|
HC EMG SURFACE FROM LARYNX
|
Facility
|
OP
|
$277.87
|
|
|
Service Code
|
CPT 95999
|
| Hospital Charge Code |
92000010
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$81.79 |
| Max. Negotiated Rate |
$429.53 |
| Rate for Payer: Aetna Commercial |
$236.19
|
| Rate for Payer: Aetna Medicare |
$158.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$180.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$190.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$190.74
|
| Rate for Payer: BCBS Complete |
$85.88
|
| Rate for Payer: BCBS MAPPO |
$152.59
|
| Rate for Payer: BCN Medicare Advantage |
$152.59
|
| Rate for Payer: Cash Price |
$222.30
|
| Rate for Payer: Cash Price |
$222.30
|
| Rate for Payer: Cofinity Commercial |
$238.97
|
| Rate for Payer: Cofinity Commercial |
$194.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$194.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$222.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$152.59
|
| Rate for Payer: Healthscope Commercial |
$250.08
|
| Rate for Payer: Mclaren Medicaid |
$81.79
|
| Rate for Payer: Mclaren Medicare |
$152.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.22
|
| Rate for Payer: Meridian Medicaid |
$85.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$175.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$236.19
|
| Rate for Payer: PACE Medicare |
$144.96
|
| Rate for Payer: PACE SWMI |
$152.59
|
| Rate for Payer: PHP Commercial |
$236.19
|
| Rate for Payer: PHP Medicare Advantage |
$152.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$81.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$180.62
|
| Rate for Payer: Priority Health Medicare |
$152.59
|
| Rate for Payer: Priority Health SBD |
$175.06
|
| Rate for Payer: Railroad Medicare Medicare |
$152.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$429.53
|
| Rate for Payer: UHC Core |
$205.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$152.59
|
| Rate for Payer: UHC Exchange |
$205.62
|
| Rate for Payer: UHC Medicare Advantage |
$152.59
|
| Rate for Payer: UHCCP Medicaid |
$85.91
|
| Rate for Payer: VA VA |
$152.59
|
|
|
HC EMG SURFACE FROM LARYNX
|
Facility
|
IP
|
$277.87
|
|
|
Service Code
|
CPT 95999
|
| Hospital Charge Code |
92000010
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$175.06 |
| Max. Negotiated Rate |
$250.08 |
| Rate for Payer: Aetna Commercial |
$236.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$180.62
|
| Rate for Payer: Cash Price |
$222.30
|
| Rate for Payer: Cofinity Commercial |
$194.51
|
| Rate for Payer: Cofinity Commercial |
$238.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$194.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$222.30
|
| Rate for Payer: Healthscope Commercial |
$250.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$236.19
|
| Rate for Payer: PHP Commercial |
$236.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$180.62
|
| Rate for Payer: Priority Health SBD |
$175.06
|
|
|
HC EMG THORACIC PSP. NEEDLE EXAM
|
Facility
|
OP
|
$525.20
|
|
|
Service Code
|
CPT 95869
|
| Hospital Charge Code |
92200008
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$162.78 |
| Max. Negotiated Rate |
$854.89 |
| Rate for Payer: Aetna Commercial |
$446.42
|
| Rate for Payer: Aetna Medicare |
$315.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$341.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$379.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$379.62
|
| Rate for Payer: BCBS Complete |
$170.92
|
| Rate for Payer: BCBS MAPPO |
$303.70
|
| Rate for Payer: BCN Medicare Advantage |
$303.70
|
| Rate for Payer: Cash Price |
$420.16
|
| Rate for Payer: Cash Price |
$420.16
|
| Rate for Payer: Cofinity Commercial |
$451.67
|
| Rate for Payer: Cofinity Commercial |
$367.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$367.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$420.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$303.70
|
| Rate for Payer: Healthscope Commercial |
$472.68
|
| Rate for Payer: Mclaren Medicaid |
$162.78
|
| Rate for Payer: Mclaren Medicare |
$303.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$318.88
|
| Rate for Payer: Meridian Medicaid |
$170.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$349.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$446.42
|
| Rate for Payer: PACE Medicare |
$288.51
|
| Rate for Payer: PACE SWMI |
$303.70
|
| Rate for Payer: PHP Commercial |
$446.42
|
| Rate for Payer: PHP Medicare Advantage |
$303.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$162.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$341.38
|
| Rate for Payer: Priority Health Medicare |
$303.70
|
| Rate for Payer: Priority Health SBD |
$330.88
|
| Rate for Payer: Railroad Medicare Medicare |
$303.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$854.89
|
| Rate for Payer: UHC Core |
$388.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$303.70
|
| Rate for Payer: UHC Exchange |
$388.65
|
| Rate for Payer: UHC Medicare Advantage |
$303.70
|
| Rate for Payer: UHCCP Medicaid |
$170.98
|
| Rate for Payer: VA VA |
$303.70
|
|
|
HC EMG THORACIC PSP. NEEDLE EXAM
|
Facility
|
IP
|
$525.20
|
|
|
Service Code
|
CPT 95869
|
| Hospital Charge Code |
92200008
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$330.88 |
| Max. Negotiated Rate |
$472.68 |
| Rate for Payer: Aetna Commercial |
$446.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$341.38
|
| Rate for Payer: Cash Price |
$420.16
|
| Rate for Payer: Cofinity Commercial |
$367.64
|
| Rate for Payer: Cofinity Commercial |
$451.67
|
| Rate for Payer: Cofinity Medicare Advantage |
$367.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$420.16
|
| Rate for Payer: Healthscope Commercial |
$472.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$446.42
|
| Rate for Payer: PHP Commercial |
$446.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$341.38
|
| Rate for Payer: Priority Health SBD |
$330.88
|
|
|
HC EMR RENAL BIOPSY (BILL ONLY)
|
Facility
|
IP
|
$584.46
|
|
|
Service Code
|
CPT 88348
|
| Hospital Charge Code |
31200008
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$368.21 |
| Max. Negotiated Rate |
$526.01 |
| Rate for Payer: Aetna Commercial |
$496.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$379.90
|
| Rate for Payer: Cash Price |
$467.57
|
| Rate for Payer: Cofinity Commercial |
$409.12
|
| Rate for Payer: Cofinity Commercial |
$502.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$409.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$467.57
|
| Rate for Payer: Healthscope Commercial |
$526.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$496.79
|
| Rate for Payer: PHP Commercial |
$496.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$379.90
|
| Rate for Payer: Priority Health SBD |
$368.21
|
|
|
HC EMR RENAL BIOPSY (BILL ONLY)
|
Facility
|
OP
|
$584.46
|
|
|
Service Code
|
CPT 88348
|
| Hospital Charge Code |
31200008
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$368.21 |
| Max. Negotiated Rate |
$2,242.66 |
| Rate for Payer: Aetna Commercial |
$496.79
|
| Rate for Payer: Aetna Medicare |
$828.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$379.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$995.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$995.89
|
| Rate for Payer: BCBS Complete |
$448.39
|
| Rate for Payer: BCBS MAPPO |
$796.71
|
| Rate for Payer: BCN Medicare Advantage |
$796.71
|
| Rate for Payer: Cash Price |
$467.57
|
| Rate for Payer: Cash Price |
$467.57
|
| Rate for Payer: Cofinity Commercial |
$502.64
|
| Rate for Payer: Cofinity Commercial |
$409.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$409.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$467.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$796.71
|
| Rate for Payer: Healthscope Commercial |
$526.01
|
| Rate for Payer: Mclaren Medicaid |
$427.04
|
| Rate for Payer: Mclaren Medicare |
$796.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$836.55
|
| Rate for Payer: Meridian Medicaid |
$448.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$916.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$496.79
|
| Rate for Payer: PACE Medicare |
$756.87
|
| Rate for Payer: PACE SWMI |
$796.71
|
| Rate for Payer: PHP Commercial |
$496.79
|
| Rate for Payer: PHP Medicare Advantage |
$796.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$427.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$379.90
|
| Rate for Payer: Priority Health Medicare |
$796.71
|
| Rate for Payer: Priority Health SBD |
$368.21
|
| Rate for Payer: Railroad Medicare Medicare |
$796.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,242.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$796.71
|
| Rate for Payer: UHC Medicare Advantage |
$796.71
|
| Rate for Payer: UHCCP Medicaid |
$448.55
|
| Rate for Payer: VA VA |
$796.71
|
|
|
HC ENA EXTRACTABLE NUCLEAR AB PANEL
|
Facility
|
IP
|
$33.10
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200170
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$20.85 |
| Max. Negotiated Rate |
$29.79 |
| Rate for Payer: Aetna Commercial |
$28.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.52
|
| Rate for Payer: Cash Price |
$26.48
|
| Rate for Payer: Cofinity Commercial |
$23.17
|
| Rate for Payer: Cofinity Commercial |
$28.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$23.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.48
|
| Rate for Payer: Healthscope Commercial |
$29.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.14
|
| Rate for Payer: PHP Commercial |
$28.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.52
|
| Rate for Payer: Priority Health SBD |
$20.85
|
|
|
HC ENA EXTRACTABLE NUCLEAR AB PANEL
|
Facility
|
OP
|
$33.10
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200170
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.61 |
| Max. Negotiated Rate |
$50.47 |
| Rate for Payer: Aetna Commercial |
$28.14
|
| Rate for Payer: Aetna Medicare |
$18.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.41
|
| Rate for Payer: BCBS Complete |
$10.09
|
| Rate for Payer: BCBS MAPPO |
$17.93
|
| Rate for Payer: BCN Medicare Advantage |
$17.93
|
| Rate for Payer: Cash Price |
$26.48
|
| Rate for Payer: Cash Price |
$26.48
|
| Rate for Payer: Cofinity Commercial |
$28.47
|
| Rate for Payer: Cofinity Commercial |
$23.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$23.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.93
|
| Rate for Payer: Healthscope Commercial |
$29.79
|
| Rate for Payer: Mclaren Medicaid |
$9.61
|
| Rate for Payer: Mclaren Medicare |
$17.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.83
|
| Rate for Payer: Meridian Medicaid |
$10.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.14
|
| Rate for Payer: PACE Medicare |
$17.03
|
| Rate for Payer: PACE SWMI |
$17.93
|
| Rate for Payer: PHP Commercial |
$28.14
|
| Rate for Payer: PHP Medicare Advantage |
$17.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.52
|
| Rate for Payer: Priority Health Medicare |
$17.93
|
| Rate for Payer: Priority Health SBD |
$20.85
|
| Rate for Payer: Railroad Medicare Medicare |
$17.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.93
|
| Rate for Payer: UHC Medicare Advantage |
$17.93
|
| Rate for Payer: UHCCP Medicaid |
$10.09
|
| Rate for Payer: VA VA |
$17.93
|
|
|
HC ENA EXTRACTABLE NUCLEAR AB SCREEN
|
Facility
|
IP
|
$35.17
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200169
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$22.16 |
| Max. Negotiated Rate |
$31.65 |
| Rate for Payer: Aetna Commercial |
$29.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.86
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cofinity Commercial |
$24.62
|
| Rate for Payer: Cofinity Commercial |
$30.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$24.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.14
|
| Rate for Payer: Healthscope Commercial |
$31.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.89
|
| Rate for Payer: PHP Commercial |
$29.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.86
|
| Rate for Payer: Priority Health SBD |
$22.16
|
|
|
HC ENA EXTRACTABLE NUCLEAR AB SCREEN
|
Facility
|
OP
|
$35.17
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200169
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.61 |
| Max. Negotiated Rate |
$50.47 |
| Rate for Payer: Aetna Commercial |
$29.89
|
| Rate for Payer: Aetna Medicare |
$18.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.41
|
| Rate for Payer: BCBS Complete |
$10.09
|
| Rate for Payer: BCBS MAPPO |
$17.93
|
| Rate for Payer: BCN Medicare Advantage |
$17.93
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cofinity Commercial |
$30.25
|
| Rate for Payer: Cofinity Commercial |
$24.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$24.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.93
|
| Rate for Payer: Healthscope Commercial |
$31.65
|
| Rate for Payer: Mclaren Medicaid |
$9.61
|
| Rate for Payer: Mclaren Medicare |
$17.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.83
|
| Rate for Payer: Meridian Medicaid |
$10.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.89
|
| Rate for Payer: PACE Medicare |
$17.03
|
| Rate for Payer: PACE SWMI |
$17.93
|
| Rate for Payer: PHP Commercial |
$29.89
|
| Rate for Payer: PHP Medicare Advantage |
$17.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.86
|
| Rate for Payer: Priority Health Medicare |
$17.93
|
| Rate for Payer: Priority Health SBD |
$22.16
|
| Rate for Payer: Railroad Medicare Medicare |
$17.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.93
|
| Rate for Payer: UHC Medicare Advantage |
$17.93
|
| Rate for Payer: UHCCP Medicaid |
$10.09
|
| Rate for Payer: VA VA |
$17.93
|
|
|
HC ENCEPHALOPATHY EVAL, CSF
|
Facility
|
IP
|
$154.02
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
30100723
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$97.03 |
| Max. Negotiated Rate |
$138.62 |
| Rate for Payer: Aetna Commercial |
$130.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$100.11
|
| Rate for Payer: Cash Price |
$123.22
|
| Rate for Payer: Cofinity Commercial |
$107.81
|
| Rate for Payer: Cofinity Commercial |
$132.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$107.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.22
|
| Rate for Payer: Healthscope Commercial |
$138.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.92
|
| Rate for Payer: PHP Commercial |
$130.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.11
|
| Rate for Payer: Priority Health SBD |
$97.03
|
|
|
HC ENCEPHALOPATHY EVAL, CSF
|
Facility
|
OP
|
$154.02
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
30100723
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.63 |
| Max. Negotiated Rate |
$138.62 |
| Rate for Payer: Aetna Commercial |
$130.92
|
| Rate for Payer: Aetna Medicare |
$24.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$100.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.46
|
| Rate for Payer: BCBS Complete |
$13.27
|
| Rate for Payer: BCBS MAPPO |
$23.57
|
| Rate for Payer: BCN Medicare Advantage |
$23.57
|
| Rate for Payer: Cash Price |
$123.22
|
| Rate for Payer: Cash Price |
$123.22
|
| Rate for Payer: Cofinity Commercial |
$132.46
|
| Rate for Payer: Cofinity Commercial |
$107.81
|
| Rate for Payer: Cofinity Medicare Advantage |
$107.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.57
|
| Rate for Payer: Healthscope Commercial |
$138.62
|
| Rate for Payer: Mclaren Medicaid |
$12.63
|
| Rate for Payer: Mclaren Medicare |
$23.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.75
|
| Rate for Payer: Meridian Medicaid |
$13.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.92
|
| Rate for Payer: PACE Medicare |
$22.39
|
| Rate for Payer: PACE SWMI |
$23.57
|
| Rate for Payer: PHP Commercial |
$130.92
|
| Rate for Payer: PHP Medicare Advantage |
$23.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.11
|
| Rate for Payer: Priority Health Medicare |
$23.57
|
| Rate for Payer: Priority Health SBD |
$97.03
|
| Rate for Payer: Railroad Medicare Medicare |
$23.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.57
|
| Rate for Payer: UHC Medicare Advantage |
$23.57
|
| Rate for Payer: UHCCP Medicaid |
$13.27
|
| Rate for Payer: VA VA |
$23.57
|
|
|
HC ENCEPHALOPATHY EVAL, CSF CMPT 1
|
Facility
|
OP
|
$67.02
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200485
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.46 |
| Max. Negotiated Rate |
$60.32 |
| Rate for Payer: Aetna Commercial |
$56.97
|
| Rate for Payer: Aetna Medicare |
$12.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.06
|
| Rate for Payer: BCBS Complete |
$6.78
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$53.62
|
| Rate for Payer: Cash Price |
$53.62
|
| Rate for Payer: Cofinity Commercial |
$57.64
|
| Rate for Payer: Cofinity Commercial |
$46.91
|
| Rate for Payer: Cofinity Medicare Advantage |
$46.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$60.32
|
| Rate for Payer: Mclaren Medicaid |
$6.46
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: Meridian Medicaid |
$6.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.97
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$56.97
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.56
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health SBD |
$42.22
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.05
|
| Rate for Payer: UHC Medicare Advantage |
$12.05
|
| Rate for Payer: UHCCP Medicaid |
$6.78
|
| Rate for Payer: VA VA |
$12.05
|
|
|
HC ENCEPHALOPATHY EVAL, CSF CMPT 1
|
Facility
|
IP
|
$67.02
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200485
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$42.22 |
| Max. Negotiated Rate |
$60.32 |
| Rate for Payer: Aetna Commercial |
$56.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.56
|
| Rate for Payer: Cash Price |
$53.62
|
| Rate for Payer: Cofinity Commercial |
$46.91
|
| Rate for Payer: Cofinity Commercial |
$57.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$46.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.62
|
| Rate for Payer: Healthscope Commercial |
$60.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.97
|
| Rate for Payer: PHP Commercial |
$56.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.56
|
| Rate for Payer: Priority Health SBD |
$42.22
|
|
|
HC ENCEPHALOPATHY EVAL, S CMPT 1
|
Facility
|
OP
|
$154.49
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
30100722
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.86 |
| Max. Negotiated Rate |
$139.04 |
| Rate for Payer: Aetna Commercial |
$131.32
|
| Rate for Payer: Aetna Medicare |
$19.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$100.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.00
|
| Rate for Payer: BCBS Complete |
$10.36
|
| Rate for Payer: BCBS MAPPO |
$18.40
|
| Rate for Payer: BCN Medicare Advantage |
$18.40
|
| Rate for Payer: Cash Price |
$123.59
|
| Rate for Payer: Cash Price |
$123.59
|
| Rate for Payer: Cofinity Commercial |
$132.86
|
| Rate for Payer: Cofinity Commercial |
$108.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$108.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.40
|
| Rate for Payer: Healthscope Commercial |
$139.04
|
| Rate for Payer: Mclaren Medicaid |
$9.86
|
| Rate for Payer: Mclaren Medicare |
$18.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.32
|
| Rate for Payer: Meridian Medicaid |
$10.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$131.32
|
| Rate for Payer: PACE Medicare |
$17.48
|
| Rate for Payer: PACE SWMI |
$18.40
|
| Rate for Payer: PHP Commercial |
$131.32
|
| Rate for Payer: PHP Medicare Advantage |
$18.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.42
|
| Rate for Payer: Priority Health Medicare |
$18.40
|
| Rate for Payer: Priority Health SBD |
$97.33
|
| Rate for Payer: Railroad Medicare Medicare |
$18.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.40
|
| Rate for Payer: UHC Medicare Advantage |
$18.40
|
| Rate for Payer: UHCCP Medicaid |
$10.36
|
| Rate for Payer: VA VA |
$18.40
|
|
|
HC ENCEPHALOPATHY EVAL, S CMPT 1
|
Facility
|
IP
|
$154.49
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
30100722
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$97.33 |
| Max. Negotiated Rate |
$139.04 |
| Rate for Payer: Aetna Commercial |
$131.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$100.42
|
| Rate for Payer: Cash Price |
$123.59
|
| Rate for Payer: Cofinity Commercial |
$108.14
|
| Rate for Payer: Cofinity Commercial |
$132.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$108.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.59
|
| Rate for Payer: Healthscope Commercial |
$139.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$131.32
|
| Rate for Payer: PHP Commercial |
$131.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.42
|
| Rate for Payer: Priority Health SBD |
$97.33
|
|
|
HC ENCEPHALOPATHY EVAL, S CMPT 2
|
Facility
|
OP
|
$94.86
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200484
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.46 |
| Max. Negotiated Rate |
$85.37 |
| Rate for Payer: Aetna Commercial |
$80.63
|
| Rate for Payer: Aetna Medicare |
$12.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.06
|
| Rate for Payer: BCBS Complete |
$6.78
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$75.89
|
| Rate for Payer: Cash Price |
$75.89
|
| Rate for Payer: Cofinity Commercial |
$81.58
|
| Rate for Payer: Cofinity Commercial |
$66.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$66.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$85.37
|
| Rate for Payer: Mclaren Medicaid |
$6.46
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: Meridian Medicaid |
$6.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.63
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$80.63
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.66
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health SBD |
$59.76
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.05
|
| Rate for Payer: UHC Medicare Advantage |
$12.05
|
| Rate for Payer: UHCCP Medicaid |
$6.78
|
| Rate for Payer: VA VA |
$12.05
|
|
|
HC ENCEPHALOPATHY EVAL, S CMPT 2
|
Facility
|
IP
|
$94.86
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200484
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$59.76 |
| Max. Negotiated Rate |
$85.37 |
| Rate for Payer: Aetna Commercial |
$80.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.66
|
| Rate for Payer: Cash Price |
$75.89
|
| Rate for Payer: Cofinity Commercial |
$66.40
|
| Rate for Payer: Cofinity Commercial |
$81.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$66.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.89
|
| Rate for Payer: Healthscope Commercial |
$85.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.63
|
| Rate for Payer: PHP Commercial |
$80.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.66
|
| Rate for Payer: Priority Health SBD |
$59.76
|
|
|
HC ENCEPHALOPATHY EVAL, SERUM
|
Facility
|
OP
|
$209.31
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
30100721
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.63 |
| Max. Negotiated Rate |
$188.38 |
| Rate for Payer: Aetna Commercial |
$177.91
|
| Rate for Payer: Aetna Medicare |
$24.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$136.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.46
|
| Rate for Payer: BCBS Complete |
$13.27
|
| Rate for Payer: BCBS MAPPO |
$23.57
|
| Rate for Payer: BCN Medicare Advantage |
$23.57
|
| Rate for Payer: Cash Price |
$167.45
|
| Rate for Payer: Cash Price |
$167.45
|
| Rate for Payer: Cofinity Commercial |
$180.01
|
| Rate for Payer: Cofinity Commercial |
$146.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$146.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$167.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.57
|
| Rate for Payer: Healthscope Commercial |
$188.38
|
| Rate for Payer: Mclaren Medicaid |
$12.63
|
| Rate for Payer: Mclaren Medicare |
$23.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.75
|
| Rate for Payer: Meridian Medicaid |
$13.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$177.91
|
| Rate for Payer: PACE Medicare |
$22.39
|
| Rate for Payer: PACE SWMI |
$23.57
|
| Rate for Payer: PHP Commercial |
$177.91
|
| Rate for Payer: PHP Medicare Advantage |
$23.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$136.05
|
| Rate for Payer: Priority Health Medicare |
$23.57
|
| Rate for Payer: Priority Health SBD |
$131.87
|
| Rate for Payer: Railroad Medicare Medicare |
$23.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.57
|
| Rate for Payer: UHC Medicare Advantage |
$23.57
|
| Rate for Payer: UHCCP Medicaid |
$13.27
|
| Rate for Payer: VA VA |
$23.57
|
|
|
HC ENCEPHALOPATHY EVAL, SERUM
|
Facility
|
IP
|
$209.31
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
30100721
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$131.87 |
| Max. Negotiated Rate |
$188.38 |
| Rate for Payer: Aetna Commercial |
$177.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$136.05
|
| Rate for Payer: Cash Price |
$167.45
|
| Rate for Payer: Cofinity Commercial |
$146.52
|
| Rate for Payer: Cofinity Commercial |
$180.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$146.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$167.45
|
| Rate for Payer: Healthscope Commercial |
$188.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$177.91
|
| Rate for Payer: PHP Commercial |
$177.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$136.05
|
| Rate for Payer: Priority Health SBD |
$131.87
|
|
|
HC ENCEPH AUTOIMMUNE EVAL
|
Facility
|
IP
|
$155.04
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
30200468
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$97.68 |
| Max. Negotiated Rate |
$139.54 |
| Rate for Payer: Aetna Commercial |
$131.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$100.78
|
| Rate for Payer: Cash Price |
$124.03
|
| Rate for Payer: Cofinity Commercial |
$108.53
|
| Rate for Payer: Cofinity Commercial |
$133.33
|
| Rate for Payer: Cofinity Medicare Advantage |
$108.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.03
|
| Rate for Payer: Healthscope Commercial |
$139.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$131.78
|
| Rate for Payer: PHP Commercial |
$131.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.78
|
| Rate for Payer: Priority Health SBD |
$97.68
|
|
|
HC ENCEPH AUTOIMMUNE EVAL
|
Facility
|
OP
|
$155.04
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
30200468
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.63 |
| Max. Negotiated Rate |
$139.54 |
| Rate for Payer: Aetna Commercial |
$131.78
|
| Rate for Payer: Aetna Medicare |
$24.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$100.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.46
|
| Rate for Payer: BCBS Complete |
$13.27
|
| Rate for Payer: BCBS MAPPO |
$23.57
|
| Rate for Payer: BCN Medicare Advantage |
$23.57
|
| Rate for Payer: Cash Price |
$124.03
|
| Rate for Payer: Cash Price |
$124.03
|
| Rate for Payer: Cofinity Commercial |
$133.33
|
| Rate for Payer: Cofinity Commercial |
$108.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$108.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.57
|
| Rate for Payer: Healthscope Commercial |
$139.54
|
| Rate for Payer: Mclaren Medicaid |
$12.63
|
| Rate for Payer: Mclaren Medicare |
$23.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.75
|
| Rate for Payer: Meridian Medicaid |
$13.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$131.78
|
| Rate for Payer: PACE Medicare |
$22.39
|
| Rate for Payer: PACE SWMI |
$23.57
|
| Rate for Payer: PHP Commercial |
$131.78
|
| Rate for Payer: PHP Medicare Advantage |
$23.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.78
|
| Rate for Payer: Priority Health Medicare |
$23.57
|
| Rate for Payer: Priority Health SBD |
$97.68
|
| Rate for Payer: Railroad Medicare Medicare |
$23.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.57
|
| Rate for Payer: UHC Medicare Advantage |
$23.57
|
| Rate for Payer: UHCCP Medicaid |
$13.27
|
| Rate for Payer: VA VA |
$23.57
|
|
|
HC ENCEPH AUTOIMMUNE EVAL CMPT
|
Facility
|
OP
|
$74.91
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200469
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.46 |
| Max. Negotiated Rate |
$67.42 |
| Rate for Payer: Aetna Commercial |
$63.67
|
| Rate for Payer: Aetna Medicare |
$12.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.06
|
| Rate for Payer: BCBS Complete |
$6.78
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$59.93
|
| Rate for Payer: Cash Price |
$59.93
|
| Rate for Payer: Cofinity Commercial |
$64.42
|
| Rate for Payer: Cofinity Commercial |
$52.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$52.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$67.42
|
| Rate for Payer: Mclaren Medicaid |
$6.46
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: Meridian Medicaid |
$6.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.67
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$63.67
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.69
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health SBD |
$47.19
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.05
|
| Rate for Payer: UHC Medicare Advantage |
$12.05
|
| Rate for Payer: UHCCP Medicaid |
$6.78
|
| Rate for Payer: VA VA |
$12.05
|
|
|
HC ENCEPH AUTOIMMUNE EVAL CMPT
|
Facility
|
IP
|
$74.91
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200469
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$47.19 |
| Max. Negotiated Rate |
$67.42 |
| Rate for Payer: Aetna Commercial |
$63.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.69
|
| Rate for Payer: Cash Price |
$59.93
|
| Rate for Payer: Cofinity Commercial |
$52.44
|
| Rate for Payer: Cofinity Commercial |
$64.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$52.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.93
|
| Rate for Payer: Healthscope Commercial |
$67.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.67
|
| Rate for Payer: PHP Commercial |
$63.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.69
|
| Rate for Payer: Priority Health SBD |
$47.19
|
|
|
HC ENCEPH AUTOIMMUNE EVAL CMPT 2
|
Facility
|
IP
|
$107.10
|
|
|
Service Code
|
CPT 84182
|
| Hospital Charge Code |
30100717
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$67.47 |
| Max. Negotiated Rate |
$96.39 |
| Rate for Payer: Aetna Commercial |
$91.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$69.61
|
| Rate for Payer: Cash Price |
$85.68
|
| Rate for Payer: Cofinity Commercial |
$74.97
|
| Rate for Payer: Cofinity Commercial |
$92.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$74.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.68
|
| Rate for Payer: Healthscope Commercial |
$96.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.03
|
| Rate for Payer: PHP Commercial |
$91.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.61
|
| Rate for Payer: Priority Health SBD |
$67.47
|
|
