| Rate for Payer: Aetna Commercial |
$825.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$630.95
|
| Rate for Payer: Cash Price |
$776.55
|
| Rate for Payer: Cofinity Commercial |
$679.48
|
| Rate for Payer: Cofinity Commercial |
$834.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$679.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$776.55
|
| Rate for Payer: Healthscope Commercial |
$873.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$825.09
|
| Rate for Payer: PHP Commercial |
$825.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$630.95
|
| Rate for Payer: Priority Health SBD |
$611.53
|
|
|
HC DRAW VENIPUNCTURE
|
Facility
|
IP
|
$15.61
|
|
|
Service Code
|
CPT 36415
|
| Hospital Charge Code |
30000001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.83 |
| Max. Negotiated Rate |
$14.05 |
| Rate for Payer: Aetna Commercial |
$13.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.15
|
| Rate for Payer: Cash Price |
$12.49
|
| Rate for Payer: Cofinity Commercial |
$10.93
|
| Rate for Payer: Cofinity Commercial |
$13.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$10.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.49
|
| Rate for Payer: Healthscope Commercial |
$14.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.27
|
| Rate for Payer: PHP Commercial |
$13.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.15
|
| Rate for Payer: Priority Health SBD |
$9.83
|
|
|
HC DRAW VENIPUNCTURE
|
Facility
|
OP
|
$15.61
|
|
|
Service Code
|
CPT 36415
|
| Hospital Charge Code |
30000001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.43 |
| Max. Negotiated Rate |
$50.00 |
| Rate for Payer: Aetna Commercial |
$13.27
|
| Rate for Payer: Aetna Medicare |
$9.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.36
|
| Rate for Payer: BCBS Complete |
$5.12
|
| Rate for Payer: BCBS MAPPO |
$9.09
|
| Rate for Payer: BCBS Trust/PPO |
$4.43
|
| Rate for Payer: BCN Commercial |
$4.43
|
| Rate for Payer: BCN Medicare Advantage |
$9.09
|
| Rate for Payer: Cash Price |
$12.49
|
| Rate for Payer: Cash Price |
$12.49
|
| Rate for Payer: Cash Price |
$12.49
|
| Rate for Payer: City of Battle Creek Police Dept Commercial |
$50.00
|
| Rate for Payer: Cofinity Commercial |
$13.42
|
| Rate for Payer: Cofinity Commercial |
$10.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$10.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.09
|
| Rate for Payer: Healthscope Commercial |
$14.05
|
| Rate for Payer: Mclaren Medicaid |
$4.87
|
| Rate for Payer: Mclaren Medicare |
$9.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.54
|
| Rate for Payer: Meridian Medicaid |
$5.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.45
|
| Rate for Payer: Michigan State Police Michigan State Police |
$50.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.27
|
| Rate for Payer: Nomi Health Commercial |
$13.64
|
| Rate for Payer: PACE Medicare |
$8.64
|
| Rate for Payer: PACE SWMI |
$9.09
|
| Rate for Payer: PHP Commercial |
$13.27
|
| Rate for Payer: PHP Medicare Advantage |
$9.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8.83
|
| Rate for Payer: Priority Health Medicare |
$9.09
|
| Rate for Payer: Priority Health Narrow Network |
$7.06
|
| Rate for Payer: Priority Health SBD |
$9.83
|
| Rate for Payer: Railroad Medicare Medicare |
$9.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.09
|
| Rate for Payer: UHC Medicare Advantage |
$9.09
|
| Rate for Payer: UHCCP Medicaid |
$5.12
|
| Rate for Payer: VA VA |
$9.09
|
|
|
HC DRSG MEPILEX AG FOAM 8X20
|
Facility
|
IP
|
$370.40
|
|
|
Service Code
|
HCPCS A6214
|
| Hospital Charge Code |
27000065
|
|
Hospital Revenue Code
|
623
|
| Min. Negotiated Rate |
$233.35 |
| Max. Negotiated Rate |
$333.36 |
| Rate for Payer: Aetna Commercial |
$314.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$240.76
|
| Rate for Payer: Cash Price |
$296.32
|
| Rate for Payer: Cofinity Commercial |
$259.28
|
| Rate for Payer: Cofinity Commercial |
$318.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$259.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$296.32
|
| Rate for Payer: Healthscope Commercial |
$333.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$314.84
|
| Rate for Payer: PHP Commercial |
$314.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$240.76
|
| Rate for Payer: Priority Health SBD |
$233.35
|
|
|
HC DRSG MEPILEX AG FOAM 8X20
|
Facility
|
OP
|
$370.40
|
|
|
Service Code
|
HCPCS A6214
|
| Hospital Charge Code |
27000065
|
|
Hospital Revenue Code
|
623
|
| Min. Negotiated Rate |
$16.86 |
| Max. Negotiated Rate |
$333.36 |
| Rate for Payer: Aetna Commercial |
$314.84
|
| Rate for Payer: Aetna Medicare |
$185.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$240.76
|
| Rate for Payer: BCBS Complete |
$148.16
|
| Rate for Payer: BCBS Trust/PPO |
$38.95
|
| Rate for Payer: BCN Commercial |
$38.95
|
| Rate for Payer: Cash Price |
$296.32
|
| Rate for Payer: Cash Price |
$296.32
|
| Rate for Payer: Cofinity Commercial |
$259.28
|
| Rate for Payer: Cofinity Commercial |
$318.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$259.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$296.32
|
| Rate for Payer: Healthscope Commercial |
$333.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$314.84
|
| Rate for Payer: PHP Commercial |
$314.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$240.76
|
| Rate for Payer: Priority Health SBD |
$233.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.86
|
|
|
HC DRSG MEPILEX BORDER LITE 4X5 EA
|
Facility
|
IP
|
$5.64
|
|
|
Service Code
|
HCPCS A6213
|
| Hospital Charge Code |
62300221
|
|
Hospital Revenue Code
|
623
|
| Min. Negotiated Rate |
$3.55 |
| Max. Negotiated Rate |
$5.08 |
| Rate for Payer: Aetna Commercial |
$4.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.67
|
| Rate for Payer: Cash Price |
$4.51
|
| Rate for Payer: Cofinity Commercial |
$3.95
|
| Rate for Payer: Cofinity Commercial |
$4.85
|
| Rate for Payer: Cofinity Medicare Advantage |
$3.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.51
|
| Rate for Payer: Healthscope Commercial |
$5.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.79
|
| Rate for Payer: PHP Commercial |
$4.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.67
|
| Rate for Payer: Priority Health SBD |
$3.55
|
|
|
HC DRSG MEPILEX BORDER LITE 4X5 EA
|
Facility
|
OP
|
$5.64
|
|
|
Service Code
|
HCPCS A6213
|
| Hospital Charge Code |
62300221
|
|
Hospital Revenue Code
|
623
|
| Min. Negotiated Rate |
$2.26 |
| Max. Negotiated Rate |
$49.90 |
| Rate for Payer: Aetna Commercial |
$4.79
|
| Rate for Payer: Aetna Medicare |
$2.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.67
|
| Rate for Payer: BCBS Complete |
$2.26
|
| Rate for Payer: BCBS Trust/PPO |
$49.90
|
| Rate for Payer: BCN Commercial |
$49.90
|
| Rate for Payer: Cash Price |
$4.51
|
| Rate for Payer: Cash Price |
$4.51
|
| Rate for Payer: Cofinity Commercial |
$3.95
|
| Rate for Payer: Cofinity Commercial |
$4.85
|
| Rate for Payer: Cofinity Medicare Advantage |
$3.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.51
|
| Rate for Payer: Healthscope Commercial |
$5.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.79
|
| Rate for Payer: PHP Commercial |
$4.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.67
|
| Rate for Payer: Priority Health SBD |
$3.55
|
|
|
HC DRSG MEPILEX BORDER SACRUM 9X9 EA
|
Facility
|
IP
|
$27.35
|
|
|
Service Code
|
HCPCS A6214
|
| Hospital Charge Code |
62300222
|
|
Hospital Revenue Code
|
623
|
| Min. Negotiated Rate |
$17.23 |
| Max. Negotiated Rate |
$24.62 |
| Rate for Payer: Aetna Commercial |
$23.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.78
|
| Rate for Payer: Cash Price |
$21.88
|
| Rate for Payer: Cofinity Commercial |
$19.14
|
| Rate for Payer: Cofinity Commercial |
$23.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$19.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.88
|
| Rate for Payer: Healthscope Commercial |
$24.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.25
|
| Rate for Payer: PHP Commercial |
$23.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.78
|
| Rate for Payer: Priority Health SBD |
$17.23
|
|
|
HC DRSG MEPILEX BORDER SACRUM 9X9 EA
|
Facility
|
OP
|
$27.35
|
|
|
Service Code
|
HCPCS A6214
|
| Hospital Charge Code |
62300222
|
|
Hospital Revenue Code
|
623
|
| Min. Negotiated Rate |
$10.94 |
| Max. Negotiated Rate |
$38.95 |
| Rate for Payer: Aetna Commercial |
$23.25
|
| Rate for Payer: Aetna Medicare |
$13.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.78
|
| Rate for Payer: BCBS Complete |
$10.94
|
| Rate for Payer: BCBS Trust/PPO |
$38.95
|
| Rate for Payer: BCN Commercial |
$38.95
|
| Rate for Payer: Cash Price |
$21.88
|
| Rate for Payer: Cash Price |
$21.88
|
| Rate for Payer: Cofinity Commercial |
$19.14
|
| Rate for Payer: Cofinity Commercial |
$23.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$19.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.88
|
| Rate for Payer: Healthscope Commercial |
$24.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.25
|
| Rate for Payer: PHP Commercial |
$23.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.78
|
| Rate for Payer: Priority Health SBD |
$17.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.86
|
|
|
HC DRUG SCREEN 10 URINE
|
Facility
|
IP
|
$104.04
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000134
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$65.55 |
| Max. Negotiated Rate |
$93.64 |
| Rate for Payer: Aetna Commercial |
$88.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.63
|
| Rate for Payer: Cash Price |
$83.23
|
| Rate for Payer: Cofinity Commercial |
$72.83
|
| Rate for Payer: Cofinity Commercial |
$89.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$72.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.23
|
| Rate for Payer: Healthscope Commercial |
$93.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.43
|
| Rate for Payer: PHP Commercial |
$88.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.63
|
| Rate for Payer: Priority Health SBD |
$65.55
|
|
