|
HC ADVANCE CARE PLANNING EA ADDL 30 MIN
|
Facility
|
OP
|
$33.96
|
|
|
Service Code
|
CPT 99498
|
| Hospital Charge Code |
51000091
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$12.57 |
| Max. Negotiated Rate |
$33.96 |
| Rate for Payer: Aetna Commercial |
$30.56
|
| Rate for Payer: Aetna Medicare |
$12.57
|
| Rate for Payer: ASR ASR |
$32.94
|
| Rate for Payer: BCBS Complete |
$13.58
|
| Rate for Payer: BCBS Trust/PPO |
$28.00
|
| Rate for Payer: BCN Commercial |
$28.00
|
| Rate for Payer: Cash Price |
$27.17
|
| Rate for Payer: Cofinity Commercial |
$31.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.17
|
| Rate for Payer: Healthscope Commercial |
$32.94
|
| Rate for Payer: Healthscope Whirlpool |
$33.96
|
| Rate for Payer: Mclaren Commercial |
$30.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.87
|
| Rate for Payer: Nomi Health Commercial |
$27.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$29.76
|
| Rate for Payer: Priority Health Narrow Network |
$23.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$29.88
|
|
|
HC ADVANCE CARE PLANNING FIRST 30 MIN
|
Facility
|
OP
|
$33.96
|
|
|
Service Code
|
CPT 99497
|
| Hospital Charge Code |
51000090
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$23.81 |
| Max. Negotiated Rate |
$156.89 |
| Rate for Payer: Aetna Commercial |
$30.56
|
| Rate for Payer: Aetna Medicare |
$101.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$126.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$126.53
|
| Rate for Payer: ASR ASR |
$32.94
|
| Rate for Payer: BCBS Complete |
$55.59
|
| Rate for Payer: BCBS MAPPO |
$101.22
|
| Rate for Payer: BCBS Trust/PPO |
$28.00
|
| Rate for Payer: BCN Commercial |
$28.00
|
| Rate for Payer: BCN Medicare Advantage |
$101.22
|
| Rate for Payer: Cash Price |
$27.17
|
| Rate for Payer: Cash Price |
$27.17
|
| Rate for Payer: Cofinity Commercial |
$31.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.22
|
| Rate for Payer: Healthscope Commercial |
$32.94
|
| Rate for Payer: Healthscope Whirlpool |
$33.96
|
| Rate for Payer: Humana Choice PPO Medicare |
$101.22
|
| Rate for Payer: Mclaren Commercial |
$30.56
|
| Rate for Payer: Mclaren Medicaid |
$101.22
|
| Rate for Payer: Mclaren Medicare |
$101.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$106.28
|
| Rate for Payer: Meridian Medicaid |
$55.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$116.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$111.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.87
|
| Rate for Payer: Nomi Health Commercial |
$27.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.47
|
| Rate for Payer: PACE Medicare |
$96.16
|
| Rate for Payer: PACE SWMI |
$101.22
|
| Rate for Payer: PHP Commercial |
$111.34
|
| Rate for Payer: PHP Medicaid |
$54.25
|
| Rate for Payer: PHP Medicare Advantage |
$101.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$52.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$29.76
|
| Rate for Payer: Priority Health Medicare |
$101.22
|
| Rate for Payer: Priority Health Narrow Network |
$23.81
|
| Rate for Payer: Railroad Medicare Medicare |
$101.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$29.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$101.22
|
| Rate for Payer: UHC Exchange |
$156.89
|
| Rate for Payer: UHC Medicaid |
$52.94
|
| Rate for Payer: UHCCP DNSP |
$101.22
|
| Rate for Payer: UHCCP Medicaid |
$52.94
|
| Rate for Payer: VA VA |
$101.22
|
|
|
HC ADVANCE CARE PLANNING FIRST 30 MIN
|
Facility
|
IP
|
$33.96
|
|
|
Service Code
|
CPT 99497
|
| Hospital Charge Code |
51000090
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$25.47 |
| Max. Negotiated Rate |
$33.96 |
| Rate for Payer: Aetna Commercial |
$30.56
|
| Rate for Payer: ASR ASR |
$32.94
|
| Rate for Payer: BCBS Trust/PPO |
$27.89
|
| Rate for Payer: BCN Commercial |
$27.89
|
| Rate for Payer: Cash Price |
$27.17
|
| Rate for Payer: Cofinity Commercial |
$31.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.17
|
| Rate for Payer: Healthscope Commercial |
$32.94
|
| Rate for Payer: Healthscope Whirlpool |
$33.96
|
| Rate for Payer: Mclaren Commercial |
$30.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.87
|
| Rate for Payer: Nomi Health Commercial |
$27.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$29.88
|
|
|
HC AEP HEARING STATUS DETER BROADBAND STIMULI I&R
|
Facility
|
IP
|
$164.38
|
|
|
Service Code
|
CPT 92651
|
| Hospital Charge Code |
76100497
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$123.28 |
| Max. Negotiated Rate |
$164.38 |
| Rate for Payer: Aetna Commercial |
$147.94
|
| Rate for Payer: ASR ASR |
$159.45
|
| Rate for Payer: BCBS Trust/PPO |
$134.99
|
| Rate for Payer: BCN Commercial |
$134.99
|
| Rate for Payer: Cash Price |
$131.50
|
| Rate for Payer: Cofinity Commercial |
$154.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$131.50
|
| Rate for Payer: Healthscope Commercial |
$159.45
|
| Rate for Payer: Healthscope Whirlpool |
$164.38
|
| Rate for Payer: Mclaren Commercial |
$147.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$139.72
|
| Rate for Payer: Nomi Health Commercial |
$134.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$123.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$144.65
|
|
|
HC AEP HEARING STATUS DETER BROADBAND STIMULI I&R
|
Facility
|
OP
|
$164.38
|
|
|
Service Code
|
CPT 92651
|
| Hospital Charge Code |
76100497
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$112.52 |
| Max. Negotiated Rate |
$333.48 |
| Rate for Payer: Aetna Commercial |
$147.94
|
| Rate for Payer: Aetna Medicare |
$215.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$268.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$268.94
|
| Rate for Payer: ASR ASR |
$159.45
|
| Rate for Payer: BCBS Complete |
$118.16
|
| Rate for Payer: BCBS MAPPO |
$215.15
|
| Rate for Payer: BCBS Trust/PPO |
$135.53
|
| Rate for Payer: BCN Commercial |
$135.53
|
| Rate for Payer: BCN Medicare Advantage |
$215.15
|
| Rate for Payer: Cash Price |
$131.50
|
| Rate for Payer: Cash Price |
$131.50
|
| Rate for Payer: Cofinity Commercial |
$154.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$131.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$215.15
|
| Rate for Payer: Healthscope Commercial |
$159.45
|
| Rate for Payer: Healthscope Whirlpool |
$164.38
|
| Rate for Payer: Humana Choice PPO Medicare |
$215.15
|
| Rate for Payer: Mclaren Commercial |
$147.94
|
| Rate for Payer: Mclaren Medicaid |
$215.15
|
| Rate for Payer: Mclaren Medicare |
$215.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$225.91
|
| Rate for Payer: Meridian Medicaid |
$118.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$247.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$236.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$139.72
|
| Rate for Payer: Nomi Health Commercial |
$134.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$123.28
|
| Rate for Payer: PACE Medicare |
$204.39
|
| Rate for Payer: PACE SWMI |
$215.15
|
| Rate for Payer: PHP Commercial |
$236.66
|
| Rate for Payer: PHP Medicaid |
$115.32
|
| Rate for Payer: PHP Medicare Advantage |
$215.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$144.03
|
| Rate for Payer: Priority Health Medicare |
$215.15
|
| Rate for Payer: Priority Health Narrow Network |
$115.23
|
| Rate for Payer: Railroad Medicare Medicare |
$215.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$144.65
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$215.15
|
| Rate for Payer: UHC Exchange |
$333.48
|
| Rate for Payer: UHC Medicaid |
$112.52
|
| Rate for Payer: UHCCP DNSP |
$215.15
|
| Rate for Payer: UHCCP Medicaid |
$112.52
|
| Rate for Payer: VA VA |
$215.15
|
|
|
HC AEP THRESHOLD ESTIMATION MLT FREQUENCIES I&R
|
Facility
|
OP
|
$292.35
|
|
|
Service Code
|
CPT 92652
|
| Hospital Charge Code |
47100401
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$112.52 |
| Max. Negotiated Rate |
$333.48 |
| Rate for Payer: Aetna Commercial |
$263.12
|
| Rate for Payer: Aetna Medicare |
$215.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$268.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$268.94
|
| Rate for Payer: ASR ASR |
$283.58
|
| Rate for Payer: BCBS Complete |
$118.16
|
| Rate for Payer: BCBS MAPPO |
$215.15
|
| Rate for Payer: BCBS Trust/PPO |
$241.04
|
| Rate for Payer: BCN Commercial |
$241.04
|
| Rate for Payer: BCN Medicare Advantage |
$215.15
|
| Rate for Payer: Cash Price |
$233.88
|
| Rate for Payer: Cash Price |
$233.88
|
| Rate for Payer: Cofinity Commercial |
$274.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$233.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$215.15
|
| Rate for Payer: Healthscope Commercial |
$283.58
|
| Rate for Payer: Healthscope Whirlpool |
$292.35
|
| Rate for Payer: Humana Choice PPO Medicare |
$215.15
|
| Rate for Payer: Mclaren Commercial |
$263.12
|
| Rate for Payer: Mclaren Medicaid |
$215.15
|
| Rate for Payer: Mclaren Medicare |
$215.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$225.91
|
| Rate for Payer: Meridian Medicaid |
$118.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$247.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$236.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$248.50
|
| Rate for Payer: Nomi Health Commercial |
$239.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$219.26
|
| Rate for Payer: PACE Medicare |
$204.39
|
| Rate for Payer: PACE SWMI |
$215.15
|
| Rate for Payer: PHP Commercial |
$236.66
|
| Rate for Payer: PHP Medicaid |
$115.32
|
| Rate for Payer: PHP Medicare Advantage |
$215.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$256.16
|
| Rate for Payer: Priority Health Medicare |
$215.15
|
| Rate for Payer: Priority Health Narrow Network |
$204.94
|
| Rate for Payer: Railroad Medicare Medicare |
$215.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$257.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$215.15
|
| Rate for Payer: UHC Exchange |
$333.48
|
| Rate for Payer: UHC Medicaid |
$112.52
|
| Rate for Payer: UHCCP DNSP |
$215.15
|
| Rate for Payer: UHCCP Medicaid |
$112.52
|
| Rate for Payer: VA VA |
$215.15
|
|
|
HC AEP THRESHOLD ESTIMATION MLT FREQUENCIES I&R
|
Facility
|
IP
|
$292.35
|
|
|
Service Code
|
CPT 92652
|
| Hospital Charge Code |
47100401
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$219.26 |
| Max. Negotiated Rate |
$292.35 |
| Rate for Payer: Aetna Commercial |
$263.12
|
| Rate for Payer: ASR ASR |
$283.58
|
| Rate for Payer: BCBS Trust/PPO |
$240.08
|
| Rate for Payer: BCN Commercial |
$240.08
|
| Rate for Payer: Cash Price |
$233.88
|
| Rate for Payer: Cofinity Commercial |
$274.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$233.88
|
| Rate for Payer: Healthscope Commercial |
$283.58
|
| Rate for Payer: Healthscope Whirlpool |
$292.35
|
| Rate for Payer: Mclaren Commercial |
$263.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$248.50
|
| Rate for Payer: Nomi Health Commercial |
$239.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$219.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$257.27
|
|
|
HC AEROBIKA
|
Facility
|
OP
|
$153.28
|
|
| Hospital Charge Code |
27000612
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$56.71 |
| Max. Negotiated Rate |
$153.28 |
| Rate for Payer: Aetna Commercial |
$137.95
|
| Rate for Payer: Aetna Medicare |
$56.71
|
| Rate for Payer: ASR ASR |
$148.68
|
| Rate for Payer: BCBS Complete |
$61.31
|
| Rate for Payer: BCBS Trust/PPO |
$126.38
|
| Rate for Payer: BCN Commercial |
$126.38
|
| Rate for Payer: Cash Price |
$122.62
|
| Rate for Payer: Cofinity Commercial |
$144.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$122.62
|
| Rate for Payer: Healthscope Commercial |
$148.68
|
| Rate for Payer: Healthscope Whirlpool |
$153.28
|
| Rate for Payer: Mclaren Commercial |
$137.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$122.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.29
|
| Rate for Payer: Nomi Health Commercial |
$125.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$114.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$134.30
|
| Rate for Payer: Priority Health Narrow Network |
$107.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$134.89
|
|
|
HC AEROBIKA
|
Facility
|
IP
|
$153.28
|
|
| Hospital Charge Code |
27000612
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$114.96 |
| Max. Negotiated Rate |
$153.28 |
| Rate for Payer: Aetna Commercial |
$137.95
|
| Rate for Payer: ASR ASR |
$148.68
|
| Rate for Payer: BCBS Trust/PPO |
$125.87
|
| Rate for Payer: BCN Commercial |
$125.87
|
| Rate for Payer: Cash Price |
$122.62
|
| Rate for Payer: Cofinity Commercial |
$144.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$122.62
|
| Rate for Payer: Healthscope Commercial |
$148.68
|
| Rate for Payer: Healthscope Whirlpool |
$153.28
|
| Rate for Payer: Mclaren Commercial |
$137.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.29
|
| Rate for Payer: Nomi Health Commercial |
$125.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$114.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$134.89
|
|
|
HC AERONEB SUPPLY
|
Facility
|
OP
|
$170.55
|
|
| Hospital Charge Code |
27000465
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$63.10 |
| Max. Negotiated Rate |
$170.55 |
| Rate for Payer: Aetna Commercial |
$153.50
|
| Rate for Payer: Aetna Medicare |
$63.10
|
| Rate for Payer: ASR ASR |
$165.43
|
| Rate for Payer: BCBS Complete |
$68.22
|
| Rate for Payer: BCBS Trust/PPO |
$140.62
|
| Rate for Payer: BCN Commercial |
$140.62
|
| Rate for Payer: Cash Price |
$136.44
|
| Rate for Payer: Cofinity Commercial |
$160.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$136.44
|
| Rate for Payer: Healthscope Commercial |
$165.43
|
| Rate for Payer: Healthscope Whirlpool |
$170.55
|
| Rate for Payer: Mclaren Commercial |
$153.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$136.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$144.97
|
| Rate for Payer: Nomi Health Commercial |
$139.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$127.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$149.44
|
| Rate for Payer: Priority Health Narrow Network |
$119.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$150.08
|
|
|
HC AERONEB SUPPLY
|
Facility
|
IP
|
$170.55
|
|
| Hospital Charge Code |
27000465
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$127.91 |
| Max. Negotiated Rate |
$170.55 |
| Rate for Payer: Aetna Commercial |
$153.50
|
| Rate for Payer: ASR ASR |
$165.43
|
| Rate for Payer: BCBS Trust/PPO |
$140.06
|
| Rate for Payer: BCN Commercial |
$140.06
|
| Rate for Payer: Cash Price |
$136.44
|
| Rate for Payer: Cofinity Commercial |
$160.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$136.44
|
| Rate for Payer: Healthscope Commercial |
$165.43
|
| Rate for Payer: Healthscope Whirlpool |
$170.55
|
| Rate for Payer: Mclaren Commercial |
$153.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$144.97
|
| Rate for Payer: Nomi Health Commercial |
$139.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$127.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$150.08
|
|
|
HC AEROSOLIZED MEDICATION
|
Facility
|
OP
|
$152.66
|
|
|
Service Code
|
CPT 94640
|
| Hospital Charge Code |
41000012
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$101.68 |
| Max. Negotiated Rate |
$338.19 |
| Rate for Payer: Aetna Commercial |
$137.39
|
| Rate for Payer: Aetna Medicare |
$218.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$272.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$272.74
|
| Rate for Payer: ASR ASR |
$148.08
|
| Rate for Payer: BCBS Complete |
$119.83
|
| Rate for Payer: BCBS MAPPO |
$218.19
|
| Rate for Payer: BCBS Trust/PPO |
$125.87
|
| Rate for Payer: BCN Commercial |
$125.87
|
| Rate for Payer: BCN Medicare Advantage |
$218.19
|
| Rate for Payer: Cash Price |
$122.13
|
| Rate for Payer: Cash Price |
$122.13
|
| Rate for Payer: Cofinity Commercial |
$143.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$122.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$218.19
|
| Rate for Payer: Healthscope Commercial |
$148.08
|
| Rate for Payer: Healthscope Whirlpool |
$152.66
|
| Rate for Payer: Humana Choice PPO Medicare |
$218.19
|
| Rate for Payer: Mclaren Commercial |
$137.39
|
| Rate for Payer: Mclaren Medicaid |
$218.19
|
| Rate for Payer: Mclaren Medicare |
$218.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$229.10
|
| Rate for Payer: Meridian Medicaid |
$119.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$250.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$240.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$129.76
|
| Rate for Payer: Nomi Health Commercial |
$125.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$114.50
|
| Rate for Payer: PACE Medicare |
$207.28
|
| Rate for Payer: PACE SWMI |
$218.19
|
| Rate for Payer: PHP Commercial |
$240.01
|
| Rate for Payer: PHP Medicaid |
$116.95
|
| Rate for Payer: PHP Medicare Advantage |
$218.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$127.10
|
| Rate for Payer: Priority Health Medicare |
$218.19
|
| Rate for Payer: Priority Health Narrow Network |
$101.68
|
| Rate for Payer: Railroad Medicare Medicare |
$218.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$134.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$218.19
|
| Rate for Payer: UHC Exchange |
$338.19
|
| Rate for Payer: UHC Medicaid |
$114.11
|
| Rate for Payer: UHCCP DNSP |
$218.19
|
| Rate for Payer: UHCCP Medicaid |
$114.11
|
| Rate for Payer: VA VA |
$218.19
|
|
|
HC AEROSOLIZED MEDICATION
|
Facility
|
IP
|
$152.66
|
|
|
Service Code
|
CPT 94640
|
| Hospital Charge Code |
41000012
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$114.50 |
| Max. Negotiated Rate |
$152.66 |
| Rate for Payer: Aetna Commercial |
$137.39
|
| Rate for Payer: ASR ASR |
$148.08
|
| Rate for Payer: BCBS Trust/PPO |
$125.36
|
| Rate for Payer: BCN Commercial |
$125.36
|
| Rate for Payer: Cash Price |
$122.13
|
| Rate for Payer: Cofinity Commercial |
$143.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$122.13
|
| Rate for Payer: Healthscope Commercial |
$148.08
|
| Rate for Payer: Healthscope Whirlpool |
$152.66
|
| Rate for Payer: Mclaren Commercial |
$137.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$129.76
|
| Rate for Payer: Nomi Health Commercial |
$125.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$114.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$134.34
|
|
|
HC AFB CULTURE
|
Facility
|
OP
|
$93.01
|
|
|
Service Code
|
CPT 87116
|
| Hospital Charge Code |
30600089
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.65 |
| Max. Negotiated Rate |
$123.48 |
| Rate for Payer: Aetna Commercial |
$83.71
|
| Rate for Payer: Aetna Medicare |
$10.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.50
|
| Rate for Payer: ASR ASR |
$90.22
|
| Rate for Payer: BCBS Complete |
$5.93
|
| Rate for Payer: BCBS MAPPO |
$10.80
|
| Rate for Payer: BCBS Trust/PPO |
$76.69
|
| Rate for Payer: BCN Commercial |
$76.69
|
| Rate for Payer: BCN Medicare Advantage |
$10.80
|
| Rate for Payer: Cash Price |
$74.41
|
| Rate for Payer: Cash Price |
$74.41
|
| Rate for Payer: Cofinity Commercial |
$87.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.80
|
| Rate for Payer: Healthscope Commercial |
$90.22
|
| Rate for Payer: Healthscope Whirlpool |
$93.01
|
| Rate for Payer: Humana Choice PPO Medicare |
$10.80
|
| Rate for Payer: Mclaren Commercial |
$83.71
|
| Rate for Payer: Mclaren Medicaid |
$10.80
|
| Rate for Payer: Mclaren Medicare |
$10.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.34
|
| Rate for Payer: Meridian Medicaid |
$5.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.06
|
| Rate for Payer: Nomi Health Commercial |
$76.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$69.76
|
| Rate for Payer: PACE Medicare |
$10.26
|
| Rate for Payer: PACE SWMI |
$10.80
|
| Rate for Payer: PHP Commercial |
$11.88
|
| Rate for Payer: PHP Medicaid |
$5.79
|
| Rate for Payer: PHP Medicare Advantage |
$10.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$123.48
|
| Rate for Payer: Priority Health Medicare |
$10.80
|
| Rate for Payer: Priority Health Narrow Network |
$98.78
|
| Rate for Payer: Railroad Medicare Medicare |
$10.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$81.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$10.80
|
| Rate for Payer: UHC Exchange |
$16.74
|
| Rate for Payer: UHC Medicaid |
$5.65
|
| Rate for Payer: UHCCP DNSP |
$10.80
|
| Rate for Payer: UHCCP Medicaid |
$5.65
|
| Rate for Payer: VA VA |
$10.80
|
|
|
HC AFB CULTURE
|
Facility
|
IP
|
$93.01
|
|
|
Service Code
|
CPT 87116
|
| Hospital Charge Code |
30600089
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$69.76 |
| Max. Negotiated Rate |
$93.01 |
| Rate for Payer: Aetna Commercial |
$83.71
|
| Rate for Payer: ASR ASR |
$90.22
|
| Rate for Payer: BCBS Trust/PPO |
$76.38
|
| Rate for Payer: BCN Commercial |
$76.38
|
| Rate for Payer: Cash Price |
$74.41
|
| Rate for Payer: Cofinity Commercial |
$87.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.41
|
| Rate for Payer: Healthscope Commercial |
$90.22
|
| Rate for Payer: Healthscope Whirlpool |
$93.01
|
| Rate for Payer: Mclaren Commercial |
$83.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.06
|
| Rate for Payer: Nomi Health Commercial |
$76.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$69.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$81.85
|
|
|
HC AFB SMEAR
|
Facility
|
OP
|
$59.82
|
|
|
Service Code
|
CPT 87206
|
| Hospital Charge Code |
30600105
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$2.82 |
| Max. Negotiated Rate |
$95.62 |
| Rate for Payer: Aetna Commercial |
$53.84
|
| Rate for Payer: Aetna Medicare |
$5.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.74
|
| Rate for Payer: ASR ASR |
$58.03
|
| Rate for Payer: BCBS Complete |
$2.96
|
| Rate for Payer: BCBS MAPPO |
$5.39
|
| Rate for Payer: BCBS Trust/PPO |
$49.32
|
| Rate for Payer: BCN Commercial |
$49.32
|
| Rate for Payer: BCN Medicare Advantage |
$5.39
|
| Rate for Payer: Cash Price |
$47.86
|
| Rate for Payer: Cash Price |
$47.86
|
| Rate for Payer: Cofinity Commercial |
$56.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.39
|
| Rate for Payer: Healthscope Commercial |
$58.03
|
| Rate for Payer: Healthscope Whirlpool |
$59.82
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.39
|
| Rate for Payer: Mclaren Commercial |
$53.84
|
| Rate for Payer: Mclaren Medicaid |
$5.39
|
| Rate for Payer: Mclaren Medicare |
$5.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.66
|
| Rate for Payer: Meridian Medicaid |
$2.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.85
|
| Rate for Payer: Nomi Health Commercial |
$49.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$44.87
|
| Rate for Payer: PACE Medicare |
$5.12
|
| Rate for Payer: PACE SWMI |
$5.39
|
| Rate for Payer: PHP Commercial |
$5.93
|
| Rate for Payer: PHP Medicaid |
$2.89
|
| Rate for Payer: PHP Medicare Advantage |
$5.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$95.62
|
| Rate for Payer: Priority Health Medicare |
$5.39
|
| Rate for Payer: Priority Health Narrow Network |
$76.50
|
| Rate for Payer: Railroad Medicare Medicare |
$5.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$52.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.39
|
| Rate for Payer: UHC Exchange |
$8.35
|
| Rate for Payer: UHC Medicaid |
$2.82
|
| Rate for Payer: UHCCP DNSP |
$5.39
|
| Rate for Payer: UHCCP Medicaid |
$2.82
|
| Rate for Payer: VA VA |
$5.39
|
|
|
HC AFB SMEAR
|
Facility
|
IP
|
$59.82
|
|
|
Service Code
|
CPT 87206
|
| Hospital Charge Code |
30600105
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$44.87 |
| Max. Negotiated Rate |
$59.82 |
| Rate for Payer: Aetna Commercial |
$53.84
|
| Rate for Payer: ASR ASR |
$58.03
|
| Rate for Payer: BCBS Trust/PPO |
$49.12
|
| Rate for Payer: BCN Commercial |
$49.12
|
| Rate for Payer: Cash Price |
$47.86
|
| Rate for Payer: Cofinity Commercial |
$56.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.86
|
| Rate for Payer: Healthscope Commercial |
$58.03
|
| Rate for Payer: Healthscope Whirlpool |
$59.82
|
| Rate for Payer: Mclaren Commercial |
$53.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.85
|
| Rate for Payer: Nomi Health Commercial |
$49.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$44.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$52.64
|
|
|
HC AFFINITY 1.5 X 1.5 PER SQ CM
|
Facility
|
IP
|
$735.42
|
|
|
Service Code
|
HCPCS Q4159
|
| Hospital Charge Code |
63600124
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$551.57 |
| Max. Negotiated Rate |
$735.42 |
| Rate for Payer: Aetna Commercial |
$661.88
|
| Rate for Payer: ASR ASR |
$713.36
|
| Rate for Payer: BCBS Trust/PPO |
$603.93
|
| Rate for Payer: BCN Commercial |
$603.93
|
| Rate for Payer: Cash Price |
$588.34
|
| Rate for Payer: Cofinity Commercial |
$691.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$588.34
|
| Rate for Payer: Healthscope Commercial |
$713.36
|
| Rate for Payer: Healthscope Whirlpool |
$735.42
|
| Rate for Payer: Mclaren Commercial |
$661.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$625.11
|
| Rate for Payer: Nomi Health Commercial |
$603.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$551.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$647.17
|
|
|
HC AFFINITY 1.5 X 1.5 PER SQ CM
|
Facility
|
OP
|
$735.42
|
|
|
Service Code
|
HCPCS Q4159
|
| Hospital Charge Code |
63600124
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$64.85 |
| Max. Negotiated Rate |
$1,076.67 |
| Rate for Payer: Aetna Commercial |
$661.88
|
| Rate for Payer: Aetna Medicare |
$124.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$155.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$155.00
|
| Rate for Payer: ASR ASR |
$713.36
|
| Rate for Payer: BCBS Complete |
$68.10
|
| Rate for Payer: BCBS MAPPO |
$124.00
|
| Rate for Payer: BCBS Trust/PPO |
$606.35
|
| Rate for Payer: BCN Commercial |
$606.35
|
| Rate for Payer: BCN Medicare Advantage |
$124.00
|
| Rate for Payer: Cash Price |
$588.34
|
| Rate for Payer: Cash Price |
$588.34
|
| Rate for Payer: Cofinity Commercial |
$691.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$588.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$124.00
|
| Rate for Payer: Healthscope Commercial |
$713.36
|
| Rate for Payer: Healthscope Whirlpool |
$735.42
|
| Rate for Payer: Humana Choice PPO Medicare |
$124.00
|
| Rate for Payer: Mclaren Commercial |
$661.88
|
| Rate for Payer: Mclaren Medicaid |
$124.00
|
| Rate for Payer: Mclaren Medicare |
$124.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$130.20
|
| Rate for Payer: Meridian Medicaid |
$68.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$142.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$136.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$625.11
|
| Rate for Payer: Nomi Health Commercial |
$603.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$551.57
|
| Rate for Payer: PACE Medicare |
$117.80
|
| Rate for Payer: PACE SWMI |
$124.00
|
| Rate for Payer: PHP Commercial |
$136.40
|
| Rate for Payer: PHP Medicaid |
$66.46
|
| Rate for Payer: PHP Medicare Advantage |
$124.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,076.67
|
| Rate for Payer: Priority Health Medicare |
$124.00
|
| Rate for Payer: Priority Health Narrow Network |
$861.34
|
| Rate for Payer: Railroad Medicare Medicare |
$124.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$647.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$124.00
|
| Rate for Payer: UHC Exchange |
$192.20
|
| Rate for Payer: UHC Medicaid |
$64.85
|
| Rate for Payer: UHCCP DNSP |
$124.00
|
| Rate for Payer: UHCCP Medicaid |
$64.85
|
| Rate for Payer: VA VA |
$124.00
|
|
|
HC AFFINITY 2.5 X 2.5 PER SQ CM
|
Facility
|
OP
|
$443.49
|
|
|
Service Code
|
HCPCS Q4159
|
| Hospital Charge Code |
63600125
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$64.85 |
| Max. Negotiated Rate |
$1,076.67 |
| Rate for Payer: Aetna Commercial |
$399.14
|
| Rate for Payer: Aetna Medicare |
$124.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$155.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$155.00
|
| Rate for Payer: ASR ASR |
$430.19
|
| Rate for Payer: BCBS Complete |
$68.10
|
| Rate for Payer: BCBS MAPPO |
$124.00
|
| Rate for Payer: BCBS Trust/PPO |
$365.66
|
| Rate for Payer: BCN Commercial |
$365.66
|
| Rate for Payer: BCN Medicare Advantage |
$124.00
|
| Rate for Payer: Cash Price |
$354.79
|
| Rate for Payer: Cash Price |
$354.79
|
| Rate for Payer: Cofinity Commercial |
$416.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$354.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$124.00
|
| Rate for Payer: Healthscope Commercial |
$430.19
|
| Rate for Payer: Healthscope Whirlpool |
$443.49
|
| Rate for Payer: Humana Choice PPO Medicare |
$124.00
|
| Rate for Payer: Mclaren Commercial |
$399.14
|
| Rate for Payer: Mclaren Medicaid |
$124.00
|
| Rate for Payer: Mclaren Medicare |
$124.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$130.20
|
| Rate for Payer: Meridian Medicaid |
$68.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$142.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$136.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$376.97
|
| Rate for Payer: Nomi Health Commercial |
$363.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$332.62
|
| Rate for Payer: PACE Medicare |
$117.80
|
| Rate for Payer: PACE SWMI |
$124.00
|
| Rate for Payer: PHP Commercial |
$136.40
|
| Rate for Payer: PHP Medicaid |
$66.46
|
| Rate for Payer: PHP Medicare Advantage |
$124.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,076.67
|
| Rate for Payer: Priority Health Medicare |
$124.00
|
| Rate for Payer: Priority Health Narrow Network |
$861.34
|
| Rate for Payer: Railroad Medicare Medicare |
$124.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$390.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$124.00
|
| Rate for Payer: UHC Exchange |
$192.20
|
| Rate for Payer: UHC Medicaid |
$64.85
|
| Rate for Payer: UHCCP DNSP |
$124.00
|
| Rate for Payer: UHCCP Medicaid |
$64.85
|
| Rate for Payer: VA VA |
$124.00
|
|
|
HC AFFINITY 2.5 X 2.5 PER SQ CM
|
Facility
|
IP
|
$443.49
|
|
|
Service Code
|
HCPCS Q4159
|
| Hospital Charge Code |
63600125
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$332.62 |
| Max. Negotiated Rate |
$443.49 |
| Rate for Payer: Aetna Commercial |
$399.14
|
| Rate for Payer: ASR ASR |
$430.19
|
| Rate for Payer: BCBS Trust/PPO |
$364.19
|
| Rate for Payer: BCN Commercial |
$364.19
|
| Rate for Payer: Cash Price |
$354.79
|
| Rate for Payer: Cofinity Commercial |
$416.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$354.79
|
| Rate for Payer: Healthscope Commercial |
$430.19
|
| Rate for Payer: Healthscope Whirlpool |
$443.49
|
| Rate for Payer: Mclaren Commercial |
$399.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$376.97
|
| Rate for Payer: Nomi Health Commercial |
$363.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$332.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$390.27
|
|
|
HC AFP SINGLE MARKER SCRN,MS
|
Facility
|
IP
|
$49.88
|
|
|
Service Code
|
CPT 82105
|
| Hospital Charge Code |
30100622
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$37.41 |
| Max. Negotiated Rate |
$49.88 |
| Rate for Payer: Aetna Commercial |
$44.89
|
| Rate for Payer: ASR ASR |
$48.38
|
| Rate for Payer: BCBS Trust/PPO |
$40.96
|
| Rate for Payer: BCN Commercial |
$40.96
|
| Rate for Payer: Cash Price |
$39.90
|
| Rate for Payer: Cofinity Commercial |
$46.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.90
|
| Rate for Payer: Healthscope Commercial |
$48.38
|
| Rate for Payer: Healthscope Whirlpool |
$49.88
|
| Rate for Payer: Mclaren Commercial |
$44.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.40
|
| Rate for Payer: Nomi Health Commercial |
$40.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$43.89
|
|
|
HC AFP SINGLE MARKER SCRN,MS
|
Facility
|
OP
|
$49.88
|
|
|
Service Code
|
CPT 82105
|
| Hospital Charge Code |
30100622
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.77 |
| Max. Negotiated Rate |
$124.68 |
| Rate for Payer: Aetna Commercial |
$44.89
|
| Rate for Payer: Aetna Medicare |
$16.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.96
|
| Rate for Payer: ASR ASR |
$48.38
|
| Rate for Payer: BCBS Complete |
$9.21
|
| Rate for Payer: BCBS MAPPO |
$16.77
|
| Rate for Payer: BCBS Trust/PPO |
$41.13
|
| Rate for Payer: BCN Commercial |
$41.13
|
| Rate for Payer: BCN Medicare Advantage |
$16.77
|
| Rate for Payer: Cash Price |
$39.90
|
| Rate for Payer: Cash Price |
$39.90
|
| Rate for Payer: Cofinity Commercial |
$46.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.77
|
| Rate for Payer: Healthscope Commercial |
$48.38
|
| Rate for Payer: Healthscope Whirlpool |
$49.88
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.77
|
| Rate for Payer: Mclaren Commercial |
$44.89
|
| Rate for Payer: Mclaren Medicaid |
$16.77
|
| Rate for Payer: Mclaren Medicare |
$16.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.61
|
| Rate for Payer: Meridian Medicaid |
$9.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.40
|
| Rate for Payer: Nomi Health Commercial |
$40.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.41
|
| Rate for Payer: PACE Medicare |
$15.93
|
| Rate for Payer: PACE SWMI |
$16.77
|
| Rate for Payer: PHP Commercial |
$18.45
|
| Rate for Payer: PHP Medicaid |
$8.99
|
| Rate for Payer: PHP Medicare Advantage |
$16.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$124.68
|
| Rate for Payer: Priority Health Medicare |
$16.77
|
| Rate for Payer: Priority Health Narrow Network |
$99.74
|
| Rate for Payer: Railroad Medicare Medicare |
$16.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$43.89
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$16.77
|
| Rate for Payer: UHC Exchange |
$25.99
|
| Rate for Payer: UHC Medicaid |
$8.77
|
| Rate for Payer: UHCCP DNSP |
$16.77
|
| Rate for Payer: UHCCP Medicaid |
$8.77
|
| Rate for Payer: VA VA |
$16.77
|
|
|
HC AFTER HOURS ACCESS
|
Facility
|
OP
|
$20.81
|
|
|
Service Code
|
CPT 99050
|
| Hospital Charge Code |
98300006
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$7.70 |
| Max. Negotiated Rate |
$20.81 |
| Rate for Payer: Aetna Commercial |
$18.73
|
| Rate for Payer: Aetna Medicare |
$7.70
|
| Rate for Payer: ASR ASR |
$20.19
|
| Rate for Payer: BCBS Complete |
$8.32
|
| Rate for Payer: BCBS Trust/PPO |
$17.16
|
| Rate for Payer: BCN Commercial |
$17.16
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$19.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Healthscope Commercial |
$20.19
|
| Rate for Payer: Healthscope Whirlpool |
$20.81
|
| Rate for Payer: Mclaren Commercial |
$18.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: Nomi Health Commercial |
$17.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$18.23
|
| Rate for Payer: Priority Health Narrow Network |
$14.59
|
|
|
HC AFTER HOURS ACCESS
|
Facility
|
IP
|
$20.81
|
|
|
Service Code
|
CPT 99050
|
| Hospital Charge Code |
98300006
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$15.61 |
| Max. Negotiated Rate |
$20.81 |
| Rate for Payer: Aetna Commercial |
$18.73
|
| Rate for Payer: ASR ASR |
$20.19
|
| Rate for Payer: BCBS Trust/PPO |
$17.09
|
| Rate for Payer: BCN Commercial |
$17.09
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$19.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Healthscope Commercial |
$20.19
|
| Rate for Payer: Healthscope Whirlpool |
$20.81
|
| Rate for Payer: Mclaren Commercial |
$18.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: Nomi Health Commercial |
$17.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.61
|
|
