|
HC ARCTIC SUN TORSO/LEG PADS
|
Facility
|
IP
|
$2,632.46
|
|
| Hospital Charge Code |
27000610
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,974.35 |
| Max. Negotiated Rate |
$2,632.46 |
| Rate for Payer: Aetna Commercial |
$2,369.21
|
| Rate for Payer: ASR ASR |
$2,553.49
|
| Rate for Payer: BCBS Trust/PPO |
$2,161.78
|
| Rate for Payer: BCN Commercial |
$2,161.78
|
| Rate for Payer: Cash Price |
$2,105.97
|
| Rate for Payer: Cofinity Commercial |
$2,474.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,105.97
|
| Rate for Payer: Healthscope Commercial |
$2,553.49
|
| Rate for Payer: Healthscope Whirlpool |
$2,632.46
|
| Rate for Payer: Mclaren Commercial |
$2,369.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,237.59
|
| Rate for Payer: Nomi Health Commercial |
$2,158.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,974.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,316.56
|
|
|
HC ARCTIC SUN TORSO/LEG PADS
|
Facility
|
OP
|
$2,632.46
|
|
| Hospital Charge Code |
27000610
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$974.01 |
| Max. Negotiated Rate |
$2,632.46 |
| Rate for Payer: Aetna Commercial |
$2,369.21
|
| Rate for Payer: Aetna Medicare |
$974.01
|
| Rate for Payer: ASR ASR |
$2,553.49
|
| Rate for Payer: BCBS Complete |
$1,052.98
|
| Rate for Payer: BCBS Trust/PPO |
$2,170.46
|
| Rate for Payer: BCN Commercial |
$2,170.46
|
| Rate for Payer: Cash Price |
$2,105.97
|
| Rate for Payer: Cofinity Commercial |
$2,474.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,105.97
|
| Rate for Payer: Healthscope Commercial |
$2,553.49
|
| Rate for Payer: Healthscope Whirlpool |
$2,632.46
|
| Rate for Payer: Mclaren Commercial |
$2,369.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,105.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,237.59
|
| Rate for Payer: Nomi Health Commercial |
$2,158.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,974.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,306.56
|
| Rate for Payer: Priority Health Narrow Network |
$1,845.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,316.56
|
|
|
HC ARCTIC SUN UNIVERSAL PAD
|
Facility
|
IP
|
$1,140.74
|
|
| Hospital Charge Code |
27000617
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$855.55 |
| Max. Negotiated Rate |
$1,140.74 |
| Rate for Payer: Aetna Commercial |
$1,026.67
|
| Rate for Payer: ASR ASR |
$1,106.52
|
| Rate for Payer: BCBS Trust/PPO |
$936.78
|
| Rate for Payer: BCN Commercial |
$936.78
|
| Rate for Payer: Cash Price |
$912.59
|
| Rate for Payer: Cofinity Commercial |
$1,072.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$912.59
|
| Rate for Payer: Healthscope Commercial |
$1,106.52
|
| Rate for Payer: Healthscope Whirlpool |
$1,140.74
|
| Rate for Payer: Mclaren Commercial |
$1,026.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$969.63
|
| Rate for Payer: Nomi Health Commercial |
$935.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$855.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,003.85
|
|
|
HC ARCTIC SUN UNIVERSAL PAD
|
Facility
|
OP
|
$1,140.74
|
|
| Hospital Charge Code |
27000617
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$422.07 |
| Max. Negotiated Rate |
$1,140.74 |
| Rate for Payer: Aetna Commercial |
$1,026.67
|
| Rate for Payer: Aetna Medicare |
$422.07
|
| Rate for Payer: ASR ASR |
$1,106.52
|
| Rate for Payer: BCBS Complete |
$456.30
|
| Rate for Payer: BCBS Trust/PPO |
$940.54
|
| Rate for Payer: BCN Commercial |
$940.54
|
| Rate for Payer: Cash Price |
$912.59
|
| Rate for Payer: Cofinity Commercial |
$1,072.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$912.59
|
| Rate for Payer: Healthscope Commercial |
$1,106.52
|
| Rate for Payer: Healthscope Whirlpool |
$1,140.74
|
| Rate for Payer: Mclaren Commercial |
$1,026.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$912.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$969.63
|
| Rate for Payer: Nomi Health Commercial |
$935.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$855.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$999.52
|
| Rate for Payer: Priority Health Narrow Network |
$799.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,003.85
|
|
|
HC ARGON PLASMA COAGULATION
|
Facility
|
IP
|
$1,897.29
|
|
| Hospital Charge Code |
36000007
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,422.97 |
| Max. Negotiated Rate |
$1,897.29 |
| Rate for Payer: Aetna Commercial |
$1,707.56
|
| Rate for Payer: ASR ASR |
$1,840.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,558.05
|
| Rate for Payer: BCN Commercial |
$1,558.05
|
| Rate for Payer: Cash Price |
$1,517.83
|
| Rate for Payer: Cofinity Commercial |
$1,783.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,517.83
|
| Rate for Payer: Healthscope Commercial |
$1,840.37
|
| Rate for Payer: Healthscope Whirlpool |
$1,897.29
|
| Rate for Payer: Mclaren Commercial |
$1,707.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,612.70
|
| Rate for Payer: Nomi Health Commercial |
$1,555.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,422.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,669.62
|
|
|
HC ARGON PLASMA COAGULATION
|
Facility
|
OP
|
$1,897.29
|
|
| Hospital Charge Code |
36000007
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$702.00 |
| Max. Negotiated Rate |
$1,897.29 |
| Rate for Payer: Aetna Commercial |
$1,707.56
|
| Rate for Payer: Aetna Medicare |
$702.00
|
| Rate for Payer: ASR ASR |
$1,840.37
|
| Rate for Payer: BCBS Complete |
$758.92
|
| Rate for Payer: BCBS Trust/PPO |
$1,564.32
|
| Rate for Payer: BCN Commercial |
$1,564.32
|
| Rate for Payer: Cash Price |
$1,517.83
|
| Rate for Payer: Cofinity Commercial |
$1,783.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,517.83
|
| Rate for Payer: Healthscope Commercial |
$1,840.37
|
| Rate for Payer: Healthscope Whirlpool |
$1,897.29
|
| Rate for Payer: Mclaren Commercial |
$1,707.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,517.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,612.70
|
| Rate for Payer: Nomi Health Commercial |
$1,555.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,422.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,662.41
|
| Rate for Payer: Priority Health Narrow Network |
$1,330.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,669.62
|
|
|
HC ARISTA HEMOSTAT
|
Facility
|
IP
|
$1,164.50
|
|
| Hospital Charge Code |
27200111
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$873.38 |
| Max. Negotiated Rate |
$1,164.50 |
| Rate for Payer: Aetna Commercial |
$1,048.05
|
| Rate for Payer: ASR ASR |
$1,129.57
|
| Rate for Payer: BCBS Trust/PPO |
$956.29
|
| Rate for Payer: BCN Commercial |
$956.29
|
| Rate for Payer: Cash Price |
$931.60
|
| Rate for Payer: Cofinity Commercial |
$1,094.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$931.60
|
| Rate for Payer: Healthscope Commercial |
$1,129.57
|
| Rate for Payer: Healthscope Whirlpool |
$1,164.50
|
| Rate for Payer: Mclaren Commercial |
$1,048.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$989.83
|
| Rate for Payer: Nomi Health Commercial |
$954.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$873.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,024.76
|
|
|
HC ARISTA HEMOSTAT
|
Facility
|
OP
|
$1,164.50
|
|
| Hospital Charge Code |
27200111
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$430.87 |
| Max. Negotiated Rate |
$1,164.50 |
| Rate for Payer: Aetna Commercial |
$1,048.05
|
| Rate for Payer: Aetna Medicare |
$430.87
|
| Rate for Payer: ASR ASR |
$1,129.57
|
| Rate for Payer: BCBS Complete |
$465.80
|
| Rate for Payer: BCBS Trust/PPO |
$960.13
|
| Rate for Payer: BCN Commercial |
$960.13
|
| Rate for Payer: Cash Price |
$931.60
|
| Rate for Payer: Cofinity Commercial |
$1,094.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$931.60
|
| Rate for Payer: Healthscope Commercial |
$1,129.57
|
| Rate for Payer: Healthscope Whirlpool |
$1,164.50
|
| Rate for Payer: Mclaren Commercial |
$1,048.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$931.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$989.83
|
| Rate for Payer: Nomi Health Commercial |
$954.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$873.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,020.33
|
| Rate for Payer: Priority Health Narrow Network |
$816.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,024.76
|
|
|
HC ARRAY COMPARATIVE GENOMIC ACGH
|
Facility
|
IP
|
$1,628.95
|
|
|
Service Code
|
CPT 81228
|
| Hospital Charge Code |
31000094
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$1,221.71 |
| Max. Negotiated Rate |
$1,628.95 |
| Rate for Payer: Aetna Commercial |
$1,466.06
|
| Rate for Payer: ASR ASR |
$1,580.08
|
| Rate for Payer: BCBS Trust/PPO |
$1,337.69
|
| Rate for Payer: BCN Commercial |
$1,337.69
|
| Rate for Payer: Cash Price |
$1,303.16
|
| Rate for Payer: Cofinity Commercial |
$1,531.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,303.16
|
| Rate for Payer: Healthscope Commercial |
$1,580.08
|
| Rate for Payer: Healthscope Whirlpool |
$1,628.95
|
| Rate for Payer: Mclaren Commercial |
$1,466.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,384.61
|
| Rate for Payer: Nomi Health Commercial |
$1,335.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,221.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,433.48
|
|
|
HC ARRAY COMPARATIVE GENOMIC ACGH
|
Facility
|
OP
|
$1,628.95
|
|
|
Service Code
|
CPT 81228
|
| Hospital Charge Code |
31000094
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$438.40 |
| Max. Negotiated Rate |
$1,628.95 |
| Rate for Payer: Aetna Commercial |
$1,466.06
|
| Rate for Payer: Aetna Medicare |
$900.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,125.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,125.00
|
| Rate for Payer: ASR ASR |
$1,580.08
|
| Rate for Payer: BCBS Complete |
$494.28
|
| Rate for Payer: BCBS MAPPO |
$900.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,343.07
|
| Rate for Payer: BCN Commercial |
$1,343.07
|
| Rate for Payer: BCN Medicare Advantage |
$900.00
|
| Rate for Payer: Cash Price |
$1,303.16
|
| Rate for Payer: Cash Price |
$1,303.16
|
| Rate for Payer: Cofinity Commercial |
$1,531.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,303.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$900.00
|
| Rate for Payer: Healthscope Commercial |
$1,580.08
|
| Rate for Payer: Healthscope Whirlpool |
$1,628.95
|
| Rate for Payer: Humana Choice PPO Medicare |
$900.00
|
| Rate for Payer: Mclaren Commercial |
$1,466.06
|
| Rate for Payer: Mclaren Medicaid |
$900.00
|
| Rate for Payer: Mclaren Medicare |
$900.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$945.00
|
| Rate for Payer: Meridian Medicaid |
$494.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,035.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$990.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,384.61
|
| Rate for Payer: Nomi Health Commercial |
$1,335.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,221.71
|
| Rate for Payer: PACE Medicare |
$855.00
|
| Rate for Payer: PACE SWMI |
$900.00
|
| Rate for Payer: PHP Commercial |
$990.00
|
| Rate for Payer: PHP Medicaid |
$482.40
|
| Rate for Payer: PHP Medicare Advantage |
$900.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$470.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$548.00
|
| Rate for Payer: Priority Health Medicare |
$900.00
|
| Rate for Payer: Priority Health Narrow Network |
$438.40
|
| Rate for Payer: Railroad Medicare Medicare |
$900.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,433.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$900.00
|
| Rate for Payer: UHC Exchange |
$1,395.00
|
| Rate for Payer: UHC Medicaid |
$470.70
|
| Rate for Payer: UHCCP DNSP |
$900.00
|
| Rate for Payer: UHCCP Medicaid |
$470.70
|
| Rate for Payer: VA VA |
$900.00
|
|
|
HC ARRAY COMPARATIVE GENOMIC CMPT
|
Facility
|
IP
|
$1,440.95
|
|
|
Service Code
|
CPT 88399
|
| Hospital Charge Code |
31000061
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$1,080.71 |
| Max. Negotiated Rate |
$1,440.95 |
| Rate for Payer: Aetna Commercial |
$1,296.86
|
| Rate for Payer: ASR ASR |
$1,397.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,183.31
|
| Rate for Payer: BCN Commercial |
$1,183.31
|
| Rate for Payer: Cash Price |
$1,152.76
|
| Rate for Payer: Cofinity Commercial |
$1,354.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,152.76
|
| Rate for Payer: Healthscope Commercial |
$1,397.72
|
| Rate for Payer: Healthscope Whirlpool |
$1,440.95
|
| Rate for Payer: Mclaren Commercial |
$1,296.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,224.81
|
| Rate for Payer: Nomi Health Commercial |
$1,181.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,080.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,268.04
|
|
|
HC ARRAY COMPARATIVE GENOMIC CMPT
|
Facility
|
OP
|
$1,440.95
|
|
|
Service Code
|
CPT 88399
|
| Hospital Charge Code |
31000061
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$27.15 |
| Max. Negotiated Rate |
$1,440.95 |
| Rate for Payer: Aetna Commercial |
$1,296.86
|
| Rate for Payer: Aetna Medicare |
$51.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$64.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$64.90
|
| Rate for Payer: ASR ASR |
$1,397.72
|
| Rate for Payer: BCBS Complete |
$28.51
|
| Rate for Payer: BCBS MAPPO |
$51.92
|
| Rate for Payer: BCBS Trust/PPO |
$1,188.06
|
| Rate for Payer: BCN Commercial |
$1,188.06
|
| Rate for Payer: BCN Medicare Advantage |
$51.92
|
| Rate for Payer: Cash Price |
$1,152.76
|
| Rate for Payer: Cash Price |
$1,152.76
|
| Rate for Payer: Cofinity Commercial |
$1,354.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,152.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.92
|
| Rate for Payer: Healthscope Commercial |
$1,397.72
|
| Rate for Payer: Healthscope Whirlpool |
$1,440.95
|
| Rate for Payer: Humana Choice PPO Medicare |
$51.92
|
| Rate for Payer: Mclaren Commercial |
$1,296.86
|
| Rate for Payer: Mclaren Medicaid |
$51.92
|
| Rate for Payer: Mclaren Medicare |
$51.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$54.52
|
| Rate for Payer: Meridian Medicaid |
$28.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$57.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,224.81
|
| Rate for Payer: Nomi Health Commercial |
$1,181.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,080.71
|
| Rate for Payer: PACE Medicare |
$49.32
|
| Rate for Payer: PACE SWMI |
$51.92
|
| Rate for Payer: PHP Commercial |
$57.11
|
| Rate for Payer: PHP Medicaid |
$27.83
|
| Rate for Payer: PHP Medicare Advantage |
$51.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,262.56
|
| Rate for Payer: Priority Health Medicare |
$51.92
|
| Rate for Payer: Priority Health Narrow Network |
$1,010.11
|
| Rate for Payer: Railroad Medicare Medicare |
$51.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,268.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$51.92
|
| Rate for Payer: UHC Exchange |
$80.48
|
| Rate for Payer: UHC Medicaid |
$27.15
|
| Rate for Payer: UHCCP DNSP |
$51.92
|
| Rate for Payer: UHCCP Medicaid |
$27.15
|
| Rate for Payer: VA VA |
$51.92
|
|
|
HC ARSENIC
|
Facility
|
IP
|
$199.96
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100108
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$149.97 |
| Max. Negotiated Rate |
$199.96 |
| Rate for Payer: Aetna Commercial |
$179.96
|
| Rate for Payer: ASR ASR |
$193.96
|
| Rate for Payer: BCBS Trust/PPO |
$164.21
|
| Rate for Payer: BCN Commercial |
$164.21
|
| Rate for Payer: Cash Price |
$159.97
|
| Rate for Payer: Cofinity Commercial |
$187.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$159.97
|
| Rate for Payer: Healthscope Commercial |
$193.96
|
| Rate for Payer: Healthscope Whirlpool |
$199.96
|
| Rate for Payer: Mclaren Commercial |
$179.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$169.97
|
| Rate for Payer: Nomi Health Commercial |
$163.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$149.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$175.96
|
|
|
HC ARSENIC
|
Facility
|
OP
|
$199.96
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100108
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.92 |
| Max. Negotiated Rate |
$199.96 |
| Rate for Payer: Aetna Commercial |
$179.96
|
| Rate for Payer: Aetna Medicare |
$18.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.71
|
| Rate for Payer: ASR ASR |
$193.96
|
| Rate for Payer: BCBS Complete |
$10.42
|
| Rate for Payer: BCBS MAPPO |
$18.97
|
| Rate for Payer: BCBS Trust/PPO |
$164.87
|
| Rate for Payer: BCN Commercial |
$164.87
|
| Rate for Payer: BCN Medicare Advantage |
$18.97
|
| Rate for Payer: Cash Price |
$159.97
|
| Rate for Payer: Cash Price |
$159.97
|
| Rate for Payer: Cofinity Commercial |
$187.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$159.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.97
|
| Rate for Payer: Healthscope Commercial |
$193.96
|
| Rate for Payer: Healthscope Whirlpool |
$199.96
|
| Rate for Payer: Humana Choice PPO Medicare |
$18.97
|
| Rate for Payer: Mclaren Commercial |
$179.96
|
| Rate for Payer: Mclaren Medicaid |
$18.97
|
| Rate for Payer: Mclaren Medicare |
$18.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.92
|
| Rate for Payer: Meridian Medicaid |
$10.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$169.97
|
| Rate for Payer: Nomi Health Commercial |
$163.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$149.97
|
| Rate for Payer: PACE Medicare |
$18.02
|
| Rate for Payer: PACE SWMI |
$18.97
|
| Rate for Payer: PHP Commercial |
$20.87
|
| Rate for Payer: PHP Medicaid |
$10.17
|
| Rate for Payer: PHP Medicare Advantage |
$18.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$130.75
|
| Rate for Payer: Priority Health Medicare |
$18.97
|
| Rate for Payer: Priority Health Narrow Network |
$104.60
|
| Rate for Payer: Railroad Medicare Medicare |
$18.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$175.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18.97
|
| Rate for Payer: UHC Exchange |
$29.40
|
| Rate for Payer: UHC Medicaid |
$9.92
|
| Rate for Payer: UHCCP DNSP |
$18.97
|
| Rate for Payer: UHCCP Medicaid |
$9.92
|
| Rate for Payer: VA VA |
$18.97
|
|
|
HC ARSENIC 24HR U
|
Facility
|
OP
|
$116.52
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100679
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.92 |
| Max. Negotiated Rate |
$130.75 |
| Rate for Payer: Aetna Commercial |
$104.87
|
| Rate for Payer: Aetna Medicare |
$18.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.71
|
| Rate for Payer: ASR ASR |
$113.02
|
| Rate for Payer: BCBS Complete |
$10.42
|
| Rate for Payer: BCBS MAPPO |
$18.97
|
| Rate for Payer: BCBS Trust/PPO |
$96.07
|
| Rate for Payer: BCN Commercial |
$96.07
|
| Rate for Payer: BCN Medicare Advantage |
$18.97
|
| Rate for Payer: Cash Price |
$93.22
|
| Rate for Payer: Cash Price |
$93.22
|
| Rate for Payer: Cofinity Commercial |
$109.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.97
|
| Rate for Payer: Healthscope Commercial |
$113.02
|
| Rate for Payer: Healthscope Whirlpool |
$116.52
|
| Rate for Payer: Humana Choice PPO Medicare |
$18.97
|
| Rate for Payer: Mclaren Commercial |
$104.87
|
| Rate for Payer: Mclaren Medicaid |
$18.97
|
| Rate for Payer: Mclaren Medicare |
$18.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.92
|
| Rate for Payer: Meridian Medicaid |
$10.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.04
|
| Rate for Payer: Nomi Health Commercial |
$95.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.39
|
| Rate for Payer: PACE Medicare |
$18.02
|
| Rate for Payer: PACE SWMI |
$18.97
|
| Rate for Payer: PHP Commercial |
$20.87
|
| Rate for Payer: PHP Medicaid |
$10.17
|
| Rate for Payer: PHP Medicare Advantage |
$18.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$130.75
|
| Rate for Payer: Priority Health Medicare |
$18.97
|
| Rate for Payer: Priority Health Narrow Network |
$104.60
|
| Rate for Payer: Railroad Medicare Medicare |
$18.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$102.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18.97
|
| Rate for Payer: UHC Exchange |
$29.40
|
| Rate for Payer: UHC Medicaid |
$9.92
|
| Rate for Payer: UHCCP DNSP |
$18.97
|
| Rate for Payer: UHCCP Medicaid |
$9.92
|
| Rate for Payer: VA VA |
$18.97
|
|
|
HC ARSENIC 24HR U
|
Facility
|
IP
|
$116.52
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100679
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$87.39 |
| Max. Negotiated Rate |
$116.52 |
| Rate for Payer: Aetna Commercial |
$104.87
|
| Rate for Payer: ASR ASR |
$113.02
|
| Rate for Payer: BCBS Trust/PPO |
$95.69
|
| Rate for Payer: BCN Commercial |
$95.69
|
| Rate for Payer: Cash Price |
$93.22
|
| Rate for Payer: Cofinity Commercial |
$109.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.22
|
| Rate for Payer: Healthscope Commercial |
$113.02
|
| Rate for Payer: Healthscope Whirlpool |
$116.52
|
| Rate for Payer: Mclaren Commercial |
$104.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.04
|
| Rate for Payer: Nomi Health Commercial |
$95.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$102.54
|
|
|
HC ARSENIC URINE
|
Facility
|
OP
|
$66.59
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100110
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.92 |
| Max. Negotiated Rate |
$130.75 |
| Rate for Payer: Aetna Commercial |
$59.93
|
| Rate for Payer: Aetna Medicare |
$18.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.71
|
| Rate for Payer: ASR ASR |
$64.59
|
| Rate for Payer: BCBS Complete |
$10.42
|
| Rate for Payer: BCBS MAPPO |
$18.97
|
| Rate for Payer: BCBS Trust/PPO |
$54.90
|
| Rate for Payer: BCN Commercial |
$54.90
|
| Rate for Payer: BCN Medicare Advantage |
$18.97
|
| Rate for Payer: Cash Price |
$53.27
|
| Rate for Payer: Cash Price |
$53.27
|
| Rate for Payer: Cofinity Commercial |
$62.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.97
|
| Rate for Payer: Healthscope Commercial |
$64.59
|
| Rate for Payer: Healthscope Whirlpool |
$66.59
|
| Rate for Payer: Humana Choice PPO Medicare |
$18.97
|
| Rate for Payer: Mclaren Commercial |
$59.93
|
| Rate for Payer: Mclaren Medicaid |
$18.97
|
| Rate for Payer: Mclaren Medicare |
$18.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.92
|
| Rate for Payer: Meridian Medicaid |
$10.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.60
|
| Rate for Payer: Nomi Health Commercial |
$54.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$49.94
|
| Rate for Payer: PACE Medicare |
$18.02
|
| Rate for Payer: PACE SWMI |
$18.97
|
| Rate for Payer: PHP Commercial |
$20.87
|
| Rate for Payer: PHP Medicaid |
$10.17
|
| Rate for Payer: PHP Medicare Advantage |
$18.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$130.75
|
| Rate for Payer: Priority Health Medicare |
$18.97
|
| Rate for Payer: Priority Health Narrow Network |
$104.60
|
| Rate for Payer: Railroad Medicare Medicare |
$18.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$58.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18.97
|
| Rate for Payer: UHC Exchange |
$29.40
|
| Rate for Payer: UHC Medicaid |
$9.92
|
| Rate for Payer: UHCCP DNSP |
$18.97
|
| Rate for Payer: UHCCP Medicaid |
$9.92
|
| Rate for Payer: VA VA |
$18.97
|
|
|
HC ARSENIC URINE
|
Facility
|
IP
|
$66.59
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100110
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$49.94 |
| Max. Negotiated Rate |
$66.59 |
| Rate for Payer: Aetna Commercial |
$59.93
|
| Rate for Payer: ASR ASR |
$64.59
|
| Rate for Payer: BCBS Trust/PPO |
$54.68
|
| Rate for Payer: BCN Commercial |
$54.68
|
| Rate for Payer: Cash Price |
$53.27
|
| Rate for Payer: Cofinity Commercial |
$62.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.27
|
| Rate for Payer: Healthscope Commercial |
$64.59
|
| Rate for Payer: Healthscope Whirlpool |
$66.59
|
| Rate for Payer: Mclaren Commercial |
$59.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.60
|
| Rate for Payer: Nomi Health Commercial |
$54.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$49.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$58.60
|
|
|
HC ART CATH INSERT
|
Facility
|
IP
|
$461.76
|
|
| Hospital Charge Code |
45000029
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$346.32 |
| Max. Negotiated Rate |
$461.76 |
| Rate for Payer: Aetna Commercial |
$415.58
|
| Rate for Payer: ASR ASR |
$447.91
|
| Rate for Payer: BCBS Trust/PPO |
$379.20
|
| Rate for Payer: BCN Commercial |
$379.20
|
| Rate for Payer: Cash Price |
$369.41
|
| Rate for Payer: Cofinity Commercial |
$434.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$369.41
|
| Rate for Payer: Healthscope Commercial |
$447.91
|
| Rate for Payer: Healthscope Whirlpool |
$461.76
|
| Rate for Payer: Mclaren Commercial |
$415.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$392.50
|
| Rate for Payer: Nomi Health Commercial |
$378.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$346.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$406.35
|
|
|
HC ART CATH INSERT
|
Facility
|
OP
|
$461.76
|
|
| Hospital Charge Code |
45000029
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$170.85 |
| Max. Negotiated Rate |
$461.76 |
| Rate for Payer: Aetna Commercial |
$415.58
|
| Rate for Payer: Aetna Medicare |
$170.85
|
| Rate for Payer: ASR ASR |
$447.91
|
| Rate for Payer: BCBS Complete |
$184.70
|
| Rate for Payer: BCBS Trust/PPO |
$380.72
|
| Rate for Payer: BCN Commercial |
$380.72
|
| Rate for Payer: Cash Price |
$369.41
|
| Rate for Payer: Cofinity Commercial |
$434.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$369.41
|
| Rate for Payer: Healthscope Commercial |
$447.91
|
| Rate for Payer: Healthscope Whirlpool |
$461.76
|
| Rate for Payer: Mclaren Commercial |
$415.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$369.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$392.50
|
| Rate for Payer: Nomi Health Commercial |
$378.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$346.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$404.59
|
| Rate for Payer: Priority Health Narrow Network |
$323.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$406.35
|
|
|
HC ARTERIAL DUPLEX IMAG BIL LOWER EXTREMITY
|
Facility
|
OP
|
$1,619.87
|
|
|
Service Code
|
CPT 93925
|
| Hospital Charge Code |
92100007
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$1,619.87 |
| Rate for Payer: Aetna Commercial |
$1,457.88
|
| Rate for Payer: Aetna Medicare |
$237.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$297.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$297.18
|
| Rate for Payer: ASR ASR |
$1,571.27
|
| Rate for Payer: BCBS Complete |
$130.57
|
| Rate for Payer: BCBS MAPPO |
$237.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,335.58
|
| Rate for Payer: BCN Commercial |
$1,335.58
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$1,295.90
|
| Rate for Payer: Cash Price |
$1,295.90
|
| Rate for Payer: Cofinity Commercial |
$1,522.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,295.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$1,571.27
|
| Rate for Payer: Healthscope Whirlpool |
$1,619.87
|
| Rate for Payer: Humana Choice PPO Medicare |
$237.74
|
| Rate for Payer: Mclaren Commercial |
$1,457.88
|
| Rate for Payer: Mclaren Medicaid |
$237.74
|
| Rate for Payer: Mclaren Medicare |
$237.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.63
|
| Rate for Payer: Meridian Medicaid |
$130.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$273.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$261.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,376.89
|
| Rate for Payer: Nomi Health Commercial |
$1,328.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,214.90
|
| Rate for Payer: PACE Medicare |
$225.85
|
| Rate for Payer: PACE SWMI |
$237.74
|
| Rate for Payer: PHP Commercial |
$261.51
|
| Rate for Payer: PHP Medicaid |
$127.43
|
| Rate for Payer: PHP Medicare Advantage |
$237.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,419.33
|
| Rate for Payer: Priority Health Medicare |
$237.74
|
| Rate for Payer: Priority Health Narrow Network |
$1,135.53
|
| Rate for Payer: Railroad Medicare Medicare |
$237.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,425.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$237.74
|
| Rate for Payer: UHC Exchange |
$368.50
|
| Rate for Payer: UHC Medicaid |
$124.34
|
| Rate for Payer: UHCCP DNSP |
$237.74
|
| Rate for Payer: UHCCP Medicaid |
$124.34
|
| Rate for Payer: VA VA |
$237.74
|
|
|
HC ARTERIAL DUPLEX IMAG BIL LOWER EXTREMITY
|
Facility
|
IP
|
$1,619.87
|
|
|
Service Code
|
CPT 93925
|
| Hospital Charge Code |
92100007
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$1,214.90 |
| Max. Negotiated Rate |
$1,619.87 |
| Rate for Payer: Aetna Commercial |
$1,457.88
|
| Rate for Payer: ASR ASR |
$1,571.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,330.24
|
| Rate for Payer: BCN Commercial |
$1,330.24
|
| Rate for Payer: Cash Price |
$1,295.90
|
| Rate for Payer: Cofinity Commercial |
$1,522.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,295.90
|
| Rate for Payer: Healthscope Commercial |
$1,571.27
|
| Rate for Payer: Healthscope Whirlpool |
$1,619.87
|
| Rate for Payer: Mclaren Commercial |
$1,457.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,376.89
|
| Rate for Payer: Nomi Health Commercial |
$1,328.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,214.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,425.49
|
|
|
HC ARTERIAL DUPLEX IMAG BIL UPPER EXTREMITY
|
Facility
|
IP
|
$1,335.07
|
|
|
Service Code
|
CPT 93930
|
| Hospital Charge Code |
92100008
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$1,001.30 |
| Max. Negotiated Rate |
$1,335.07 |
| Rate for Payer: Aetna Commercial |
$1,201.56
|
| Rate for Payer: ASR ASR |
$1,295.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,096.36
|
| Rate for Payer: BCN Commercial |
$1,096.36
|
| Rate for Payer: Cash Price |
$1,068.06
|
| Rate for Payer: Cofinity Commercial |
$1,254.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,068.06
|
| Rate for Payer: Healthscope Commercial |
$1,295.02
|
| Rate for Payer: Healthscope Whirlpool |
$1,335.07
|
| Rate for Payer: Mclaren Commercial |
$1,201.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,134.81
|
| Rate for Payer: Nomi Health Commercial |
$1,094.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,001.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,174.86
|
|
|
HC ARTERIAL DUPLEX IMAG BIL UPPER EXTREMITY
|
Facility
|
OP
|
$1,335.07
|
|
|
Service Code
|
CPT 93930
|
| Hospital Charge Code |
92100008
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$1,335.07 |
| Rate for Payer: Aetna Commercial |
$1,201.56
|
| Rate for Payer: Aetna Medicare |
$237.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$297.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$297.18
|
| Rate for Payer: ASR ASR |
$1,295.02
|
| Rate for Payer: BCBS Complete |
$130.57
|
| Rate for Payer: BCBS MAPPO |
$237.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,100.77
|
| Rate for Payer: BCN Commercial |
$1,100.77
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$1,068.06
|
| Rate for Payer: Cash Price |
$1,068.06
|
| Rate for Payer: Cofinity Commercial |
$1,254.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,068.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$1,295.02
|
| Rate for Payer: Healthscope Whirlpool |
$1,335.07
|
| Rate for Payer: Humana Choice PPO Medicare |
$237.74
|
| Rate for Payer: Mclaren Commercial |
$1,201.56
|
| Rate for Payer: Mclaren Medicaid |
$237.74
|
| Rate for Payer: Mclaren Medicare |
$237.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.63
|
| Rate for Payer: Meridian Medicaid |
$130.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$273.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$261.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,134.81
|
| Rate for Payer: Nomi Health Commercial |
$1,094.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,001.30
|
| Rate for Payer: PACE Medicare |
$225.85
|
| Rate for Payer: PACE SWMI |
$237.74
|
| Rate for Payer: PHP Commercial |
$261.51
|
| Rate for Payer: PHP Medicaid |
$127.43
|
| Rate for Payer: PHP Medicare Advantage |
$237.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,169.79
|
| Rate for Payer: Priority Health Medicare |
$237.74
|
| Rate for Payer: Priority Health Narrow Network |
$935.88
|
| Rate for Payer: Railroad Medicare Medicare |
$237.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,174.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$237.74
|
| Rate for Payer: UHC Exchange |
$368.50
|
| Rate for Payer: UHC Medicaid |
$124.34
|
| Rate for Payer: UHCCP DNSP |
$237.74
|
| Rate for Payer: UHCCP Medicaid |
$124.34
|
| Rate for Payer: VA VA |
$237.74
|
|
|
HC ARTERIAL PUNCTURE
|
Facility
|
IP
|
$138.61
|
|
|
Service Code
|
CPT 36600
|
| Hospital Charge Code |
36100442
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$103.96 |
| Max. Negotiated Rate |
$138.61 |
| Rate for Payer: Aetna Commercial |
$124.75
|
| Rate for Payer: ASR ASR |
$134.45
|
| Rate for Payer: BCBS Trust/PPO |
$113.83
|
| Rate for Payer: BCN Commercial |
$113.83
|
| Rate for Payer: Cash Price |
$110.89
|
| Rate for Payer: Cofinity Commercial |
$130.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$110.89
|
| Rate for Payer: Healthscope Commercial |
$134.45
|
| Rate for Payer: Healthscope Whirlpool |
$138.61
|
| Rate for Payer: Mclaren Commercial |
$124.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$117.82
|
| Rate for Payer: Nomi Health Commercial |
$113.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$103.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$121.98
|
|
