|
HC COLPOSCOPY CERVIX VAG LOOP ELTRD BX CERVIX
|
Facility
|
OP
|
$7,950.00
|
|
|
Service Code
|
CPT 57460
|
| Hospital Charge Code |
76100395
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$331.36 |
| Max. Negotiated Rate |
$7,950.00 |
| Rate for Payer: Aetna Commercial |
$7,155.00
|
| Rate for Payer: Aetna Medicare |
$2,778.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,473.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,473.69
|
| Rate for Payer: ASR ASR |
$7,711.50
|
| Rate for Payer: BCBS Complete |
$1,596.23
|
| Rate for Payer: BCBS MAPPO |
$2,778.95
|
| Rate for Payer: BCBS Trust/PPO |
$6,163.64
|
| Rate for Payer: BCCCP Commercial |
$331.36
|
| Rate for Payer: BCN Commercial |
$6,163.64
|
| Rate for Payer: BCN Medicare Advantage |
$2,778.95
|
| Rate for Payer: Cash Price |
$6,360.00
|
| Rate for Payer: Cash Price |
$6,360.00
|
| Rate for Payer: Cofinity Commercial |
$7,473.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,360.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,778.95
|
| Rate for Payer: Healthscope Commercial |
$7,950.00
|
| Rate for Payer: Healthscope Whirlpool |
$7,711.50
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,778.95
|
| Rate for Payer: Mclaren Commercial |
$7,155.00
|
| Rate for Payer: Mclaren Medicaid |
$1,520.09
|
| Rate for Payer: Mclaren Medicare |
$2,778.95
|
| Rate for Payer: Meridian Medicaid |
$1,596.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,917.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,195.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,757.50
|
| Rate for Payer: PACE Medicare |
$2,640.00
|
| Rate for Payer: PACE SWMI |
$2,778.95
|
| Rate for Payer: PHP Commercial |
$3,056.84
|
| Rate for Payer: PHP Medicaid |
$1,520.09
|
| Rate for Payer: PHP Medicare Advantage |
$2,778.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,520.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,565.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,234.50
|
| Rate for Payer: Priority Health Medicare |
$2,778.95
|
| Rate for Payer: Priority Health Narrow Network |
$5,644.50
|
| Rate for Payer: Railroad Medicare Medicare |
$2,778.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,996.00
|
| Rate for Payer: UHC Medicare Advantage |
$2,862.32
|
| Rate for Payer: VA VA |
$2,778.95
|
|
|
HC COLPOSCOPY CERVIX W ADJ VAGINA
|
Facility
|
IP
|
$279.48
|
|
|
Service Code
|
CPT 57452
|
| Hospital Charge Code |
76100204
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$195.64 |
| Max. Negotiated Rate |
$279.48 |
| Rate for Payer: Aetna Commercial |
$251.53
|
| Rate for Payer: ASR ASR |
$271.10
|
| Rate for Payer: BCBS Trust/PPO |
$216.68
|
| Rate for Payer: BCN Commercial |
$216.68
|
| Rate for Payer: Cash Price |
$223.58
|
| Rate for Payer: Cofinity Commercial |
$262.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$223.58
|
| Rate for Payer: Healthscope Commercial |
$279.48
|
| Rate for Payer: Healthscope Whirlpool |
$271.10
|
| Rate for Payer: Mclaren Commercial |
$251.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$237.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$195.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$245.94
|
|
|
HC COLPOSCOPY CERVIX W ADJ VAGINA
|
Facility
|
OP
|
$279.48
|
|
|
Service Code
|
CPT 57452
|
| Hospital Charge Code |
76100204
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$96.88 |
| Max. Negotiated Rate |
$279.48 |
| Rate for Payer: Aetna Commercial |
$251.53
|
| Rate for Payer: Aetna Medicare |
$177.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$221.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$221.40
|
| Rate for Payer: ASR ASR |
$271.10
|
| Rate for Payer: BCBS Complete |
$101.74
|
| Rate for Payer: BCBS MAPPO |
$177.12
|
| Rate for Payer: BCBS Trust/PPO |
$216.68
|
| Rate for Payer: BCCCP Commercial |
$134.56
|
| Rate for Payer: BCN Commercial |
$216.68
|
| Rate for Payer: BCN Medicare Advantage |
$177.12
|
| Rate for Payer: Cash Price |
$223.58
|
| Rate for Payer: Cash Price |
$223.58
|
| Rate for Payer: Cofinity Commercial |
$262.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$223.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.12
|
| Rate for Payer: Healthscope Commercial |
$279.48
|
| Rate for Payer: Healthscope Whirlpool |
$271.10
|
| Rate for Payer: Humana Choice PPO Medicare |
$177.12
|
| Rate for Payer: Mclaren Commercial |
$251.53
|
| Rate for Payer: Mclaren Medicaid |
$96.88
|
| Rate for Payer: Mclaren Medicare |
$177.12
|
| Rate for Payer: Meridian Medicaid |
$101.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$185.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$203.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$237.56
|
| Rate for Payer: PACE Medicare |
$168.26
|
| Rate for Payer: PACE SWMI |
$177.12
|
| Rate for Payer: PHP Commercial |
$194.83
|
| Rate for Payer: PHP Medicaid |
$96.88
|
| Rate for Payer: PHP Medicare Advantage |
$177.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$96.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$195.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$254.33
|
| Rate for Payer: Priority Health Medicare |
$177.12
|
| Rate for Payer: Priority Health Narrow Network |
$198.43
|
| Rate for Payer: Railroad Medicare Medicare |
$177.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$245.94
|
| Rate for Payer: UHC Medicare Advantage |
$182.43
|
| Rate for Payer: VA VA |
$177.12
|
|
|
HC COLPOSCOPY CERVIX W ADJ VAGINA CURETTAGE
|
Facility
|
OP
|
$417.69
|
|
|
Service Code
|
CPT 57456
|
| Hospital Charge Code |
76100206
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$155.98 |
| Max. Negotiated Rate |
$417.69 |
| Rate for Payer: Aetna Commercial |
$375.92
|
| Rate for Payer: Aetna Medicare |
$285.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$356.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$356.45
|
| Rate for Payer: ASR ASR |
$405.16
|
| Rate for Payer: BCBS Complete |
$163.80
|
| Rate for Payer: BCBS MAPPO |
$285.16
|
| Rate for Payer: BCBS Trust/PPO |
$323.84
|
| Rate for Payer: BCCCP Commercial |
$161.36
|
| Rate for Payer: BCN Commercial |
$323.84
|
| Rate for Payer: BCN Medicare Advantage |
$285.16
|
| Rate for Payer: Cash Price |
$334.15
|
| Rate for Payer: Cash Price |
$334.15
|
| Rate for Payer: Cofinity Commercial |
$392.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$334.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$285.16
|
| Rate for Payer: Healthscope Commercial |
$417.69
|
| Rate for Payer: Healthscope Whirlpool |
$405.16
|
| Rate for Payer: Humana Choice PPO Medicare |
$285.16
|
| Rate for Payer: Mclaren Commercial |
$375.92
|
| Rate for Payer: Mclaren Medicaid |
$155.98
|
| Rate for Payer: Mclaren Medicare |
$285.16
|
| Rate for Payer: Meridian Medicaid |
$163.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$299.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$327.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$355.04
|
| Rate for Payer: PACE Medicare |
$270.90
|
| Rate for Payer: PACE SWMI |
$285.16
|
| Rate for Payer: PHP Commercial |
$313.68
|
| Rate for Payer: PHP Medicaid |
$155.98
|
| Rate for Payer: PHP Medicare Advantage |
$285.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$155.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$292.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$380.10
|
| Rate for Payer: Priority Health Medicare |
$285.16
|
| Rate for Payer: Priority Health Narrow Network |
$296.56
|
| Rate for Payer: Railroad Medicare Medicare |
$285.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$367.57
|
| Rate for Payer: UHC Medicare Advantage |
$293.71
|
| Rate for Payer: VA VA |
$285.16
|
|
|
HC COLPOSCOPY CERVIX W ADJ VAGINA CURETTAGE
|
Facility
|
IP
|
$417.69
|
|
|
Service Code
|
CPT 57456
|
| Hospital Charge Code |
76100206
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$292.38 |
| Max. Negotiated Rate |
$417.69 |
| Rate for Payer: Aetna Commercial |
$375.92
|
| Rate for Payer: ASR ASR |
$405.16
|
| Rate for Payer: BCBS Trust/PPO |
$323.84
|
| Rate for Payer: BCN Commercial |
$323.84
|
| Rate for Payer: Cash Price |
$334.15
|
| Rate for Payer: Cofinity Commercial |
$392.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$334.15
|
| Rate for Payer: Healthscope Commercial |
$417.69
|
| Rate for Payer: Healthscope Whirlpool |
$405.16
|
| Rate for Payer: Mclaren Commercial |
$375.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$355.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$292.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$367.57
|
|
|
HC COLPOSCOPY CERVIX W ADJ VAGINA W BX
|
Facility
|
IP
|
$417.69
|
|
|
Service Code
|
CPT 57455
|
| Hospital Charge Code |
76100205
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$292.38 |
| Max. Negotiated Rate |
$417.69 |
| Rate for Payer: Aetna Commercial |
$375.92
|
| Rate for Payer: ASR ASR |
$405.16
|
| Rate for Payer: BCBS Trust/PPO |
$323.84
|
| Rate for Payer: BCN Commercial |
$323.84
|
| Rate for Payer: Cash Price |
$334.15
|
| Rate for Payer: Cofinity Commercial |
$392.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$334.15
|
| Rate for Payer: Healthscope Commercial |
$417.69
|
| Rate for Payer: Healthscope Whirlpool |
$405.16
|
| Rate for Payer: Mclaren Commercial |
$375.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$355.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$292.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$367.57
|
|
|
HC COLPOSCOPY CERVIX W ADJ VAGINA W BX
|
Facility
|
OP
|
$417.69
|
|
|
Service Code
|
CPT 57455
|
| Hospital Charge Code |
76100205
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$155.98 |
| Max. Negotiated Rate |
$417.69 |
| Rate for Payer: Aetna Commercial |
$375.92
|
| Rate for Payer: Aetna Medicare |
$285.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$356.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$356.45
|
| Rate for Payer: ASR ASR |
$405.16
|
| Rate for Payer: BCBS Complete |
$163.80
|
| Rate for Payer: BCBS MAPPO |
$285.16
|
| Rate for Payer: BCBS Trust/PPO |
$323.84
|
| Rate for Payer: BCCCP Commercial |
$170.70
|
| Rate for Payer: BCN Commercial |
$323.84
|
| Rate for Payer: BCN Medicare Advantage |
$285.16
|
| Rate for Payer: Cash Price |
$334.15
|
| Rate for Payer: Cash Price |
$334.15
|
| Rate for Payer: Cofinity Commercial |
$392.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$334.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$285.16
|
| Rate for Payer: Healthscope Commercial |
$417.69
|
| Rate for Payer: Healthscope Whirlpool |
$405.16
|
| Rate for Payer: Humana Choice PPO Medicare |
$285.16
|
| Rate for Payer: Mclaren Commercial |
$375.92
|
| Rate for Payer: Mclaren Medicaid |
$155.98
|
| Rate for Payer: Mclaren Medicare |
$285.16
|
| Rate for Payer: Meridian Medicaid |
$163.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$299.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$327.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$355.04
|
| Rate for Payer: PACE Medicare |
$270.90
|
| Rate for Payer: PACE SWMI |
$285.16
|
| Rate for Payer: PHP Commercial |
$313.68
|
| Rate for Payer: PHP Medicaid |
$155.98
|
| Rate for Payer: PHP Medicare Advantage |
$285.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$155.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$292.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$380.10
|
| Rate for Payer: Priority Health Medicare |
$285.16
|
| Rate for Payer: Priority Health Narrow Network |
$296.56
|
| Rate for Payer: Railroad Medicare Medicare |
$285.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$367.57
|
| Rate for Payer: UHC Medicare Advantage |
$293.71
|
| Rate for Payer: VA VA |
$285.16
|
|
|
HC COLPOSCOPY OF CERVIX/VAGINA W/BIOPSY AND CURETTAGE
|
Facility
|
IP
|
$361.08
|
|
|
Service Code
|
CPT 57454
|
| Hospital Charge Code |
76100140
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$252.76 |
| Max. Negotiated Rate |
$361.08 |
| Rate for Payer: Aetna Commercial |
$324.97
|
| Rate for Payer: ASR ASR |
$350.25
|
| Rate for Payer: BCBS Trust/PPO |
$279.95
|
| Rate for Payer: BCN Commercial |
$279.95
|
| Rate for Payer: Cash Price |
$288.86
|
| Rate for Payer: Cofinity Commercial |
$339.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$288.86
|
| Rate for Payer: Healthscope Commercial |
$361.08
|
| Rate for Payer: Healthscope Whirlpool |
$350.25
|
| Rate for Payer: Mclaren Commercial |
$324.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$306.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$252.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$317.75
|
|
|
HC COLPOSCOPY OF CERVIX/VAGINA W/BIOPSY AND CURETTAGE
|
Facility
|
OP
|
$361.08
|
|
|
Service Code
|
CPT 57454
|
| Hospital Charge Code |
76100140
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$155.98 |
| Max. Negotiated Rate |
$361.08 |
| Rate for Payer: Aetna Commercial |
$324.97
|
| Rate for Payer: Aetna Medicare |
$285.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$356.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$356.45
|
| Rate for Payer: ASR ASR |
$350.25
|
| Rate for Payer: BCBS Complete |
$163.80
|
| Rate for Payer: BCBS MAPPO |
$285.16
|
| Rate for Payer: BCBS Trust/PPO |
$279.95
|
| Rate for Payer: BCCCP Commercial |
$179.90
|
| Rate for Payer: BCN Commercial |
$279.95
|
| Rate for Payer: BCN Medicare Advantage |
$285.16
|
| Rate for Payer: Cash Price |
$288.86
|
| Rate for Payer: Cash Price |
$288.86
|
| Rate for Payer: Cofinity Commercial |
$339.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$288.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$285.16
|
| Rate for Payer: Healthscope Commercial |
$361.08
|
| Rate for Payer: Healthscope Whirlpool |
$350.25
|
| Rate for Payer: Humana Choice PPO Medicare |
$285.16
|
| Rate for Payer: Mclaren Commercial |
$324.97
|
| Rate for Payer: Mclaren Medicaid |
$155.98
|
| Rate for Payer: Mclaren Medicare |
$285.16
|
| Rate for Payer: Meridian Medicaid |
$163.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$299.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$327.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$306.92
|
| Rate for Payer: PACE Medicare |
$270.90
|
| Rate for Payer: PACE SWMI |
$285.16
|
| Rate for Payer: PHP Commercial |
$313.68
|
| Rate for Payer: PHP Medicaid |
$155.98
|
| Rate for Payer: PHP Medicare Advantage |
$285.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$155.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$252.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$328.58
|
| Rate for Payer: Priority Health Medicare |
$285.16
|
| Rate for Payer: Priority Health Narrow Network |
$256.37
|
| Rate for Payer: Railroad Medicare Medicare |
$285.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$317.75
|
| Rate for Payer: UHC Medicare Advantage |
$293.71
|
| Rate for Payer: VA VA |
$285.16
|
|
|
HC COLPOSCOPY VAGINA W/BIOPSY
|
Facility
|
IP
|
$853.74
|
|
|
Service Code
|
CPT 57421
|
| Hospital Charge Code |
76100223
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$597.62 |
| Max. Negotiated Rate |
$853.74 |
| Rate for Payer: Aetna Commercial |
$768.37
|
| Rate for Payer: ASR ASR |
$828.13
|
| Rate for Payer: BCBS Trust/PPO |
$661.90
|
| Rate for Payer: BCN Commercial |
$661.90
|
| Rate for Payer: Cash Price |
$682.99
|
| Rate for Payer: Cofinity Commercial |
$802.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$682.99
|
| Rate for Payer: Healthscope Commercial |
$853.74
|
| Rate for Payer: Healthscope Whirlpool |
$828.13
|
| Rate for Payer: Mclaren Commercial |
$768.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$725.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$597.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$751.29
|
|
|
HC COLPOSCOPY VAGINA W/BIOPSY
|
Facility
|
OP
|
$853.74
|
|
|
Service Code
|
CPT 57421
|
| Hospital Charge Code |
76100223
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$390.88 |
| Max. Negotiated Rate |
$893.22 |
| Rate for Payer: Aetna Commercial |
$768.37
|
| Rate for Payer: Aetna Medicare |
$714.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$893.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$893.22
|
| Rate for Payer: ASR ASR |
$828.13
|
| Rate for Payer: BCBS Complete |
$410.45
|
| Rate for Payer: BCBS MAPPO |
$714.58
|
| Rate for Payer: BCBS Trust/PPO |
$661.90
|
| Rate for Payer: BCN Commercial |
$661.90
|
| Rate for Payer: BCN Medicare Advantage |
$714.58
|
| Rate for Payer: Cash Price |
$682.99
|
| Rate for Payer: Cash Price |
$682.99
|
| Rate for Payer: Cofinity Commercial |
$802.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$682.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$714.58
|
| Rate for Payer: Healthscope Commercial |
$853.74
|
| Rate for Payer: Healthscope Whirlpool |
$828.13
|
| Rate for Payer: Humana Choice PPO Medicare |
$714.58
|
| Rate for Payer: Mclaren Commercial |
$768.37
|
| Rate for Payer: Mclaren Medicaid |
$390.88
|
| Rate for Payer: Mclaren Medicare |
$714.58
|
| Rate for Payer: Meridian Medicaid |
$410.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$750.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$821.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$725.68
|
| Rate for Payer: PACE Medicare |
$678.85
|
| Rate for Payer: PACE SWMI |
$714.58
|
| Rate for Payer: PHP Commercial |
$786.04
|
| Rate for Payer: PHP Medicaid |
$390.88
|
| Rate for Payer: PHP Medicare Advantage |
$714.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$390.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$597.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$776.90
|
| Rate for Payer: Priority Health Medicare |
$714.58
|
| Rate for Payer: Priority Health Narrow Network |
$606.16
|
| Rate for Payer: Railroad Medicare Medicare |
$714.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$751.29
|
| Rate for Payer: UHC Medicare Advantage |
$736.02
|
| Rate for Payer: VA VA |
$714.58
|
|
|
HC COLPOSCOPY VAGINA W/O BIOPSY
|
Facility
|
IP
|
$414.20
|
|
|
Service Code
|
CPT 57420
|
| Hospital Charge Code |
76100254
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$289.94 |
| Max. Negotiated Rate |
$414.20 |
| Rate for Payer: Aetna Commercial |
$372.78
|
| Rate for Payer: ASR ASR |
$401.77
|
| Rate for Payer: BCBS Trust/PPO |
$321.13
|
| Rate for Payer: BCN Commercial |
$321.13
|
| Rate for Payer: Cash Price |
$331.36
|
| Rate for Payer: Cofinity Commercial |
$389.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$331.36
|
| Rate for Payer: Healthscope Commercial |
$414.20
|
| Rate for Payer: Healthscope Whirlpool |
$401.77
|
| Rate for Payer: Mclaren Commercial |
$372.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$352.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$289.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$364.50
|
|
|
HC COLPOSCOPY VAGINA W/O BIOPSY
|
Facility
|
OP
|
$414.20
|
|
|
Service Code
|
CPT 57420
|
| Hospital Charge Code |
76100254
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$155.98 |
| Max. Negotiated Rate |
$414.20 |
| Rate for Payer: Aetna Commercial |
$372.78
|
| Rate for Payer: Aetna Medicare |
$285.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$356.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$356.45
|
| Rate for Payer: ASR ASR |
$401.77
|
| Rate for Payer: BCBS Complete |
$163.80
|
| Rate for Payer: BCBS MAPPO |
$285.16
|
| Rate for Payer: BCBS Trust/PPO |
$321.13
|
| Rate for Payer: BCN Commercial |
$321.13
|
| Rate for Payer: BCN Medicare Advantage |
$285.16
|
| Rate for Payer: Cash Price |
$331.36
|
| Rate for Payer: Cash Price |
$331.36
|
| Rate for Payer: Cofinity Commercial |
$389.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$331.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$285.16
|
| Rate for Payer: Healthscope Commercial |
$414.20
|
| Rate for Payer: Healthscope Whirlpool |
$401.77
|
| Rate for Payer: Humana Choice PPO Medicare |
$285.16
|
| Rate for Payer: Mclaren Commercial |
$372.78
|
| Rate for Payer: Mclaren Medicaid |
$155.98
|
| Rate for Payer: Mclaren Medicare |
$285.16
|
| Rate for Payer: Meridian Medicaid |
$163.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$299.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$327.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$352.07
|
| Rate for Payer: PACE Medicare |
$270.90
|
| Rate for Payer: PACE SWMI |
$285.16
|
| Rate for Payer: PHP Commercial |
$313.68
|
| Rate for Payer: PHP Medicaid |
$155.98
|
| Rate for Payer: PHP Medicare Advantage |
$285.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$155.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$289.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$376.92
|
| Rate for Payer: Priority Health Medicare |
$285.16
|
| Rate for Payer: Priority Health Narrow Network |
$294.08
|
| Rate for Payer: Railroad Medicare Medicare |
$285.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$364.50
|
| Rate for Payer: UHC Medicare Advantage |
$293.71
|
| Rate for Payer: VA VA |
$285.16
|
|
|
HC COLPOSCOPY, VULVA
|
Facility
|
OP
|
$322.32
|
|
|
Service Code
|
CPT 56820
|
| Hospital Charge Code |
76100258
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$96.88 |
| Max. Negotiated Rate |
$322.32 |
| Rate for Payer: Aetna Commercial |
$290.09
|
| Rate for Payer: Aetna Medicare |
$177.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$221.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$221.40
|
| Rate for Payer: ASR ASR |
$312.65
|
| Rate for Payer: BCBS Complete |
$101.74
|
| Rate for Payer: BCBS MAPPO |
$177.12
|
| Rate for Payer: BCBS Trust/PPO |
$249.89
|
| Rate for Payer: BCN Commercial |
$249.89
|
| Rate for Payer: BCN Medicare Advantage |
$177.12
|
| Rate for Payer: Cash Price |
$257.86
|
| Rate for Payer: Cash Price |
$257.86
|
| Rate for Payer: Cofinity Commercial |
$302.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$257.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.12
|
| Rate for Payer: Healthscope Commercial |
$322.32
|
| Rate for Payer: Healthscope Whirlpool |
$312.65
|
| Rate for Payer: Humana Choice PPO Medicare |
$177.12
|
| Rate for Payer: Mclaren Commercial |
$290.09
|
| Rate for Payer: Mclaren Medicaid |
$96.88
|
| Rate for Payer: Mclaren Medicare |
$177.12
|
| Rate for Payer: Meridian Medicaid |
$101.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$185.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$203.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$273.97
|
| Rate for Payer: PACE Medicare |
$168.26
|
| Rate for Payer: PACE SWMI |
$177.12
|
| Rate for Payer: PHP Commercial |
$194.83
|
| Rate for Payer: PHP Medicaid |
$96.88
|
| Rate for Payer: PHP Medicare Advantage |
$177.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$96.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$225.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$293.31
|
| Rate for Payer: Priority Health Medicare |
$177.12
|
| Rate for Payer: Priority Health Narrow Network |
$228.85
|
| Rate for Payer: Railroad Medicare Medicare |
$177.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$283.64
|
| Rate for Payer: UHC Medicare Advantage |
$182.43
|
| Rate for Payer: VA VA |
$177.12
|
|
|
HC COLPOSCOPY, VULVA
|
Facility
|
IP
|
$322.32
|
|
|
Service Code
|
CPT 56820
|
| Hospital Charge Code |
76100258
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$225.62 |
| Max. Negotiated Rate |
$322.32 |
| Rate for Payer: Aetna Commercial |
$290.09
|
| Rate for Payer: ASR ASR |
$312.65
|
| Rate for Payer: BCBS Trust/PPO |
$249.89
|
| Rate for Payer: BCN Commercial |
$249.89
|
| Rate for Payer: Cash Price |
$257.86
|
| Rate for Payer: Cofinity Commercial |
$302.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$257.86
|
| Rate for Payer: Healthscope Commercial |
$322.32
|
| Rate for Payer: Healthscope Whirlpool |
$312.65
|
| Rate for Payer: Mclaren Commercial |
$290.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$273.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$225.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$283.64
|
|
|
HC COLPOSCOPY VULVA W/BIOPSY
|
Facility
|
OP
|
$837.42
|
|
|
Service Code
|
CPT 56821
|
| Hospital Charge Code |
76100332
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$155.98 |
| Max. Negotiated Rate |
$837.42 |
| Rate for Payer: Aetna Commercial |
$753.68
|
| Rate for Payer: Aetna Medicare |
$285.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$356.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$356.45
|
| Rate for Payer: ASR ASR |
$812.30
|
| Rate for Payer: BCBS Complete |
$163.80
|
| Rate for Payer: BCBS MAPPO |
$285.16
|
| Rate for Payer: BCBS Trust/PPO |
$649.25
|
| Rate for Payer: BCN Commercial |
$649.25
|
| Rate for Payer: BCN Medicare Advantage |
$285.16
|
| Rate for Payer: Cash Price |
$669.94
|
| Rate for Payer: Cash Price |
$669.94
|
| Rate for Payer: Cofinity Commercial |
$787.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$669.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$285.16
|
| Rate for Payer: Healthscope Commercial |
$837.42
|
| Rate for Payer: Healthscope Whirlpool |
$812.30
|
| Rate for Payer: Humana Choice PPO Medicare |
$285.16
|
| Rate for Payer: Mclaren Commercial |
$753.68
|
| Rate for Payer: Mclaren Medicaid |
$155.98
|
| Rate for Payer: Mclaren Medicare |
$285.16
|
| Rate for Payer: Meridian Medicaid |
$163.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$299.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$327.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$711.81
|
| Rate for Payer: PACE Medicare |
$270.90
|
| Rate for Payer: PACE SWMI |
$285.16
|
| Rate for Payer: PHP Commercial |
$313.68
|
| Rate for Payer: PHP Medicaid |
$155.98
|
| Rate for Payer: PHP Medicare Advantage |
$285.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$155.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$586.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$762.05
|
| Rate for Payer: Priority Health Medicare |
$285.16
|
| Rate for Payer: Priority Health Narrow Network |
$594.57
|
| Rate for Payer: Railroad Medicare Medicare |
$285.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$736.93
|
| Rate for Payer: UHC Medicare Advantage |
$293.71
|
| Rate for Payer: VA VA |
$285.16
|
|
|
HC COLPOSCOPY VULVA W/BIOPSY
|
Facility
|
IP
|
$837.42
|
|
|
Service Code
|
CPT 56821
|
| Hospital Charge Code |
76100332
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$586.19 |
| Max. Negotiated Rate |
$837.42 |
| Rate for Payer: Aetna Commercial |
$753.68
|
| Rate for Payer: ASR ASR |
$812.30
|
| Rate for Payer: BCBS Trust/PPO |
$649.25
|
| Rate for Payer: BCN Commercial |
$649.25
|
| Rate for Payer: Cash Price |
$669.94
|
| Rate for Payer: Cofinity Commercial |
$787.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$669.94
|
| Rate for Payer: Healthscope Commercial |
$837.42
|
| Rate for Payer: Healthscope Whirlpool |
$812.30
|
| Rate for Payer: Mclaren Commercial |
$753.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$711.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$586.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$736.93
|
|
|
HC COMBI CATH SUPPLY
|
Facility
|
OP
|
$121.04
|
|
| Hospital Charge Code |
27200116
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$48.42 |
| Max. Negotiated Rate |
$121.04 |
| Rate for Payer: Aetna Commercial |
$108.94
|
| Rate for Payer: ASR ASR |
$117.41
|
| Rate for Payer: BCBS Complete |
$48.42
|
| Rate for Payer: BCBS Trust/PPO |
$93.84
|
| Rate for Payer: BCN Commercial |
$93.84
|
| Rate for Payer: Cash Price |
$96.83
|
| Rate for Payer: Cofinity Commercial |
$113.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.83
|
| Rate for Payer: Healthscope Commercial |
$121.04
|
| Rate for Payer: Healthscope Whirlpool |
$117.41
|
| Rate for Payer: Mclaren Commercial |
$108.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$102.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$110.15
|
| Rate for Payer: Priority Health Narrow Network |
$85.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$106.52
|
|
|
HC COMBI CATH SUPPLY
|
Facility
|
IP
|
$121.04
|
|
| Hospital Charge Code |
27200116
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$84.73 |
| Max. Negotiated Rate |
$121.04 |
| Rate for Payer: Aetna Commercial |
$108.94
|
| Rate for Payer: ASR ASR |
$117.41
|
| Rate for Payer: BCBS Trust/PPO |
$93.84
|
| Rate for Payer: BCN Commercial |
$93.84
|
| Rate for Payer: Cash Price |
$96.83
|
| Rate for Payer: Cofinity Commercial |
$113.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.83
|
| Rate for Payer: Healthscope Commercial |
$121.04
|
| Rate for Payer: Healthscope Whirlpool |
$117.41
|
| Rate for Payer: Mclaren Commercial |
$108.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$102.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$106.52
|
|
|
HC COMBINED VACCINE, MMR+VARICELLA, SUBQ
|
Facility
|
OP
|
$209.10
|
|
|
Service Code
|
CPT 90710
|
| Hospital Charge Code |
63600206
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$67.71 |
| Max. Negotiated Rate |
$209.10 |
| Rate for Payer: Aetna Commercial |
$188.19
|
| Rate for Payer: Aetna Medicare |
$123.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$154.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$154.74
|
| Rate for Payer: ASR ASR |
$202.83
|
| Rate for Payer: BCBS Complete |
$71.10
|
| Rate for Payer: BCBS MAPPO |
$123.79
|
| Rate for Payer: BCBS Trust/PPO |
$162.12
|
| Rate for Payer: BCN Commercial |
$162.12
|
| Rate for Payer: BCN Medicare Advantage |
$123.79
|
| Rate for Payer: Cash Price |
$167.28
|
| Rate for Payer: Cash Price |
$167.28
|
| Rate for Payer: Cofinity Commercial |
$196.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$167.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$123.79
|
| Rate for Payer: Healthscope Commercial |
$209.10
|
| Rate for Payer: Healthscope Whirlpool |
$202.83
|
| Rate for Payer: Humana Choice PPO Medicare |
$123.79
|
| Rate for Payer: Mclaren Commercial |
$188.19
|
| Rate for Payer: Mclaren Medicaid |
$67.71
|
| Rate for Payer: Mclaren Medicare |
$123.79
|
| Rate for Payer: Meridian Medicaid |
$71.10
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$129.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$142.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$177.74
|
| Rate for Payer: PACE Medicare |
$117.60
|
| Rate for Payer: PACE SWMI |
$123.79
|
| Rate for Payer: PHP Commercial |
$136.17
|
| Rate for Payer: PHP Medicaid |
$67.71
|
| Rate for Payer: PHP Medicare Advantage |
$123.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.37
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$190.28
|
| Rate for Payer: Priority Health Medicare |
$123.79
|
| Rate for Payer: Priority Health Narrow Network |
$148.46
|
| Rate for Payer: Railroad Medicare Medicare |
$123.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$184.01
|
| Rate for Payer: UHC Medicare Advantage |
$127.50
|
| Rate for Payer: VA VA |
$123.79
|
|
|
HC COMBINED VACCINE, MMR+VARICELLA, SUBQ
|
Facility
|
IP
|
$209.10
|
|
|
Service Code
|
CPT 90710
|
| Hospital Charge Code |
63600206
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$146.37 |
| Max. Negotiated Rate |
$209.10 |
| Rate for Payer: Aetna Commercial |
$188.19
|
| Rate for Payer: ASR ASR |
$202.83
|
| Rate for Payer: BCBS Trust/PPO |
$162.12
|
| Rate for Payer: BCN Commercial |
$162.12
|
| Rate for Payer: Cash Price |
$167.28
|
| Rate for Payer: Cofinity Commercial |
$196.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$167.28
|
| Rate for Payer: Healthscope Commercial |
$209.10
|
| Rate for Payer: Healthscope Whirlpool |
$202.83
|
| Rate for Payer: Mclaren Commercial |
$188.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$177.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$184.01
|
|
|
HC COMMON REED IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200080
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.86 |
| Max. Negotiated Rate |
$24.89 |
| Rate for Payer: Aetna Commercial |
$22.40
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: ASR ASR |
$24.14
|
| Rate for Payer: BCBS Complete |
$3.00
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.30
|
| Rate for Payer: BCN Commercial |
$19.30
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$23.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$24.89
|
| Rate for Payer: Healthscope Whirlpool |
$24.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$22.40
|
| Rate for Payer: Mclaren Medicaid |
$2.86
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Medicaid |
$3.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$5.74
|
| Rate for Payer: PHP Medicaid |
$2.86
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.65
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$17.67
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.90
|
| Rate for Payer: UHC Medicare Advantage |
$5.38
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC COMMON REED IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200080
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$17.42 |
| Max. Negotiated Rate |
$24.89 |
| Rate for Payer: Aetna Commercial |
$22.40
|
| Rate for Payer: ASR ASR |
$24.14
|
| Rate for Payer: BCBS Trust/PPO |
$19.30
|
| Rate for Payer: BCN Commercial |
$19.30
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$23.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$24.89
|
| Rate for Payer: Healthscope Whirlpool |
$24.14
|
| Rate for Payer: Mclaren Commercial |
$22.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.90
|
|
|
HC COMM WORK REINTEGRATION EA 15 MIN
|
Facility
|
OP
|
$95.00
|
|
|
Service Code
|
CPT 97537
|
| Hospital Charge Code |
42000031
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$38.00 |
| Max. Negotiated Rate |
$95.00 |
| Rate for Payer: Aetna Commercial |
$85.50
|
| Rate for Payer: ASR ASR |
$92.15
|
| Rate for Payer: BCBS Complete |
$38.00
|
| Rate for Payer: BCBS Trust/PPO |
$73.65
|
| Rate for Payer: BCN Commercial |
$73.65
|
| Rate for Payer: Cash Price |
$76.00
|
| Rate for Payer: Cash Price |
$76.00
|
| Rate for Payer: Cofinity Commercial |
$89.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.00
|
| Rate for Payer: Healthscope Commercial |
$95.00
|
| Rate for Payer: Healthscope Whirlpool |
$92.15
|
| Rate for Payer: Mclaren Commercial |
$85.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$80.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$56.44
|
| Rate for Payer: Priority Health Narrow Network |
$45.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$83.60
|
|
|
HC COMM WORK REINTEGRATION EA 15 MIN
|
Facility
|
IP
|
$95.00
|
|
|
Service Code
|
CPT 97537
|
| Hospital Charge Code |
42000031
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$66.50 |
| Max. Negotiated Rate |
$95.00 |
| Rate for Payer: Aetna Commercial |
$85.50
|
| Rate for Payer: ASR ASR |
$92.15
|
| Rate for Payer: BCBS Trust/PPO |
$73.65
|
| Rate for Payer: BCN Commercial |
$73.65
|
| Rate for Payer: Cash Price |
$76.00
|
| Rate for Payer: Cofinity Commercial |
$89.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.00
|
| Rate for Payer: Healthscope Commercial |
$95.00
|
| Rate for Payer: Healthscope Whirlpool |
$92.15
|
| Rate for Payer: Mclaren Commercial |
$85.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$80.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$83.60
|
|
