|
HC OT Z STOCKINGS CUSTOM EA $275
|
Facility
|
IP
|
$286.11
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300101
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$180.25 |
| Max. Negotiated Rate |
$257.50 |
| Rate for Payer: Aetna Commercial |
$243.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$185.97
|
| Rate for Payer: Cash Price |
$228.89
|
| Rate for Payer: Cofinity Advantage |
$200.28
|
| Rate for Payer: Cofinity Commercial |
$246.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.89
|
| Rate for Payer: Healthscope Commercial |
$257.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$243.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$214.58
|
| Rate for Payer: PHP Commercial |
$243.19
|
| Rate for Payer: Priority Health SBD |
$180.25
|
|
|
HC OT Z STOCKINGS CUSTOM EA $275
|
Facility
|
OP
|
$286.11
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300101
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$112.44 |
| Max. Negotiated Rate |
$365.03 |
| Rate for Payer: Aetna Commercial |
$243.19
|
| Rate for Payer: Aetna Medicare |
$143.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$185.97
|
| Rate for Payer: BCBS Complete |
$114.44
|
| Rate for Payer: BCBS Trust/PPO |
$365.03
|
| Rate for Payer: BCN Commercial |
$365.03
|
| Rate for Payer: Cash Price |
$228.89
|
| Rate for Payer: Cash Price |
$228.89
|
| Rate for Payer: Cofinity Advantage |
$200.28
|
| Rate for Payer: Cofinity Commercial |
$246.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.89
|
| Rate for Payer: Healthscope Commercial |
$257.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$228.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$243.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$214.58
|
| Rate for Payer: PHP Commercial |
$243.19
|
| Rate for Payer: Priority Health SBD |
$180.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$185.97
|
| Rate for Payer: UHC Core |
$149.06
|
| Rate for Payer: UHC Exchange |
$112.44
|
|
|
HC OT Z STOCKINGS CUSTOM EA $300
|
Facility
|
IP
|
$312.12
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300102
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$196.64 |
| Max. Negotiated Rate |
$280.91 |
| Rate for Payer: Aetna Commercial |
$265.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$202.88
|
| Rate for Payer: Cash Price |
$249.70
|
| Rate for Payer: Cofinity Advantage |
$218.48
|
| Rate for Payer: Cofinity Commercial |
$268.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$249.70
|
| Rate for Payer: Healthscope Commercial |
$280.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$265.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$234.09
|
| Rate for Payer: PHP Commercial |
$265.30
|
| Rate for Payer: Priority Health SBD |
$196.64
|
|
|
HC OT Z STOCKINGS CUSTOM EA $300
|
Facility
|
OP
|
$312.12
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300102
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$122.66 |
| Max. Negotiated Rate |
$365.03 |
| Rate for Payer: Aetna Commercial |
$265.30
|
| Rate for Payer: Aetna Medicare |
$156.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$202.88
|
| Rate for Payer: BCBS Complete |
$124.85
|
| Rate for Payer: BCBS Trust/PPO |
$365.03
|
| Rate for Payer: BCN Commercial |
$365.03
|
| Rate for Payer: Cash Price |
$249.70
|
| Rate for Payer: Cash Price |
$249.70
|
| Rate for Payer: Cofinity Advantage |
$218.48
|
| Rate for Payer: Cofinity Commercial |
$268.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$249.70
|
| Rate for Payer: Healthscope Commercial |
$280.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$249.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$265.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$234.09
|
| Rate for Payer: PHP Commercial |
$265.30
|
| Rate for Payer: Priority Health SBD |
$196.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$202.88
|
| Rate for Payer: UHC Core |
$162.61
|
| Rate for Payer: UHC Exchange |
$122.66
|
|
|
HC OT Z STOCKINGS CUSTOM EA $325
|
Facility
|
IP
|
$338.13
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300103
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$213.02 |
| Max. Negotiated Rate |
$304.32 |
| Rate for Payer: Aetna Commercial |
$287.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$219.78
|
| Rate for Payer: Cash Price |
$270.50
|
| Rate for Payer: Cofinity Advantage |
$236.69
|
| Rate for Payer: Cofinity Commercial |
$290.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$270.50
|
| Rate for Payer: Healthscope Commercial |
$304.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$287.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$253.60
|
| Rate for Payer: PHP Commercial |
$287.41
|
| Rate for Payer: Priority Health SBD |
$213.02
|
|
|
HC OT Z STOCKINGS CUSTOM EA $325
|
Facility
|
OP
|
$338.13
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300103
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$132.89 |
| Max. Negotiated Rate |
$365.03 |
| Rate for Payer: Aetna Commercial |
$287.41
|
| Rate for Payer: Aetna Medicare |
$169.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$219.78
|
| Rate for Payer: BCBS Complete |
$135.25
|
| Rate for Payer: BCBS Trust/PPO |
$365.03
|
| Rate for Payer: BCN Commercial |
$365.03
|
| Rate for Payer: Cash Price |
$270.50
|
| Rate for Payer: Cash Price |
$270.50
|
| Rate for Payer: Cofinity Advantage |
$236.69
|
| Rate for Payer: Cofinity Commercial |
$290.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$270.50
|
| Rate for Payer: Healthscope Commercial |
$304.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$270.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$287.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$253.60
|
| Rate for Payer: PHP Commercial |
$287.41
|
| Rate for Payer: Priority Health SBD |
$213.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$219.78
|
| Rate for Payer: UHC Core |
$176.17
|
| Rate for Payer: UHC Exchange |
$132.89
|
|
|
HC OT Z STOCKINGS CUSTOM EA $350
|
Facility
|
OP
|
$364.14
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300104
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$143.11 |
| Max. Negotiated Rate |
$365.03 |
| Rate for Payer: BCN Commercial |
$365.03
|
| Rate for Payer: Aetna Commercial |
$309.52
|
| Rate for Payer: Aetna Medicare |
$182.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$236.69
|
| Rate for Payer: BCBS Complete |
$145.66
|
| Rate for Payer: BCBS Trust/PPO |
$365.03
|
| Rate for Payer: Cash Price |
$291.31
|
| Rate for Payer: Cash Price |
$291.31
|
| Rate for Payer: Cofinity Advantage |
$254.90
|
| Rate for Payer: Cofinity Commercial |
$313.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$291.31
|
| Rate for Payer: Healthscope Commercial |
$327.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$291.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$309.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$273.11
|
| Rate for Payer: PHP Commercial |
$309.52
|
| Rate for Payer: Priority Health SBD |
$229.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$236.69
|
| Rate for Payer: UHC Core |
$189.72
|
| Rate for Payer: UHC Exchange |
$143.11
|
|
|
HC OT Z STOCKINGS CUSTOM EA $350
|
Facility
|
IP
|
$364.14
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300104
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$229.41 |
| Max. Negotiated Rate |
$327.73 |
| Rate for Payer: Aetna Commercial |
$309.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$236.69
|
| Rate for Payer: Cash Price |
$291.31
|
| Rate for Payer: Cofinity Advantage |
$254.90
|
| Rate for Payer: Cofinity Commercial |
$313.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$291.31
|
| Rate for Payer: Healthscope Commercial |
$327.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$309.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$273.11
|
| Rate for Payer: PHP Commercial |
$309.52
|
| Rate for Payer: Priority Health SBD |
$229.41
|
|
|
HC OT Z STOCKINGS CUSTOM EA $375
|
Facility
|
IP
|
$390.15
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300105
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$245.79 |
| Max. Negotiated Rate |
$351.13 |
| Rate for Payer: Aetna Commercial |
$331.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$253.60
|
| Rate for Payer: Cash Price |
$312.12
|
| Rate for Payer: Cofinity Advantage |
$273.11
|
| Rate for Payer: Cofinity Commercial |
$335.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$312.12
|
| Rate for Payer: Healthscope Commercial |
$351.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$331.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$292.61
|
| Rate for Payer: PHP Commercial |
$331.63
|
| Rate for Payer: Priority Health SBD |
$245.79
|
|
|
HC OT Z STOCKINGS CUSTOM EA $375
|
Facility
|
OP
|
$390.15
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300105
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$153.33 |
| Max. Negotiated Rate |
$365.03 |
| Rate for Payer: Aetna Commercial |
$331.63
|
| Rate for Payer: Aetna Medicare |
$195.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$253.60
|
| Rate for Payer: BCBS Complete |
$156.06
|
| Rate for Payer: BCBS Trust/PPO |
$365.03
|
| Rate for Payer: BCN Commercial |
$365.03
|
| Rate for Payer: Cash Price |
$312.12
|
| Rate for Payer: Cash Price |
$312.12
|
| Rate for Payer: Cofinity Advantage |
$273.11
|
| Rate for Payer: Cofinity Commercial |
$335.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$312.12
|
| Rate for Payer: Healthscope Commercial |
$351.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$312.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$331.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$292.61
|
| Rate for Payer: PHP Commercial |
$331.63
|
| Rate for Payer: Priority Health SBD |
$245.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$253.60
|
| Rate for Payer: UHC Core |
$203.27
|
| Rate for Payer: UHC Exchange |
$153.33
|
|
|
HC OT Z STOCKINGS CUSTOM EA $40
|
Facility
|
OP
|
$41.62
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300106
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$16.36 |
| Max. Negotiated Rate |
$365.03 |
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: Aetna Medicare |
$20.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.05
|
| Rate for Payer: BCBS Complete |
$16.65
|
| Rate for Payer: BCBS Trust/PPO |
$365.03
|
| Rate for Payer: BCN Commercial |
$365.03
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Advantage |
$29.13
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.21
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: Priority Health SBD |
$26.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.05
|
| Rate for Payer: UHC Core |
$21.68
|
| Rate for Payer: UHC Exchange |
$16.36
|
|
|
HC OT Z STOCKINGS CUSTOM EA $40
|
Facility
|
IP
|
$41.62
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300106
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$26.22 |
| Max. Negotiated Rate |
$37.46 |
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.05
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Advantage |
$29.13
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.21
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: Priority Health SBD |
$26.22
|
|
|
HC OT Z STOCKINGS CUSTOM EA $400
|
Facility
|
IP
|
$416.16
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300107
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$262.18 |
| Max. Negotiated Rate |
$374.54 |
| Rate for Payer: Aetna Commercial |
$353.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$270.50
|
| Rate for Payer: Cash Price |
$332.93
|
| Rate for Payer: Cofinity Advantage |
$291.31
|
| Rate for Payer: Cofinity Commercial |
$357.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$332.93
|
| Rate for Payer: Healthscope Commercial |
$374.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$353.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.12
|
| Rate for Payer: PHP Commercial |
$353.74
|
| Rate for Payer: Priority Health SBD |
$262.18
|
|
|
HC OT Z STOCKINGS CUSTOM EA $400
|
Facility
|
OP
|
$416.16
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300107
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$163.55 |
| Max. Negotiated Rate |
$374.54 |
| Rate for Payer: Aetna Commercial |
$353.74
|
| Rate for Payer: Aetna Medicare |
$208.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$270.50
|
| Rate for Payer: BCBS Complete |
$166.46
|
| Rate for Payer: BCBS Trust/PPO |
$365.03
|
| Rate for Payer: BCN Commercial |
$365.03
|
| Rate for Payer: Cash Price |
$332.93
|
| Rate for Payer: Cash Price |
$332.93
|
| Rate for Payer: Cofinity Advantage |
$291.31
|
| Rate for Payer: Cofinity Commercial |
$357.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$332.93
|
| Rate for Payer: Healthscope Commercial |
$374.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$332.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$353.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.12
|
| Rate for Payer: PHP Commercial |
$353.74
|
| Rate for Payer: Priority Health SBD |
$262.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$270.50
|
| Rate for Payer: UHC Core |
$216.82
|
| Rate for Payer: UHC Exchange |
$163.55
|
|
|
HC OT Z STOCKINGS CUSTOM EA $425
|
Facility
|
IP
|
$442.17
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300108
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$278.57 |
| Max. Negotiated Rate |
$397.95 |
| Rate for Payer: Aetna Commercial |
$375.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$287.41
|
| Rate for Payer: Cash Price |
$353.74
|
| Rate for Payer: Cofinity Advantage |
$309.52
|
| Rate for Payer: Cofinity Commercial |
$380.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$353.74
|
| Rate for Payer: Healthscope Commercial |
$397.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$375.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$331.63
|
| Rate for Payer: PHP Commercial |
$375.84
|
| Rate for Payer: Priority Health SBD |
$278.57
|
|
|
HC OT Z STOCKINGS CUSTOM EA $425
|
Facility
|
OP
|
$442.17
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300108
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$173.77 |
| Max. Negotiated Rate |
$397.95 |
| Rate for Payer: Aetna Commercial |
$375.84
|
| Rate for Payer: Aetna Medicare |
$221.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$287.41
|
| Rate for Payer: BCBS Complete |
$176.87
|
| Rate for Payer: BCBS Trust/PPO |
$365.03
|
| Rate for Payer: BCN Commercial |
$365.03
|
| Rate for Payer: Cash Price |
$353.74
|
| Rate for Payer: Cash Price |
$353.74
|
| Rate for Payer: Cofinity Advantage |
$309.52
|
| Rate for Payer: Cofinity Commercial |
$380.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$353.74
|
| Rate for Payer: Healthscope Commercial |
$397.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$353.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$375.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$331.63
|
| Rate for Payer: PHP Commercial |
$375.84
|
| Rate for Payer: Priority Health SBD |
$278.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$287.41
|
| Rate for Payer: UHC Core |
$230.37
|
| Rate for Payer: UHC Exchange |
$173.77
|
|
|
HC OT Z STOCKINGS CUSTOM EA $450
|
Facility
|
OP
|
$468.18
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300109
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$183.99 |
| Max. Negotiated Rate |
$421.36 |
| Rate for Payer: Aetna Commercial |
$397.95
|
| Rate for Payer: Aetna Medicare |
$234.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$304.32
|
| Rate for Payer: BCBS Complete |
$187.27
|
| Rate for Payer: BCBS Trust/PPO |
$365.03
|
| Rate for Payer: BCN Commercial |
$365.03
|
| Rate for Payer: Cash Price |
$374.54
|
| Rate for Payer: Cash Price |
$374.54
|
| Rate for Payer: Cofinity Advantage |
$327.73
|
| Rate for Payer: Cofinity Commercial |
$402.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$374.54
|
| Rate for Payer: Healthscope Commercial |
$421.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$374.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$397.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$351.13
|
| Rate for Payer: PHP Commercial |
$397.95
|
| Rate for Payer: Priority Health SBD |
$294.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$304.32
|
| Rate for Payer: UHC Core |
$243.92
|
| Rate for Payer: UHC Exchange |
$183.99
|
|
|
HC OT Z STOCKINGS CUSTOM EA $450
|
Facility
|
IP
|
$468.18
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300109
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$294.95 |
| Max. Negotiated Rate |
$421.36 |
| Rate for Payer: Aetna Commercial |
$397.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$304.32
|
| Rate for Payer: Cash Price |
$374.54
|
| Rate for Payer: Cofinity Advantage |
$327.73
|
| Rate for Payer: Cofinity Commercial |
$402.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$374.54
|
| Rate for Payer: Healthscope Commercial |
$421.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$397.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$351.13
|
| Rate for Payer: PHP Commercial |
$397.95
|
| Rate for Payer: Priority Health SBD |
$294.95
|
|
|
HC OT Z STOCKINGS CUSTOM EA $50
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300110
|
|
Hospital Revenue Code
|
270
|
| 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 OT Z STOCKINGS CUSTOM EA $50
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300110
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$20.44 |
| Max. Negotiated Rate |
$365.03 |
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: Aetna Medicare |
$26.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.81
|
| Rate for Payer: BCBS Complete |
$20.81
|
| Rate for Payer: BCBS Trust/PPO |
$365.03
|
| Rate for Payer: BCN Commercial |
$365.03
|
| 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: Healthscope Commercial |
$46.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$41.62
|
| 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
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.81
|
| Rate for Payer: UHC Core |
$27.10
|
| Rate for Payer: UHC Exchange |
$20.44
|
|
|
HC OT Z STOCKINGS CUSTOM EA $60
|
Facility
|
OP
|
$62.42
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300111
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$24.53 |
| Max. Negotiated Rate |
$365.03 |
| Rate for Payer: Aetna Commercial |
$53.06
|
| Rate for Payer: Aetna Medicare |
$31.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.57
|
| Rate for Payer: BCBS Complete |
$24.97
|
| Rate for Payer: BCBS Trust/PPO |
$365.03
|
| Rate for Payer: BCN Commercial |
$365.03
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cofinity Advantage |
$43.69
|
| Rate for Payer: Cofinity Commercial |
$53.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.94
|
| Rate for Payer: Healthscope Commercial |
$56.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$49.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$46.81
|
| Rate for Payer: PHP Commercial |
$53.06
|
| Rate for Payer: Priority Health SBD |
$39.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.57
|
| Rate for Payer: UHC Core |
$32.52
|
| Rate for Payer: UHC Exchange |
$24.53
|
|
|
HC OT Z STOCKINGS CUSTOM EA $60
|
Facility
|
IP
|
$62.42
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300111
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$39.32 |
| Max. Negotiated Rate |
$56.18 |
| Rate for Payer: Aetna Commercial |
$53.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.57
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cofinity Advantage |
$43.69
|
| Rate for Payer: Cofinity Commercial |
$53.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.94
|
| Rate for Payer: Healthscope Commercial |
$56.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$46.81
|
| Rate for Payer: PHP Commercial |
$53.06
|
| Rate for Payer: Priority Health SBD |
$39.32
|
|
|
HC OT Z STOCKINGS CUSTOM EA $70
|
Facility
|
IP
|
$72.83
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300112
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$45.88 |
| Max. Negotiated Rate |
$65.55 |
| Rate for Payer: Aetna Commercial |
$61.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.34
|
| Rate for Payer: Cash Price |
$58.26
|
| Rate for Payer: Cofinity Advantage |
$50.98
|
| Rate for Payer: Cofinity Commercial |
$62.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.26
|
| Rate for Payer: Healthscope Commercial |
$65.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.62
|
| Rate for Payer: PHP Commercial |
$61.91
|
| Rate for Payer: Priority Health SBD |
$45.88
|
|
|
HC OT Z STOCKINGS CUSTOM EA $70
|
Facility
|
OP
|
$72.83
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300112
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$28.62 |
| Max. Negotiated Rate |
$365.03 |
| Rate for Payer: Aetna Commercial |
$61.91
|
| Rate for Payer: Aetna Medicare |
$36.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.34
|
| Rate for Payer: BCBS Complete |
$29.13
|
| Rate for Payer: BCBS Trust/PPO |
$365.03
|
| Rate for Payer: BCN Commercial |
$365.03
|
| Rate for Payer: Cash Price |
$58.26
|
| Rate for Payer: Cash Price |
$58.26
|
| Rate for Payer: Cofinity Advantage |
$50.98
|
| Rate for Payer: Cofinity Commercial |
$62.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.26
|
| Rate for Payer: Healthscope Commercial |
$65.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.62
|
| Rate for Payer: PHP Commercial |
$61.91
|
| Rate for Payer: Priority Health SBD |
$45.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.34
|
| Rate for Payer: UHC Core |
$37.94
|
| Rate for Payer: UHC Exchange |
$28.62
|
|
|
HC OT Z STOCKINGS CUSTOM EA $80
|
Facility
|
IP
|
$83.23
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300113
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$52.43 |
| Max. Negotiated Rate |
$74.91 |
| Rate for Payer: Aetna Commercial |
$70.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.10
|
| Rate for Payer: Cash Price |
$66.58
|
| Rate for Payer: Cofinity Advantage |
$58.26
|
| Rate for Payer: Cofinity Commercial |
$71.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.58
|
| Rate for Payer: Healthscope Commercial |
$74.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$62.42
|
| Rate for Payer: PHP Commercial |
$70.75
|
| Rate for Payer: Priority Health SBD |
$52.43
|
|
