|
HALOPERIDOL 5 MG TABLET
|
Facility
|
IP
|
$415.15
|
|
|
Service Code
|
NDC 00904678261
|
| Hospital Charge Code |
3583
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$269.85 |
| Max. Negotiated Rate |
$415.15 |
| Rate for Payer: Aetna Commercial |
$373.63
|
| Rate for Payer: ASR ASR |
$402.70
|
| Rate for Payer: ASR Commercial |
$402.70
|
| Rate for Payer: BCBS Trust/PPO |
$338.31
|
| Rate for Payer: BCN Commercial |
$321.87
|
| Rate for Payer: Cash Price |
$332.12
|
| Rate for Payer: Cofinity Commercial |
$390.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$332.12
|
| Rate for Payer: Healthscope Commercial |
$415.15
|
| Rate for Payer: Healthscope Whirlpool |
$402.70
|
| Rate for Payer: Mclaren Commercial |
$373.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$352.88
|
| Rate for Payer: Nomi Health Commercial |
$340.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$269.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$365.33
|
|
|
HALOPERIDOL 5 MG TABLET
|
Facility
|
OP
|
$415.15
|
|
|
Service Code
|
NDC 00904678261
|
| Hospital Charge Code |
3583
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$166.06 |
| Max. Negotiated Rate |
$415.15 |
| Rate for Payer: Aetna Commercial |
$373.63
|
| Rate for Payer: Aetna Medicare |
$207.57
|
| Rate for Payer: ASR ASR |
$402.70
|
| Rate for Payer: ASR Commercial |
$402.70
|
| Rate for Payer: BCBS Complete |
$166.06
|
| Rate for Payer: BCBS Trust/PPO |
$339.97
|
| Rate for Payer: BCN Commercial |
$321.87
|
| Rate for Payer: Cash Price |
$332.12
|
| Rate for Payer: Cofinity Commercial |
$390.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$332.12
|
| Rate for Payer: Healthscope Commercial |
$415.15
|
| Rate for Payer: Healthscope Whirlpool |
$402.70
|
| Rate for Payer: Mclaren Commercial |
$373.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$352.88
|
| Rate for Payer: Nomi Health Commercial |
$340.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$269.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$363.75
|
| Rate for Payer: Priority Health Narrow Network |
$291.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$365.33
|
|
|
HALOPERIDOL 5 MG TABLET
|
Facility
|
OP
|
$425.60
|
|
|
Service Code
|
NDC 68382007901
|
| Hospital Charge Code |
3583
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$170.24 |
| Max. Negotiated Rate |
$425.60 |
| Rate for Payer: Aetna Commercial |
$383.04
|
| Rate for Payer: Aetna Medicare |
$212.80
|
| Rate for Payer: ASR ASR |
$412.83
|
| Rate for Payer: ASR Commercial |
$412.83
|
| Rate for Payer: BCBS Complete |
$170.24
|
| Rate for Payer: BCBS Trust/PPO |
$348.52
|
| Rate for Payer: BCN Commercial |
$329.97
|
| Rate for Payer: Cash Price |
$340.48
|
| Rate for Payer: Cofinity Commercial |
$400.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$340.48
|
| Rate for Payer: Healthscope Commercial |
$425.60
|
| Rate for Payer: Healthscope Whirlpool |
$412.83
|
| Rate for Payer: Mclaren Commercial |
$383.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$361.76
|
| Rate for Payer: Nomi Health Commercial |
$348.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$276.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$372.91
|
| Rate for Payer: Priority Health Narrow Network |
$298.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$374.53
|
|
|
HALOPERIDOL 5 MG TABLET
|
Facility
|
IP
|
$2.74
|
|
|
Service Code
|
NDC 51079073601
|
| Hospital Charge Code |
3583
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.78 |
| Max. Negotiated Rate |
$2.74 |
| Rate for Payer: Aetna Commercial |
$2.47
|
| Rate for Payer: ASR ASR |
$2.66
|
| Rate for Payer: ASR Commercial |
$2.66
|
| Rate for Payer: BCBS Trust/PPO |
$2.23
|
| Rate for Payer: BCN Commercial |
$2.12
|
| Rate for Payer: Cash Price |
$2.19
|
| Rate for Payer: Cofinity Commercial |
$2.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.19
|
| Rate for Payer: Healthscope Commercial |
$2.74
|
| Rate for Payer: Healthscope Whirlpool |
$2.66
|
| Rate for Payer: Mclaren Commercial |
$2.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.33
|
| Rate for Payer: Nomi Health Commercial |
$2.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2.41
|
|
|
HALOPERIDOL 5 MG TABLET
|
Facility
|
OP
|
$2.74
|
|
|
Service Code
|
NDC 51079073601
|
| Hospital Charge Code |
3583
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.10 |
| Max. Negotiated Rate |
$2.74 |
| Rate for Payer: Aetna Commercial |
$2.47
|
| Rate for Payer: Aetna Medicare |
$1.37
|
| Rate for Payer: ASR ASR |
$2.66
|
| Rate for Payer: ASR Commercial |
$2.66
|
| Rate for Payer: BCBS Complete |
$1.10
|
| Rate for Payer: BCBS Trust/PPO |
$2.24
|
| Rate for Payer: BCN Commercial |
$2.12
|
| Rate for Payer: Cash Price |
$2.19
|
| Rate for Payer: Cofinity Commercial |
$2.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.19
|
| Rate for Payer: Healthscope Commercial |
$2.74
|
| Rate for Payer: Healthscope Whirlpool |
$2.66
|
| Rate for Payer: Mclaren Commercial |
$2.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.33
|
| Rate for Payer: Nomi Health Commercial |
$2.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2.40
|
| Rate for Payer: Priority Health Narrow Network |
$1.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2.41
|
|
|
HALOPERIDOL 5 MG TABLET
|
Facility
|
IP
|
$425.60
|
|
|
Service Code
|
NDC 68382007901
|
| Hospital Charge Code |
3583
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$276.64 |
| Max. Negotiated Rate |
$425.60 |
| Rate for Payer: Aetna Commercial |
$383.04
|
| Rate for Payer: ASR ASR |
$412.83
|
| Rate for Payer: ASR Commercial |
$412.83
|
| Rate for Payer: BCBS Trust/PPO |
$346.82
|
| Rate for Payer: BCN Commercial |
$329.97
|
| Rate for Payer: Cash Price |
$340.48
|
| Rate for Payer: Cofinity Commercial |
$400.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$340.48
|
| Rate for Payer: Healthscope Commercial |
$425.60
|
| Rate for Payer: Healthscope Whirlpool |
$412.83
|
| Rate for Payer: Mclaren Commercial |
$383.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$361.76
|
| Rate for Payer: Nomi Health Commercial |
$348.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$276.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$374.53
|
|
|
HALOPERIDOL DECANOATE 50 MG/ML INTRAMUSCULAR SOLUTION
|
Facility
|
OP
|
$107.14
|
|
|
Service Code
|
HCPCS J1631
|
| Hospital Charge Code |
10163
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$42.86 |
| Max. Negotiated Rate |
$107.14 |
| Rate for Payer: Aetna Commercial |
$96.43
|
| Rate for Payer: Aetna Medicare |
$53.57
|
| Rate for Payer: ASR ASR |
$103.93
|
| Rate for Payer: ASR Commercial |
$103.93
|
| Rate for Payer: BCBS Complete |
$42.86
|
| Rate for Payer: BCBS Trust/PPO |
$87.74
|
| Rate for Payer: BCN Commercial |
$83.07
|
| Rate for Payer: Cash Price |
$85.71
|
| Rate for Payer: Cofinity Commercial |
$100.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.71
|
| Rate for Payer: Healthscope Commercial |
$107.14
|
| Rate for Payer: Healthscope Whirlpool |
$103.93
|
| Rate for Payer: Mclaren Commercial |
$96.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.07
|
| Rate for Payer: Nomi Health Commercial |
$87.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$93.88
|
| Rate for Payer: Priority Health Narrow Network |
$75.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$94.28
|
|
|
HALOPERIDOL DECANOATE 50 MG/ML INTRAMUSCULAR SOLUTION
|
Facility
|
IP
|
$107.14
|
|
|
Service Code
|
HCPCS J1631
|
| Hospital Charge Code |
10163
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$69.64 |
| Max. Negotiated Rate |
$107.14 |
| Rate for Payer: Aetna Commercial |
$96.43
|
| Rate for Payer: ASR ASR |
$103.93
|
| Rate for Payer: ASR Commercial |
$103.93
|
| Rate for Payer: BCBS Trust/PPO |
$87.31
|
| Rate for Payer: BCN Commercial |
$83.07
|
| Rate for Payer: Cash Price |
$85.71
|
| Rate for Payer: Cofinity Commercial |
$100.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.71
|
| Rate for Payer: Healthscope Commercial |
$107.14
|
| Rate for Payer: Healthscope Whirlpool |
$103.93
|
| Rate for Payer: Mclaren Commercial |
$96.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.07
|
| Rate for Payer: Nomi Health Commercial |
$87.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$94.28
|
|
|
HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLUTION
|
Facility
|
IP
|
$17.20
|
|
|
Service Code
|
HCPCS J1630
|
| Hospital Charge Code |
3584
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$11.18 |
| Max. Negotiated Rate |
$17.20 |
| Rate for Payer: Aetna Commercial |
$15.48
|
| Rate for Payer: Aetna Commercial |
$10.67
|
| Rate for Payer: Aetna Commercial |
$20.94
|
| Rate for Payer: Aetna Commercial |
$9.59
|
| Rate for Payer: ASR ASR |
$10.34
|
| Rate for Payer: ASR ASR |
$16.68
|
| Rate for Payer: ASR ASR |
$11.50
|
| Rate for Payer: ASR ASR |
$22.57
|
| Rate for Payer: ASR Commercial |
$16.68
|
| Rate for Payer: ASR Commercial |
$22.57
|
| Rate for Payer: ASR Commercial |
$11.50
|
| Rate for Payer: ASR Commercial |
$10.34
|
| Rate for Payer: BCBS Trust/PPO |
$18.96
|
| Rate for Payer: BCBS Trust/PPO |
$8.69
|
| Rate for Payer: BCBS Trust/PPO |
$9.66
|
| Rate for Payer: BCBS Trust/PPO |
$14.02
|
| Rate for Payer: BCN Commercial |
$18.04
|
| Rate for Payer: BCN Commercial |
$8.26
|
| Rate for Payer: BCN Commercial |
$13.34
|
| Rate for Payer: BCN Commercial |
$9.20
|
| Rate for Payer: Cash Price |
$9.49
|
| Rate for Payer: Cash Price |
$8.53
|
| Rate for Payer: Cash Price |
$18.62
|
| Rate for Payer: Cash Price |
$13.76
|
| Rate for Payer: Cofinity Commercial |
$16.17
|
| Rate for Payer: Cofinity Commercial |
$11.15
|
| Rate for Payer: Cofinity Commercial |
$21.87
|
| Rate for Payer: Cofinity Commercial |
$10.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.76
|
| Rate for Payer: Healthscope Commercial |
$11.86
|
| Rate for Payer: Healthscope Commercial |
$10.66
|
| Rate for Payer: Healthscope Commercial |
$17.20
|
| Rate for Payer: Healthscope Commercial |
$23.27
|
| Rate for Payer: Healthscope Whirlpool |
$22.57
|
| Rate for Payer: Healthscope Whirlpool |
$11.50
|
| Rate for Payer: Healthscope Whirlpool |
$16.68
|
| Rate for Payer: Healthscope Whirlpool |
$10.34
|
| Rate for Payer: Mclaren Commercial |
$15.48
|
| Rate for Payer: Mclaren Commercial |
$20.94
|
| Rate for Payer: Mclaren Commercial |
$10.67
|
| Rate for Payer: Mclaren Commercial |
$9.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.06
|
| Rate for Payer: Nomi Health Commercial |
$8.74
|
| Rate for Payer: Nomi Health Commercial |
$19.08
|
| Rate for Payer: Nomi Health Commercial |
$14.10
|
| Rate for Payer: Nomi Health Commercial |
$9.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$20.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9.38
|
|
|
HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLUTION
|
Facility
|
OP
|
$11.86
|
|
|
Service Code
|
HCPCS J1630
|
| Hospital Charge Code |
3584
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.74 |
| Max. Negotiated Rate |
$11.86 |
| Rate for Payer: Aetna Commercial |
$10.67
|
| Rate for Payer: Aetna Commercial |
$20.94
|
| Rate for Payer: Aetna Commercial |
$9.59
|
| Rate for Payer: Aetna Commercial |
$15.48
|
| Rate for Payer: Aetna Medicare |
$11.63
|
| Rate for Payer: Aetna Medicare |
$5.93
|
| Rate for Payer: Aetna Medicare |
$8.60
|
| Rate for Payer: Aetna Medicare |
$5.33
|
| Rate for Payer: ASR ASR |
$16.68
|
| Rate for Payer: ASR ASR |
$10.34
|
| Rate for Payer: ASR ASR |
$22.57
|
| Rate for Payer: ASR ASR |
$11.50
|
| Rate for Payer: ASR Commercial |
$11.50
|
| Rate for Payer: ASR Commercial |
$16.68
|
| Rate for Payer: ASR Commercial |
$22.57
|
| Rate for Payer: ASR Commercial |
$10.34
|
| Rate for Payer: BCBS Complete |
$4.26
|
| Rate for Payer: BCBS Complete |
$9.31
|
| Rate for Payer: BCBS Complete |
$6.88
|
| Rate for Payer: BCBS Complete |
$4.74
|
| Rate for Payer: BCBS Trust/PPO |
$9.71
|
| Rate for Payer: BCBS Trust/PPO |
$19.06
|
| Rate for Payer: BCBS Trust/PPO |
$8.73
|
| Rate for Payer: BCBS Trust/PPO |
$14.09
|
| Rate for Payer: BCN Commercial |
$18.04
|
| Rate for Payer: BCN Commercial |
$9.20
|
| Rate for Payer: BCN Commercial |
$8.26
|
| Rate for Payer: BCN Commercial |
$13.34
|
| Rate for Payer: Cash Price |
$9.49
|
| Rate for Payer: Cash Price |
$8.53
|
| Rate for Payer: Cash Price |
$13.76
|
| Rate for Payer: Cash Price |
$18.62
|
| Rate for Payer: Cofinity Commercial |
$10.02
|
| Rate for Payer: Cofinity Commercial |
$11.15
|
| Rate for Payer: Cofinity Commercial |
$16.17
|
| Rate for Payer: Cofinity Commercial |
$21.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.49
|
| Rate for Payer: Healthscope Commercial |
$17.20
|
| Rate for Payer: Healthscope Commercial |
$10.66
|
| Rate for Payer: Healthscope Commercial |
$11.86
|
| Rate for Payer: Healthscope Commercial |
$23.27
|
| Rate for Payer: Healthscope Whirlpool |
$22.57
|
| Rate for Payer: Healthscope Whirlpool |
$16.68
|
| Rate for Payer: Healthscope Whirlpool |
$11.50
|
| Rate for Payer: Healthscope Whirlpool |
$10.34
|
| Rate for Payer: Mclaren Commercial |
$9.59
|
| Rate for Payer: Mclaren Commercial |
$10.67
|
| Rate for Payer: Mclaren Commercial |
$15.48
|
| Rate for Payer: Mclaren Commercial |
$20.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.62
|
| Rate for Payer: Nomi Health Commercial |
$14.10
|
| Rate for Payer: Nomi Health Commercial |
$9.73
|
| Rate for Payer: Nomi Health Commercial |
$19.08
|
| Rate for Payer: Nomi Health Commercial |
$8.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9.34
|
| Rate for Payer: Priority Health Narrow Network |
$12.06
|
| Rate for Payer: Priority Health Narrow Network |
$8.31
|
| Rate for Payer: Priority Health Narrow Network |
$16.31
|
| Rate for Payer: Priority Health Narrow Network |
$7.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$20.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10.44
|
|
|
HC 11 DEOXYCORTISOL
|
Facility
|
IP
|
$65.55
|
|
|
Service Code
|
CPT 82634
|
| Hospital Charge Code |
30100189
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$42.61 |
| Max. Negotiated Rate |
$65.55 |
| Rate for Payer: Aetna Commercial |
$58.99
|
| Rate for Payer: ASR ASR |
$63.58
|
| Rate for Payer: ASR Commercial |
$63.58
|
| Rate for Payer: BCBS Trust/PPO |
$53.42
|
| Rate for Payer: BCN Commercial |
$50.82
|
| Rate for Payer: Cash Price |
$52.44
|
| Rate for Payer: Cofinity Commercial |
$61.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.44
|
| Rate for Payer: Healthscope Commercial |
$65.55
|
| Rate for Payer: Healthscope Whirlpool |
$63.58
|
| Rate for Payer: Mclaren Commercial |
$58.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.72
|
| Rate for Payer: Nomi Health Commercial |
$53.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$57.68
|
|
|
HC 11 DEOXYCORTISOL
|
Facility
|
OP
|
$65.55
|
|
|
Service Code
|
CPT 82634
|
| Hospital Charge Code |
30100189
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.69 |
| Max. Negotiated Rate |
$65.55 |
| Rate for Payer: Aetna Commercial |
$58.99
|
| Rate for Payer: Aetna Medicare |
$29.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.60
|
| Rate for Payer: ASR ASR |
$63.58
|
| Rate for Payer: ASR Commercial |
$63.58
|
| Rate for Payer: BCBS Complete |
$16.48
|
| Rate for Payer: BCBS MAPPO |
$29.28
|
| Rate for Payer: BCBS Trust/PPO |
$53.68
|
| Rate for Payer: BCN Commercial |
$50.82
|
| Rate for Payer: BCN Medicare Advantage |
$29.28
|
| Rate for Payer: Cash Price |
$52.44
|
| Rate for Payer: Cash Price |
$52.44
|
| Rate for Payer: Cofinity Commercial |
$61.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.28
|
| Rate for Payer: Healthscope Commercial |
$65.55
|
| Rate for Payer: Healthscope Whirlpool |
$63.58
|
| Rate for Payer: Humana Choice PPO Medicare |
$29.28
|
| Rate for Payer: Mclaren Commercial |
$58.99
|
| Rate for Payer: Mclaren Medicaid |
$15.69
|
| Rate for Payer: Mclaren Medicare |
$29.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.74
|
| Rate for Payer: Meridian Medicaid |
$16.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.72
|
| Rate for Payer: Nomi Health Commercial |
$53.75
|
| Rate for Payer: PACE Medicare |
$27.82
|
| Rate for Payer: PACE SWMI |
$29.28
|
| Rate for Payer: PHP Commercial |
$32.21
|
| Rate for Payer: PHP Medicaid |
$15.69
|
| Rate for Payer: PHP Medicare Advantage |
$29.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$57.43
|
| Rate for Payer: Priority Health Medicare |
$29.28
|
| Rate for Payer: Priority Health Narrow Network |
$45.95
|
| Rate for Payer: Railroad Medicare Medicare |
$29.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$57.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.28
|
| Rate for Payer: UHC Exchange |
$45.38
|
| Rate for Payer: UHC Medicare Advantage |
$29.28
|
| Rate for Payer: UHCCP DNSP |
$29.28
|
| Rate for Payer: UHCCP Medicaid |
$15.69
|
| Rate for Payer: VA VA |
$29.28
|
|
|
HC 1/2 X 1/2 STERILE W/LL
|
Facility
|
OP
|
$6.89
|
|
| Hospital Charge Code |
27000680
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.76 |
| Max. Negotiated Rate |
$6.89 |
| Rate for Payer: Aetna Commercial |
$6.20
|
| Rate for Payer: Aetna Medicare |
$3.44
|
| Rate for Payer: ASR ASR |
$6.68
|
| Rate for Payer: ASR Commercial |
$6.68
|
| Rate for Payer: BCBS Complete |
$2.76
|
| Rate for Payer: BCBS Trust/PPO |
$5.64
|
| Rate for Payer: BCN Commercial |
$5.34
|
| Rate for Payer: Cash Price |
$5.51
|
| Rate for Payer: Cofinity Commercial |
$6.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5.51
|
| Rate for Payer: Healthscope Commercial |
$6.89
|
| Rate for Payer: Healthscope Whirlpool |
$6.68
|
| Rate for Payer: Mclaren Commercial |
$6.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5.86
|
| Rate for Payer: Nomi Health Commercial |
$5.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6.04
|
| Rate for Payer: Priority Health Narrow Network |
$4.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6.06
|
|
|
HC 1/2 X 1/2 STERILE W/LL
|
Facility
|
IP
|
$6.89
|
|
| Hospital Charge Code |
27000680
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.48 |
| Max. Negotiated Rate |
$6.89 |
| Rate for Payer: Aetna Commercial |
$6.20
|
| Rate for Payer: ASR ASR |
$6.68
|
| Rate for Payer: ASR Commercial |
$6.68
|
| Rate for Payer: BCBS Trust/PPO |
$5.61
|
| Rate for Payer: BCN Commercial |
$5.34
|
| Rate for Payer: Cash Price |
$5.51
|
| Rate for Payer: Cofinity Commercial |
$6.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5.51
|
| Rate for Payer: Healthscope Commercial |
$6.89
|
| Rate for Payer: Healthscope Whirlpool |
$6.68
|
| Rate for Payer: Mclaren Commercial |
$6.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5.86
|
| Rate for Payer: Nomi Health Commercial |
$5.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6.06
|
|
|
HC 20CM TL CATHETER
|
Facility
|
IP
|
$278.41
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200007
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$180.97 |
| Max. Negotiated Rate |
$278.41 |
| Rate for Payer: Aetna Commercial |
$250.57
|
| Rate for Payer: ASR ASR |
$270.06
|
| Rate for Payer: ASR Commercial |
$270.06
|
| Rate for Payer: BCBS Trust/PPO |
$226.88
|
| Rate for Payer: BCN Commercial |
$215.85
|
| Rate for Payer: Cash Price |
$222.73
|
| Rate for Payer: Cofinity Commercial |
$261.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$222.73
|
| Rate for Payer: Healthscope Commercial |
$278.41
|
| Rate for Payer: Healthscope Whirlpool |
$270.06
|
| Rate for Payer: Mclaren Commercial |
$250.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$236.65
|
| Rate for Payer: Nomi Health Commercial |
$228.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$180.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$245.00
|
|
|
HC 20CM TL CATHETER
|
Facility
|
OP
|
$278.41
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200007
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$111.36 |
| Max. Negotiated Rate |
$278.41 |
| Rate for Payer: Aetna Commercial |
$250.57
|
| Rate for Payer: Aetna Medicare |
$139.21
|
| Rate for Payer: ASR ASR |
$270.06
|
| Rate for Payer: ASR Commercial |
$270.06
|
| Rate for Payer: BCBS Complete |
$111.36
|
| Rate for Payer: BCBS Trust/PPO |
$227.99
|
| Rate for Payer: BCN Commercial |
$215.85
|
| Rate for Payer: Cash Price |
$222.73
|
| Rate for Payer: Cofinity Commercial |
$261.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$222.73
|
| Rate for Payer: Healthscope Commercial |
$278.41
|
| Rate for Payer: Healthscope Whirlpool |
$270.06
|
| Rate for Payer: Mclaren Commercial |
$250.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$236.65
|
| Rate for Payer: Nomi Health Commercial |
$228.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$180.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$243.94
|
| Rate for Payer: Priority Health Narrow Network |
$195.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$245.00
|
|
|
HC 23BPG, U
|
Facility
|
IP
|
$74.91
|
|
|
Service Code
|
CPT 84150
|
| Hospital Charge Code |
30100714
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$48.69 |
| Max. Negotiated Rate |
$74.91 |
| Rate for Payer: Aetna Commercial |
$67.42
|
| Rate for Payer: ASR ASR |
$72.66
|
| Rate for Payer: ASR Commercial |
$72.66
|
| Rate for Payer: BCBS Trust/PPO |
$61.04
|
| Rate for Payer: BCN Commercial |
$58.08
|
| Rate for Payer: Cash Price |
$59.93
|
| Rate for Payer: Cofinity Commercial |
$70.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.93
|
| Rate for Payer: Healthscope Commercial |
$74.91
|
| Rate for Payer: Healthscope Whirlpool |
$72.66
|
| Rate for Payer: Mclaren Commercial |
$67.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.67
|
| Rate for Payer: Nomi Health Commercial |
$61.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$65.92
|
|
|
HC 23BPG, U
|
Facility
|
OP
|
$74.91
|
|
|
Service Code
|
CPT 84150
|
| Hospital Charge Code |
30100714
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$22.39 |
| Max. Negotiated Rate |
$74.91 |
| Rate for Payer: Aetna Commercial |
$67.42
|
| Rate for Payer: Aetna Medicare |
$41.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$52.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$52.21
|
| Rate for Payer: ASR ASR |
$72.66
|
| Rate for Payer: ASR Commercial |
$72.66
|
| Rate for Payer: BCBS Complete |
$23.51
|
| Rate for Payer: BCBS MAPPO |
$41.77
|
| Rate for Payer: BCBS Trust/PPO |
$61.34
|
| Rate for Payer: BCN Commercial |
$58.08
|
| Rate for Payer: BCN Medicare Advantage |
$41.77
|
| Rate for Payer: Cash Price |
$59.93
|
| Rate for Payer: Cash Price |
$59.93
|
| Rate for Payer: Cofinity Commercial |
$70.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.77
|
| Rate for Payer: Healthscope Commercial |
$74.91
|
| Rate for Payer: Healthscope Whirlpool |
$72.66
|
| Rate for Payer: Humana Choice PPO Medicare |
$41.77
|
| Rate for Payer: Mclaren Commercial |
$67.42
|
| Rate for Payer: Mclaren Medicaid |
$22.39
|
| Rate for Payer: Mclaren Medicare |
$41.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.86
|
| Rate for Payer: Meridian Medicaid |
$23.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$48.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.67
|
| Rate for Payer: Nomi Health Commercial |
$61.43
|
| Rate for Payer: PACE Medicare |
$39.68
|
| Rate for Payer: PACE SWMI |
$41.77
|
| Rate for Payer: PHP Commercial |
$45.95
|
| Rate for Payer: PHP Medicaid |
$22.39
|
| Rate for Payer: PHP Medicare Advantage |
$41.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$65.64
|
| Rate for Payer: Priority Health Medicare |
$41.77
|
| Rate for Payer: Priority Health Narrow Network |
$52.51
|
| Rate for Payer: Railroad Medicare Medicare |
$41.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$65.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$41.77
|
| Rate for Payer: UHC Exchange |
$64.74
|
| Rate for Payer: UHC Medicare Advantage |
$41.77
|
| Rate for Payer: UHCCP DNSP |
$41.77
|
| Rate for Payer: UHCCP Medicaid |
$22.39
|
| Rate for Payer: VA VA |
$41.77
|
|
|
HC 23BPR URINE
|
Facility
|
IP
|
$86.91
|
|
|
Service Code
|
CPT 84150
|
| Hospital Charge Code |
30100735
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$56.49 |
| Max. Negotiated Rate |
$86.91 |
| Rate for Payer: Aetna Commercial |
$78.22
|
| Rate for Payer: ASR ASR |
$84.30
|
| Rate for Payer: ASR Commercial |
$84.30
|
| Rate for Payer: BCBS Trust/PPO |
$70.82
|
| Rate for Payer: BCN Commercial |
$67.38
|
| Rate for Payer: Cash Price |
$69.53
|
| Rate for Payer: Cofinity Commercial |
$81.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.53
|
| Rate for Payer: Healthscope Commercial |
$86.91
|
| Rate for Payer: Healthscope Whirlpool |
$84.30
|
| Rate for Payer: Mclaren Commercial |
$78.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.87
|
| Rate for Payer: Nomi Health Commercial |
$71.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$76.48
|
|
|
HC 23BPR URINE
|
Facility
|
OP
|
$86.91
|
|
|
Service Code
|
CPT 84150
|
| Hospital Charge Code |
30100735
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$22.39 |
| Max. Negotiated Rate |
$86.91 |
| Rate for Payer: Aetna Commercial |
$78.22
|
| Rate for Payer: Aetna Medicare |
$41.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$52.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$52.21
|
| Rate for Payer: ASR ASR |
$84.30
|
| Rate for Payer: ASR Commercial |
$84.30
|
| Rate for Payer: BCBS Complete |
$23.51
|
| Rate for Payer: BCBS MAPPO |
$41.77
|
| Rate for Payer: BCBS Trust/PPO |
$71.17
|
| Rate for Payer: BCN Commercial |
$67.38
|
| Rate for Payer: BCN Medicare Advantage |
$41.77
|
| Rate for Payer: Cash Price |
$69.53
|
| Rate for Payer: Cash Price |
$69.53
|
| Rate for Payer: Cofinity Commercial |
$81.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.77
|
| Rate for Payer: Healthscope Commercial |
$86.91
|
| Rate for Payer: Healthscope Whirlpool |
$84.30
|
| Rate for Payer: Humana Choice PPO Medicare |
$41.77
|
| Rate for Payer: Mclaren Commercial |
$78.22
|
| Rate for Payer: Mclaren Medicaid |
$22.39
|
| Rate for Payer: Mclaren Medicare |
$41.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.86
|
| Rate for Payer: Meridian Medicaid |
$23.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$48.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.87
|
| Rate for Payer: Nomi Health Commercial |
$71.27
|
| Rate for Payer: PACE Medicare |
$39.68
|
| Rate for Payer: PACE SWMI |
$41.77
|
| Rate for Payer: PHP Commercial |
$45.95
|
| Rate for Payer: PHP Medicaid |
$22.39
|
| Rate for Payer: PHP Medicare Advantage |
$41.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.49
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$76.15
|
| Rate for Payer: Priority Health Medicare |
$41.77
|
| Rate for Payer: Priority Health Narrow Network |
$60.92
|
| Rate for Payer: Railroad Medicare Medicare |
$41.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$76.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$41.77
|
| Rate for Payer: UHC Exchange |
$64.74
|
| Rate for Payer: UHC Medicare Advantage |
$41.77
|
| Rate for Payer: UHCCP DNSP |
$41.77
|
| Rate for Payer: UHCCP Medicaid |
$22.39
|
| Rate for Payer: VA VA |
$41.77
|
|
|
HC 24 HOUR PH MONITOR
|
Facility
|
IP
|
$1,552.14
|
|
|
Service Code
|
CPT 91034
|
| Hospital Charge Code |
75000001
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,008.89 |
| Max. Negotiated Rate |
$1,552.14 |
| Rate for Payer: Aetna Commercial |
$1,396.93
|
| Rate for Payer: ASR ASR |
$1,505.58
|
| Rate for Payer: ASR Commercial |
$1,505.58
|
| Rate for Payer: BCBS Trust/PPO |
$1,264.84
|
| Rate for Payer: BCN Commercial |
$1,203.37
|
| Rate for Payer: Cash Price |
$1,241.71
|
| Rate for Payer: Cofinity Commercial |
$1,459.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,241.71
|
| Rate for Payer: Healthscope Commercial |
$1,552.14
|
| Rate for Payer: Healthscope Whirlpool |
$1,505.58
|
| Rate for Payer: Mclaren Commercial |
$1,396.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,319.32
|
| Rate for Payer: Nomi Health Commercial |
$1,272.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,008.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,365.88
|
|
|
HC 24 HOUR PH MONITOR
|
Facility
|
OP
|
$1,552.14
|
|
|
Service Code
|
CPT 91034
|
| Hospital Charge Code |
75000001
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$277.37 |
| Max. Negotiated Rate |
$1,552.14 |
| Rate for Payer: Aetna Commercial |
$1,396.93
|
| Rate for Payer: Aetna Medicare |
$517.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$646.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$646.85
|
| Rate for Payer: ASR ASR |
$1,505.58
|
| Rate for Payer: ASR Commercial |
$1,505.58
|
| Rate for Payer: BCBS Complete |
$291.24
|
| Rate for Payer: BCBS MAPPO |
$517.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,271.05
|
| Rate for Payer: BCN Commercial |
$1,203.37
|
| Rate for Payer: BCN Medicare Advantage |
$517.48
|
| Rate for Payer: Cash Price |
$1,241.71
|
| Rate for Payer: Cash Price |
$1,241.71
|
| Rate for Payer: Cofinity Commercial |
$1,459.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,241.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$517.48
|
| Rate for Payer: Healthscope Commercial |
$1,552.14
|
| Rate for Payer: Healthscope Whirlpool |
$1,505.58
|
| Rate for Payer: Humana Choice PPO Medicare |
$517.48
|
| Rate for Payer: Mclaren Commercial |
$1,396.93
|
| Rate for Payer: Mclaren Medicaid |
$277.37
|
| Rate for Payer: Mclaren Medicare |
$517.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$543.35
|
| Rate for Payer: Meridian Medicaid |
$291.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$595.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,319.32
|
| Rate for Payer: Nomi Health Commercial |
$1,272.75
|
| Rate for Payer: PACE Medicare |
$491.61
|
| Rate for Payer: PACE SWMI |
$517.48
|
| Rate for Payer: PHP Commercial |
$569.23
|
| Rate for Payer: PHP Medicaid |
$277.37
|
| Rate for Payer: PHP Medicare Advantage |
$517.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$277.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,008.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,359.99
|
| Rate for Payer: Priority Health Medicare |
$517.48
|
| Rate for Payer: Priority Health Narrow Network |
$1,088.05
|
| Rate for Payer: Railroad Medicare Medicare |
$517.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,365.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$517.48
|
| Rate for Payer: UHC Exchange |
$802.09
|
| Rate for Payer: UHC Medicare Advantage |
$517.48
|
| Rate for Payer: UHCCP DNSP |
$517.48
|
| Rate for Payer: UHCCP Medicaid |
$277.37
|
| Rate for Payer: VA VA |
$517.48
|
|
|
HC 2D ECHOCARDIOGRAM LIMITED STUDY
|
Facility
|
OP
|
$825.55
|
|
|
Service Code
|
CPT 93308
|
| Hospital Charge Code |
48300002
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$126.36 |
| Max. Negotiated Rate |
$825.55 |
| Rate for Payer: Aetna Commercial |
$743.00
|
| Rate for Payer: Aetna Medicare |
$235.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$294.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$294.68
|
| Rate for Payer: ASR ASR |
$800.78
|
| Rate for Payer: ASR Commercial |
$800.78
|
| Rate for Payer: BCBS Complete |
$132.67
|
| Rate for Payer: BCBS MAPPO |
$235.74
|
| Rate for Payer: BCBS Trust/PPO |
$676.04
|
| Rate for Payer: BCN Commercial |
$640.05
|
| Rate for Payer: BCN Medicare Advantage |
$235.74
|
| Rate for Payer: Cash Price |
$660.44
|
| Rate for Payer: Cash Price |
$660.44
|
| Rate for Payer: Cofinity Commercial |
$776.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$660.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.74
|
| Rate for Payer: Healthscope Commercial |
$825.55
|
| Rate for Payer: Healthscope Whirlpool |
$800.78
|
| Rate for Payer: Humana Choice PPO Medicare |
$235.74
|
| Rate for Payer: Mclaren Commercial |
$743.00
|
| Rate for Payer: Mclaren Medicaid |
$126.36
|
| Rate for Payer: Mclaren Medicare |
$235.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.53
|
| Rate for Payer: Meridian Medicaid |
$132.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$271.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$701.72
|
| Rate for Payer: Nomi Health Commercial |
$676.95
|
| Rate for Payer: PACE Medicare |
$223.95
|
| Rate for Payer: PACE SWMI |
$235.74
|
| Rate for Payer: PHP Commercial |
$259.31
|
| Rate for Payer: PHP Medicaid |
$126.36
|
| Rate for Payer: PHP Medicare Advantage |
$235.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$536.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$723.35
|
| Rate for Payer: Priority Health Medicare |
$235.74
|
| Rate for Payer: Priority Health Narrow Network |
$578.71
|
| Rate for Payer: Railroad Medicare Medicare |
$235.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$726.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.74
|
| Rate for Payer: UHC Exchange |
$365.40
|
| Rate for Payer: UHC Medicare Advantage |
$235.74
|
| Rate for Payer: UHCCP DNSP |
$235.74
|
| Rate for Payer: UHCCP Medicaid |
$126.36
|
| Rate for Payer: VA VA |
$235.74
|
|
|
HC 2D ECHOCARDIOGRAM LIMITED STUDY
|
Facility
|
IP
|
$825.55
|
|
|
Service Code
|
CPT 93308
|
| Hospital Charge Code |
48300002
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$536.61 |
| Max. Negotiated Rate |
$825.55 |
| Rate for Payer: Aetna Commercial |
$743.00
|
| Rate for Payer: ASR ASR |
$800.78
|
| Rate for Payer: ASR Commercial |
$800.78
|
| Rate for Payer: BCBS Trust/PPO |
$672.74
|
| Rate for Payer: BCN Commercial |
$640.05
|
| Rate for Payer: Cash Price |
$660.44
|
| Rate for Payer: Cofinity Commercial |
$776.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$660.44
|
| Rate for Payer: Healthscope Commercial |
$825.55
|
| Rate for Payer: Healthscope Whirlpool |
$800.78
|
| Rate for Payer: Mclaren Commercial |
$743.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$701.72
|
| Rate for Payer: Nomi Health Commercial |
$676.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$536.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$726.48
|
|
|
HC 2 PIECE WAFER
|
Facility
|
OP
|
$13.42
|
|
| Hospital Charge Code |
27100001
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$5.37 |
| Max. Negotiated Rate |
$13.42 |
| Rate for Payer: Aetna Commercial |
$12.08
|
| Rate for Payer: Aetna Medicare |
$6.71
|
| Rate for Payer: ASR ASR |
$13.02
|
| Rate for Payer: ASR Commercial |
$13.02
|
| Rate for Payer: BCBS Complete |
$5.37
|
| Rate for Payer: BCBS Trust/PPO |
$10.99
|
| Rate for Payer: BCN Commercial |
$10.40
|
| Rate for Payer: Cash Price |
$10.74
|
| Rate for Payer: Cofinity Commercial |
$12.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.74
|
| Rate for Payer: Healthscope Commercial |
$13.42
|
| Rate for Payer: Healthscope Whirlpool |
$13.02
|
| Rate for Payer: Mclaren Commercial |
$12.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.41
|
| Rate for Payer: Nomi Health Commercial |
$11.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11.76
|
| Rate for Payer: Priority Health Narrow Network |
$9.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11.81
|
|
