|
HC BI V PACEMAKER
|
Facility
|
OP
|
$27,388.65
|
|
|
Service Code
|
HCPCS C2621
|
| Hospital Charge Code |
27500001
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$10,955.46 |
| Max. Negotiated Rate |
$27,388.65 |
| Rate for Payer: Aetna Commercial |
$24,649.78
|
| Rate for Payer: ASR ASR |
$26,566.99
|
| Rate for Payer: BCBS Complete |
$10,955.46
|
| Rate for Payer: BCBS Trust/PPO |
$21,234.42
|
| Rate for Payer: BCN Commercial |
$21,234.42
|
| Rate for Payer: Cash Price |
$21,910.92
|
| Rate for Payer: Cofinity Commercial |
$25,745.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21,910.92
|
| Rate for Payer: Healthscope Commercial |
$27,388.65
|
| Rate for Payer: Healthscope Whirlpool |
$26,566.99
|
| Rate for Payer: Mclaren Commercial |
$24,649.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$23,280.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19,172.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24,923.67
|
| Rate for Payer: Priority Health Narrow Network |
$19,445.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$24,102.01
|
|
|
HC BI V PACEMAKER
|
Facility
|
IP
|
$27,388.65
|
|
|
Service Code
|
HCPCS C2621
|
| Hospital Charge Code |
27500001
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$19,172.06 |
| Max. Negotiated Rate |
$27,388.65 |
| Rate for Payer: Aetna Commercial |
$24,649.78
|
| Rate for Payer: ASR ASR |
$26,566.99
|
| Rate for Payer: BCBS Trust/PPO |
$21,234.42
|
| Rate for Payer: BCN Commercial |
$21,234.42
|
| Rate for Payer: Cash Price |
$21,910.92
|
| Rate for Payer: Cofinity Commercial |
$25,745.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21,910.92
|
| Rate for Payer: Healthscope Commercial |
$27,388.65
|
| Rate for Payer: Healthscope Whirlpool |
$26,566.99
|
| Rate for Payer: Mclaren Commercial |
$24,649.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$23,280.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19,172.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$24,102.01
|
|
|
HC BK VIRUS PCR, QUANT
|
Facility
|
OP
|
$111.18
|
|
|
Service Code
|
CPT 87799
|
| Hospital Charge Code |
30600289
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$23.43 |
| Max. Negotiated Rate |
$111.18 |
| Rate for Payer: Aetna Commercial |
$100.06
|
| Rate for Payer: Aetna Medicare |
$42.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$53.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$53.55
|
| Rate for Payer: ASR ASR |
$107.84
|
| Rate for Payer: BCBS Complete |
$24.61
|
| Rate for Payer: BCBS MAPPO |
$42.84
|
| Rate for Payer: BCBS Trust/PPO |
$86.20
|
| Rate for Payer: BCN Commercial |
$86.20
|
| Rate for Payer: BCN Medicare Advantage |
$42.84
|
| Rate for Payer: Cash Price |
$88.94
|
| Rate for Payer: Cash Price |
$88.94
|
| Rate for Payer: Cofinity Commercial |
$104.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.84
|
| Rate for Payer: Healthscope Commercial |
$111.18
|
| Rate for Payer: Healthscope Whirlpool |
$107.84
|
| Rate for Payer: Humana Choice PPO Medicare |
$42.84
|
| Rate for Payer: Mclaren Commercial |
$100.06
|
| Rate for Payer: Mclaren Medicaid |
$23.43
|
| Rate for Payer: Mclaren Medicare |
$42.84
|
| Rate for Payer: Meridian Medicaid |
$24.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$44.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$49.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$94.50
|
| Rate for Payer: PACE Medicare |
$40.70
|
| Rate for Payer: PACE SWMI |
$42.84
|
| Rate for Payer: PHP Commercial |
$47.12
|
| Rate for Payer: PHP Medicaid |
$23.43
|
| Rate for Payer: PHP Medicare Advantage |
$42.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$101.17
|
| Rate for Payer: Priority Health Medicare |
$42.84
|
| Rate for Payer: Priority Health Narrow Network |
$78.94
|
| Rate for Payer: Railroad Medicare Medicare |
$42.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$97.84
|
| Rate for Payer: UHC Medicare Advantage |
$44.13
|
| Rate for Payer: VA VA |
$42.84
|
|
|
HC BK VIRUS PCR, QUANT
|
Facility
|
IP
|
$111.18
|
|
|
Service Code
|
CPT 87799
|
| Hospital Charge Code |
30600289
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$77.83 |
| Max. Negotiated Rate |
$111.18 |
| Rate for Payer: Aetna Commercial |
$100.06
|
| Rate for Payer: ASR ASR |
$107.84
|
| Rate for Payer: BCBS Trust/PPO |
$86.20
|
| Rate for Payer: BCN Commercial |
$86.20
|
| Rate for Payer: Cash Price |
$88.94
|
| Rate for Payer: Cofinity Commercial |
$104.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.94
|
| Rate for Payer: Healthscope Commercial |
$111.18
|
| Rate for Payer: Healthscope Whirlpool |
$107.84
|
| Rate for Payer: Mclaren Commercial |
$100.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$94.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$97.84
|
|
|
HC BLADDER IRRIGATION
|
Facility
|
IP
|
$274.36
|
|
| Hospital Charge Code |
45000032
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$192.05 |
| Max. Negotiated Rate |
$274.36 |
| Rate for Payer: Aetna Commercial |
$246.92
|
| Rate for Payer: ASR ASR |
$266.13
|
| Rate for Payer: BCBS Trust/PPO |
$212.71
|
| Rate for Payer: BCN Commercial |
$212.71
|
| Rate for Payer: Cash Price |
$219.49
|
| Rate for Payer: Cofinity Commercial |
$257.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$219.49
|
| Rate for Payer: Healthscope Commercial |
$274.36
|
| Rate for Payer: Healthscope Whirlpool |
$266.13
|
| Rate for Payer: Mclaren Commercial |
$246.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$233.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$192.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$241.44
|
|
|
HC BLADDER IRRIGATION
|
Facility
|
OP
|
$274.36
|
|
| Hospital Charge Code |
45000032
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$109.74 |
| Max. Negotiated Rate |
$274.36 |
| Rate for Payer: Aetna Commercial |
$246.92
|
| Rate for Payer: ASR ASR |
$266.13
|
| Rate for Payer: BCBS Complete |
$109.74
|
| Rate for Payer: BCBS Trust/PPO |
$212.71
|
| Rate for Payer: BCN Commercial |
$212.71
|
| Rate for Payer: Cash Price |
$219.49
|
| Rate for Payer: Cofinity Commercial |
$257.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$219.49
|
| Rate for Payer: Healthscope Commercial |
$274.36
|
| Rate for Payer: Healthscope Whirlpool |
$266.13
|
| Rate for Payer: Mclaren Commercial |
$246.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$233.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$192.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$249.67
|
| Rate for Payer: Priority Health Narrow Network |
$194.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$241.44
|
|
|
HC BLADDER SCAN
|
Facility
|
OP
|
$150.14
|
|
|
Service Code
|
CPT 51798
|
| Hospital Charge Code |
45000006
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$29.74 |
| Max. Negotiated Rate |
$150.14 |
| Rate for Payer: Aetna Commercial |
$135.13
|
| Rate for Payer: Aetna Medicare |
$54.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$67.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$67.96
|
| Rate for Payer: ASR ASR |
$145.64
|
| Rate for Payer: BCBS Complete |
$31.23
|
| Rate for Payer: BCBS MAPPO |
$54.37
|
| Rate for Payer: BCBS Trust/PPO |
$116.40
|
| Rate for Payer: BCN Commercial |
$116.40
|
| Rate for Payer: BCN Medicare Advantage |
$54.37
|
| Rate for Payer: Cash Price |
$120.11
|
| Rate for Payer: Cash Price |
$120.11
|
| Rate for Payer: Cofinity Commercial |
$141.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.37
|
| Rate for Payer: Healthscope Commercial |
$150.14
|
| Rate for Payer: Healthscope Whirlpool |
$145.64
|
| Rate for Payer: Humana Choice PPO Medicare |
$54.37
|
| Rate for Payer: Mclaren Commercial |
$135.13
|
| Rate for Payer: Mclaren Medicaid |
$29.74
|
| Rate for Payer: Mclaren Medicare |
$54.37
|
| Rate for Payer: Meridian Medicaid |
$31.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$57.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$62.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$127.62
|
| Rate for Payer: PACE Medicare |
$51.65
|
| Rate for Payer: PACE SWMI |
$54.37
|
| Rate for Payer: PHP Commercial |
$59.81
|
| Rate for Payer: PHP Medicaid |
$29.74
|
| Rate for Payer: PHP Medicare Advantage |
$54.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$136.63
|
| Rate for Payer: Priority Health Medicare |
$54.37
|
| Rate for Payer: Priority Health Narrow Network |
$106.60
|
| Rate for Payer: Railroad Medicare Medicare |
$54.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$132.12
|
| Rate for Payer: UHC Medicare Advantage |
$56.00
|
| Rate for Payer: VA VA |
$54.37
|
|
|
HC BLADDER SCAN
|
Facility
|
IP
|
$150.14
|
|
|
Service Code
|
CPT 51798
|
| Hospital Charge Code |
45000006
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$105.10 |
| Max. Negotiated Rate |
$150.14 |
| Rate for Payer: Aetna Commercial |
$135.13
|
| Rate for Payer: ASR ASR |
$145.64
|
| Rate for Payer: BCBS Trust/PPO |
$116.40
|
| Rate for Payer: BCN Commercial |
$116.40
|
| Rate for Payer: Cash Price |
$120.11
|
| Rate for Payer: Cofinity Commercial |
$141.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.11
|
| Rate for Payer: Healthscope Commercial |
$150.14
|
| Rate for Payer: Healthscope Whirlpool |
$145.64
|
| Rate for Payer: Mclaren Commercial |
$135.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$127.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$132.12
|
|
|
HC BLASTOMYCES ABS BY COMP FIX
|
Facility
|
IP
|
$75.00
|
|
|
Service Code
|
CPT 86612
|
| Hospital Charge Code |
30200230
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$52.50 |
| Max. Negotiated Rate |
$75.00 |
| Rate for Payer: Aetna Commercial |
$67.50
|
| Rate for Payer: ASR ASR |
$72.75
|
| Rate for Payer: BCBS Trust/PPO |
$58.15
|
| Rate for Payer: BCN Commercial |
$58.15
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cofinity Commercial |
$70.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.00
|
| Rate for Payer: Healthscope Commercial |
$75.00
|
| Rate for Payer: Healthscope Whirlpool |
$72.75
|
| Rate for Payer: Mclaren Commercial |
$67.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$63.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$66.00
|
|
|
HC BLASTOMYCES ABS BY COMP FIX
|
Facility
|
OP
|
$75.00
|
|
|
Service Code
|
CPT 86612
|
| Hospital Charge Code |
30200230
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.06 |
| Max. Negotiated Rate |
$75.00 |
| Rate for Payer: Aetna Commercial |
$67.50
|
| Rate for Payer: Aetna Medicare |
$12.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.12
|
| Rate for Payer: ASR ASR |
$72.75
|
| Rate for Payer: BCBS Complete |
$7.41
|
| Rate for Payer: BCBS MAPPO |
$12.90
|
| Rate for Payer: BCBS Trust/PPO |
$58.15
|
| Rate for Payer: BCN Commercial |
$58.15
|
| Rate for Payer: BCN Medicare Advantage |
$12.90
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cofinity Commercial |
$70.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.90
|
| Rate for Payer: Healthscope Commercial |
$75.00
|
| Rate for Payer: Healthscope Whirlpool |
$72.75
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.90
|
| Rate for Payer: Mclaren Commercial |
$67.50
|
| Rate for Payer: Mclaren Medicaid |
$7.06
|
| Rate for Payer: Mclaren Medicare |
$12.90
|
| Rate for Payer: Meridian Medicaid |
$7.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$63.75
|
| Rate for Payer: PACE Medicare |
$12.26
|
| Rate for Payer: PACE SWMI |
$12.90
|
| Rate for Payer: PHP Commercial |
$14.19
|
| Rate for Payer: PHP Medicaid |
$7.06
|
| Rate for Payer: PHP Medicare Advantage |
$12.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$68.25
|
| Rate for Payer: Priority Health Medicare |
$12.90
|
| Rate for Payer: Priority Health Narrow Network |
$53.25
|
| Rate for Payer: Railroad Medicare Medicare |
$12.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$66.00
|
| Rate for Payer: UHC Medicare Advantage |
$13.29
|
| Rate for Payer: VA VA |
$12.90
|
|
|
HC BLD DRAW CENTRAL/PERIPH VENOUS CATH
|
Facility
|
OP
|
$122.08
|
|
|
Service Code
|
CPT 36592
|
| Hospital Charge Code |
76100004
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$62.11 |
| Max. Negotiated Rate |
$141.94 |
| Rate for Payer: Aetna Commercial |
$109.87
|
| Rate for Payer: Aetna Medicare |
$113.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$141.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$141.94
|
| Rate for Payer: ASR ASR |
$118.42
|
| Rate for Payer: BCBS Complete |
$65.22
|
| Rate for Payer: BCBS MAPPO |
$113.55
|
| Rate for Payer: BCBS Trust/PPO |
$94.65
|
| Rate for Payer: BCN Commercial |
$94.65
|
| Rate for Payer: BCN Medicare Advantage |
$113.55
|
| Rate for Payer: Cash Price |
$97.66
|
| Rate for Payer: Cash Price |
$97.66
|
| Rate for Payer: Cofinity Commercial |
$114.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$113.55
|
| Rate for Payer: Healthscope Commercial |
$122.08
|
| Rate for Payer: Healthscope Whirlpool |
$118.42
|
| Rate for Payer: Humana Choice PPO Medicare |
$113.55
|
| Rate for Payer: Mclaren Commercial |
$109.87
|
| Rate for Payer: Mclaren Medicaid |
$62.11
|
| Rate for Payer: Mclaren Medicare |
$113.55
|
| Rate for Payer: Meridian Medicaid |
$65.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$119.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$130.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$103.77
|
| Rate for Payer: PACE Medicare |
$107.87
|
| Rate for Payer: PACE SWMI |
$113.55
|
| Rate for Payer: PHP Commercial |
$124.90
|
| Rate for Payer: PHP Medicaid |
$62.11
|
| Rate for Payer: PHP Medicare Advantage |
$113.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$89.28
|
| Rate for Payer: Priority Health Medicare |
$113.55
|
| Rate for Payer: Priority Health Narrow Network |
$71.42
|
| Rate for Payer: Railroad Medicare Medicare |
$113.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$107.43
|
| Rate for Payer: UHC Medicare Advantage |
$116.96
|
| Rate for Payer: VA VA |
$113.55
|
|
|
HC BLD DRAW CENTRAL/PERIPH VENOUS CATH
|
Facility
|
IP
|
$122.08
|
|
|
Service Code
|
CPT 36592
|
| Hospital Charge Code |
76100004
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$85.46 |
| Max. Negotiated Rate |
$122.08 |
| Rate for Payer: Aetna Commercial |
$109.87
|
| Rate for Payer: ASR ASR |
$118.42
|
| Rate for Payer: BCBS Trust/PPO |
$94.65
|
| Rate for Payer: BCN Commercial |
$94.65
|
| Rate for Payer: Cash Price |
$97.66
|
| Rate for Payer: Cofinity Commercial |
$114.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.66
|
| Rate for Payer: Healthscope Commercial |
$122.08
|
| Rate for Payer: Healthscope Whirlpool |
$118.42
|
| Rate for Payer: Mclaren Commercial |
$109.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$103.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$107.43
|
|
|
HC BLEEDING TIME
|
Facility
|
IP
|
$75.40
|
|
|
Service Code
|
CPT 85002
|
| Hospital Charge Code |
30500001
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$52.78 |
| Max. Negotiated Rate |
$75.40 |
| Rate for Payer: Aetna Commercial |
$67.86
|
| Rate for Payer: ASR ASR |
$73.14
|
| Rate for Payer: BCBS Trust/PPO |
$58.46
|
| Rate for Payer: BCN Commercial |
$58.46
|
| Rate for Payer: Cash Price |
$60.32
|
| Rate for Payer: Cofinity Commercial |
$70.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.32
|
| Rate for Payer: Healthscope Commercial |
$75.40
|
| Rate for Payer: Healthscope Whirlpool |
$73.14
|
| Rate for Payer: Mclaren Commercial |
$67.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$64.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$66.35
|
|
|
HC BLEEDING TIME
|
Facility
|
OP
|
$75.40
|
|
|
Service Code
|
CPT 85002
|
| Hospital Charge Code |
30500001
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.64 |
| Max. Negotiated Rate |
$75.40 |
| Rate for Payer: Aetna Commercial |
$67.86
|
| Rate for Payer: Aetna Medicare |
$4.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.02
|
| Rate for Payer: ASR ASR |
$73.14
|
| Rate for Payer: BCBS Complete |
$2.77
|
| Rate for Payer: BCBS MAPPO |
$4.82
|
| Rate for Payer: BCBS Trust/PPO |
$58.46
|
| Rate for Payer: BCN Commercial |
$58.46
|
| Rate for Payer: BCN Medicare Advantage |
$4.82
|
| Rate for Payer: Cash Price |
$60.32
|
| Rate for Payer: Cash Price |
$60.32
|
| Rate for Payer: Cofinity Commercial |
$70.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.82
|
| Rate for Payer: Healthscope Commercial |
$75.40
|
| Rate for Payer: Healthscope Whirlpool |
$73.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$4.82
|
| Rate for Payer: Mclaren Commercial |
$67.86
|
| Rate for Payer: Mclaren Medicaid |
$2.64
|
| Rate for Payer: Mclaren Medicare |
$4.82
|
| Rate for Payer: Meridian Medicaid |
$2.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$64.09
|
| Rate for Payer: PACE Medicare |
$4.58
|
| Rate for Payer: PACE SWMI |
$4.82
|
| Rate for Payer: PHP Commercial |
$5.30
|
| Rate for Payer: PHP Medicaid |
$2.64
|
| Rate for Payer: PHP Medicare Advantage |
$4.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$42.07
|
| Rate for Payer: Priority Health Medicare |
$4.82
|
| Rate for Payer: Priority Health Narrow Network |
$33.66
|
| Rate for Payer: Railroad Medicare Medicare |
$4.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$66.35
|
| Rate for Payer: UHC Medicare Advantage |
$4.96
|
| Rate for Payer: VA VA |
$4.82
|
|
|
HC BLOOD CULTURE
|
Facility
|
IP
|
$95.78
|
|
|
Service Code
|
CPT 87040
|
| Hospital Charge Code |
30600072
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$67.05 |
| Max. Negotiated Rate |
$95.78 |
| Rate for Payer: Aetna Commercial |
$86.20
|
| Rate for Payer: ASR ASR |
$92.91
|
| Rate for Payer: BCBS Trust/PPO |
$74.26
|
| Rate for Payer: BCN Commercial |
$74.26
|
| Rate for Payer: Cash Price |
$76.62
|
| Rate for Payer: Cofinity Commercial |
$90.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.62
|
| Rate for Payer: Healthscope Commercial |
$95.78
|
| Rate for Payer: Healthscope Whirlpool |
$92.91
|
| Rate for Payer: Mclaren Commercial |
$86.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$81.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$84.29
|
|
|
HC BLOOD CULTURE
|
Facility
|
OP
|
$95.78
|
|
|
Service Code
|
CPT 87040
|
| Hospital Charge Code |
30600072
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.65 |
| Max. Negotiated Rate |
$121.61 |
| Rate for Payer: Aetna Commercial |
$86.20
|
| Rate for Payer: Aetna Medicare |
$10.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.90
|
| Rate for Payer: ASR ASR |
$92.91
|
| Rate for Payer: BCBS Complete |
$5.93
|
| Rate for Payer: BCBS MAPPO |
$10.32
|
| Rate for Payer: BCBS Trust/PPO |
$74.26
|
| Rate for Payer: BCN Commercial |
$74.26
|
| Rate for Payer: BCN Medicare Advantage |
$10.32
|
| Rate for Payer: Cash Price |
$76.62
|
| Rate for Payer: Cash Price |
$76.62
|
| Rate for Payer: Cofinity Commercial |
$90.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.32
|
| Rate for Payer: Healthscope Commercial |
$95.78
|
| Rate for Payer: Healthscope Whirlpool |
$92.91
|
| Rate for Payer: Humana Choice PPO Medicare |
$10.32
|
| Rate for Payer: Mclaren Commercial |
$86.20
|
| Rate for Payer: Mclaren Medicaid |
$5.65
|
| Rate for Payer: Mclaren Medicare |
$10.32
|
| Rate for Payer: Meridian Medicaid |
$5.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$81.41
|
| Rate for Payer: PACE Medicare |
$9.80
|
| Rate for Payer: PACE SWMI |
$10.32
|
| Rate for Payer: PHP Commercial |
$11.35
|
| Rate for Payer: PHP Medicaid |
$5.65
|
| Rate for Payer: PHP Medicare Advantage |
$10.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$121.61
|
| Rate for Payer: Priority Health Medicare |
$10.32
|
| Rate for Payer: Priority Health Narrow Network |
$97.29
|
| Rate for Payer: Railroad Medicare Medicare |
$10.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$84.29
|
| Rate for Payer: UHC Medicare Advantage |
$10.63
|
| Rate for Payer: VA VA |
$10.32
|
|
|
HC BLOOD DRAW IMPLANTED DEVICE
|
Facility
|
OP
|
$164.48
|
|
|
Service Code
|
CPT 36591
|
| Hospital Charge Code |
76100003
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$62.11 |
| Max. Negotiated Rate |
$164.48 |
| Rate for Payer: Aetna Commercial |
$148.03
|
| Rate for Payer: Aetna Medicare |
$113.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$141.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$141.94
|
| Rate for Payer: ASR ASR |
$159.55
|
| Rate for Payer: BCBS Complete |
$65.22
|
| Rate for Payer: BCBS MAPPO |
$113.55
|
| Rate for Payer: BCBS Trust/PPO |
$127.52
|
| Rate for Payer: BCN Commercial |
$127.52
|
| Rate for Payer: BCN Medicare Advantage |
$113.55
|
| Rate for Payer: Cash Price |
$131.58
|
| Rate for Payer: Cash Price |
$131.58
|
| Rate for Payer: Cofinity Commercial |
$154.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$131.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$113.55
|
| Rate for Payer: Healthscope Commercial |
$164.48
|
| Rate for Payer: Healthscope Whirlpool |
$159.55
|
| Rate for Payer: Humana Choice PPO Medicare |
$113.55
|
| Rate for Payer: Mclaren Commercial |
$148.03
|
| Rate for Payer: Mclaren Medicaid |
$62.11
|
| Rate for Payer: Mclaren Medicare |
$113.55
|
| Rate for Payer: Meridian Medicaid |
$65.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$119.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$130.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$139.81
|
| Rate for Payer: PACE Medicare |
$107.87
|
| Rate for Payer: PACE SWMI |
$113.55
|
| Rate for Payer: PHP Commercial |
$124.90
|
| Rate for Payer: PHP Medicaid |
$62.11
|
| Rate for Payer: PHP Medicare Advantage |
$113.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$115.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$89.28
|
| Rate for Payer: Priority Health Medicare |
$113.55
|
| Rate for Payer: Priority Health Narrow Network |
$71.42
|
| Rate for Payer: Railroad Medicare Medicare |
$113.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$144.74
|
| Rate for Payer: UHC Medicare Advantage |
$116.96
|
| Rate for Payer: VA VA |
$113.55
|
|
|
HC BLOOD DRAW IMPLANTED DEVICE
|
Facility
|
IP
|
$164.48
|
|
|
Service Code
|
CPT 36591
|
| Hospital Charge Code |
76100003
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$115.14 |
| Max. Negotiated Rate |
$164.48 |
| Rate for Payer: Aetna Commercial |
$148.03
|
| Rate for Payer: ASR ASR |
$159.55
|
| Rate for Payer: BCBS Trust/PPO |
$127.52
|
| Rate for Payer: BCN Commercial |
$127.52
|
| Rate for Payer: Cash Price |
$131.58
|
| Rate for Payer: Cofinity Commercial |
$154.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$131.58
|
| Rate for Payer: Healthscope Commercial |
$164.48
|
| Rate for Payer: Healthscope Whirlpool |
$159.55
|
| Rate for Payer: Mclaren Commercial |
$148.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$139.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$115.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$144.74
|
|
|
HC BLOOD GAS PKG, CALC O2 SAT
|
Facility
|
OP
|
$173.50
|
|
|
Service Code
|
CPT 82803
|
| Hospital Charge Code |
30100216
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.26 |
| Max. Negotiated Rate |
$173.50 |
| Rate for Payer: Aetna Commercial |
$156.15
|
| Rate for Payer: Aetna Medicare |
$26.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.59
|
| Rate for Payer: ASR ASR |
$168.30
|
| Rate for Payer: BCBS Complete |
$14.97
|
| Rate for Payer: BCBS MAPPO |
$26.07
|
| Rate for Payer: BCBS Trust/PPO |
$134.51
|
| Rate for Payer: BCN Commercial |
$134.51
|
| Rate for Payer: BCN Medicare Advantage |
$26.07
|
| Rate for Payer: Cash Price |
$138.80
|
| Rate for Payer: Cash Price |
$138.80
|
| Rate for Payer: Cofinity Commercial |
$163.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$138.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.07
|
| Rate for Payer: Healthscope Commercial |
$173.50
|
| Rate for Payer: Healthscope Whirlpool |
$168.30
|
| Rate for Payer: Humana Choice PPO Medicare |
$26.07
|
| Rate for Payer: Mclaren Commercial |
$156.15
|
| Rate for Payer: Mclaren Medicaid |
$14.26
|
| Rate for Payer: Mclaren Medicare |
$26.07
|
| Rate for Payer: Meridian Medicaid |
$14.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$27.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$147.48
|
| Rate for Payer: PACE Medicare |
$24.77
|
| Rate for Payer: PACE SWMI |
$26.07
|
| Rate for Payer: PHP Commercial |
$28.68
|
| Rate for Payer: PHP Medicaid |
$14.26
|
| Rate for Payer: PHP Medicare Advantage |
$26.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$152.39
|
| Rate for Payer: Priority Health Medicare |
$26.07
|
| Rate for Payer: Priority Health Narrow Network |
$121.91
|
| Rate for Payer: Railroad Medicare Medicare |
$26.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$152.68
|
| Rate for Payer: UHC Medicare Advantage |
$26.85
|
| Rate for Payer: VA VA |
$26.07
|
|
|
HC BLOOD GAS PKG, CALC O2 SAT
|
Facility
|
IP
|
$173.50
|
|
|
Service Code
|
CPT 82803
|
| Hospital Charge Code |
30100216
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$121.45 |
| Max. Negotiated Rate |
$173.50 |
| Rate for Payer: Aetna Commercial |
$156.15
|
| Rate for Payer: ASR ASR |
$168.30
|
| Rate for Payer: BCBS Trust/PPO |
$134.51
|
| Rate for Payer: BCN Commercial |
$134.51
|
| Rate for Payer: Cash Price |
$138.80
|
| Rate for Payer: Cofinity Commercial |
$163.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$138.80
|
| Rate for Payer: Healthscope Commercial |
$173.50
|
| Rate for Payer: Healthscope Whirlpool |
$168.30
|
| Rate for Payer: Mclaren Commercial |
$156.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$147.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$152.68
|
|
|
HC BLOOD GAS PKG & DIRECT O2 SAT
|
Facility
|
OP
|
$184.31
|
|
|
Service Code
|
CPT 82805
|
| Hospital Charge Code |
30100218
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$43.09 |
| Max. Negotiated Rate |
$184.31 |
| Rate for Payer: Aetna Commercial |
$165.88
|
| Rate for Payer: Aetna Medicare |
$78.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$98.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$98.46
|
| Rate for Payer: ASR ASR |
$178.78
|
| Rate for Payer: BCBS Complete |
$45.25
|
| Rate for Payer: BCBS MAPPO |
$78.77
|
| Rate for Payer: BCBS Trust/PPO |
$142.90
|
| Rate for Payer: BCN Commercial |
$142.90
|
| Rate for Payer: BCN Medicare Advantage |
$78.77
|
| Rate for Payer: Cash Price |
$147.45
|
| Rate for Payer: Cash Price |
$147.45
|
| Rate for Payer: Cofinity Commercial |
$173.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$147.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$78.77
|
| Rate for Payer: Healthscope Commercial |
$184.31
|
| Rate for Payer: Healthscope Whirlpool |
$178.78
|
| Rate for Payer: Humana Choice PPO Medicare |
$78.77
|
| Rate for Payer: Mclaren Commercial |
$165.88
|
| Rate for Payer: Mclaren Medicaid |
$43.09
|
| Rate for Payer: Mclaren Medicare |
$78.77
|
| Rate for Payer: Meridian Medicaid |
$45.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$82.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$90.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$156.66
|
| Rate for Payer: PACE Medicare |
$74.83
|
| Rate for Payer: PACE SWMI |
$78.77
|
| Rate for Payer: PHP Commercial |
$86.65
|
| Rate for Payer: PHP Medicaid |
$43.09
|
| Rate for Payer: PHP Medicare Advantage |
$78.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$129.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$167.72
|
| Rate for Payer: Priority Health Medicare |
$78.77
|
| Rate for Payer: Priority Health Narrow Network |
$130.86
|
| Rate for Payer: Railroad Medicare Medicare |
$78.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$162.19
|
| Rate for Payer: UHC Medicare Advantage |
$81.13
|
| Rate for Payer: VA VA |
$78.77
|
|
|
HC BLOOD GAS PKG & DIRECT O2 SAT
|
Facility
|
IP
|
$184.31
|
|
|
Service Code
|
CPT 82805
|
| Hospital Charge Code |
30100218
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$129.02 |
| Max. Negotiated Rate |
$184.31 |
| Rate for Payer: Aetna Commercial |
$165.88
|
| Rate for Payer: ASR ASR |
$178.78
|
| Rate for Payer: BCBS Trust/PPO |
$142.90
|
| Rate for Payer: BCN Commercial |
$142.90
|
| Rate for Payer: Cash Price |
$147.45
|
| Rate for Payer: Cofinity Commercial |
$173.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$147.45
|
| Rate for Payer: Healthscope Commercial |
$184.31
|
| Rate for Payer: Healthscope Whirlpool |
$178.78
|
| Rate for Payer: Mclaren Commercial |
$165.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$156.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$129.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$162.19
|
|
|
HC BLOOD,OCLT,FECES IMMUNO SCREEN
|
Facility
|
IP
|
$30.68
|
|
|
Service Code
|
HCPCS G0328
|
| Hospital Charge Code |
30100000
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.48 |
| Max. Negotiated Rate |
$30.68 |
| Rate for Payer: Aetna Commercial |
$27.61
|
| Rate for Payer: ASR ASR |
$29.76
|
| Rate for Payer: BCBS Trust/PPO |
$23.79
|
| Rate for Payer: BCN Commercial |
$23.79
|
| Rate for Payer: Cash Price |
$24.54
|
| Rate for Payer: Cofinity Commercial |
$28.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.54
|
| Rate for Payer: Healthscope Commercial |
$30.68
|
| Rate for Payer: Healthscope Whirlpool |
$29.76
|
| Rate for Payer: Mclaren Commercial |
$27.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.00
|
|
|
HC BLOOD,OCLT,FECES IMMUNO SCREEN
|
Facility
|
OP
|
$30.68
|
|
|
Service Code
|
HCPCS G0328
|
| Hospital Charge Code |
30100000
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.87 |
| Max. Negotiated Rate |
$30.68 |
| Rate for Payer: Aetna Commercial |
$27.61
|
| Rate for Payer: Aetna Medicare |
$18.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.56
|
| Rate for Payer: ASR ASR |
$29.76
|
| Rate for Payer: BCBS Complete |
$10.37
|
| Rate for Payer: BCBS MAPPO |
$18.05
|
| Rate for Payer: BCBS Trust/PPO |
$23.79
|
| Rate for Payer: BCN Commercial |
$23.79
|
| Rate for Payer: BCN Medicare Advantage |
$18.05
|
| Rate for Payer: Cash Price |
$24.54
|
| Rate for Payer: Cash Price |
$24.54
|
| Rate for Payer: Cofinity Commercial |
$28.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.05
|
| Rate for Payer: Healthscope Commercial |
$30.68
|
| Rate for Payer: Healthscope Whirlpool |
$29.76
|
| Rate for Payer: Humana Choice PPO Medicare |
$18.05
|
| Rate for Payer: Mclaren Commercial |
$27.61
|
| Rate for Payer: Mclaren Medicaid |
$9.87
|
| Rate for Payer: Mclaren Medicare |
$18.05
|
| Rate for Payer: Meridian Medicaid |
$10.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$18.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.08
|
| Rate for Payer: PACE Medicare |
$17.15
|
| Rate for Payer: PACE SWMI |
$18.05
|
| Rate for Payer: PHP Commercial |
$19.86
|
| Rate for Payer: PHP Medicaid |
$9.87
|
| Rate for Payer: PHP Medicare Advantage |
$18.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$27.92
|
| Rate for Payer: Priority Health Medicare |
$18.05
|
| Rate for Payer: Priority Health Narrow Network |
$21.78
|
| Rate for Payer: Railroad Medicare Medicare |
$18.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.00
|
| Rate for Payer: UHC Medicare Advantage |
$18.59
|
| Rate for Payer: VA VA |
$18.05
|
|
|
HC BLOOD PATCH
|
Facility
|
IP
|
$1,188.74
|
|
|
Service Code
|
CPT 62273
|
| Hospital Charge Code |
45000033
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$832.12 |
| Max. Negotiated Rate |
$1,188.74 |
| Rate for Payer: Aetna Commercial |
$1,069.87
|
| Rate for Payer: ASR ASR |
$1,153.08
|
| Rate for Payer: BCBS Trust/PPO |
$921.63
|
| Rate for Payer: BCN Commercial |
$921.63
|
| Rate for Payer: Cash Price |
$950.99
|
| Rate for Payer: Cofinity Commercial |
$1,117.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$950.99
|
| Rate for Payer: Healthscope Commercial |
$1,188.74
|
| Rate for Payer: Healthscope Whirlpool |
$1,153.08
|
| Rate for Payer: Mclaren Commercial |
$1,069.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,010.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$832.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,046.09
|
|
