|
HC US BREAST UNI, COMPLETE
|
Facility
|
OP
|
$572.82
|
|
|
Service Code
|
CPT 76641
|
| Hospital Charge Code |
40200068
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$515.54 |
| Rate for Payer: Aetna Commercial |
$486.90
|
| Rate for Payer: Aetna Medicare |
$108.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$372.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$152.95
|
| Rate for Payer: BCCCP Commercial |
$95.65
|
| Rate for Payer: BCN Commercial |
$152.95
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$458.26
|
| Rate for Payer: Cash Price |
$458.26
|
| Rate for Payer: Cofinity Advantage |
$400.97
|
| Rate for Payer: Cofinity Commercial |
$492.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$458.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$515.54
|
| Rate for Payer: Mclaren Medicaid |
$54.48
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$109.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$486.90
|
| Rate for Payer: Nomi Health Commercial |
$312.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$429.62
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$486.90
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$336.87
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health SBD |
$360.88
|
| Rate for Payer: Priority Health Tiered Network |
$269.50
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$372.33
|
| Rate for Payer: UHC Core |
$298.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$225.12
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: VA VA |
$104.17
|
|
|
HC US BREAST UNI, COMPLETE
|
Facility
|
IP
|
$572.82
|
|
|
Service Code
|
CPT 76641
|
| Hospital Charge Code |
40200068
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$360.88 |
| Max. Negotiated Rate |
$515.54 |
| Rate for Payer: Aetna Commercial |
$486.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$372.33
|
| Rate for Payer: Cash Price |
$458.26
|
| Rate for Payer: Cofinity Advantage |
$400.97
|
| Rate for Payer: Cofinity Commercial |
$492.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$458.26
|
| Rate for Payer: Healthscope Commercial |
$515.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$486.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$429.62
|
| Rate for Payer: PHP Commercial |
$486.90
|
| Rate for Payer: Priority Health SBD |
$360.88
|
|
|
HC US BREAST UNI, LIMITED
|
Facility
|
IP
|
$572.82
|
|
|
Service Code
|
CPT 76642
|
| Hospital Charge Code |
40200069
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$360.88 |
| Max. Negotiated Rate |
$515.54 |
| Rate for Payer: Aetna Commercial |
$486.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$372.33
|
| Rate for Payer: Cash Price |
$458.26
|
| Rate for Payer: Cofinity Advantage |
$400.97
|
| Rate for Payer: Cofinity Commercial |
$492.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$458.26
|
| Rate for Payer: Healthscope Commercial |
$515.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$486.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$429.62
|
| Rate for Payer: PHP Commercial |
$486.90
|
| Rate for Payer: Priority Health SBD |
$360.88
|
|
|
HC US BREAST UNI, LIMITED
|
Facility
|
OP
|
$572.82
|
|
|
Service Code
|
CPT 76642
|
| Hospital Charge Code |
40200069
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$45.35 |
| Max. Negotiated Rate |
$515.54 |
| Rate for Payer: Aetna Commercial |
$486.90
|
| Rate for Payer: Aetna Medicare |
$90.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$372.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$108.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$108.39
|
| Rate for Payer: BCBS Complete |
$47.62
|
| Rate for Payer: BCBS MAPPO |
$86.71
|
| Rate for Payer: BCBS Trust/PPO |
$118.87
|
| Rate for Payer: BCCCP Commercial |
$79.63
|
| Rate for Payer: BCN Commercial |
$118.87
|
| Rate for Payer: BCN Medicare Advantage |
$86.71
|
| Rate for Payer: Cash Price |
$458.26
|
| Rate for Payer: Cash Price |
$458.26
|
| Rate for Payer: Cofinity Advantage |
$400.97
|
| Rate for Payer: Cofinity Commercial |
$492.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$458.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.71
|
| Rate for Payer: Healthscope Commercial |
$515.54
|
| Rate for Payer: Mclaren Medicaid |
$45.35
|
| Rate for Payer: Mclaren Medicare |
$86.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.05
|
| Rate for Payer: Meridian Medicaid |
$91.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$95.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$486.90
|
| Rate for Payer: Nomi Health Commercial |
$260.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$429.62
|
| Rate for Payer: PACE Medicare |
$82.37
|
| Rate for Payer: PACE SWMI |
$86.71
|
| Rate for Payer: PHP Commercial |
$486.90
|
| Rate for Payer: PHP Medicare Advantage |
$86.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$280.42
|
| Rate for Payer: Priority Health Medicare |
$86.71
|
| Rate for Payer: Priority Health SBD |
$360.88
|
| Rate for Payer: Priority Health Tiered Network |
$224.34
|
| Rate for Payer: Railroad Medicare Medicare |
$86.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$372.33
|
| Rate for Payer: UHC Core |
$298.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$86.71
|
| Rate for Payer: UHC Exchange |
$225.12
|
| Rate for Payer: UHC Medicaid |
$45.35
|
| Rate for Payer: UHCCP Medicaid |
$45.35
|
| Rate for Payer: VA VA |
$86.71
|
|
|
HC US CHEST
|
Facility
|
OP
|
$572.82
|
|
|
Service Code
|
CPT 76604
|
| Hospital Charge Code |
40200007
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$515.54 |
| Rate for Payer: Aetna Commercial |
$486.90
|
| Rate for Payer: Aetna Medicare |
$108.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$372.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$70.41
|
| Rate for Payer: BCN Commercial |
$70.41
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$458.26
|
| Rate for Payer: Cash Price |
$458.26
|
| Rate for Payer: Cofinity Advantage |
$400.97
|
| Rate for Payer: Cofinity Commercial |
$492.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$458.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$515.54
|
| Rate for Payer: Mclaren Medicaid |
$54.48
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$109.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$486.90
|
| Rate for Payer: Nomi Health Commercial |
$312.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$429.62
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$486.90
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$336.87
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health SBD |
$360.88
|
| Rate for Payer: Priority Health Tiered Network |
$269.50
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$372.33
|
| Rate for Payer: UHC Core |
$298.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$225.12
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: VA VA |
$104.17
|
|
|
HC US CHEST
|
Facility
|
IP
|
$572.82
|
|
|
Service Code
|
CPT 76604
|
| Hospital Charge Code |
40200007
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$360.88 |
| Max. Negotiated Rate |
$515.54 |
| Rate for Payer: Aetna Commercial |
$486.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$372.33
|
| Rate for Payer: Cash Price |
$458.26
|
| Rate for Payer: Cofinity Advantage |
$400.97
|
| Rate for Payer: Cofinity Commercial |
$492.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$458.26
|
| Rate for Payer: Healthscope Commercial |
$515.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$486.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$429.62
|
| Rate for Payer: PHP Commercial |
$486.90
|
| Rate for Payer: Priority Health SBD |
$360.88
|
|
|
HC US CHORIONIC VILLIS SAMPLE
|
Facility
|
OP
|
$585.07
|
|
|
Service Code
|
CPT 76945
|
| Hospital Charge Code |
40200048
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$125.68 |
| Max. Negotiated Rate |
$526.56 |
| Rate for Payer: Aetna Commercial |
$497.31
|
| Rate for Payer: Aetna Medicare |
$292.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$380.30
|
| Rate for Payer: BCBS Complete |
$234.03
|
| Rate for Payer: BCBS Trust/PPO |
$125.68
|
| Rate for Payer: BCN Commercial |
$125.68
|
| Rate for Payer: Cash Price |
$468.06
|
| Rate for Payer: Cash Price |
$468.06
|
| Rate for Payer: Cofinity Advantage |
$409.55
|
| Rate for Payer: Cofinity Commercial |
$503.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$468.06
|
| Rate for Payer: Healthscope Commercial |
$526.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$468.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$497.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$438.80
|
| Rate for Payer: PHP Commercial |
$497.31
|
| Rate for Payer: Priority Health SBD |
$368.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$380.30
|
| Rate for Payer: UHC Core |
$304.82
|
| Rate for Payer: UHC Exchange |
$229.93
|
|
|
HC US CHORIONIC VILLIS SAMPLE
|
Facility
|
IP
|
$585.07
|
|
|
Service Code
|
CPT 76945
|
| Hospital Charge Code |
40200048
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$368.59 |
| Max. Negotiated Rate |
$526.56 |
| Rate for Payer: Aetna Commercial |
$497.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$380.30
|
| Rate for Payer: Cash Price |
$468.06
|
| Rate for Payer: Cofinity Advantage |
$409.55
|
| Rate for Payer: Cofinity Commercial |
$503.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$468.06
|
| Rate for Payer: Healthscope Commercial |
$526.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$497.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$438.80
|
| Rate for Payer: PHP Commercial |
$497.31
|
| Rate for Payer: Priority Health SBD |
$368.59
|
|
|
HC US CRANIAL
|
Facility
|
OP
|
$842.88
|
|
|
Service Code
|
CPT 76506
|
| Hospital Charge Code |
40200053
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$758.59 |
| Rate for Payer: Aetna Commercial |
$716.45
|
| Rate for Payer: Aetna Medicare |
$108.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$547.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$180.20
|
| Rate for Payer: BCN Commercial |
$180.20
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$674.30
|
| Rate for Payer: Cash Price |
$674.30
|
| Rate for Payer: Cofinity Advantage |
$590.02
|
| Rate for Payer: Cofinity Commercial |
$724.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$674.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$758.59
|
| Rate for Payer: Mclaren Medicaid |
$54.48
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$109.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$716.45
|
| Rate for Payer: Nomi Health Commercial |
$312.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$632.16
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$716.45
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$336.87
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health SBD |
$531.01
|
| Rate for Payer: Priority Health Tiered Network |
$269.50
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$547.87
|
| Rate for Payer: UHC Core |
$439.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$331.25
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: VA VA |
$104.17
|
|
|
HC US CRANIAL
|
Facility
|
IP
|
$842.88
|
|
|
Service Code
|
CPT 76506
|
| Hospital Charge Code |
40200053
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$531.01 |
| Max. Negotiated Rate |
$758.59 |
| Rate for Payer: Aetna Commercial |
$716.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$547.87
|
| Rate for Payer: Cash Price |
$674.30
|
| Rate for Payer: Cofinity Advantage |
$590.02
|
| Rate for Payer: Cofinity Commercial |
$724.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$674.30
|
| Rate for Payer: Healthscope Commercial |
$758.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$716.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$632.16
|
| Rate for Payer: PHP Commercial |
$716.45
|
| Rate for Payer: Priority Health SBD |
$531.01
|
|
|
HC US DUPLX DOP ABD PEL SCROT LTD
|
Facility
|
OP
|
$1,031.66
|
|
|
Service Code
|
CPT 93976
|
| Hospital Charge Code |
92100014
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$928.49 |
| Rate for Payer: Aetna Commercial |
$876.91
|
| Rate for Payer: Aetna Medicare |
$108.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$670.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$534.45
|
| Rate for Payer: BCN Commercial |
$534.45
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$825.33
|
| Rate for Payer: Cash Price |
$825.33
|
| Rate for Payer: Cofinity Advantage |
$722.16
|
| Rate for Payer: Cofinity Commercial |
$887.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$825.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$928.49
|
| Rate for Payer: Mclaren Medicaid |
$54.48
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$109.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$876.91
|
| Rate for Payer: Nomi Health Commercial |
$312.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$773.75
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$876.91
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$336.87
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health SBD |
$649.95
|
| Rate for Payer: Priority Health Tiered Network |
$269.50
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$670.58
|
| Rate for Payer: UHC Core |
$537.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$405.44
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: VA VA |
$104.17
|
|
|
HC US DUPLX DOP ABD PEL SCROT LTD
|
Facility
|
IP
|
$1,031.66
|
|
|
Service Code
|
CPT 93976
|
| Hospital Charge Code |
92100014
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$649.95 |
| Max. Negotiated Rate |
$928.49 |
| Rate for Payer: Aetna Commercial |
$876.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$670.58
|
| Rate for Payer: Cash Price |
$825.33
|
| Rate for Payer: Cofinity Advantage |
$722.16
|
| Rate for Payer: Cofinity Commercial |
$887.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$825.33
|
| Rate for Payer: Healthscope Commercial |
$928.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$876.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$773.75
|
| Rate for Payer: PHP Commercial |
$876.91
|
| Rate for Payer: Priority Health SBD |
$649.95
|
|
|
HC US DUPLX DOP ABD PELV SCROTUM
|
Facility
|
OP
|
$1,777.31
|
|
|
Service Code
|
CPT 93975
|
| Hospital Charge Code |
92100013
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$1,599.58 |
| Rate for Payer: Aetna Commercial |
$1,510.71
|
| Rate for Payer: Aetna Medicare |
$247.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,155.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$297.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$297.18
|
| Rate for Payer: BCBS Complete |
$130.57
|
| Rate for Payer: BCBS MAPPO |
$237.74
|
| Rate for Payer: BCBS Trust/PPO |
$916.41
|
| Rate for Payer: BCN Commercial |
$916.41
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$1,421.85
|
| Rate for Payer: Cash Price |
$1,421.85
|
| Rate for Payer: Cofinity Advantage |
$1,244.12
|
| Rate for Payer: Cofinity Commercial |
$1,528.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,421.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$1,599.58
|
| Rate for Payer: Mclaren Medicaid |
$124.34
|
| Rate for Payer: Mclaren Medicare |
$237.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.63
|
| Rate for Payer: Meridian Medicaid |
$249.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$273.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$261.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,510.71
|
| Rate for Payer: Nomi Health Commercial |
$713.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,332.98
|
| Rate for Payer: PACE Medicare |
$225.85
|
| Rate for Payer: PACE SWMI |
$237.74
|
| Rate for Payer: PHP Commercial |
$1,510.71
|
| Rate for Payer: PHP Medicare Advantage |
$237.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$768.83
|
| Rate for Payer: Priority Health Medicare |
$237.74
|
| Rate for Payer: Priority Health SBD |
$1,119.71
|
| Rate for Payer: Priority Health Tiered Network |
$615.06
|
| Rate for Payer: Railroad Medicare Medicare |
$237.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,155.25
|
| Rate for Payer: UHC Core |
$925.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$237.74
|
| Rate for Payer: UHC Exchange |
$698.48
|
| Rate for Payer: UHC Medicaid |
$124.34
|
| Rate for Payer: UHCCP Medicaid |
$124.34
|
| Rate for Payer: VA VA |
$237.74
|
|
|
HC US DUPLX DOP ABD PELV SCROTUM
|
Facility
|
IP
|
$1,777.31
|
|
|
Service Code
|
CPT 93975
|
| Hospital Charge Code |
92100013
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$1,119.71 |
| Max. Negotiated Rate |
$1,599.58 |
| Rate for Payer: Aetna Commercial |
$1,510.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,155.25
|
| Rate for Payer: Cash Price |
$1,421.85
|
| Rate for Payer: Cofinity Advantage |
$1,244.12
|
| Rate for Payer: Cofinity Commercial |
$1,528.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,421.85
|
| Rate for Payer: Healthscope Commercial |
$1,599.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,510.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,332.98
|
| Rate for Payer: PHP Commercial |
$1,510.71
|
| Rate for Payer: Priority Health SBD |
$1,119.71
|
|
|
HC US EACH ADDL FETUS BPP
|
Facility
|
IP
|
$495.72
|
|
|
Service Code
|
CPT 76819
|
| Hospital Charge Code |
40200026
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$312.30 |
| Max. Negotiated Rate |
$446.15 |
| Rate for Payer: Aetna Commercial |
$421.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$322.22
|
| Rate for Payer: Cash Price |
$396.58
|
| Rate for Payer: Cofinity Advantage |
$347.00
|
| Rate for Payer: Cofinity Commercial |
$426.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$396.58
|
| Rate for Payer: Healthscope Commercial |
$446.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$421.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$371.79
|
| Rate for Payer: PHP Commercial |
$421.36
|
| Rate for Payer: Priority Health SBD |
$312.30
|
|
|
HC US EACH ADDL FETUS BPP
|
Facility
|
OP
|
$495.72
|
|
|
Service Code
|
CPT 76819
|
| Hospital Charge Code |
40200026
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$446.15 |
| Rate for Payer: Aetna Commercial |
$421.36
|
| Rate for Payer: Aetna Medicare |
$108.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$322.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$112.82
|
| Rate for Payer: BCN Commercial |
$112.82
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$396.58
|
| Rate for Payer: Cash Price |
$396.58
|
| Rate for Payer: Cofinity Advantage |
$347.00
|
| Rate for Payer: Cofinity Commercial |
$426.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$396.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$446.15
|
| Rate for Payer: Mclaren Medicaid |
$54.48
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$109.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$421.36
|
| Rate for Payer: Nomi Health Commercial |
$312.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$371.79
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$421.36
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$336.87
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health SBD |
$312.30
|
| Rate for Payer: Priority Health Tiered Network |
$269.50
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$322.22
|
| Rate for Payer: UHC Core |
$258.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$194.82
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: VA VA |
$104.17
|
|
|
HC US EACH ADDL FETUS GT 14 WKS
|
Facility
|
OP
|
$440.41
|
|
|
Service Code
|
CPT 76810
|
| Hospital Charge Code |
40200018
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$91.61 |
| Max. Negotiated Rate |
$396.37 |
| Rate for Payer: Aetna Commercial |
$374.35
|
| Rate for Payer: Aetna Medicare |
$220.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$286.27
|
| Rate for Payer: BCBS Complete |
$176.16
|
| Rate for Payer: BCBS Trust/PPO |
$91.61
|
| Rate for Payer: BCN Commercial |
$91.61
|
| Rate for Payer: Cash Price |
$352.33
|
| Rate for Payer: Cash Price |
$352.33
|
| Rate for Payer: Cofinity Advantage |
$308.29
|
| Rate for Payer: Cofinity Commercial |
$378.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$352.33
|
| Rate for Payer: Healthscope Commercial |
$396.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$352.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$374.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$330.31
|
| Rate for Payer: PHP Commercial |
$374.35
|
| Rate for Payer: Priority Health SBD |
$277.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$286.27
|
| Rate for Payer: UHC Core |
$229.45
|
| Rate for Payer: UHC Exchange |
$173.08
|
|
|
HC US EACH ADDL FETUS GT 14 WKS
|
Facility
|
IP
|
$440.41
|
|
|
Service Code
|
CPT 76810
|
| Hospital Charge Code |
40200018
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$277.46 |
| Max. Negotiated Rate |
$396.37 |
| Rate for Payer: Aetna Commercial |
$374.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$286.27
|
| Rate for Payer: Cash Price |
$352.33
|
| Rate for Payer: Cofinity Advantage |
$308.29
|
| Rate for Payer: Cofinity Commercial |
$378.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$352.33
|
| Rate for Payer: Healthscope Commercial |
$396.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$374.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$330.31
|
| Rate for Payer: PHP Commercial |
$374.35
|
| Rate for Payer: Priority Health SBD |
$277.46
|
|
|
HC US EACH ADDL FETUS LESS THAN 14 WKS
|
Facility
|
OP
|
$362.55
|
|
|
Service Code
|
CPT 76802
|
| Hospital Charge Code |
40200016
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$46.94 |
| Max. Negotiated Rate |
$326.30 |
| Rate for Payer: Aetna Commercial |
$308.17
|
| Rate for Payer: Aetna Medicare |
$181.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$235.66
|
| Rate for Payer: BCBS Complete |
$145.02
|
| Rate for Payer: BCBS Trust/PPO |
$46.94
|
| Rate for Payer: BCN Commercial |
$46.94
|
| Rate for Payer: Cash Price |
$290.04
|
| Rate for Payer: Cash Price |
$290.04
|
| Rate for Payer: Cofinity Advantage |
$253.78
|
| Rate for Payer: Cofinity Commercial |
$311.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$290.04
|
| Rate for Payer: Healthscope Commercial |
$326.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$290.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$308.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$271.91
|
| Rate for Payer: PHP Commercial |
$308.17
|
| Rate for Payer: Priority Health SBD |
$228.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$235.66
|
| Rate for Payer: UHC Core |
$188.89
|
| Rate for Payer: UHC Exchange |
$142.48
|
|
|
HC US EACH ADDL FETUS LESS THAN 14 WKS
|
Facility
|
IP
|
$362.55
|
|
|
Service Code
|
CPT 76802
|
| Hospital Charge Code |
40200016
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$228.41 |
| Max. Negotiated Rate |
$326.30 |
| Rate for Payer: Aetna Commercial |
$308.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$235.66
|
| Rate for Payer: Cash Price |
$290.04
|
| Rate for Payer: Cofinity Advantage |
$253.78
|
| Rate for Payer: Cofinity Commercial |
$311.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$290.04
|
| Rate for Payer: Healthscope Commercial |
$326.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$308.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$271.91
|
| Rate for Payer: PHP Commercial |
$308.17
|
| Rate for Payer: Priority Health SBD |
$228.41
|
|
|
HC US ELASTOGRAPHY 1ST LESION
|
Facility
|
IP
|
$212.24
|
|
|
Service Code
|
CPT 76982
|
| Hospital Charge Code |
40200075
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$133.71 |
| Max. Negotiated Rate |
$191.02 |
| Rate for Payer: Aetna Commercial |
$180.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$137.96
|
| Rate for Payer: Cash Price |
$169.79
|
| Rate for Payer: Cofinity Advantage |
$148.57
|
| Rate for Payer: Cofinity Commercial |
$182.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$169.79
|
| Rate for Payer: Healthscope Commercial |
$191.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$180.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$159.18
|
| Rate for Payer: PHP Commercial |
$180.40
|
| Rate for Payer: Priority Health SBD |
$133.71
|
|
|
HC US ELASTOGRAPHY 1ST LESION
|
Facility
|
OP
|
$212.24
|
|
|
Service Code
|
CPT 76982
|
| Hospital Charge Code |
40200075
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$336.87 |
| Rate for Payer: Aetna Commercial |
$180.40
|
| Rate for Payer: Aetna Medicare |
$108.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$137.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$146.13
|
| Rate for Payer: BCCCP Commercial |
$86.41
|
| Rate for Payer: BCN Commercial |
$146.13
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$169.79
|
| Rate for Payer: Cash Price |
$169.79
|
| Rate for Payer: Cofinity Advantage |
$148.57
|
| Rate for Payer: Cofinity Commercial |
$182.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$169.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$191.02
|
| Rate for Payer: Mclaren Medicaid |
$54.48
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$109.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$180.40
|
| Rate for Payer: Nomi Health Commercial |
$312.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$159.18
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$180.40
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$336.87
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health SBD |
$133.71
|
| Rate for Payer: Priority Health Tiered Network |
$269.50
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$137.96
|
| Rate for Payer: UHC Core |
$110.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$83.41
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: VA VA |
$104.17
|
|
|
HC US ELASTOGRAPHY 1ST TARGET LESION
|
Facility
|
IP
|
$316.20
|
|
|
Service Code
|
CPT 76982
|
| Hospital Charge Code |
40200082
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$199.21 |
| Max. Negotiated Rate |
$284.58 |
| Rate for Payer: Aetna Commercial |
$268.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$205.53
|
| Rate for Payer: Cash Price |
$252.96
|
| Rate for Payer: Cofinity Advantage |
$221.34
|
| Rate for Payer: Cofinity Commercial |
$271.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.96
|
| Rate for Payer: Healthscope Commercial |
$284.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$268.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$237.15
|
| Rate for Payer: PHP Commercial |
$268.77
|
| Rate for Payer: Priority Health SBD |
$199.21
|
|
|
HC US ELASTOGRAPHY 1ST TARGET LESION
|
Facility
|
OP
|
$316.20
|
|
|
Service Code
|
CPT 76982
|
| Hospital Charge Code |
40200082
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$336.87 |
| Rate for Payer: Aetna Commercial |
$268.77
|
| Rate for Payer: Aetna Medicare |
$108.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$205.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$146.13
|
| Rate for Payer: BCCCP Commercial |
$86.41
|
| Rate for Payer: BCN Commercial |
$146.13
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$252.96
|
| Rate for Payer: Cash Price |
$252.96
|
| Rate for Payer: Cofinity Advantage |
$221.34
|
| Rate for Payer: Cofinity Commercial |
$271.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$284.58
|
| Rate for Payer: Mclaren Medicaid |
$54.48
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$109.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$268.77
|
| Rate for Payer: Nomi Health Commercial |
$312.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$237.15
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$268.77
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$336.87
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health SBD |
$199.21
|
| Rate for Payer: Priority Health Tiered Network |
$269.50
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$205.53
|
| Rate for Payer: UHC Core |
$164.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$124.27
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: VA VA |
$104.17
|
|
|
HC US ELASTOGRAPHY EA ADDL LESION
|
Facility
|
OP
|
$31.83
|
|
|
Service Code
|
CPT 76983
|
| Hospital Charge Code |
40200076
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$12.51 |
| Max. Negotiated Rate |
$82.52 |
| Rate for Payer: Aetna Commercial |
$27.06
|
| Rate for Payer: Aetna Medicare |
$15.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.69
|
| Rate for Payer: BCBS Complete |
$12.73
|
| Rate for Payer: BCBS Trust/PPO |
$82.52
|
| Rate for Payer: BCN Commercial |
$82.52
|
| Rate for Payer: Cash Price |
$25.46
|
| Rate for Payer: Cash Price |
$25.46
|
| Rate for Payer: Cofinity Advantage |
$22.28
|
| Rate for Payer: Cofinity Commercial |
$27.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.46
|
| Rate for Payer: Healthscope Commercial |
$28.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.87
|
| Rate for Payer: PHP Commercial |
$27.06
|
| Rate for Payer: Priority Health SBD |
$20.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.69
|
| Rate for Payer: UHC Core |
$16.58
|
| Rate for Payer: UHC Exchange |
$12.51
|
|
