|
HC CARDIOLIPIN AB IGA
|
Facility
|
IP
|
$50.17
|
|
|
Service Code
|
CPT 86147
|
| Hospital Charge Code |
30200146
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$35.12 |
| Max. Negotiated Rate |
$50.17 |
| Rate for Payer: Aetna Commercial |
$45.15
|
| Rate for Payer: ASR ASR |
$48.66
|
| Rate for Payer: BCBS Trust/PPO |
$38.90
|
| Rate for Payer: BCN Commercial |
$38.90
|
| Rate for Payer: Cash Price |
$40.14
|
| Rate for Payer: Cofinity Commercial |
$47.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.14
|
| Rate for Payer: Healthscope Commercial |
$50.17
|
| Rate for Payer: Healthscope Whirlpool |
$48.66
|
| Rate for Payer: Mclaren Commercial |
$45.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.15
|
|
|
HC CARDIOLIPIN AB IGG
|
Facility
|
IP
|
$50.17
|
|
|
Service Code
|
CPT 86147
|
| Hospital Charge Code |
30200144
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$35.12 |
| Max. Negotiated Rate |
$50.17 |
| Rate for Payer: Aetna Commercial |
$45.15
|
| Rate for Payer: ASR ASR |
$48.66
|
| Rate for Payer: BCBS Trust/PPO |
$38.90
|
| Rate for Payer: BCN Commercial |
$38.90
|
| Rate for Payer: Cash Price |
$40.14
|
| Rate for Payer: Cofinity Commercial |
$47.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.14
|
| Rate for Payer: Healthscope Commercial |
$50.17
|
| Rate for Payer: Healthscope Whirlpool |
$48.66
|
| Rate for Payer: Mclaren Commercial |
$45.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.15
|
|
|
HC CARDIOLIPIN AB IGG
|
Facility
|
OP
|
$50.17
|
|
|
Service Code
|
CPT 86147
|
| Hospital Charge Code |
30200144
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.92 |
| Max. Negotiated Rate |
$130.33 |
| Rate for Payer: Aetna Commercial |
$45.15
|
| Rate for Payer: Aetna Medicare |
$25.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.81
|
| Rate for Payer: ASR ASR |
$48.66
|
| Rate for Payer: BCBS Complete |
$14.62
|
| Rate for Payer: BCBS MAPPO |
$25.45
|
| Rate for Payer: BCBS Trust/PPO |
$38.90
|
| Rate for Payer: BCN Commercial |
$38.90
|
| Rate for Payer: BCN Medicare Advantage |
$25.45
|
| Rate for Payer: Cash Price |
$40.14
|
| Rate for Payer: Cash Price |
$40.14
|
| Rate for Payer: Cofinity Commercial |
$47.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.45
|
| Rate for Payer: Healthscope Commercial |
$50.17
|
| Rate for Payer: Healthscope Whirlpool |
$48.66
|
| Rate for Payer: Humana Choice PPO Medicare |
$25.45
|
| Rate for Payer: Mclaren Commercial |
$45.15
|
| Rate for Payer: Mclaren Medicaid |
$13.92
|
| Rate for Payer: Mclaren Medicare |
$25.45
|
| Rate for Payer: Meridian Medicaid |
$14.62
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$26.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.64
|
| Rate for Payer: PACE Medicare |
$24.18
|
| Rate for Payer: PACE SWMI |
$25.45
|
| Rate for Payer: PHP Commercial |
$28.00
|
| Rate for Payer: PHP Medicaid |
$13.92
|
| Rate for Payer: PHP Medicare Advantage |
$25.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$130.33
|
| Rate for Payer: Priority Health Medicare |
$25.45
|
| Rate for Payer: Priority Health Narrow Network |
$104.26
|
| Rate for Payer: Railroad Medicare Medicare |
$25.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.15
|
| Rate for Payer: UHC Medicare Advantage |
$26.21
|
| Rate for Payer: VA VA |
$25.45
|
|
|
HC CARDIOLIPIN AB IGM
|
Facility
|
IP
|
$50.17
|
|
|
Service Code
|
CPT 86147
|
| Hospital Charge Code |
30200145
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$35.12 |
| Max. Negotiated Rate |
$50.17 |
| Rate for Payer: Aetna Commercial |
$45.15
|
| Rate for Payer: ASR ASR |
$48.66
|
| Rate for Payer: BCBS Trust/PPO |
$38.90
|
| Rate for Payer: BCN Commercial |
$38.90
|
| Rate for Payer: Cash Price |
$40.14
|
| Rate for Payer: Cofinity Commercial |
$47.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.14
|
| Rate for Payer: Healthscope Commercial |
$50.17
|
| Rate for Payer: Healthscope Whirlpool |
$48.66
|
| Rate for Payer: Mclaren Commercial |
$45.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.15
|
|
|
HC CARDIOLIPIN AB IGM
|
Facility
|
OP
|
$50.17
|
|
|
Service Code
|
CPT 86147
|
| Hospital Charge Code |
30200145
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.92 |
| Max. Negotiated Rate |
$130.33 |
| Rate for Payer: Aetna Commercial |
$45.15
|
| Rate for Payer: Aetna Medicare |
$25.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.81
|
| Rate for Payer: ASR ASR |
$48.66
|
| Rate for Payer: BCBS Complete |
$14.62
|
| Rate for Payer: BCBS MAPPO |
$25.45
|
| Rate for Payer: BCBS Trust/PPO |
$38.90
|
| Rate for Payer: BCN Commercial |
$38.90
|
| Rate for Payer: BCN Medicare Advantage |
$25.45
|
| Rate for Payer: Cash Price |
$40.14
|
| Rate for Payer: Cash Price |
$40.14
|
| Rate for Payer: Cofinity Commercial |
$47.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.45
|
| Rate for Payer: Healthscope Commercial |
$50.17
|
| Rate for Payer: Healthscope Whirlpool |
$48.66
|
| Rate for Payer: Humana Choice PPO Medicare |
$25.45
|
| Rate for Payer: Mclaren Commercial |
$45.15
|
| Rate for Payer: Mclaren Medicaid |
$13.92
|
| Rate for Payer: Mclaren Medicare |
$25.45
|
| Rate for Payer: Meridian Medicaid |
$14.62
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$26.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.64
|
| Rate for Payer: PACE Medicare |
$24.18
|
| Rate for Payer: PACE SWMI |
$25.45
|
| Rate for Payer: PHP Commercial |
$28.00
|
| Rate for Payer: PHP Medicaid |
$13.92
|
| Rate for Payer: PHP Medicare Advantage |
$25.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$130.33
|
| Rate for Payer: Priority Health Medicare |
$25.45
|
| Rate for Payer: Priority Health Narrow Network |
$104.26
|
| Rate for Payer: Railroad Medicare Medicare |
$25.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.15
|
| Rate for Payer: UHC Medicare Advantage |
$26.21
|
| Rate for Payer: VA VA |
$25.45
|
|
|
HC CARDIOLITE/MIRALUMA STUDY
|
Facility
|
IP
|
$505.43
|
|
|
Service Code
|
HCPCS A9500
|
| Hospital Charge Code |
34300001
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$353.80 |
| Max. Negotiated Rate |
$505.43 |
| Rate for Payer: Aetna Commercial |
$454.89
|
| Rate for Payer: ASR ASR |
$490.27
|
| Rate for Payer: BCBS Trust/PPO |
$391.86
|
| Rate for Payer: BCN Commercial |
$391.86
|
| Rate for Payer: Cash Price |
$404.34
|
| Rate for Payer: Cofinity Commercial |
$475.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$404.34
|
| Rate for Payer: Healthscope Commercial |
$505.43
|
| Rate for Payer: Healthscope Whirlpool |
$490.27
|
| Rate for Payer: Mclaren Commercial |
$454.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$429.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$353.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$444.78
|
|
|
HC CARDIOLITE/MIRALUMA STUDY
|
Facility
|
OP
|
$505.43
|
|
|
Service Code
|
HCPCS A9500
|
| Hospital Charge Code |
34300001
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$202.17 |
| Max. Negotiated Rate |
$505.43 |
| Rate for Payer: Aetna Commercial |
$454.89
|
| Rate for Payer: ASR ASR |
$490.27
|
| Rate for Payer: BCBS Complete |
$202.17
|
| Rate for Payer: BCBS Trust/PPO |
$391.86
|
| Rate for Payer: BCN Commercial |
$391.86
|
| Rate for Payer: Cash Price |
$404.34
|
| Rate for Payer: Cash Price |
$404.34
|
| Rate for Payer: Cofinity Commercial |
$475.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$404.34
|
| Rate for Payer: Healthscope Commercial |
$505.43
|
| Rate for Payer: Healthscope Whirlpool |
$490.27
|
| Rate for Payer: Mclaren Commercial |
$454.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$429.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$353.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$258.08
|
| Rate for Payer: Priority Health Narrow Network |
$206.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$444.78
|
|
|
HC CARDIOPULMONARY EX TEST
|
Facility
|
IP
|
$1,100.68
|
|
|
Service Code
|
CPT 94621
|
| Hospital Charge Code |
46000007
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$770.48 |
| Max. Negotiated Rate |
$1,100.68 |
| Rate for Payer: Aetna Commercial |
$990.61
|
| Rate for Payer: ASR ASR |
$1,067.66
|
| Rate for Payer: BCBS Trust/PPO |
$853.36
|
| Rate for Payer: BCN Commercial |
$853.36
|
| Rate for Payer: Cash Price |
$880.54
|
| Rate for Payer: Cofinity Commercial |
$1,034.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$880.54
|
| Rate for Payer: Healthscope Commercial |
$1,100.68
|
| Rate for Payer: Healthscope Whirlpool |
$1,067.66
|
| Rate for Payer: Mclaren Commercial |
$990.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$935.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$770.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$968.60
|
|
|
HC CARDIOPULMONARY EX TEST
|
Facility
|
OP
|
$1,100.68
|
|
|
Service Code
|
CPT 94621
|
| Hospital Charge Code |
46000007
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$152.61 |
| Max. Negotiated Rate |
$1,100.68 |
| Rate for Payer: Aetna Commercial |
$990.61
|
| Rate for Payer: Aetna Medicare |
$279.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$348.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$348.75
|
| Rate for Payer: ASR ASR |
$1,067.66
|
| Rate for Payer: BCBS Complete |
$160.26
|
| Rate for Payer: BCBS MAPPO |
$279.00
|
| Rate for Payer: BCBS Trust/PPO |
$853.36
|
| Rate for Payer: BCN Commercial |
$853.36
|
| Rate for Payer: BCN Medicare Advantage |
$279.00
|
| Rate for Payer: Cash Price |
$880.54
|
| Rate for Payer: Cash Price |
$880.54
|
| Rate for Payer: Cofinity Commercial |
$1,034.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$880.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$279.00
|
| Rate for Payer: Healthscope Commercial |
$1,100.68
|
| Rate for Payer: Healthscope Whirlpool |
$1,067.66
|
| Rate for Payer: Humana Choice PPO Medicare |
$279.00
|
| Rate for Payer: Mclaren Commercial |
$990.61
|
| Rate for Payer: Mclaren Medicaid |
$152.61
|
| Rate for Payer: Mclaren Medicare |
$279.00
|
| Rate for Payer: Meridian Medicaid |
$160.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$292.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$320.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$935.58
|
| Rate for Payer: PACE Medicare |
$265.05
|
| Rate for Payer: PACE SWMI |
$279.00
|
| Rate for Payer: PHP Commercial |
$306.90
|
| Rate for Payer: PHP Medicaid |
$152.61
|
| Rate for Payer: PHP Medicare Advantage |
$279.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$152.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$770.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$425.86
|
| Rate for Payer: Priority Health Medicare |
$279.00
|
| Rate for Payer: Priority Health Narrow Network |
$340.69
|
| Rate for Payer: Railroad Medicare Medicare |
$279.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$968.60
|
| Rate for Payer: UHC Medicare Advantage |
$287.37
|
| Rate for Payer: VA VA |
$279.00
|
|
|
HC CARDIOVERSION
|
Facility
|
OP
|
$1,174.36
|
|
|
Service Code
|
CPT 92960
|
| Hospital Charge Code |
48000002
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$316.44 |
| Max. Negotiated Rate |
$1,174.36 |
| Rate for Payer: Aetna Commercial |
$1,056.92
|
| Rate for Payer: Aetna Medicare |
$578.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$723.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$723.12
|
| Rate for Payer: ASR ASR |
$1,139.13
|
| Rate for Payer: BCBS Complete |
$332.29
|
| Rate for Payer: BCBS MAPPO |
$578.50
|
| Rate for Payer: BCBS Trust/PPO |
$910.48
|
| Rate for Payer: BCN Commercial |
$910.48
|
| Rate for Payer: BCN Medicare Advantage |
$578.50
|
| Rate for Payer: Cash Price |
$939.49
|
| Rate for Payer: Cash Price |
$939.49
|
| Rate for Payer: Cofinity Commercial |
$1,103.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$939.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$578.50
|
| Rate for Payer: Healthscope Commercial |
$1,174.36
|
| Rate for Payer: Healthscope Whirlpool |
$1,139.13
|
| Rate for Payer: Humana Choice PPO Medicare |
$578.50
|
| Rate for Payer: Mclaren Commercial |
$1,056.92
|
| Rate for Payer: Mclaren Medicaid |
$316.44
|
| Rate for Payer: Mclaren Medicare |
$578.50
|
| Rate for Payer: Meridian Medicaid |
$332.29
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$607.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$665.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$998.21
|
| Rate for Payer: PACE Medicare |
$549.58
|
| Rate for Payer: PACE SWMI |
$578.50
|
| Rate for Payer: PHP Commercial |
$636.35
|
| Rate for Payer: PHP Medicaid |
$316.44
|
| Rate for Payer: PHP Medicare Advantage |
$578.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$316.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$822.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$763.48
|
| Rate for Payer: Priority Health Medicare |
$578.50
|
| Rate for Payer: Priority Health Narrow Network |
$610.78
|
| Rate for Payer: Railroad Medicare Medicare |
$578.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,033.44
|
| Rate for Payer: UHC Medicare Advantage |
$595.86
|
| Rate for Payer: VA VA |
$578.50
|
|
|
HC CARDIOVERSION
|
Facility
|
IP
|
$1,174.36
|
|
|
Service Code
|
CPT 92960
|
| Hospital Charge Code |
48000002
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$822.05 |
| Max. Negotiated Rate |
$1,174.36 |
| Rate for Payer: Aetna Commercial |
$1,056.92
|
| Rate for Payer: ASR ASR |
$1,139.13
|
| Rate for Payer: BCBS Trust/PPO |
$910.48
|
| Rate for Payer: BCN Commercial |
$910.48
|
| Rate for Payer: Cash Price |
$939.49
|
| Rate for Payer: Cofinity Commercial |
$1,103.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$939.49
|
| Rate for Payer: Healthscope Commercial |
$1,174.36
|
| Rate for Payer: Healthscope Whirlpool |
$1,139.13
|
| Rate for Payer: Mclaren Commercial |
$1,056.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$998.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$822.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,033.44
|
|
|
HC CARDIOVERSION EXT
|
Facility
|
OP
|
$978.63
|
|
| Hospital Charge Code |
45000034
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$391.45 |
| Max. Negotiated Rate |
$978.63 |
| Rate for Payer: Aetna Commercial |
$880.77
|
| Rate for Payer: ASR ASR |
$949.27
|
| Rate for Payer: BCBS Complete |
$391.45
|
| Rate for Payer: BCBS Trust/PPO |
$758.73
|
| Rate for Payer: BCN Commercial |
$758.73
|
| Rate for Payer: Cash Price |
$782.90
|
| Rate for Payer: Cofinity Commercial |
$919.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$782.90
|
| Rate for Payer: Healthscope Commercial |
$978.63
|
| Rate for Payer: Healthscope Whirlpool |
$949.27
|
| Rate for Payer: Mclaren Commercial |
$880.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$831.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$685.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$890.55
|
| Rate for Payer: Priority Health Narrow Network |
$694.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$861.19
|
|
|
HC CARDIOVERSION EXT
|
Facility
|
IP
|
$978.63
|
|
| Hospital Charge Code |
45000034
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$685.04 |
| Max. Negotiated Rate |
$978.63 |
| Rate for Payer: Aetna Commercial |
$880.77
|
| Rate for Payer: ASR ASR |
$949.27
|
| Rate for Payer: BCBS Trust/PPO |
$758.73
|
| Rate for Payer: BCN Commercial |
$758.73
|
| Rate for Payer: Cash Price |
$782.90
|
| Rate for Payer: Cofinity Commercial |
$919.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$782.90
|
| Rate for Payer: Healthscope Commercial |
$978.63
|
| Rate for Payer: Healthscope Whirlpool |
$949.27
|
| Rate for Payer: Mclaren Commercial |
$880.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$831.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$685.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$861.19
|
|
|
HC CAREGIVER HEALTH RISK ASSMT
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 96161
|
| Hospital Charge Code |
51000095
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$13.95 |
| Max. Negotiated Rate |
$52.02 |
| Rate for Payer: Aetna Commercial |
$46.82
|
| Rate for Payer: Aetna Medicare |
$25.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.89
|
| Rate for Payer: ASR ASR |
$50.46
|
| Rate for Payer: BCBS Complete |
$14.65
|
| Rate for Payer: BCBS MAPPO |
$25.51
|
| Rate for Payer: BCBS Trust/PPO |
$40.33
|
| Rate for Payer: BCN Commercial |
$40.33
|
| Rate for Payer: BCN Medicare Advantage |
$25.51
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$48.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.51
|
| Rate for Payer: Healthscope Commercial |
$52.02
|
| Rate for Payer: Healthscope Whirlpool |
$50.46
|
| Rate for Payer: Humana Choice PPO Medicare |
$25.51
|
| Rate for Payer: Mclaren Commercial |
$46.82
|
| Rate for Payer: Mclaren Medicaid |
$13.95
|
| Rate for Payer: Mclaren Medicare |
$25.51
|
| Rate for Payer: Meridian Medicaid |
$14.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$26.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$44.22
|
| Rate for Payer: PACE Medicare |
$24.23
|
| Rate for Payer: PACE SWMI |
$25.51
|
| Rate for Payer: PHP Commercial |
$28.06
|
| Rate for Payer: PHP Medicaid |
$13.95
|
| Rate for Payer: PHP Medicare Advantage |
$25.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$47.34
|
| Rate for Payer: Priority Health Medicare |
$25.51
|
| Rate for Payer: Priority Health Narrow Network |
$36.93
|
| Rate for Payer: Railroad Medicare Medicare |
$25.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.78
|
| Rate for Payer: UHC Medicare Advantage |
$26.28
|
| Rate for Payer: VA VA |
$25.51
|
|
|
HC CAREGIVER HEALTH RISK ASSMT
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 96161
|
| Hospital Charge Code |
51000095
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$36.41 |
| Max. Negotiated Rate |
$52.02 |
| Rate for Payer: Aetna Commercial |
$46.82
|
| Rate for Payer: ASR ASR |
$50.46
|
| Rate for Payer: BCBS Trust/PPO |
$40.33
|
| Rate for Payer: BCN Commercial |
$40.33
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$48.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$52.02
|
| Rate for Payer: Healthscope Whirlpool |
$50.46
|
| Rate for Payer: Mclaren Commercial |
$46.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$44.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.78
|
|
|
HC CAREGIVER TRAINING 1ST 30 MIN
|
Facility
|
IP
|
$127.00
|
|
|
Service Code
|
CPT 97550
|
| Hospital Charge Code |
42000065
|
| Min. Negotiated Rate |
$88.90 |
| Max. Negotiated Rate |
$127.00 |
| Rate for Payer: Aetna Commercial |
$114.30
|
| Rate for Payer: ASR ASR |
$123.19
|
| Rate for Payer: BCBS Trust/PPO |
$98.46
|
| Rate for Payer: BCN Commercial |
$98.46
|
| Rate for Payer: Cash Price |
$101.60
|
| Rate for Payer: Cofinity Commercial |
$119.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$101.60
|
| Rate for Payer: Healthscope Commercial |
$127.00
|
| Rate for Payer: Healthscope Whirlpool |
$123.19
|
| Rate for Payer: Mclaren Commercial |
$114.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$107.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$88.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$111.76
|
|
|
HC CAREGIVER TRAINING 1ST 30 MIN
|
Facility
|
OP
|
$127.00
|
|
|
Service Code
|
CPT 97550
|
| Hospital Charge Code |
42000065
|
| Min. Negotiated Rate |
$50.80 |
| Max. Negotiated Rate |
$127.00 |
| Rate for Payer: Aetna Commercial |
$114.30
|
| Rate for Payer: ASR ASR |
$123.19
|
| Rate for Payer: BCBS Complete |
$50.80
|
| Rate for Payer: BCBS Trust/PPO |
$98.46
|
| Rate for Payer: BCN Commercial |
$98.46
|
| Rate for Payer: Cash Price |
$101.60
|
| Rate for Payer: Cofinity Commercial |
$119.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$101.60
|
| Rate for Payer: Healthscope Commercial |
$127.00
|
| Rate for Payer: Healthscope Whirlpool |
$123.19
|
| Rate for Payer: Mclaren Commercial |
$114.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$107.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$88.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$115.57
|
| Rate for Payer: Priority Health Narrow Network |
$90.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$111.76
|
|
|
HC CAREGIVER TRAINING EA ADDL 15 MIN
|
Facility
|
IP
|
$60.00
|
|
|
Service Code
|
CPT 97551
|
| Hospital Charge Code |
42000066
|
| Min. Negotiated Rate |
$42.00 |
| Max. Negotiated Rate |
$60.00 |
| Rate for Payer: Aetna Commercial |
$54.00
|
| Rate for Payer: ASR ASR |
$58.20
|
| Rate for Payer: BCBS Trust/PPO |
$46.52
|
| Rate for Payer: BCN Commercial |
$46.52
|
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Cofinity Commercial |
$56.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.00
|
| Rate for Payer: Healthscope Commercial |
$60.00
|
| Rate for Payer: Healthscope Whirlpool |
$58.20
|
| Rate for Payer: Mclaren Commercial |
$54.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$52.80
|
|
|
HC CAREGIVER TRAINING EA ADDL 15 MIN
|
Facility
|
OP
|
$60.00
|
|
|
Service Code
|
CPT 97551
|
| Hospital Charge Code |
42000066
|
| Min. Negotiated Rate |
$24.00 |
| Max. Negotiated Rate |
$60.00 |
| Rate for Payer: Aetna Commercial |
$54.00
|
| Rate for Payer: ASR ASR |
$58.20
|
| Rate for Payer: BCBS Complete |
$24.00
|
| Rate for Payer: BCBS Trust/PPO |
$46.52
|
| Rate for Payer: BCN Commercial |
$46.52
|
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Cofinity Commercial |
$56.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.00
|
| Rate for Payer: Healthscope Commercial |
$60.00
|
| Rate for Payer: Healthscope Whirlpool |
$58.20
|
| Rate for Payer: Mclaren Commercial |
$54.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$54.60
|
| Rate for Payer: Priority Health Narrow Network |
$42.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$52.80
|
|
|
HC CARE MGMT SERVICES BEHAVIORAL HLTH COND 20 MINS
|
Facility
|
IP
|
$80.58
|
|
|
Service Code
|
CPT 99484
|
| Hospital Charge Code |
51000107
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$56.41 |
| Max. Negotiated Rate |
$80.58 |
| Rate for Payer: Aetna Commercial |
$72.52
|
| Rate for Payer: ASR ASR |
$78.16
|
| Rate for Payer: BCBS Trust/PPO |
$62.47
|
| Rate for Payer: BCN Commercial |
$62.47
|
| Rate for Payer: Cash Price |
$64.46
|
| Rate for Payer: Cofinity Commercial |
$75.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.46
|
| Rate for Payer: Healthscope Commercial |
$80.58
|
| Rate for Payer: Healthscope Whirlpool |
$78.16
|
| Rate for Payer: Mclaren Commercial |
$72.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$68.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$70.91
|
|
|
HC CARE MGMT SERVICES BEHAVIORAL HLTH COND 20 MINS
|
Facility
|
OP
|
$80.58
|
|
|
Service Code
|
CPT 99484
|
| Hospital Charge Code |
51000107
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$13.95 |
| Max. Negotiated Rate |
$80.58 |
| Rate for Payer: Aetna Commercial |
$72.52
|
| Rate for Payer: Aetna Medicare |
$25.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.89
|
| Rate for Payer: ASR ASR |
$78.16
|
| Rate for Payer: BCBS Complete |
$14.65
|
| Rate for Payer: BCBS MAPPO |
$25.51
|
| Rate for Payer: BCBS Trust/PPO |
$62.47
|
| Rate for Payer: BCN Commercial |
$62.47
|
| Rate for Payer: BCN Medicare Advantage |
$25.51
|
| Rate for Payer: Cash Price |
$64.46
|
| Rate for Payer: Cash Price |
$64.46
|
| Rate for Payer: Cofinity Commercial |
$75.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.51
|
| Rate for Payer: Healthscope Commercial |
$80.58
|
| Rate for Payer: Healthscope Whirlpool |
$78.16
|
| Rate for Payer: Humana Choice PPO Medicare |
$25.51
|
| Rate for Payer: Mclaren Commercial |
$72.52
|
| Rate for Payer: Mclaren Medicaid |
$13.95
|
| Rate for Payer: Mclaren Medicare |
$25.51
|
| Rate for Payer: Meridian Medicaid |
$14.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$26.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$68.49
|
| Rate for Payer: PACE Medicare |
$24.23
|
| Rate for Payer: PACE SWMI |
$25.51
|
| Rate for Payer: PHP Commercial |
$28.06
|
| Rate for Payer: PHP Medicaid |
$13.95
|
| Rate for Payer: PHP Medicare Advantage |
$25.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$32.54
|
| Rate for Payer: Priority Health Medicare |
$25.51
|
| Rate for Payer: Priority Health Narrow Network |
$26.03
|
| Rate for Payer: Railroad Medicare Medicare |
$25.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$70.91
|
| Rate for Payer: UHC Medicare Advantage |
$26.28
|
| Rate for Payer: VA VA |
$25.51
|
|
|
HC CARNITINE
|
Facility
|
OP
|
$58.00
|
|
|
Service Code
|
CPT 82379
|
| Hospital Charge Code |
30100136
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.23 |
| Max. Negotiated Rate |
$212.42 |
| Rate for Payer: Aetna Commercial |
$52.20
|
| Rate for Payer: Aetna Medicare |
$16.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.09
|
| Rate for Payer: ASR ASR |
$56.26
|
| Rate for Payer: BCBS Complete |
$9.69
|
| Rate for Payer: BCBS MAPPO |
$16.87
|
| Rate for Payer: BCBS Trust/PPO |
$44.97
|
| Rate for Payer: BCN Commercial |
$44.97
|
| Rate for Payer: BCN Medicare Advantage |
$16.87
|
| Rate for Payer: Cash Price |
$46.40
|
| Rate for Payer: Cash Price |
$46.40
|
| Rate for Payer: Cofinity Commercial |
$54.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.87
|
| Rate for Payer: Healthscope Commercial |
$58.00
|
| Rate for Payer: Healthscope Whirlpool |
$56.26
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.87
|
| Rate for Payer: Mclaren Commercial |
$52.20
|
| Rate for Payer: Mclaren Medicaid |
$9.23
|
| Rate for Payer: Mclaren Medicare |
$16.87
|
| Rate for Payer: Meridian Medicaid |
$9.69
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$17.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$49.30
|
| Rate for Payer: PACE Medicare |
$16.03
|
| Rate for Payer: PACE SWMI |
$16.87
|
| Rate for Payer: PHP Commercial |
$18.56
|
| Rate for Payer: PHP Medicaid |
$9.23
|
| Rate for Payer: PHP Medicare Advantage |
$16.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$212.42
|
| Rate for Payer: Priority Health Medicare |
$16.87
|
| Rate for Payer: Priority Health Narrow Network |
$169.94
|
| Rate for Payer: Railroad Medicare Medicare |
$16.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$51.04
|
| Rate for Payer: UHC Medicare Advantage |
$17.38
|
| Rate for Payer: VA VA |
$16.87
|
|
|
HC CARNITINE
|
Facility
|
IP
|
$58.00
|
|
|
Service Code
|
CPT 82379
|
| Hospital Charge Code |
30100136
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$40.60 |
| Max. Negotiated Rate |
$58.00 |
| Rate for Payer: Aetna Commercial |
$52.20
|
| Rate for Payer: ASR ASR |
$56.26
|
| Rate for Payer: BCBS Trust/PPO |
$44.97
|
| Rate for Payer: BCN Commercial |
$44.97
|
| Rate for Payer: Cash Price |
$46.40
|
| Rate for Payer: Cofinity Commercial |
$54.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.40
|
| Rate for Payer: Healthscope Commercial |
$58.00
|
| Rate for Payer: Healthscope Whirlpool |
$56.26
|
| Rate for Payer: Mclaren Commercial |
$52.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$49.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$51.04
|
|
|
HC CAR OBSERVATION PER HOUR
|
Facility
|
IP
|
$134.33
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200010
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$94.03 |
| Max. Negotiated Rate |
$134.33 |
| Rate for Payer: Aetna Commercial |
$120.90
|
| Rate for Payer: ASR ASR |
$130.30
|
| Rate for Payer: BCBS Trust/PPO |
$104.15
|
| Rate for Payer: BCN Commercial |
$104.15
|
| Rate for Payer: Cash Price |
$107.46
|
| Rate for Payer: Cofinity Commercial |
$126.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.46
|
| Rate for Payer: Healthscope Commercial |
$134.33
|
| Rate for Payer: Healthscope Whirlpool |
$130.30
|
| Rate for Payer: Mclaren Commercial |
$120.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$114.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$118.21
|
|
|
HC CAR OBSERVATION PER HOUR
|
Facility
|
OP
|
$134.33
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200010
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$46.14 |
| Max. Negotiated Rate |
$134.33 |
| Rate for Payer: Aetna Commercial |
$120.90
|
| Rate for Payer: ASR ASR |
$130.30
|
| Rate for Payer: BCBS Complete |
$53.73
|
| Rate for Payer: BCBS Trust/PPO |
$104.15
|
| Rate for Payer: BCN Commercial |
$104.15
|
| Rate for Payer: Cash Price |
$107.46
|
| Rate for Payer: Cash Price |
$107.46
|
| Rate for Payer: Cofinity Commercial |
$126.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.46
|
| Rate for Payer: Healthscope Commercial |
$134.33
|
| Rate for Payer: Healthscope Whirlpool |
$130.30
|
| Rate for Payer: Mclaren Commercial |
$120.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$114.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$57.68
|
| Rate for Payer: Priority Health Narrow Network |
$46.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$118.21
|
|
