|
HC NCS 1-2 STUDIES INCL F&H WAVES
|
Facility
|
OP
|
$504.23
|
|
|
Service Code
|
CPT 95907
|
| Hospital Charge Code |
92200027
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$112.52 |
| Max. Negotiated Rate |
$695.77 |
| Rate for Payer: Aetna Commercial |
$428.60
|
| Rate for Payer: Aetna Medicare |
$223.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$327.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$268.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$268.94
|
| Rate for Payer: BCBS Complete |
$118.16
|
| Rate for Payer: BCBS MAPPO |
$215.15
|
| Rate for Payer: BCBS Trust/PPO |
$162.86
|
| Rate for Payer: BCN Commercial |
$162.86
|
| Rate for Payer: BCN Medicare Advantage |
$215.15
|
| Rate for Payer: Cash Price |
$403.38
|
| Rate for Payer: Cash Price |
$403.38
|
| Rate for Payer: Cofinity Advantage |
$352.96
|
| Rate for Payer: Cofinity Commercial |
$433.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$403.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$215.15
|
| Rate for Payer: Healthscope Commercial |
$453.81
|
| Rate for Payer: Mclaren Medicaid |
$112.52
|
| Rate for Payer: Mclaren Medicare |
$215.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$225.91
|
| Rate for Payer: Meridian Medicaid |
$225.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$247.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$236.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$428.60
|
| Rate for Payer: Nomi Health Commercial |
$645.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$378.17
|
| Rate for Payer: PACE Medicare |
$204.39
|
| Rate for Payer: PACE SWMI |
$215.15
|
| Rate for Payer: PHP Commercial |
$428.60
|
| Rate for Payer: PHP Medicare Advantage |
$215.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$695.77
|
| Rate for Payer: Priority Health Medicare |
$215.15
|
| Rate for Payer: Priority Health SBD |
$317.66
|
| Rate for Payer: Priority Health Tiered Network |
$556.62
|
| Rate for Payer: Railroad Medicare Medicare |
$215.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$327.75
|
| Rate for Payer: UHC Core |
$262.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$215.15
|
| Rate for Payer: UHC Exchange |
$198.16
|
| Rate for Payer: UHC Medicaid |
$112.52
|
| Rate for Payer: UHCCP Medicaid |
$112.52
|
| Rate for Payer: VA VA |
$215.15
|
|
|
HC NCS 13 OR MORE STUDIES INCL F&H WAVES
|
Facility
|
OP
|
$3,013.52
|
|
|
Service Code
|
CPT 95913
|
| Hospital Charge Code |
92200033
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$194.46 |
| Max. Negotiated Rate |
$2,712.17 |
| Rate for Payer: Aetna Commercial |
$2,561.49
|
| Rate for Payer: Aetna Medicare |
$386.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,958.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$464.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$464.77
|
| Rate for Payer: BCBS Complete |
$204.20
|
| Rate for Payer: BCBS MAPPO |
$371.82
|
| Rate for Payer: BCBS Trust/PPO |
$447.11
|
| Rate for Payer: BCN Commercial |
$447.11
|
| Rate for Payer: BCN Medicare Advantage |
$371.82
|
| Rate for Payer: Cash Price |
$2,410.82
|
| Rate for Payer: Cash Price |
$2,410.82
|
| Rate for Payer: Cofinity Advantage |
$2,109.46
|
| Rate for Payer: Cofinity Commercial |
$2,591.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,410.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$371.82
|
| Rate for Payer: Healthscope Commercial |
$2,712.17
|
| Rate for Payer: Mclaren Medicaid |
$194.46
|
| Rate for Payer: Mclaren Medicare |
$371.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$390.41
|
| Rate for Payer: Meridian Medicaid |
$390.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$427.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$409.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,561.49
|
| Rate for Payer: Nomi Health Commercial |
$1,115.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,260.14
|
| Rate for Payer: PACE Medicare |
$353.23
|
| Rate for Payer: PACE SWMI |
$371.82
|
| Rate for Payer: PHP Commercial |
$2,561.49
|
| Rate for Payer: PHP Medicare Advantage |
$371.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$194.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,202.41
|
| Rate for Payer: Priority Health Medicare |
$371.82
|
| Rate for Payer: Priority Health SBD |
$1,898.52
|
| Rate for Payer: Priority Health Tiered Network |
$961.93
|
| Rate for Payer: Railroad Medicare Medicare |
$371.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,958.79
|
| Rate for Payer: UHC Core |
$1,570.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$371.82
|
| Rate for Payer: UHC Exchange |
$1,184.31
|
| Rate for Payer: UHC Medicaid |
$194.46
|
| Rate for Payer: UHCCP Medicaid |
$194.46
|
| Rate for Payer: VA VA |
$371.82
|
|
|
HC NCS 13 OR MORE STUDIES INCL F&H WAVES
|
Facility
|
IP
|
$3,013.52
|
|
|
Service Code
|
CPT 95913
|
| Hospital Charge Code |
92200033
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$1,898.52 |
| Max. Negotiated Rate |
$2,712.17 |
| Rate for Payer: Aetna Commercial |
$2,561.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,958.79
|
| Rate for Payer: Cash Price |
$2,410.82
|
| Rate for Payer: Cofinity Advantage |
$2,109.46
|
| Rate for Payer: Cofinity Commercial |
$2,591.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,410.82
|
| Rate for Payer: Healthscope Commercial |
$2,712.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,561.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,260.14
|
| Rate for Payer: PHP Commercial |
$2,561.49
|
| Rate for Payer: Priority Health SBD |
$1,898.52
|
|
|
HC NCS 3-4 STUDIES INCL F&H WAVES
|
Facility
|
IP
|
$931.70
|
|
|
Service Code
|
CPT 95908
|
| Hospital Charge Code |
92200028
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$586.97 |
| Max. Negotiated Rate |
$838.53 |
| Rate for Payer: Aetna Commercial |
$791.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$605.61
|
| Rate for Payer: Cash Price |
$745.36
|
| Rate for Payer: Cofinity Advantage |
$652.19
|
| Rate for Payer: Cofinity Commercial |
$801.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$745.36
|
| Rate for Payer: Healthscope Commercial |
$838.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$791.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$698.77
|
| Rate for Payer: PHP Commercial |
$791.95
|
| Rate for Payer: Priority Health SBD |
$586.97
|
|
|
HC NCS 3-4 STUDIES INCL F&H WAVES
|
Facility
|
OP
|
$931.70
|
|
|
Service Code
|
CPT 95908
|
| Hospital Charge Code |
92200028
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$112.52 |
| Max. Negotiated Rate |
$838.53 |
| Rate for Payer: Aetna Commercial |
$791.95
|
| Rate for Payer: Aetna Medicare |
$223.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$605.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$268.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$268.94
|
| Rate for Payer: BCBS Complete |
$118.16
|
| Rate for Payer: BCBS MAPPO |
$215.15
|
| Rate for Payer: BCBS Trust/PPO |
$202.83
|
| Rate for Payer: BCN Commercial |
$202.83
|
| Rate for Payer: BCN Medicare Advantage |
$215.15
|
| Rate for Payer: Cash Price |
$745.36
|
| Rate for Payer: Cash Price |
$745.36
|
| Rate for Payer: Cofinity Advantage |
$652.19
|
| Rate for Payer: Cofinity Commercial |
$801.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$745.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$215.15
|
| Rate for Payer: Healthscope Commercial |
$838.53
|
| Rate for Payer: Mclaren Medicaid |
$112.52
|
| Rate for Payer: Mclaren Medicare |
$215.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$225.91
|
| Rate for Payer: Meridian Medicaid |
$225.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$247.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$236.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$791.95
|
| Rate for Payer: Nomi Health Commercial |
$645.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$698.77
|
| Rate for Payer: PACE Medicare |
$204.39
|
| Rate for Payer: PACE SWMI |
$215.15
|
| Rate for Payer: PHP Commercial |
$791.95
|
| Rate for Payer: PHP Medicare Advantage |
$215.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$695.77
|
| Rate for Payer: Priority Health Medicare |
$215.15
|
| Rate for Payer: Priority Health SBD |
$586.97
|
| Rate for Payer: Priority Health Tiered Network |
$556.62
|
| Rate for Payer: Railroad Medicare Medicare |
$215.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$605.61
|
| Rate for Payer: UHC Core |
$485.42
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$215.15
|
| Rate for Payer: UHC Exchange |
$366.16
|
| Rate for Payer: UHC Medicaid |
$112.52
|
| Rate for Payer: UHCCP Medicaid |
$112.52
|
| Rate for Payer: VA VA |
$215.15
|
|
|
HC NCS 5-6 STUDIES INCL F&H WAVES
|
Facility
|
IP
|
$1,151.47
|
|
|
Service Code
|
CPT 95909
|
| Hospital Charge Code |
92200029
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$725.43 |
| Max. Negotiated Rate |
$1,036.32 |
| Rate for Payer: Aetna Commercial |
$978.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$748.46
|
| Rate for Payer: Cash Price |
$921.18
|
| Rate for Payer: Cofinity Advantage |
$806.03
|
| Rate for Payer: Cofinity Commercial |
$990.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$921.18
|
| Rate for Payer: Healthscope Commercial |
$1,036.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$978.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$863.60
|
| Rate for Payer: PHP Commercial |
$978.75
|
| Rate for Payer: Priority Health SBD |
$725.43
|
|
|
HC NCS 5-6 STUDIES INCL F&H WAVES
|
Facility
|
OP
|
$1,151.47
|
|
|
Service Code
|
CPT 95909
|
| Hospital Charge Code |
92200029
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$112.52 |
| Max. Negotiated Rate |
$1,036.32 |
| Rate for Payer: Aetna Commercial |
$978.75
|
| Rate for Payer: Aetna Medicare |
$223.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$748.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$268.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$268.94
|
| Rate for Payer: BCBS Complete |
$118.16
|
| Rate for Payer: BCBS MAPPO |
$215.15
|
| Rate for Payer: BCBS Trust/PPO |
$244.28
|
| Rate for Payer: BCN Commercial |
$244.28
|
| Rate for Payer: BCN Medicare Advantage |
$215.15
|
| Rate for Payer: Cash Price |
$921.18
|
| Rate for Payer: Cash Price |
$921.18
|
| Rate for Payer: Cofinity Advantage |
$806.03
|
| Rate for Payer: Cofinity Commercial |
$990.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$921.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$215.15
|
| Rate for Payer: Healthscope Commercial |
$1,036.32
|
| Rate for Payer: Mclaren Medicaid |
$112.52
|
| Rate for Payer: Mclaren Medicare |
$215.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$225.91
|
| Rate for Payer: Meridian Medicaid |
$225.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$247.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$236.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$978.75
|
| Rate for Payer: Nomi Health Commercial |
$645.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$863.60
|
| Rate for Payer: PACE Medicare |
$204.39
|
| Rate for Payer: PACE SWMI |
$215.15
|
| Rate for Payer: PHP Commercial |
$978.75
|
| Rate for Payer: PHP Medicare Advantage |
$215.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$695.77
|
| Rate for Payer: Priority Health Medicare |
$215.15
|
| Rate for Payer: Priority Health SBD |
$725.43
|
| Rate for Payer: Priority Health Tiered Network |
$556.62
|
| Rate for Payer: Railroad Medicare Medicare |
$215.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$748.46
|
| Rate for Payer: UHC Core |
$599.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$215.15
|
| Rate for Payer: UHC Exchange |
$452.53
|
| Rate for Payer: UHC Medicaid |
$112.52
|
| Rate for Payer: UHCCP Medicaid |
$112.52
|
| Rate for Payer: VA VA |
$215.15
|
|
|
HC NCS 7-8 STUDIES INCL F&H WAVES
|
Facility
|
IP
|
$1,487.04
|
|
|
Service Code
|
CPT 95910
|
| Hospital Charge Code |
92200030
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$936.84 |
| Max. Negotiated Rate |
$1,338.34 |
| Rate for Payer: Aetna Commercial |
$1,263.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$966.58
|
| Rate for Payer: Cash Price |
$1,189.63
|
| Rate for Payer: Cofinity Advantage |
$1,040.93
|
| Rate for Payer: Cofinity Commercial |
$1,278.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,189.63
|
| Rate for Payer: Healthscope Commercial |
$1,338.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,263.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,115.28
|
| Rate for Payer: PHP Commercial |
$1,263.98
|
| Rate for Payer: Priority Health SBD |
$936.84
|
|
|
HC NCS 7-8 STUDIES INCL F&H WAVES
|
Facility
|
OP
|
$1,487.04
|
|
|
Service Code
|
CPT 95910
|
| Hospital Charge Code |
92200030
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$194.46 |
| Max. Negotiated Rate |
$1,338.34 |
| Rate for Payer: Aetna Commercial |
$1,263.98
|
| Rate for Payer: Aetna Medicare |
$386.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$966.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$464.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$464.77
|
| Rate for Payer: BCBS Complete |
$204.20
|
| Rate for Payer: BCBS MAPPO |
$371.82
|
| Rate for Payer: BCBS Trust/PPO |
$310.91
|
| Rate for Payer: BCN Commercial |
$310.91
|
| Rate for Payer: BCN Medicare Advantage |
$371.82
|
| Rate for Payer: Cash Price |
$1,189.63
|
| Rate for Payer: Cash Price |
$1,189.63
|
| Rate for Payer: Cofinity Advantage |
$1,040.93
|
| Rate for Payer: Cofinity Commercial |
$1,278.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,189.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$371.82
|
| Rate for Payer: Healthscope Commercial |
$1,338.34
|
| Rate for Payer: Mclaren Medicaid |
$194.46
|
| Rate for Payer: Mclaren Medicare |
$371.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$390.41
|
| Rate for Payer: Meridian Medicaid |
$390.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$427.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$409.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,263.98
|
| Rate for Payer: Nomi Health Commercial |
$1,115.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,115.28
|
| Rate for Payer: PACE Medicare |
$353.23
|
| Rate for Payer: PACE SWMI |
$371.82
|
| Rate for Payer: PHP Commercial |
$1,263.98
|
| Rate for Payer: PHP Medicare Advantage |
$371.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$194.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,202.41
|
| Rate for Payer: Priority Health Medicare |
$371.82
|
| Rate for Payer: Priority Health SBD |
$936.84
|
| Rate for Payer: Priority Health Tiered Network |
$961.93
|
| Rate for Payer: Railroad Medicare Medicare |
$371.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$966.58
|
| Rate for Payer: UHC Core |
$774.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$371.82
|
| Rate for Payer: UHC Exchange |
$584.41
|
| Rate for Payer: UHC Medicaid |
$194.46
|
| Rate for Payer: UHCCP Medicaid |
$194.46
|
| Rate for Payer: VA VA |
$371.82
|
|
|
HC NCS 9-10 STUDIES INCL F&H WAVES
|
Facility
|
IP
|
$1,842.32
|
|
|
Service Code
|
CPT 95911
|
| Hospital Charge Code |
92200031
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$1,160.66 |
| Max. Negotiated Rate |
$1,658.09 |
| Rate for Payer: Aetna Commercial |
$1,565.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,197.51
|
| Rate for Payer: Cash Price |
$1,473.86
|
| Rate for Payer: Cofinity Advantage |
$1,289.62
|
| Rate for Payer: Cofinity Commercial |
$1,584.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,473.86
|
| Rate for Payer: Healthscope Commercial |
$1,658.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,565.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,381.74
|
| Rate for Payer: PHP Commercial |
$1,565.97
|
| Rate for Payer: Priority Health SBD |
$1,160.66
|
|
|
HC NCS 9-10 STUDIES INCL F&H WAVES
|
Facility
|
OP
|
$1,842.32
|
|
|
Service Code
|
CPT 95911
|
| Hospital Charge Code |
92200031
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$194.46 |
| Max. Negotiated Rate |
$1,658.09 |
| Rate for Payer: Aetna Commercial |
$1,565.97
|
| Rate for Payer: Aetna Medicare |
$386.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,197.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$464.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$464.77
|
| Rate for Payer: BCBS Complete |
$204.20
|
| Rate for Payer: BCBS MAPPO |
$371.82
|
| Rate for Payer: BCBS Trust/PPO |
$350.88
|
| Rate for Payer: BCN Commercial |
$350.88
|
| Rate for Payer: BCN Medicare Advantage |
$371.82
|
| Rate for Payer: Cash Price |
$1,473.86
|
| Rate for Payer: Cash Price |
$1,473.86
|
| Rate for Payer: Cofinity Advantage |
$1,289.62
|
| Rate for Payer: Cofinity Commercial |
$1,584.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,473.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$371.82
|
| Rate for Payer: Healthscope Commercial |
$1,658.09
|
| Rate for Payer: Mclaren Medicaid |
$194.46
|
| Rate for Payer: Mclaren Medicare |
$371.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$390.41
|
| Rate for Payer: Meridian Medicaid |
$390.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$427.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$409.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,565.97
|
| Rate for Payer: Nomi Health Commercial |
$1,115.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,381.74
|
| Rate for Payer: PACE Medicare |
$353.23
|
| Rate for Payer: PACE SWMI |
$371.82
|
| Rate for Payer: PHP Commercial |
$1,565.97
|
| Rate for Payer: PHP Medicare Advantage |
$371.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$194.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,202.41
|
| Rate for Payer: Priority Health Medicare |
$371.82
|
| Rate for Payer: Priority Health SBD |
$1,160.66
|
| Rate for Payer: Priority Health Tiered Network |
$961.93
|
| Rate for Payer: Railroad Medicare Medicare |
$371.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,197.51
|
| Rate for Payer: UHC Core |
$959.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$371.82
|
| Rate for Payer: UHC Exchange |
$724.03
|
| Rate for Payer: UHC Medicaid |
$194.46
|
| Rate for Payer: UHCCP Medicaid |
$194.46
|
| Rate for Payer: VA VA |
$371.82
|
|
|
HC NEEDLE 14 GAUGE LONG
|
Facility
|
OP
|
$112.36
|
|
| Hospital Charge Code |
27000674
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$44.16 |
| Max. Negotiated Rate |
$101.12 |
| Rate for Payer: Aetna Commercial |
$95.51
|
| Rate for Payer: Aetna Medicare |
$56.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$73.03
|
| Rate for Payer: BCBS Complete |
$44.94
|
| Rate for Payer: Cash Price |
$89.89
|
| Rate for Payer: Cofinity Advantage |
$78.65
|
| Rate for Payer: Cofinity Commercial |
$96.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.89
|
| Rate for Payer: Healthscope Commercial |
$101.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$89.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$84.27
|
| Rate for Payer: PHP Commercial |
$95.51
|
| Rate for Payer: Priority Health SBD |
$70.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.03
|
| Rate for Payer: UHC Core |
$58.54
|
| Rate for Payer: UHC Exchange |
$44.16
|
|
|
HC NEEDLE 14 GAUGE LONG
|
Facility
|
IP
|
$112.36
|
|
| Hospital Charge Code |
27000674
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$70.79 |
| Max. Negotiated Rate |
$101.12 |
| Rate for Payer: Aetna Commercial |
$95.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$73.03
|
| Rate for Payer: Cash Price |
$89.89
|
| Rate for Payer: Cofinity Advantage |
$78.65
|
| Rate for Payer: Cofinity Commercial |
$96.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.89
|
| Rate for Payer: Healthscope Commercial |
$101.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$84.27
|
| Rate for Payer: PHP Commercial |
$95.51
|
| Rate for Payer: Priority Health SBD |
$70.79
|
|
|
HC NEEDLE 1 EXTREMITY NON PARASPINAL
|
Facility
|
IP
|
$257.66
|
|
|
Service Code
|
CPT 95870
|
| Hospital Charge Code |
92200009
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$162.33 |
| Max. Negotiated Rate |
$231.89 |
| Rate for Payer: Aetna Commercial |
$219.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$167.48
|
| Rate for Payer: Cash Price |
$206.13
|
| Rate for Payer: Cofinity Advantage |
$180.36
|
| Rate for Payer: Cofinity Commercial |
$221.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$206.13
|
| Rate for Payer: Healthscope Commercial |
$231.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$219.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$193.25
|
| Rate for Payer: PHP Commercial |
$219.01
|
| Rate for Payer: Priority Health SBD |
$162.33
|
|
|
HC NEEDLE 1 EXTREMITY NON PARASPINAL
|
Facility
|
OP
|
$257.66
|
|
|
Service Code
|
CPT 95870
|
| Hospital Charge Code |
92200009
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$69.33 |
| Max. Negotiated Rate |
$428.73 |
| Rate for Payer: Aetna Commercial |
$219.01
|
| Rate for Payer: Aetna Medicare |
$137.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$167.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$165.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$165.71
|
| Rate for Payer: BCBS Complete |
$72.81
|
| Rate for Payer: BCBS MAPPO |
$132.57
|
| Rate for Payer: BCBS Trust/PPO |
$269.44
|
| Rate for Payer: BCN Commercial |
$269.44
|
| Rate for Payer: BCN Medicare Advantage |
$132.57
|
| Rate for Payer: Cash Price |
$206.13
|
| Rate for Payer: Cash Price |
$206.13
|
| Rate for Payer: Cofinity Advantage |
$180.36
|
| Rate for Payer: Cofinity Commercial |
$221.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$206.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.57
|
| Rate for Payer: Healthscope Commercial |
$231.89
|
| Rate for Payer: Mclaren Medicaid |
$69.33
|
| Rate for Payer: Mclaren Medicare |
$132.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$139.20
|
| Rate for Payer: Meridian Medicaid |
$139.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$145.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$219.01
|
| Rate for Payer: Nomi Health Commercial |
$397.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$193.25
|
| Rate for Payer: PACE Medicare |
$125.94
|
| Rate for Payer: PACE SWMI |
$132.57
|
| Rate for Payer: PHP Commercial |
$219.01
|
| Rate for Payer: PHP Medicare Advantage |
$132.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$428.73
|
| Rate for Payer: Priority Health Medicare |
$132.57
|
| Rate for Payer: Priority Health SBD |
$162.33
|
| Rate for Payer: Priority Health Tiered Network |
$342.98
|
| Rate for Payer: Railroad Medicare Medicare |
$132.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$167.48
|
| Rate for Payer: UHC Core |
$134.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$132.57
|
| Rate for Payer: UHC Exchange |
$101.26
|
| Rate for Payer: UHC Medicaid |
$69.33
|
| Rate for Payer: UHCCP Medicaid |
$69.33
|
| Rate for Payer: VA VA |
$132.57
|
|
|
HC NEEDLE BRACHYTHERAPY EACH
|
Facility
|
OP
|
$75.38
|
|
|
Service Code
|
HCPCS C1715
|
| Hospital Charge Code |
27200247
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$67.84 |
| Rate for Payer: Aetna Commercial |
$64.07
|
| Rate for Payer: Aetna Medicare |
$37.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.00
|
| Rate for Payer: BCBS Complete |
$30.15
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$60.30
|
| Rate for Payer: Cash Price |
$60.30
|
| Rate for Payer: Cofinity Advantage |
$52.77
|
| Rate for Payer: Cofinity Commercial |
$64.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.30
|
| Rate for Payer: Healthscope Commercial |
$67.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$60.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.53
|
| Rate for Payer: PHP Commercial |
$64.07
|
| Rate for Payer: Priority Health SBD |
$47.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.00
|
| Rate for Payer: UHC Core |
$39.27
|
| Rate for Payer: UHC Exchange |
$29.62
|
|
|
HC NEEDLE BRACHYTHERAPY EACH
|
Facility
|
IP
|
$75.38
|
|
|
Service Code
|
HCPCS C1715
|
| Hospital Charge Code |
27200247
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$47.49 |
| Max. Negotiated Rate |
$67.84 |
| Rate for Payer: Aetna Commercial |
$64.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.00
|
| Rate for Payer: Cash Price |
$60.30
|
| Rate for Payer: Cofinity Advantage |
$52.77
|
| Rate for Payer: Cofinity Commercial |
$64.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.30
|
| Rate for Payer: Healthscope Commercial |
$67.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.53
|
| Rate for Payer: PHP Commercial |
$64.07
|
| Rate for Payer: Priority Health SBD |
$47.49
|
|
|
HC NEEDLE INSERT W/O INJECT 1 OR 2 MUSCLES
|
Facility
|
OP
|
$53.06
|
|
|
Service Code
|
CPT 20560
|
| Hospital Charge Code |
76100364
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$15.07 |
| Max. Negotiated Rate |
$93.19 |
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: Aetna Medicare |
$29.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.02
|
| Rate for Payer: BCBS Complete |
$15.83
|
| Rate for Payer: BCBS MAPPO |
$28.82
|
| Rate for Payer: BCN Medicare Advantage |
$28.82
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Advantage |
$37.14
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.82
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Mclaren Medicaid |
$15.07
|
| Rate for Payer: Mclaren Medicare |
$28.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.26
|
| Rate for Payer: Meridian Medicaid |
$30.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$31.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$86.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PACE Medicare |
$27.38
|
| Rate for Payer: PACE SWMI |
$28.82
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: PHP Medicare Advantage |
$28.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$93.19
|
| Rate for Payer: Priority Health Medicare |
$28.82
|
| Rate for Payer: Priority Health SBD |
$33.43
|
| Rate for Payer: Priority Health Tiered Network |
$74.55
|
| Rate for Payer: Railroad Medicare Medicare |
$28.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.49
|
| Rate for Payer: UHC Core |
$27.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$28.82
|
| Rate for Payer: UHC Exchange |
$20.85
|
| Rate for Payer: UHC Medicaid |
$15.07
|
| Rate for Payer: UHCCP Medicaid |
$15.07
|
| Rate for Payer: VA VA |
$28.82
|
|
|
HC NEEDLE INSERT W/O INJECT 1 OR 2 MUSCLES
|
Facility
|
IP
|
$53.06
|
|
|
Service Code
|
CPT 20560
|
| Hospital Charge Code |
76100364
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$33.43 |
| Max. Negotiated Rate |
$47.75 |
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.49
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Advantage |
$37.14
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: Priority Health SBD |
$33.43
|
|
|
HC NEEDLE INSERT W/O INJECTION, 1 OR 2 MUSCLES
|
Facility
|
OP
|
$31.21
|
|
|
Service Code
|
CPT 20560
|
| Hospital Charge Code |
42000060
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$12.27 |
| Max. Negotiated Rate |
$135.00 |
| Rate for Payer: Aetna Commercial |
$26.53
|
| Rate for Payer: Aetna Medicare |
$29.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.02
|
| Rate for Payer: BCBS Complete |
$15.83
|
| Rate for Payer: BCBS MAPPO |
$28.82
|
| Rate for Payer: BCN Medicare Advantage |
$28.82
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cofinity Advantage |
$21.85
|
| Rate for Payer: Cofinity Commercial |
$26.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.82
|
| Rate for Payer: Healthscope Commercial |
$28.09
|
| Rate for Payer: Mclaren Medicaid |
$15.07
|
| Rate for Payer: Mclaren Medicare |
$28.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.26
|
| Rate for Payer: Meridian Medicaid |
$30.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$31.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.53
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.41
|
| Rate for Payer: PACE Medicare |
$27.38
|
| Rate for Payer: PACE SWMI |
$28.82
|
| Rate for Payer: PHP Commercial |
$26.53
|
| Rate for Payer: PHP Medicare Advantage |
$28.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$93.19
|
| Rate for Payer: Priority Health Medicare |
$28.82
|
| Rate for Payer: Priority Health SBD |
$19.66
|
| Rate for Payer: Priority Health Tiered Network |
$74.55
|
| Rate for Payer: Railroad Medicare Medicare |
$28.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.29
|
| Rate for Payer: UHC Core |
$16.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$28.82
|
| Rate for Payer: UHC Exchange |
$12.27
|
| Rate for Payer: UHC Medicaid |
$15.07
|
| Rate for Payer: UHCCP Medicaid |
$15.07
|
| Rate for Payer: VA VA |
$28.82
|
|
|
HC NEEDLE INSERT W/O INJECTION, 1 OR 2 MUSCLES
|
Facility
|
IP
|
$31.21
|
|
|
Service Code
|
CPT 20560
|
| Hospital Charge Code |
42000060
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$19.66 |
| Max. Negotiated Rate |
$28.09 |
| Rate for Payer: Aetna Commercial |
$26.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.29
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cofinity Advantage |
$21.85
|
| Rate for Payer: Cofinity Commercial |
$26.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.97
|
| Rate for Payer: Healthscope Commercial |
$28.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.41
|
| Rate for Payer: PHP Commercial |
$26.53
|
| Rate for Payer: Priority Health SBD |
$19.66
|
|
|
HC NEEDLE INSERT W/O INJECTION, 3 OR MORE MUSCLES
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 20561
|
| Hospital Charge Code |
42000061
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$32.77 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.81
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Advantage |
$36.41
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.02
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: Priority Health SBD |
$32.77
|
|
|
HC NEEDLE INSERT W/O INJECTION, 3 OR MORE MUSCLES
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 20561
|
| Hospital Charge Code |
42000061
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$15.07 |
| Max. Negotiated Rate |
$135.00 |
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: Aetna Medicare |
$29.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.02
|
| Rate for Payer: BCBS Complete |
$15.83
|
| Rate for Payer: BCBS MAPPO |
$28.82
|
| Rate for Payer: BCN Medicare Advantage |
$28.82
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Advantage |
$36.41
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.82
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Mclaren Medicaid |
$15.07
|
| Rate for Payer: Mclaren Medicare |
$28.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.26
|
| Rate for Payer: Meridian Medicaid |
$30.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$31.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.02
|
| Rate for Payer: PACE Medicare |
$27.38
|
| Rate for Payer: PACE SWMI |
$28.82
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: PHP Medicare Advantage |
$28.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$93.19
|
| Rate for Payer: Priority Health Medicare |
$28.82
|
| Rate for Payer: Priority Health SBD |
$32.77
|
| Rate for Payer: Priority Health Tiered Network |
$74.55
|
| Rate for Payer: Railroad Medicare Medicare |
$28.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.81
|
| Rate for Payer: UHC Core |
$27.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$28.82
|
| Rate for Payer: UHC Exchange |
$20.44
|
| Rate for Payer: UHC Medicaid |
$15.07
|
| Rate for Payer: UHCCP Medicaid |
$15.07
|
| Rate for Payer: VA VA |
$28.82
|
|
|
HC NEEDLE LOC WIRE
|
Facility
|
IP
|
$54.12
|
|
|
Service Code
|
HCPCS C1819
|
| Hospital Charge Code |
27200323
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$34.10 |
| Max. Negotiated Rate |
$48.71 |
| Rate for Payer: Aetna Commercial |
$46.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.18
|
| Rate for Payer: Cash Price |
$43.30
|
| Rate for Payer: Cofinity Advantage |
$37.88
|
| Rate for Payer: Cofinity Commercial |
$46.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.30
|
| Rate for Payer: Healthscope Commercial |
$48.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.59
|
| Rate for Payer: PHP Commercial |
$46.00
|
| Rate for Payer: Priority Health SBD |
$34.10
|
|
|
HC NEEDLE LOC WIRE
|
Facility
|
OP
|
$54.12
|
|
|
Service Code
|
HCPCS C1819
|
| Hospital Charge Code |
27200323
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$21.27 |
| Max. Negotiated Rate |
$48.71 |
| Rate for Payer: Aetna Commercial |
$46.00
|
| Rate for Payer: Aetna Medicare |
$27.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.18
|
| Rate for Payer: BCBS Complete |
$21.65
|
| Rate for Payer: Cash Price |
$43.30
|
| Rate for Payer: Cofinity Advantage |
$37.88
|
| Rate for Payer: Cofinity Commercial |
$46.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.30
|
| Rate for Payer: Healthscope Commercial |
$48.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.59
|
| Rate for Payer: PHP Commercial |
$46.00
|
| Rate for Payer: Priority Health SBD |
$34.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.18
|
| Rate for Payer: UHC Core |
$28.20
|
| Rate for Payer: UHC Exchange |
$21.27
|
|
