|
HC BLOOD PATCH
|
Facility
|
OP
|
$1,188.74
|
|
|
Service Code
|
CPT 62273
|
| Hospital Charge Code |
45000033
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$336.24 |
| Max. Negotiated Rate |
$1,233.46 |
| Rate for Payer: Aetna Commercial |
$1,069.87
|
| Rate for Payer: Aetna Medicare |
$614.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$768.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$768.38
|
| Rate for Payer: ASR ASR |
$1,153.08
|
| Rate for Payer: BCBS Complete |
$353.08
|
| Rate for Payer: BCBS MAPPO |
$614.70
|
| Rate for Payer: BCBS Trust/PPO |
$921.63
|
| Rate for Payer: BCN Commercial |
$921.63
|
| Rate for Payer: BCN Medicare Advantage |
$614.70
|
| Rate for Payer: Cash Price |
$950.99
|
| 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: Health Alliance Plan Medicare Advantage |
$614.70
|
| Rate for Payer: Healthscope Commercial |
$1,188.74
|
| Rate for Payer: Healthscope Whirlpool |
$1,153.08
|
| Rate for Payer: Humana Choice PPO Medicare |
$614.70
|
| Rate for Payer: Mclaren Commercial |
$1,069.87
|
| Rate for Payer: Mclaren Medicaid |
$336.24
|
| Rate for Payer: Mclaren Medicare |
$614.70
|
| Rate for Payer: Meridian Medicaid |
$353.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$645.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$706.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,010.43
|
| Rate for Payer: PACE Medicare |
$583.96
|
| Rate for Payer: PACE SWMI |
$614.70
|
| Rate for Payer: PHP Commercial |
$676.17
|
| Rate for Payer: PHP Medicaid |
$336.24
|
| Rate for Payer: PHP Medicare Advantage |
$614.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$336.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$832.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,233.46
|
| Rate for Payer: Priority Health Medicare |
$614.70
|
| Rate for Payer: Priority Health Narrow Network |
$986.77
|
| Rate for Payer: Railroad Medicare Medicare |
$614.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,046.09
|
| Rate for Payer: UHC Medicare Advantage |
$633.14
|
| Rate for Payer: VA VA |
$614.70
|
|
|
HC BLOOD PATCH PROCEDURE
|
Facility
|
OP
|
$1,188.74
|
|
|
Service Code
|
CPT 62273
|
| Hospital Charge Code |
36100280
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$336.24 |
| Max. Negotiated Rate |
$1,233.46 |
| Rate for Payer: Aetna Commercial |
$1,069.87
|
| Rate for Payer: Aetna Medicare |
$614.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$768.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$768.38
|
| Rate for Payer: ASR ASR |
$1,153.08
|
| Rate for Payer: BCBS Complete |
$353.08
|
| Rate for Payer: BCBS MAPPO |
$614.70
|
| Rate for Payer: BCBS Trust/PPO |
$921.63
|
| Rate for Payer: BCN Commercial |
$921.63
|
| Rate for Payer: BCN Medicare Advantage |
$614.70
|
| Rate for Payer: Cash Price |
$950.99
|
| 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: Health Alliance Plan Medicare Advantage |
$614.70
|
| Rate for Payer: Healthscope Commercial |
$1,188.74
|
| Rate for Payer: Healthscope Whirlpool |
$1,153.08
|
| Rate for Payer: Humana Choice PPO Medicare |
$614.70
|
| Rate for Payer: Mclaren Commercial |
$1,069.87
|
| Rate for Payer: Mclaren Medicaid |
$336.24
|
| Rate for Payer: Mclaren Medicare |
$614.70
|
| Rate for Payer: Meridian Medicaid |
$353.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$645.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$706.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,010.43
|
| Rate for Payer: PACE Medicare |
$583.96
|
| Rate for Payer: PACE SWMI |
$614.70
|
| Rate for Payer: PHP Commercial |
$676.17
|
| Rate for Payer: PHP Medicaid |
$336.24
|
| Rate for Payer: PHP Medicare Advantage |
$614.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$336.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$832.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,233.46
|
| Rate for Payer: Priority Health Medicare |
$614.70
|
| Rate for Payer: Priority Health Narrow Network |
$986.77
|
| Rate for Payer: Railroad Medicare Medicare |
$614.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,046.09
|
| Rate for Payer: UHC Medicare Advantage |
$633.14
|
| Rate for Payer: VA VA |
$614.70
|
|
|
HC BLOOD PATCH PROCEDURE
|
Facility
|
IP
|
$1,188.74
|
|
|
Service Code
|
CPT 62273
|
| Hospital Charge Code |
36100280
|
|
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
|
|
|
HC BLOOD SMEAR EXAM
|
Facility
|
OP
|
$22.60
|
|
|
Service Code
|
CPT 85008
|
| Hospital Charge Code |
30500003
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$1.88 |
| Max. Negotiated Rate |
$22.60 |
| Rate for Payer: Aetna Commercial |
$20.34
|
| Rate for Payer: Aetna Medicare |
$3.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.29
|
| Rate for Payer: ASR ASR |
$21.92
|
| Rate for Payer: BCBS Complete |
$1.97
|
| Rate for Payer: BCBS MAPPO |
$3.43
|
| Rate for Payer: BCBS Trust/PPO |
$17.52
|
| Rate for Payer: BCN Commercial |
$17.52
|
| Rate for Payer: BCN Medicare Advantage |
$3.43
|
| Rate for Payer: Cash Price |
$18.08
|
| Rate for Payer: Cash Price |
$18.08
|
| Rate for Payer: Cofinity Commercial |
$21.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.43
|
| Rate for Payer: Healthscope Commercial |
$22.60
|
| Rate for Payer: Healthscope Whirlpool |
$21.92
|
| Rate for Payer: Humana Choice PPO Medicare |
$3.43
|
| Rate for Payer: Mclaren Commercial |
$20.34
|
| Rate for Payer: Mclaren Medicaid |
$1.88
|
| Rate for Payer: Mclaren Medicare |
$3.43
|
| Rate for Payer: Meridian Medicaid |
$1.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$19.21
|
| Rate for Payer: PACE Medicare |
$3.26
|
| Rate for Payer: PACE SWMI |
$3.43
|
| Rate for Payer: PHP Commercial |
$3.77
|
| Rate for Payer: PHP Medicaid |
$1.88
|
| Rate for Payer: PHP Medicare Advantage |
$3.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20.57
|
| Rate for Payer: Priority Health Medicare |
$3.43
|
| Rate for Payer: Priority Health Narrow Network |
$16.05
|
| Rate for Payer: Railroad Medicare Medicare |
$3.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19.89
|
| Rate for Payer: UHC Medicare Advantage |
$3.53
|
| Rate for Payer: VA VA |
$3.43
|
|
|
HC BLOOD SMEAR EXAM
|
Facility
|
IP
|
$22.60
|
|
|
Service Code
|
CPT 85008
|
| Hospital Charge Code |
30500003
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$15.82 |
| Max. Negotiated Rate |
$22.60 |
| Rate for Payer: Aetna Commercial |
$20.34
|
| Rate for Payer: ASR ASR |
$21.92
|
| Rate for Payer: BCBS Trust/PPO |
$17.52
|
| Rate for Payer: BCN Commercial |
$17.52
|
| Rate for Payer: Cash Price |
$18.08
|
| Rate for Payer: Cofinity Commercial |
$21.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.08
|
| Rate for Payer: Healthscope Commercial |
$22.60
|
| Rate for Payer: Healthscope Whirlpool |
$21.92
|
| Rate for Payer: Mclaren Commercial |
$20.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$19.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19.89
|
|
|
HC BLOOD SPLIT CRYOPRECIPITATE UNIT
|
Facility
|
IP
|
$243.92
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000094
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$170.74 |
| Max. Negotiated Rate |
$243.92 |
| Rate for Payer: Aetna Commercial |
$219.53
|
| Rate for Payer: ASR ASR |
$236.60
|
| Rate for Payer: BCBS Trust/PPO |
$189.11
|
| Rate for Payer: BCN Commercial |
$189.11
|
| Rate for Payer: Cash Price |
$195.14
|
| Rate for Payer: Cofinity Commercial |
$229.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.14
|
| Rate for Payer: Healthscope Commercial |
$243.92
|
| Rate for Payer: Healthscope Whirlpool |
$236.60
|
| Rate for Payer: Mclaren Commercial |
$219.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$207.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$170.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$214.65
|
|
|
HC BLOOD SPLIT CRYOPRECIPITATE UNIT
|
Facility
|
OP
|
$243.92
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000094
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$76.07 |
| Max. Negotiated Rate |
$243.92 |
| Rate for Payer: Aetna Commercial |
$219.53
|
| Rate for Payer: Aetna Medicare |
$139.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$173.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$173.84
|
| Rate for Payer: ASR ASR |
$236.60
|
| Rate for Payer: BCBS Complete |
$79.88
|
| Rate for Payer: BCBS MAPPO |
$139.07
|
| Rate for Payer: BCBS Trust/PPO |
$189.11
|
| Rate for Payer: BCN Commercial |
$189.11
|
| Rate for Payer: BCN Medicare Advantage |
$139.07
|
| Rate for Payer: Cash Price |
$195.14
|
| Rate for Payer: Cash Price |
$195.14
|
| Rate for Payer: Cofinity Commercial |
$229.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$139.07
|
| Rate for Payer: Healthscope Commercial |
$243.92
|
| Rate for Payer: Healthscope Whirlpool |
$236.60
|
| Rate for Payer: Humana Choice PPO Medicare |
$139.07
|
| Rate for Payer: Mclaren Commercial |
$219.53
|
| Rate for Payer: Mclaren Medicaid |
$76.07
|
| Rate for Payer: Mclaren Medicare |
$139.07
|
| Rate for Payer: Meridian Medicaid |
$79.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$146.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$159.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$207.33
|
| Rate for Payer: PACE Medicare |
$132.12
|
| Rate for Payer: PACE SWMI |
$139.07
|
| Rate for Payer: PHP Commercial |
$152.98
|
| Rate for Payer: PHP Medicaid |
$76.07
|
| Rate for Payer: PHP Medicare Advantage |
$139.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$170.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$221.97
|
| Rate for Payer: Priority Health Medicare |
$139.07
|
| Rate for Payer: Priority Health Narrow Network |
$173.18
|
| Rate for Payer: Railroad Medicare Medicare |
$139.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$214.65
|
| Rate for Payer: UHC Medicare Advantage |
$143.24
|
| Rate for Payer: VA VA |
$139.07
|
|
|
HC BLOOD SPLIT FFP UNIT
|
Facility
|
OP
|
$45.52
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000091
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$31.86 |
| Max. Negotiated Rate |
$173.84 |
| Rate for Payer: Aetna Commercial |
$40.97
|
| Rate for Payer: Aetna Medicare |
$139.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$173.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$173.84
|
| Rate for Payer: ASR ASR |
$44.15
|
| Rate for Payer: BCBS Complete |
$79.88
|
| Rate for Payer: BCBS MAPPO |
$139.07
|
| Rate for Payer: BCBS Trust/PPO |
$35.29
|
| Rate for Payer: BCN Commercial |
$35.29
|
| Rate for Payer: BCN Medicare Advantage |
$139.07
|
| Rate for Payer: Cash Price |
$36.42
|
| Rate for Payer: Cash Price |
$36.42
|
| Rate for Payer: Cofinity Commercial |
$42.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$139.07
|
| Rate for Payer: Healthscope Commercial |
$45.52
|
| Rate for Payer: Healthscope Whirlpool |
$44.15
|
| Rate for Payer: Humana Choice PPO Medicare |
$139.07
|
| Rate for Payer: Mclaren Commercial |
$40.97
|
| Rate for Payer: Mclaren Medicaid |
$76.07
|
| Rate for Payer: Mclaren Medicare |
$139.07
|
| Rate for Payer: Meridian Medicaid |
$79.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$146.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$159.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$38.69
|
| Rate for Payer: PACE Medicare |
$132.12
|
| Rate for Payer: PACE SWMI |
$139.07
|
| Rate for Payer: PHP Commercial |
$152.98
|
| Rate for Payer: PHP Medicaid |
$76.07
|
| Rate for Payer: PHP Medicare Advantage |
$139.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$41.42
|
| Rate for Payer: Priority Health Medicare |
$139.07
|
| Rate for Payer: Priority Health Narrow Network |
$32.32
|
| Rate for Payer: Railroad Medicare Medicare |
$139.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.06
|
| Rate for Payer: UHC Medicare Advantage |
$143.24
|
| Rate for Payer: VA VA |
$139.07
|
|
|
HC BLOOD SPLIT FFP UNIT
|
Facility
|
IP
|
$45.52
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000091
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$31.86 |
| Max. Negotiated Rate |
$45.52 |
| Rate for Payer: Aetna Commercial |
$40.97
|
| Rate for Payer: ASR ASR |
$44.15
|
| Rate for Payer: BCBS Trust/PPO |
$35.29
|
| Rate for Payer: BCN Commercial |
$35.29
|
| Rate for Payer: Cash Price |
$36.42
|
| Rate for Payer: Cofinity Commercial |
$42.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.42
|
| Rate for Payer: Healthscope Commercial |
$45.52
|
| Rate for Payer: Healthscope Whirlpool |
$44.15
|
| Rate for Payer: Mclaren Commercial |
$40.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$38.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.06
|
|
|
HC BLOOD SPLIT LVDS PLT UNIT
|
Facility
|
IP
|
$351.55
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000092
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$246.08 |
| Max. Negotiated Rate |
$351.55 |
| Rate for Payer: Aetna Commercial |
$316.40
|
| Rate for Payer: ASR ASR |
$341.00
|
| Rate for Payer: BCBS Trust/PPO |
$272.56
|
| Rate for Payer: BCN Commercial |
$272.56
|
| Rate for Payer: Cash Price |
$281.24
|
| Rate for Payer: Cofinity Commercial |
$330.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$281.24
|
| Rate for Payer: Healthscope Commercial |
$351.55
|
| Rate for Payer: Healthscope Whirlpool |
$341.00
|
| Rate for Payer: Mclaren Commercial |
$316.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$298.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$246.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$309.36
|
|
|
HC BLOOD SPLIT LVDS PLT UNIT
|
Facility
|
OP
|
$351.55
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000092
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$76.07 |
| Max. Negotiated Rate |
$351.55 |
| Rate for Payer: Aetna Commercial |
$316.40
|
| Rate for Payer: Aetna Medicare |
$139.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$173.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$173.84
|
| Rate for Payer: ASR ASR |
$341.00
|
| Rate for Payer: BCBS Complete |
$79.88
|
| Rate for Payer: BCBS MAPPO |
$139.07
|
| Rate for Payer: BCBS Trust/PPO |
$272.56
|
| Rate for Payer: BCN Commercial |
$272.56
|
| Rate for Payer: BCN Medicare Advantage |
$139.07
|
| Rate for Payer: Cash Price |
$281.24
|
| Rate for Payer: Cash Price |
$281.24
|
| Rate for Payer: Cofinity Commercial |
$330.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$281.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$139.07
|
| Rate for Payer: Healthscope Commercial |
$351.55
|
| Rate for Payer: Healthscope Whirlpool |
$341.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$139.07
|
| Rate for Payer: Mclaren Commercial |
$316.40
|
| Rate for Payer: Mclaren Medicaid |
$76.07
|
| Rate for Payer: Mclaren Medicare |
$139.07
|
| Rate for Payer: Meridian Medicaid |
$79.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$146.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$159.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$298.82
|
| Rate for Payer: PACE Medicare |
$132.12
|
| Rate for Payer: PACE SWMI |
$139.07
|
| Rate for Payer: PHP Commercial |
$152.98
|
| Rate for Payer: PHP Medicaid |
$76.07
|
| Rate for Payer: PHP Medicare Advantage |
$139.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$246.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$319.91
|
| Rate for Payer: Priority Health Medicare |
$139.07
|
| Rate for Payer: Priority Health Narrow Network |
$249.60
|
| Rate for Payer: Railroad Medicare Medicare |
$139.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$309.36
|
| Rate for Payer: UHC Medicare Advantage |
$143.24
|
| Rate for Payer: VA VA |
$139.07
|
|
|
HC BLOOD SPLIT PSORALEN PLT UNIT
|
Facility
|
OP
|
$294.78
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000093
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$76.07 |
| Max. Negotiated Rate |
$294.78 |
| Rate for Payer: Aetna Commercial |
$265.30
|
| Rate for Payer: Aetna Medicare |
$139.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$173.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$173.84
|
| Rate for Payer: ASR ASR |
$285.94
|
| Rate for Payer: BCBS Complete |
$79.88
|
| Rate for Payer: BCBS MAPPO |
$139.07
|
| Rate for Payer: BCBS Trust/PPO |
$228.54
|
| Rate for Payer: BCN Commercial |
$228.54
|
| Rate for Payer: BCN Medicare Advantage |
$139.07
|
| Rate for Payer: Cash Price |
$235.82
|
| Rate for Payer: Cash Price |
$235.82
|
| Rate for Payer: Cofinity Commercial |
$277.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$235.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$139.07
|
| Rate for Payer: Healthscope Commercial |
$294.78
|
| Rate for Payer: Healthscope Whirlpool |
$285.94
|
| Rate for Payer: Humana Choice PPO Medicare |
$139.07
|
| Rate for Payer: Mclaren Commercial |
$265.30
|
| Rate for Payer: Mclaren Medicaid |
$76.07
|
| Rate for Payer: Mclaren Medicare |
$139.07
|
| Rate for Payer: Meridian Medicaid |
$79.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$146.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$159.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$250.56
|
| Rate for Payer: PACE Medicare |
$132.12
|
| Rate for Payer: PACE SWMI |
$139.07
|
| Rate for Payer: PHP Commercial |
$152.98
|
| Rate for Payer: PHP Medicaid |
$76.07
|
| Rate for Payer: PHP Medicare Advantage |
$139.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$206.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$268.25
|
| Rate for Payer: Priority Health Medicare |
$139.07
|
| Rate for Payer: Priority Health Narrow Network |
$209.29
|
| Rate for Payer: Railroad Medicare Medicare |
$139.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$259.41
|
| Rate for Payer: UHC Medicare Advantage |
$143.24
|
| Rate for Payer: VA VA |
$139.07
|
|
|
HC BLOOD SPLIT PSORALEN PLT UNIT
|
Facility
|
IP
|
$294.78
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000093
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$206.35 |
| Max. Negotiated Rate |
$294.78 |
| Rate for Payer: Aetna Commercial |
$265.30
|
| Rate for Payer: ASR ASR |
$285.94
|
| Rate for Payer: BCBS Trust/PPO |
$228.54
|
| Rate for Payer: BCN Commercial |
$228.54
|
| Rate for Payer: Cash Price |
$235.82
|
| Rate for Payer: Cofinity Commercial |
$277.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$235.82
|
| Rate for Payer: Healthscope Commercial |
$294.78
|
| Rate for Payer: Healthscope Whirlpool |
$285.94
|
| Rate for Payer: Mclaren Commercial |
$265.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$250.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$206.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$259.41
|
|
|
HC BLOOD SPLIT RBC UNIT
|
Facility
|
OP
|
$80.08
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000090
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$56.06 |
| Max. Negotiated Rate |
$173.84 |
| Rate for Payer: Aetna Commercial |
$72.07
|
| Rate for Payer: Aetna Medicare |
$139.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$173.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$173.84
|
| Rate for Payer: ASR ASR |
$77.68
|
| Rate for Payer: BCBS Complete |
$79.88
|
| Rate for Payer: BCBS MAPPO |
$139.07
|
| Rate for Payer: BCBS Trust/PPO |
$62.09
|
| Rate for Payer: BCN Commercial |
$62.09
|
| Rate for Payer: BCN Medicare Advantage |
$139.07
|
| Rate for Payer: Cash Price |
$64.06
|
| Rate for Payer: Cash Price |
$64.06
|
| Rate for Payer: Cofinity Commercial |
$75.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$139.07
|
| Rate for Payer: Healthscope Commercial |
$80.08
|
| Rate for Payer: Healthscope Whirlpool |
$77.68
|
| Rate for Payer: Humana Choice PPO Medicare |
$139.07
|
| Rate for Payer: Mclaren Commercial |
$72.07
|
| Rate for Payer: Mclaren Medicaid |
$76.07
|
| Rate for Payer: Mclaren Medicare |
$139.07
|
| Rate for Payer: Meridian Medicaid |
$79.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$146.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$159.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$68.07
|
| Rate for Payer: PACE Medicare |
$132.12
|
| Rate for Payer: PACE SWMI |
$139.07
|
| Rate for Payer: PHP Commercial |
$152.98
|
| Rate for Payer: PHP Medicaid |
$76.07
|
| Rate for Payer: PHP Medicare Advantage |
$139.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$72.87
|
| Rate for Payer: Priority Health Medicare |
$139.07
|
| Rate for Payer: Priority Health Narrow Network |
$56.86
|
| Rate for Payer: Railroad Medicare Medicare |
$139.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$70.47
|
| Rate for Payer: UHC Medicare Advantage |
$143.24
|
| Rate for Payer: VA VA |
$139.07
|
|
|
HC BLOOD SPLIT RBC UNIT
|
Facility
|
IP
|
$80.08
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000090
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$56.06 |
| Max. Negotiated Rate |
$80.08 |
| Rate for Payer: Aetna Commercial |
$72.07
|
| Rate for Payer: ASR ASR |
$77.68
|
| Rate for Payer: BCBS Trust/PPO |
$62.09
|
| Rate for Payer: BCN Commercial |
$62.09
|
| Rate for Payer: Cash Price |
$64.06
|
| Rate for Payer: Cofinity Commercial |
$75.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.06
|
| Rate for Payer: Healthscope Commercial |
$80.08
|
| Rate for Payer: Healthscope Whirlpool |
$77.68
|
| Rate for Payer: Mclaren Commercial |
$72.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$68.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$70.47
|
|
|
HC BLOOD SPLIT WASHED RBC UNIT
|
Facility
|
IP
|
$101.62
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000095
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$71.13 |
| Max. Negotiated Rate |
$101.62 |
| Rate for Payer: Aetna Commercial |
$91.46
|
| Rate for Payer: ASR ASR |
$98.57
|
| Rate for Payer: BCBS Trust/PPO |
$78.79
|
| Rate for Payer: BCN Commercial |
$78.79
|
| Rate for Payer: Cash Price |
$81.30
|
| Rate for Payer: Cofinity Commercial |
$95.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.30
|
| Rate for Payer: Healthscope Commercial |
$101.62
|
| Rate for Payer: Healthscope Whirlpool |
$98.57
|
| Rate for Payer: Mclaren Commercial |
$91.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$86.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$89.43
|
|
|
HC BLOOD SPLIT WASHED RBC UNIT
|
Facility
|
OP
|
$101.62
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000095
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$71.13 |
| Max. Negotiated Rate |
$173.84 |
| Rate for Payer: Aetna Commercial |
$91.46
|
| Rate for Payer: Aetna Medicare |
$139.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$173.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$173.84
|
| Rate for Payer: ASR ASR |
$98.57
|
| Rate for Payer: BCBS Complete |
$79.88
|
| Rate for Payer: BCBS MAPPO |
$139.07
|
| Rate for Payer: BCBS Trust/PPO |
$78.79
|
| Rate for Payer: BCN Commercial |
$78.79
|
| Rate for Payer: BCN Medicare Advantage |
$139.07
|
| Rate for Payer: Cash Price |
$81.30
|
| Rate for Payer: Cash Price |
$81.30
|
| Rate for Payer: Cofinity Commercial |
$95.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$139.07
|
| Rate for Payer: Healthscope Commercial |
$101.62
|
| Rate for Payer: Healthscope Whirlpool |
$98.57
|
| Rate for Payer: Humana Choice PPO Medicare |
$139.07
|
| Rate for Payer: Mclaren Commercial |
$91.46
|
| Rate for Payer: Mclaren Medicaid |
$76.07
|
| Rate for Payer: Mclaren Medicare |
$139.07
|
| Rate for Payer: Meridian Medicaid |
$79.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$146.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$159.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$86.38
|
| Rate for Payer: PACE Medicare |
$132.12
|
| Rate for Payer: PACE SWMI |
$139.07
|
| Rate for Payer: PHP Commercial |
$152.98
|
| Rate for Payer: PHP Medicaid |
$76.07
|
| Rate for Payer: PHP Medicare Advantage |
$139.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$92.47
|
| Rate for Payer: Priority Health Medicare |
$139.07
|
| Rate for Payer: Priority Health Narrow Network |
$72.15
|
| Rate for Payer: Railroad Medicare Medicare |
$139.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$89.43
|
| Rate for Payer: UHC Medicare Advantage |
$143.24
|
| Rate for Payer: VA VA |
$139.07
|
|
|
HC BLOOD TYPING RH
|
Facility
|
IP
|
$21.83
|
|
|
Service Code
|
CPT 86901
|
| Hospital Charge Code |
30200348
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.28 |
| Max. Negotiated Rate |
$21.83 |
| Rate for Payer: Aetna Commercial |
$19.65
|
| Rate for Payer: ASR ASR |
$21.18
|
| Rate for Payer: BCBS Trust/PPO |
$16.92
|
| Rate for Payer: BCN Commercial |
$16.92
|
| Rate for Payer: Cash Price |
$17.46
|
| Rate for Payer: Cofinity Commercial |
$20.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.46
|
| Rate for Payer: Healthscope Commercial |
$21.83
|
| Rate for Payer: Healthscope Whirlpool |
$21.18
|
| Rate for Payer: Mclaren Commercial |
$19.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19.21
|
|
|
HC BLOOD TYPING RH
|
Facility
|
OP
|
$21.83
|
|
|
Service Code
|
CPT 86901
|
| Hospital Charge Code |
30200348
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.28 |
| Max. Negotiated Rate |
$55.42 |
| Rate for Payer: Aetna Commercial |
$19.65
|
| Rate for Payer: Aetna Medicare |
$35.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$44.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$44.56
|
| Rate for Payer: ASR ASR |
$21.18
|
| Rate for Payer: BCBS Complete |
$20.48
|
| Rate for Payer: BCBS MAPPO |
$35.65
|
| Rate for Payer: BCBS Trust/PPO |
$16.92
|
| Rate for Payer: BCN Commercial |
$16.92
|
| Rate for Payer: BCN Medicare Advantage |
$35.65
|
| Rate for Payer: Cash Price |
$17.46
|
| Rate for Payer: Cash Price |
$17.46
|
| Rate for Payer: Cofinity Commercial |
$20.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.65
|
| Rate for Payer: Healthscope Commercial |
$21.83
|
| Rate for Payer: Healthscope Whirlpool |
$21.18
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.65
|
| Rate for Payer: Mclaren Commercial |
$19.65
|
| Rate for Payer: Mclaren Medicaid |
$19.50
|
| Rate for Payer: Mclaren Medicare |
$35.65
|
| Rate for Payer: Meridian Medicaid |
$20.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$37.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$41.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18.56
|
| Rate for Payer: PACE Medicare |
$33.87
|
| Rate for Payer: PACE SWMI |
$35.65
|
| Rate for Payer: PHP Commercial |
$39.22
|
| Rate for Payer: PHP Medicaid |
$19.50
|
| Rate for Payer: PHP Medicare Advantage |
$35.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$55.42
|
| Rate for Payer: Priority Health Medicare |
$35.65
|
| Rate for Payer: Priority Health Narrow Network |
$44.34
|
| Rate for Payer: Railroad Medicare Medicare |
$35.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19.21
|
| Rate for Payer: UHC Medicare Advantage |
$36.72
|
| Rate for Payer: VA VA |
$35.65
|
|
|
HC BLOOD (WHOLE) FOR TRANSFUSION PER UNIT
|
Facility
|
IP
|
$1,500.00
|
|
|
Service Code
|
HCPCS P9010
|
| Hospital Charge Code |
39000089
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$1,050.00 |
| Max. Negotiated Rate |
$1,500.00 |
| Rate for Payer: Aetna Commercial |
$1,350.00
|
| Rate for Payer: ASR ASR |
$1,455.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,162.95
|
| Rate for Payer: BCN Commercial |
$1,162.95
|
| Rate for Payer: Cash Price |
$1,200.00
|
| Rate for Payer: Cofinity Commercial |
$1,410.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,200.00
|
| Rate for Payer: Healthscope Commercial |
$1,500.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,455.00
|
| Rate for Payer: Mclaren Commercial |
$1,350.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,275.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,050.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,320.00
|
|
|
HC BLOOD (WHOLE) FOR TRANSFUSION PER UNIT
|
Facility
|
OP
|
$1,500.00
|
|
|
Service Code
|
HCPCS P9010
|
| Hospital Charge Code |
39000089
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$103.65 |
| Max. Negotiated Rate |
$1,500.00 |
| Rate for Payer: Aetna Commercial |
$1,350.00
|
| Rate for Payer: Aetna Medicare |
$189.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$236.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$236.85
|
| Rate for Payer: ASR ASR |
$1,455.00
|
| Rate for Payer: BCBS Complete |
$108.84
|
| Rate for Payer: BCBS MAPPO |
$189.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,162.95
|
| Rate for Payer: BCN Commercial |
$1,162.95
|
| Rate for Payer: BCN Medicare Advantage |
$189.48
|
| Rate for Payer: Cash Price |
$1,200.00
|
| Rate for Payer: Cash Price |
$1,200.00
|
| Rate for Payer: Cofinity Commercial |
$1,410.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,200.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$189.48
|
| Rate for Payer: Healthscope Commercial |
$1,500.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,455.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$189.48
|
| Rate for Payer: Mclaren Commercial |
$1,350.00
|
| Rate for Payer: Mclaren Medicaid |
$103.65
|
| Rate for Payer: Mclaren Medicare |
$189.48
|
| Rate for Payer: Meridian Medicaid |
$108.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$198.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$217.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,275.00
|
| Rate for Payer: PACE Medicare |
$180.01
|
| Rate for Payer: PACE SWMI |
$189.48
|
| Rate for Payer: PHP Commercial |
$208.43
|
| Rate for Payer: PHP Medicaid |
$103.65
|
| Rate for Payer: PHP Medicare Advantage |
$189.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,050.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$416.63
|
| Rate for Payer: Priority Health Medicare |
$189.48
|
| Rate for Payer: Priority Health Narrow Network |
$333.30
|
| Rate for Payer: Railroad Medicare Medicare |
$189.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,320.00
|
| Rate for Payer: UHC Medicare Advantage |
$195.16
|
| Rate for Payer: VA VA |
$189.48
|
|
|
HC B.NATRIURETIC PEPTIDE
|
Facility
|
OP
|
$151.20
|
|
|
Service Code
|
HCPCS 83880
|
| Hospital Charge Code |
30100562
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.48 |
| Max. Negotiated Rate |
$199.07 |
| Rate for Payer: Aetna Commercial |
$136.08
|
| Rate for Payer: Aetna Medicare |
$39.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$49.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$49.08
|
| Rate for Payer: ASR ASR |
$146.66
|
| Rate for Payer: BCBS Complete |
$22.55
|
| Rate for Payer: BCBS MAPPO |
$39.26
|
| Rate for Payer: BCBS Trust/PPO |
$117.23
|
| Rate for Payer: BCN Commercial |
$117.23
|
| Rate for Payer: BCN Medicare Advantage |
$39.26
|
| Rate for Payer: Cash Price |
$120.96
|
| Rate for Payer: Cash Price |
$120.96
|
| Rate for Payer: Cofinity Commercial |
$142.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.26
|
| Rate for Payer: Healthscope Commercial |
$151.20
|
| Rate for Payer: Healthscope Whirlpool |
$146.66
|
| Rate for Payer: Humana Choice PPO Medicare |
$39.26
|
| Rate for Payer: Mclaren Commercial |
$136.08
|
| Rate for Payer: Mclaren Medicaid |
$21.48
|
| Rate for Payer: Mclaren Medicare |
$39.26
|
| Rate for Payer: Meridian Medicaid |
$22.55
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$41.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$45.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$128.52
|
| Rate for Payer: PACE Medicare |
$37.30
|
| Rate for Payer: PACE SWMI |
$39.26
|
| Rate for Payer: PHP Commercial |
$43.19
|
| Rate for Payer: PHP Medicaid |
$21.48
|
| Rate for Payer: PHP Medicare Advantage |
$39.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$199.07
|
| Rate for Payer: Priority Health Medicare |
$39.26
|
| Rate for Payer: Priority Health Narrow Network |
$159.26
|
| Rate for Payer: Railroad Medicare Medicare |
$39.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$133.06
|
| Rate for Payer: UHC Medicare Advantage |
$40.44
|
| Rate for Payer: VA VA |
$39.26
|
|
|
HC B.NATRIURETIC PEPTIDE
|
Facility
|
IP
|
$151.20
|
|
|
Service Code
|
HCPCS 83880
|
| Hospital Charge Code |
30100562
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$105.84 |
| Max. Negotiated Rate |
$151.20 |
| Rate for Payer: Aetna Commercial |
$136.08
|
| Rate for Payer: ASR ASR |
$146.66
|
| Rate for Payer: BCBS Trust/PPO |
$117.23
|
| Rate for Payer: BCN Commercial |
$117.23
|
| Rate for Payer: Cash Price |
$120.96
|
| Rate for Payer: Cofinity Commercial |
$142.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.96
|
| Rate for Payer: Healthscope Commercial |
$151.20
|
| Rate for Payer: Healthscope Whirlpool |
$146.66
|
| Rate for Payer: Mclaren Commercial |
$136.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$128.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$133.06
|
|
|
HC BONE CEMENT
|
Facility
|
OP
|
$1,995.52
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27800095
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$798.21 |
| Max. Negotiated Rate |
$1,995.52 |
| Rate for Payer: Aetna Commercial |
$1,795.97
|
| Rate for Payer: ASR ASR |
$1,935.65
|
| Rate for Payer: BCBS Complete |
$798.21
|
| Rate for Payer: BCBS Trust/PPO |
$1,547.13
|
| Rate for Payer: BCN Commercial |
$1,547.13
|
| Rate for Payer: Cash Price |
$1,596.42
|
| Rate for Payer: Cofinity Commercial |
$1,875.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,596.42
|
| Rate for Payer: Healthscope Commercial |
$1,995.52
|
| Rate for Payer: Healthscope Whirlpool |
$1,935.65
|
| Rate for Payer: Mclaren Commercial |
$1,795.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,696.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,396.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,815.92
|
| Rate for Payer: Priority Health Narrow Network |
$1,416.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,756.06
|
|
|
HC BONE CEMENT
|
Facility
|
IP
|
$1,995.52
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27800095
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,396.86 |
| Max. Negotiated Rate |
$1,995.52 |
| Rate for Payer: Aetna Commercial |
$1,795.97
|
| Rate for Payer: ASR ASR |
$1,935.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,547.13
|
| Rate for Payer: BCN Commercial |
$1,547.13
|
| Rate for Payer: Cash Price |
$1,596.42
|
| Rate for Payer: Cofinity Commercial |
$1,875.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,596.42
|
| Rate for Payer: Healthscope Commercial |
$1,995.52
|
| Rate for Payer: Healthscope Whirlpool |
$1,935.65
|
| Rate for Payer: Mclaren Commercial |
$1,795.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,696.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,396.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,756.06
|
|
