|
HC EMG NEEDLE EXAM 4 EXT
|
Facility
|
OP
|
$816.54
|
|
|
Service Code
|
CPT 95864
|
| Hospital Charge Code |
92200004
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$82.17 |
| Max. Negotiated Rate |
$734.89 |
| Rate for Payer: Aetna Commercial |
$694.06
|
| Rate for Payer: Aetna Medicare |
$159.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$530.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$191.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$191.62
|
| Rate for Payer: BCBS Complete |
$86.28
|
| Rate for Payer: BCBS MAPPO |
$153.30
|
| Rate for Payer: BCBS Trust/PPO |
$568.50
|
| Rate for Payer: BCN Commercial |
$568.50
|
| Rate for Payer: BCN Medicare Advantage |
$153.30
|
| Rate for Payer: Cash Price |
$653.23
|
| Rate for Payer: Cash Price |
$653.23
|
| Rate for Payer: Cofinity Commercial |
$702.22
|
| Rate for Payer: Cofinity Commercial |
$571.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$571.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$653.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.30
|
| Rate for Payer: Healthscope Commercial |
$734.89
|
| Rate for Payer: Mclaren Medicaid |
$82.17
|
| Rate for Payer: Mclaren Medicare |
$153.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.96
|
| Rate for Payer: Meridian Medicaid |
$86.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$176.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$694.06
|
| Rate for Payer: Nomi Health Commercial |
$459.90
|
| Rate for Payer: PACE Medicare |
$145.64
|
| Rate for Payer: PACE SWMI |
$153.30
|
| Rate for Payer: PHP Commercial |
$694.06
|
| Rate for Payer: PHP Medicare Advantage |
$153.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$530.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$481.80
|
| Rate for Payer: Priority Health Medicare |
$153.30
|
| Rate for Payer: Priority Health Narrow Network |
$385.44
|
| Rate for Payer: Priority Health SBD |
$514.42
|
| Rate for Payer: Railroad Medicare Medicare |
$153.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$235.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.30
|
| Rate for Payer: UHC Exchange |
$604.24
|
| Rate for Payer: UHC Medicare Advantage |
$153.30
|
| Rate for Payer: UHCCP Medicaid |
$86.31
|
| Rate for Payer: VA VA |
$153.30
|
|
|
HC EMG NEEDLE EXAM 4 EXT
|
Facility
|
IP
|
$816.54
|
|
|
Service Code
|
CPT 95864
|
| Hospital Charge Code |
92200004
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$514.42 |
| Max. Negotiated Rate |
$734.89 |
| Rate for Payer: Aetna Commercial |
$694.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$530.75
|
| Rate for Payer: Cash Price |
$653.23
|
| Rate for Payer: Cofinity Commercial |
$571.58
|
| Rate for Payer: Cofinity Commercial |
$702.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$571.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$653.23
|
| Rate for Payer: Healthscope Commercial |
$734.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$694.06
|
| Rate for Payer: PHP Commercial |
$694.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$530.75
|
| Rate for Payer: Priority Health SBD |
$514.42
|
|
|
HC EMG NEEDLE EXAM CRANIAL BILAT NCS
|
Facility
|
OP
|
$816.54
|
|
|
Service Code
|
CPT 95868
|
| Hospital Charge Code |
92200007
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$140.52 |
| Max. Negotiated Rate |
$958.92 |
| Rate for Payer: Aetna Commercial |
$694.06
|
| Rate for Payer: Aetna Medicare |
$317.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$530.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$381.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$381.38
|
| Rate for Payer: BCBS Complete |
$171.71
|
| Rate for Payer: BCBS MAPPO |
$305.10
|
| Rate for Payer: BCBS Trust/PPO |
$342.57
|
| Rate for Payer: BCN Commercial |
$342.57
|
| Rate for Payer: BCN Medicare Advantage |
$305.10
|
| Rate for Payer: Cash Price |
$653.23
|
| Rate for Payer: Cash Price |
$653.23
|
| Rate for Payer: Cofinity Commercial |
$702.22
|
| Rate for Payer: Cofinity Commercial |
$571.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$571.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$653.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.10
|
| Rate for Payer: Healthscope Commercial |
$734.89
|
| Rate for Payer: Mclaren Medicaid |
$163.53
|
| Rate for Payer: Mclaren Medicare |
$305.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$320.36
|
| Rate for Payer: Meridian Medicaid |
$171.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$350.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$694.06
|
| Rate for Payer: Nomi Health Commercial |
$915.30
|
| Rate for Payer: PACE Medicare |
$289.84
|
| Rate for Payer: PACE SWMI |
$305.10
|
| Rate for Payer: PHP Commercial |
$694.06
|
| Rate for Payer: PHP Medicare Advantage |
$305.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$163.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$530.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$958.92
|
| Rate for Payer: Priority Health Medicare |
$305.10
|
| Rate for Payer: Priority Health Narrow Network |
$767.14
|
| Rate for Payer: Priority Health SBD |
$514.42
|
| Rate for Payer: Railroad Medicare Medicare |
$305.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$140.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$305.10
|
| Rate for Payer: UHC Exchange |
$604.24
|
| Rate for Payer: UHC Medicare Advantage |
$305.10
|
| Rate for Payer: UHCCP Medicaid |
$171.77
|
| Rate for Payer: VA VA |
$305.10
|
|
|
HC EMG NEEDLE EXAM CRANIAL BILAT NCS
|
Facility
|
IP
|
$816.54
|
|
|
Service Code
|
CPT 95868
|
| Hospital Charge Code |
92200007
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$514.42 |
| Max. Negotiated Rate |
$734.89 |
| Rate for Payer: Aetna Commercial |
$694.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$530.75
|
| Rate for Payer: Cash Price |
$653.23
|
| Rate for Payer: Cofinity Commercial |
$571.58
|
| Rate for Payer: Cofinity Commercial |
$702.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$571.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$653.23
|
| Rate for Payer: Healthscope Commercial |
$734.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$694.06
|
| Rate for Payer: PHP Commercial |
$694.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$530.75
|
| Rate for Payer: Priority Health SBD |
$514.42
|
|
|
HC EMG NEEDLE EXAM CRANIAL UNILAT WO NCS
|
Facility
|
OP
|
$734.93
|
|
|
Service Code
|
CPT 95867
|
| Hospital Charge Code |
92200006
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$107.68 |
| Max. Negotiated Rate |
$958.92 |
| Rate for Payer: Aetna Commercial |
$624.69
|
| Rate for Payer: Aetna Medicare |
$317.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$477.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$381.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$381.38
|
| Rate for Payer: BCBS Complete |
$171.71
|
| Rate for Payer: BCBS MAPPO |
$305.10
|
| Rate for Payer: BCBS Trust/PPO |
$290.89
|
| Rate for Payer: BCN Commercial |
$290.89
|
| Rate for Payer: BCN Medicare Advantage |
$305.10
|
| Rate for Payer: Cash Price |
$587.94
|
| Rate for Payer: Cash Price |
$587.94
|
| Rate for Payer: Cofinity Commercial |
$632.04
|
| Rate for Payer: Cofinity Commercial |
$514.45
|
| Rate for Payer: Cofinity Medicare Advantage |
$514.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$587.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.10
|
| Rate for Payer: Healthscope Commercial |
$661.44
|
| Rate for Payer: Mclaren Medicaid |
$163.53
|
| Rate for Payer: Mclaren Medicare |
$305.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$320.36
|
| Rate for Payer: Meridian Medicaid |
$171.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$350.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$624.69
|
| Rate for Payer: Nomi Health Commercial |
$915.30
|
| Rate for Payer: PACE Medicare |
$289.84
|
| Rate for Payer: PACE SWMI |
$305.10
|
| Rate for Payer: PHP Commercial |
$624.69
|
| Rate for Payer: PHP Medicare Advantage |
$305.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$163.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$477.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$958.92
|
| Rate for Payer: Priority Health Medicare |
$305.10
|
| Rate for Payer: Priority Health Narrow Network |
$767.14
|
| Rate for Payer: Priority Health SBD |
$463.01
|
| Rate for Payer: Railroad Medicare Medicare |
$305.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$107.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$305.10
|
| Rate for Payer: UHC Exchange |
$543.85
|
| Rate for Payer: UHC Medicare Advantage |
$305.10
|
| Rate for Payer: UHCCP Medicaid |
$171.77
|
| Rate for Payer: VA VA |
$305.10
|
|
|
HC EMG NEEDLE EXAM CRANIAL UNILAT WO NCS
|
Facility
|
IP
|
$734.93
|
|
|
Service Code
|
CPT 95867
|
| Hospital Charge Code |
92200006
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$463.01 |
| Max. Negotiated Rate |
$661.44 |
| Rate for Payer: Aetna Commercial |
$624.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$477.70
|
| Rate for Payer: Cash Price |
$587.94
|
| Rate for Payer: Cofinity Commercial |
$514.45
|
| Rate for Payer: Cofinity Commercial |
$632.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$514.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$587.94
|
| Rate for Payer: Healthscope Commercial |
$661.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$624.69
|
| Rate for Payer: PHP Commercial |
$624.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$477.70
|
| Rate for Payer: Priority Health SBD |
$463.01
|
|
|
HC EMG NEEDLE EXAM WITH NCS LIMITED
|
Facility
|
OP
|
$374.98
|
|
|
Service Code
|
CPT 95885
|
| Hospital Charge Code |
92200022
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$61.92 |
| Max. Negotiated Rate |
$337.48 |
| Rate for Payer: Aetna Commercial |
$318.73
|
| Rate for Payer: Aetna Medicare |
$187.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$243.74
|
| Rate for Payer: BCBS Complete |
$149.99
|
| Rate for Payer: BCBS Trust/PPO |
$193.44
|
| Rate for Payer: BCN Commercial |
$193.44
|
| Rate for Payer: Cash Price |
$299.98
|
| Rate for Payer: Cash Price |
$299.98
|
| Rate for Payer: Cofinity Commercial |
$262.49
|
| Rate for Payer: Cofinity Commercial |
$322.48
|
| Rate for Payer: Cofinity Medicare Advantage |
$262.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$299.98
|
| Rate for Payer: Healthscope Commercial |
$337.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$318.73
|
| Rate for Payer: PHP Commercial |
$318.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$243.74
|
| Rate for Payer: Priority Health SBD |
$236.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.92
|
| Rate for Payer: UHC Exchange |
$277.49
|
|
|
HC EMG NEEDLE EXAM WITH NCS LIMITED
|
Facility
|
IP
|
$374.98
|
|
|
Service Code
|
CPT 95885
|
| Hospital Charge Code |
92200022
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$236.24 |
| Max. Negotiated Rate |
$337.48 |
| Rate for Payer: Aetna Commercial |
$318.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$243.74
|
| Rate for Payer: Cash Price |
$299.98
|
| Rate for Payer: Cofinity Commercial |
$262.49
|
| Rate for Payer: Cofinity Commercial |
$322.48
|
| Rate for Payer: Cofinity Medicare Advantage |
$262.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$299.98
|
| Rate for Payer: Healthscope Commercial |
$337.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$318.73
|
| Rate for Payer: PHP Commercial |
$318.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$243.74
|
| Rate for Payer: Priority Health SBD |
$236.24
|
|
|
HC EMG NEEDLE EXAM WITH NCV COMPLETE
|
Facility
|
IP
|
$454.09
|
|
|
Service Code
|
CPT 95886
|
| Hospital Charge Code |
92200023
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$286.08 |
| Max. Negotiated Rate |
$408.68 |
| Rate for Payer: Aetna Commercial |
$385.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$295.16
|
| Rate for Payer: Cash Price |
$363.27
|
| Rate for Payer: Cofinity Commercial |
$317.86
|
| Rate for Payer: Cofinity Commercial |
$390.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$317.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$363.27
|
| Rate for Payer: Healthscope Commercial |
$408.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$385.98
|
| Rate for Payer: PHP Commercial |
$385.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$295.16
|
| Rate for Payer: Priority Health SBD |
$286.08
|
|
|
HC EMG NEEDLE EXAM WITH NCV COMPLETE
|
Facility
|
OP
|
$454.09
|
|
|
Service Code
|
CPT 95886
|
| Hospital Charge Code |
92200023
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$97.54 |
| Max. Negotiated Rate |
$408.68 |
| Rate for Payer: Aetna Commercial |
$385.98
|
| Rate for Payer: Aetna Medicare |
$227.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$295.16
|
| Rate for Payer: BCBS Complete |
$181.64
|
| Rate for Payer: BCBS Trust/PPO |
$230.37
|
| Rate for Payer: BCN Commercial |
$230.37
|
| Rate for Payer: Cash Price |
$363.27
|
| Rate for Payer: Cash Price |
$363.27
|
| Rate for Payer: Cofinity Commercial |
$390.52
|
| Rate for Payer: Cofinity Commercial |
$317.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$317.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$363.27
|
| Rate for Payer: Healthscope Commercial |
$408.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$385.98
|
| Rate for Payer: PHP Commercial |
$385.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$295.16
|
| Rate for Payer: Priority Health SBD |
$286.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$97.54
|
| Rate for Payer: UHC Exchange |
$336.03
|
|
|
HC EMG NEEDLE FROM LARYNX
|
Facility
|
OP
|
$398.14
|
|
|
Service Code
|
CPT 95865
|
| Hospital Charge Code |
92200005
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$67.69 |
| Max. Negotiated Rate |
$396.95 |
| Rate for Payer: Aetna Commercial |
$338.42
|
| Rate for Payer: Aetna Medicare |
$131.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$258.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.86
|
| Rate for Payer: BCBS Complete |
$71.08
|
| Rate for Payer: BCBS MAPPO |
$126.29
|
| Rate for Payer: BCBS Trust/PPO |
$301.23
|
| Rate for Payer: BCN Commercial |
$301.23
|
| Rate for Payer: BCN Medicare Advantage |
$126.29
|
| Rate for Payer: Cash Price |
$318.51
|
| Rate for Payer: Cash Price |
$318.51
|
| Rate for Payer: Cofinity Commercial |
$342.40
|
| Rate for Payer: Cofinity Commercial |
$278.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$278.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$318.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.29
|
| Rate for Payer: Healthscope Commercial |
$358.33
|
| Rate for Payer: Mclaren Medicaid |
$67.69
|
| Rate for Payer: Mclaren Medicare |
$126.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.60
|
| Rate for Payer: Meridian Medicaid |
$71.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$145.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$338.42
|
| Rate for Payer: Nomi Health Commercial |
$378.87
|
| Rate for Payer: PACE Medicare |
$119.98
|
| Rate for Payer: PACE SWMI |
$126.29
|
| Rate for Payer: PHP Commercial |
$338.42
|
| Rate for Payer: PHP Medicare Advantage |
$126.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$258.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$396.95
|
| Rate for Payer: Priority Health Medicare |
$126.29
|
| Rate for Payer: Priority Health Narrow Network |
$317.56
|
| Rate for Payer: Priority Health SBD |
$250.83
|
| Rate for Payer: Railroad Medicare Medicare |
$126.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$152.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$126.29
|
| Rate for Payer: UHC Exchange |
$294.62
|
| Rate for Payer: UHC Medicare Advantage |
$126.29
|
| Rate for Payer: UHCCP Medicaid |
$71.10
|
| Rate for Payer: VA VA |
$126.29
|
|
|
HC EMG NEEDLE FROM LARYNX
|
Facility
|
IP
|
$398.14
|
|
|
Service Code
|
CPT 95865
|
| Hospital Charge Code |
92200005
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$250.83 |
| Max. Negotiated Rate |
$358.33 |
| Rate for Payer: Aetna Commercial |
$338.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$258.79
|
| Rate for Payer: Cash Price |
$318.51
|
| Rate for Payer: Cofinity Commercial |
$278.70
|
| Rate for Payer: Cofinity Commercial |
$342.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$278.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$318.51
|
| Rate for Payer: Healthscope Commercial |
$358.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$338.42
|
| Rate for Payer: PHP Commercial |
$338.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$258.79
|
| Rate for Payer: Priority Health SBD |
$250.83
|
|
|
HC EMG REPETITIVE STIMULATION
|
Facility
|
OP
|
$439.01
|
|
|
Service Code
|
CPT 95937
|
| Hospital Charge Code |
92200021
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$82.17 |
| Max. Negotiated Rate |
$481.80 |
| Rate for Payer: Aetna Commercial |
$373.16
|
| Rate for Payer: Aetna Medicare |
$159.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$285.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$191.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$191.62
|
| Rate for Payer: BCBS Complete |
$86.28
|
| Rate for Payer: BCBS MAPPO |
$153.30
|
| Rate for Payer: BCBS Trust/PPO |
$311.57
|
| Rate for Payer: BCN Commercial |
$311.57
|
| Rate for Payer: BCN Medicare Advantage |
$153.30
|
| Rate for Payer: Cash Price |
$351.21
|
| Rate for Payer: Cash Price |
$351.21
|
| Rate for Payer: Cofinity Commercial |
$377.55
|
| Rate for Payer: Cofinity Commercial |
$307.31
|
| Rate for Payer: Cofinity Medicare Advantage |
$307.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$351.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.30
|
| Rate for Payer: Healthscope Commercial |
$395.11
|
| Rate for Payer: Mclaren Medicaid |
$82.17
|
| Rate for Payer: Mclaren Medicare |
$153.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.96
|
| Rate for Payer: Meridian Medicaid |
$86.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$176.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$373.16
|
| Rate for Payer: Nomi Health Commercial |
$459.90
|
| Rate for Payer: PACE Medicare |
$145.64
|
| Rate for Payer: PACE SWMI |
$153.30
|
| Rate for Payer: PHP Commercial |
$373.16
|
| Rate for Payer: PHP Medicare Advantage |
$153.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$285.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$481.80
|
| Rate for Payer: Priority Health Medicare |
$153.30
|
| Rate for Payer: Priority Health Narrow Network |
$385.44
|
| Rate for Payer: Priority Health SBD |
$276.58
|
| Rate for Payer: Railroad Medicare Medicare |
$153.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$104.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.30
|
| Rate for Payer: UHC Exchange |
$324.87
|
| Rate for Payer: UHC Medicare Advantage |
$153.30
|
| Rate for Payer: UHCCP Medicaid |
$86.31
|
| Rate for Payer: VA VA |
$153.30
|
|
|
HC EMG REPETITIVE STIMULATION
|
Facility
|
IP
|
$439.01
|
|
|
Service Code
|
CPT 95937
|
| Hospital Charge Code |
92200021
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$276.58 |
| Max. Negotiated Rate |
$395.11 |
| Rate for Payer: Aetna Commercial |
$373.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$285.36
|
| Rate for Payer: Cash Price |
$351.21
|
| Rate for Payer: Cofinity Commercial |
$307.31
|
| Rate for Payer: Cofinity Commercial |
$377.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$307.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$351.21
|
| Rate for Payer: Healthscope Commercial |
$395.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$373.16
|
| Rate for Payer: PHP Commercial |
$373.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$285.36
|
| Rate for Payer: Priority Health SBD |
$276.58
|
|
|
HC EMG SINGLE FIBER
|
Facility
|
OP
|
$459.55
|
|
|
Service Code
|
CPT 95872
|
| Hospital Charge Code |
92200010
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$82.17 |
| Max. Negotiated Rate |
$481.80 |
| Rate for Payer: Aetna Commercial |
$390.62
|
| Rate for Payer: Aetna Medicare |
$159.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$298.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$191.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$191.62
|
| Rate for Payer: BCBS Complete |
$86.28
|
| Rate for Payer: BCBS MAPPO |
$153.30
|
| Rate for Payer: BCBS Trust/PPO |
$187.53
|
| Rate for Payer: BCN Commercial |
$187.53
|
| Rate for Payer: BCN Medicare Advantage |
$153.30
|
| Rate for Payer: Cash Price |
$367.64
|
| Rate for Payer: Cash Price |
$367.64
|
| Rate for Payer: Cofinity Commercial |
$395.21
|
| Rate for Payer: Cofinity Commercial |
$321.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$321.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$367.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.30
|
| Rate for Payer: Healthscope Commercial |
$413.60
|
| Rate for Payer: Mclaren Medicaid |
$82.17
|
| Rate for Payer: Mclaren Medicare |
$153.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.96
|
| Rate for Payer: Meridian Medicaid |
$86.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$176.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$390.62
|
| Rate for Payer: Nomi Health Commercial |
$459.90
|
| Rate for Payer: PACE Medicare |
$145.64
|
| Rate for Payer: PACE SWMI |
$153.30
|
| Rate for Payer: PHP Commercial |
$390.62
|
| Rate for Payer: PHP Medicare Advantage |
$153.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$298.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$481.80
|
| Rate for Payer: Priority Health Medicare |
$153.30
|
| Rate for Payer: Priority Health Narrow Network |
$385.44
|
| Rate for Payer: Priority Health SBD |
$289.52
|
| Rate for Payer: Railroad Medicare Medicare |
$153.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$195.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.30
|
| Rate for Payer: UHC Exchange |
$340.07
|
| Rate for Payer: UHC Medicare Advantage |
$153.30
|
| Rate for Payer: UHCCP Medicaid |
$86.31
|
| Rate for Payer: VA VA |
$153.30
|
|
|
HC EMG SINGLE FIBER
|
Facility
|
IP
|
$459.55
|
|
|
Service Code
|
CPT 95872
|
| Hospital Charge Code |
92200010
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$289.52 |
| Max. Negotiated Rate |
$413.60 |
| Rate for Payer: Aetna Commercial |
$390.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$298.71
|
| Rate for Payer: Cash Price |
$367.64
|
| Rate for Payer: Cofinity Commercial |
$321.68
|
| Rate for Payer: Cofinity Commercial |
$395.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$321.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$367.64
|
| Rate for Payer: Healthscope Commercial |
$413.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$390.62
|
| Rate for Payer: PHP Commercial |
$390.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$298.71
|
| Rate for Payer: Priority Health SBD |
$289.52
|
|
|
HC EMG SURFACE FROM LARYNX
|
Facility
|
OP
|
$277.87
|
|
|
Service Code
|
CPT 95999
|
| Hospital Charge Code |
92000010
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$82.17 |
| Max. Negotiated Rate |
$481.80 |
| Rate for Payer: Aetna Commercial |
$236.19
|
| Rate for Payer: Aetna Medicare |
$159.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$180.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$191.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$191.62
|
| Rate for Payer: BCBS Complete |
$86.28
|
| Rate for Payer: BCBS MAPPO |
$153.30
|
| Rate for Payer: BCBS Trust/PPO |
$412.63
|
| Rate for Payer: BCN Commercial |
$412.63
|
| Rate for Payer: BCN Medicare Advantage |
$153.30
|
| 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 |
$153.30
|
| Rate for Payer: Healthscope Commercial |
$250.08
|
| Rate for Payer: Mclaren Medicaid |
$82.17
|
| Rate for Payer: Mclaren Medicare |
$153.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.96
|
| Rate for Payer: Meridian Medicaid |
$86.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$176.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$236.19
|
| Rate for Payer: Nomi Health Commercial |
$459.90
|
| Rate for Payer: PACE Medicare |
$145.64
|
| Rate for Payer: PACE SWMI |
$153.30
|
| Rate for Payer: PHP Commercial |
$236.19
|
| Rate for Payer: PHP Medicare Advantage |
$153.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$180.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$481.80
|
| Rate for Payer: Priority Health Medicare |
$153.30
|
| Rate for Payer: Priority Health Narrow Network |
$385.44
|
| Rate for Payer: Priority Health SBD |
$175.06
|
| Rate for Payer: Railroad Medicare Medicare |
$153.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$431.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.30
|
| Rate for Payer: UHC Exchange |
$205.62
|
| Rate for Payer: UHC Medicare Advantage |
$153.30
|
| Rate for Payer: UHCCP Medicaid |
$86.31
|
| Rate for Payer: VA VA |
$153.30
|
|
|
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
|
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 EMG THORACIC PSP. NEEDLE EXAM
|
Facility
|
OP
|
$525.20
|
|
|
Service Code
|
CPT 95869
|
| Hospital Charge Code |
92200008
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$94.98 |
| Max. Negotiated Rate |
$958.92 |
| Rate for Payer: Aetna Commercial |
$446.42
|
| Rate for Payer: Aetna Medicare |
$317.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$341.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$381.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$381.38
|
| Rate for Payer: BCBS Complete |
$171.71
|
| Rate for Payer: BCBS MAPPO |
$305.10
|
| Rate for Payer: BCBS Trust/PPO |
$335.20
|
| Rate for Payer: BCN Commercial |
$335.20
|
| Rate for Payer: BCN Medicare Advantage |
$305.10
|
| 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 |
$305.10
|
| Rate for Payer: Healthscope Commercial |
$472.68
|
| Rate for Payer: Mclaren Medicaid |
$163.53
|
| Rate for Payer: Mclaren Medicare |
$305.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$320.36
|
| Rate for Payer: Meridian Medicaid |
$171.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$350.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$446.42
|
| Rate for Payer: Nomi Health Commercial |
$915.30
|
| Rate for Payer: PACE Medicare |
$289.84
|
| Rate for Payer: PACE SWMI |
$305.10
|
| Rate for Payer: PHP Commercial |
$446.42
|
| Rate for Payer: PHP Medicare Advantage |
$305.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$163.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$341.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$958.92
|
| Rate for Payer: Priority Health Medicare |
$305.10
|
| Rate for Payer: Priority Health Narrow Network |
$767.14
|
| Rate for Payer: Priority Health SBD |
$330.88
|
| Rate for Payer: Railroad Medicare Medicare |
$305.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$94.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$305.10
|
| Rate for Payer: UHC Exchange |
$388.65
|
| Rate for Payer: UHC Medicare Advantage |
$305.10
|
| Rate for Payer: UHCCP Medicaid |
$171.77
|
| Rate for Payer: VA VA |
$305.10
|
|
|
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 |
$2,515.60 |
| Rate for Payer: Aetna Commercial |
$496.79
|
| Rate for Payer: Aetna Medicare |
$832.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$379.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,000.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,000.48
|
| Rate for Payer: BCBS Complete |
$450.45
|
| Rate for Payer: BCBS MAPPO |
$800.38
|
| Rate for Payer: BCBS Trust/PPO |
$579.92
|
| Rate for Payer: BCN Commercial |
$579.92
|
| Rate for Payer: BCN Medicare Advantage |
$800.38
|
| 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 |
$800.38
|
| Rate for Payer: Healthscope Commercial |
$526.01
|
| Rate for Payer: Mclaren Medicaid |
$429.00
|
| Rate for Payer: Mclaren Medicare |
$800.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$840.40
|
| Rate for Payer: Meridian Medicaid |
$450.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$920.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$496.79
|
| Rate for Payer: Nomi Health Commercial |
$2,401.14
|
| Rate for Payer: PACE Medicare |
$760.36
|
| Rate for Payer: PACE SWMI |
$800.38
|
| Rate for Payer: PHP Commercial |
$496.79
|
| Rate for Payer: PHP Medicare Advantage |
$800.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$429.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$379.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,515.60
|
| Rate for Payer: Priority Health Medicare |
$800.38
|
| Rate for Payer: Priority Health Narrow Network |
$2,012.48
|
| Rate for Payer: Priority Health SBD |
$368.21
|
| Rate for Payer: Railroad Medicare Medicare |
$800.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$482.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$800.38
|
| Rate for Payer: UHC Medicare Advantage |
$800.38
|
| Rate for Payer: UHCCP Medicaid |
$450.61
|
| Rate for Payer: VA VA |
$800.38
|
|
|
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 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 |
$29.79 |
| 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: BCBS Trust/PPO |
$15.88
|
| Rate for Payer: BCN Commercial |
$15.88
|
| 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: Nomi Health Commercial |
$26.90
|
| 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 HMO/PPO/Tiered Network |
$17.93
|
| Rate for Payer: Priority Health Medicare |
$17.93
|
| Rate for Payer: Priority Health Narrow Network |
$14.34
|
| Rate for Payer: Priority Health SBD |
$20.85
|
| Rate for Payer: Railroad Medicare Medicare |
$17.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.52
|
| 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 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 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
|
|
