|
HC CONVEX WAFER
|
Facility
|
OP
|
$55.92
|
|
| Hospital Charge Code |
27000049
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$22.37 |
| Max. Negotiated Rate |
$55.92 |
| Rate for Payer: Aetna Commercial |
$50.33
|
| Rate for Payer: ASR ASR |
$54.24
|
| Rate for Payer: BCBS Complete |
$22.37
|
| Rate for Payer: BCBS Trust/PPO |
$43.35
|
| Rate for Payer: BCN Commercial |
$43.35
|
| Rate for Payer: Cash Price |
$44.74
|
| Rate for Payer: Cofinity Commercial |
$52.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.74
|
| Rate for Payer: Healthscope Commercial |
$55.92
|
| Rate for Payer: Healthscope Whirlpool |
$54.24
|
| Rate for Payer: Mclaren Commercial |
$50.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$47.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$50.89
|
| Rate for Payer: Priority Health Narrow Network |
$39.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$49.21
|
|
|
HC CONVEX WAFER
|
Facility
|
IP
|
$55.92
|
|
| Hospital Charge Code |
27000049
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$39.14 |
| Max. Negotiated Rate |
$55.92 |
| Rate for Payer: Aetna Commercial |
$50.33
|
| Rate for Payer: ASR ASR |
$54.24
|
| Rate for Payer: BCBS Trust/PPO |
$43.35
|
| Rate for Payer: BCN Commercial |
$43.35
|
| Rate for Payer: Cash Price |
$44.74
|
| Rate for Payer: Cofinity Commercial |
$52.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.74
|
| Rate for Payer: Healthscope Commercial |
$55.92
|
| Rate for Payer: Healthscope Whirlpool |
$54.24
|
| Rate for Payer: Mclaren Commercial |
$50.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$47.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$49.21
|
|
|
HC COOK GUIDEWIRE
|
Facility
|
OP
|
$46.93
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200019
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$18.77 |
| Max. Negotiated Rate |
$46.93 |
| Rate for Payer: Aetna Commercial |
$42.24
|
| Rate for Payer: ASR ASR |
$45.52
|
| Rate for Payer: BCBS Complete |
$18.77
|
| Rate for Payer: BCBS Trust/PPO |
$36.38
|
| Rate for Payer: BCN Commercial |
$36.38
|
| Rate for Payer: Cash Price |
$37.54
|
| Rate for Payer: Cofinity Commercial |
$44.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.54
|
| Rate for Payer: Healthscope Commercial |
$46.93
|
| Rate for Payer: Healthscope Whirlpool |
$45.52
|
| Rate for Payer: Mclaren Commercial |
$42.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$42.71
|
| Rate for Payer: Priority Health Narrow Network |
$33.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$41.30
|
|
|
HC COOK GUIDEWIRE
|
Facility
|
IP
|
$46.93
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200019
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$32.85 |
| Max. Negotiated Rate |
$46.93 |
| Rate for Payer: Aetna Commercial |
$42.24
|
| Rate for Payer: ASR ASR |
$45.52
|
| Rate for Payer: BCBS Trust/PPO |
$36.38
|
| Rate for Payer: BCN Commercial |
$36.38
|
| Rate for Payer: Cash Price |
$37.54
|
| Rate for Payer: Cofinity Commercial |
$44.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.54
|
| Rate for Payer: Healthscope Commercial |
$46.93
|
| Rate for Payer: Healthscope Whirlpool |
$45.52
|
| Rate for Payer: Mclaren Commercial |
$42.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$41.30
|
|
|
HC COOK PIGTAIL
|
Facility
|
IP
|
$459.14
|
|
| Hospital Charge Code |
27200233
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$321.40 |
| Max. Negotiated Rate |
$459.14 |
| Rate for Payer: Aetna Commercial |
$413.23
|
| Rate for Payer: ASR ASR |
$445.37
|
| Rate for Payer: BCBS Trust/PPO |
$355.97
|
| Rate for Payer: BCN Commercial |
$355.97
|
| Rate for Payer: Cash Price |
$367.31
|
| Rate for Payer: Cofinity Commercial |
$431.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$367.31
|
| Rate for Payer: Healthscope Commercial |
$459.14
|
| Rate for Payer: Healthscope Whirlpool |
$445.37
|
| Rate for Payer: Mclaren Commercial |
$413.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$390.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$321.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$404.04
|
|
|
HC COOK PIGTAIL
|
Facility
|
OP
|
$459.14
|
|
| Hospital Charge Code |
27200233
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$183.66 |
| Max. Negotiated Rate |
$459.14 |
| Rate for Payer: Aetna Commercial |
$413.23
|
| Rate for Payer: ASR ASR |
$445.37
|
| Rate for Payer: BCBS Complete |
$183.66
|
| Rate for Payer: BCBS Trust/PPO |
$355.97
|
| Rate for Payer: BCN Commercial |
$355.97
|
| Rate for Payer: Cash Price |
$367.31
|
| Rate for Payer: Cofinity Commercial |
$431.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$367.31
|
| Rate for Payer: Healthscope Commercial |
$459.14
|
| Rate for Payer: Healthscope Whirlpool |
$445.37
|
| Rate for Payer: Mclaren Commercial |
$413.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$390.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$321.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$417.82
|
| Rate for Payer: Priority Health Narrow Network |
$325.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$404.04
|
|
|
HC COOLIEF RF PROBE
|
Facility
|
IP
|
$1,875.00
|
|
| Hospital Charge Code |
27200355
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,312.50 |
| Max. Negotiated Rate |
$1,875.00 |
| Rate for Payer: Aetna Commercial |
$1,687.50
|
| Rate for Payer: ASR ASR |
$1,818.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,453.69
|
| Rate for Payer: BCN Commercial |
$1,453.69
|
| Rate for Payer: Cash Price |
$1,500.00
|
| Rate for Payer: Cofinity Commercial |
$1,762.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,500.00
|
| Rate for Payer: Healthscope Commercial |
$1,875.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,818.75
|
| Rate for Payer: Mclaren Commercial |
$1,687.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,593.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,312.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,650.00
|
|
|
HC COOLIEF RF PROBE
|
Facility
|
OP
|
$1,875.00
|
|
| Hospital Charge Code |
27200355
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$750.00 |
| Max. Negotiated Rate |
$1,875.00 |
| Rate for Payer: Aetna Commercial |
$1,687.50
|
| Rate for Payer: ASR ASR |
$1,818.75
|
| Rate for Payer: BCBS Complete |
$750.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,453.69
|
| Rate for Payer: BCN Commercial |
$1,453.69
|
| Rate for Payer: Cash Price |
$1,500.00
|
| Rate for Payer: Cofinity Commercial |
$1,762.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,500.00
|
| Rate for Payer: Healthscope Commercial |
$1,875.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,818.75
|
| Rate for Payer: Mclaren Commercial |
$1,687.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,593.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,312.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,706.25
|
| Rate for Payer: Priority Health Narrow Network |
$1,331.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,650.00
|
|
|
HC COPPER SERUM
|
Facility
|
OP
|
$44.00
|
|
|
Service Code
|
CPT 82525
|
| Hospital Charge Code |
30100170
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.79 |
| Max. Negotiated Rate |
$61.57 |
| Rate for Payer: Aetna Commercial |
$39.60
|
| Rate for Payer: Aetna Medicare |
$12.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.51
|
| Rate for Payer: ASR ASR |
$42.68
|
| Rate for Payer: BCBS Complete |
$7.13
|
| Rate for Payer: BCBS MAPPO |
$12.41
|
| Rate for Payer: BCBS Trust/PPO |
$34.11
|
| Rate for Payer: BCN Commercial |
$34.11
|
| Rate for Payer: BCN Medicare Advantage |
$12.41
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cofinity Commercial |
$41.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.41
|
| Rate for Payer: Healthscope Commercial |
$44.00
|
| Rate for Payer: Healthscope Whirlpool |
$42.68
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.41
|
| Rate for Payer: Mclaren Commercial |
$39.60
|
| Rate for Payer: Mclaren Medicaid |
$6.79
|
| Rate for Payer: Mclaren Medicare |
$12.41
|
| Rate for Payer: Meridian Medicaid |
$7.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$37.40
|
| Rate for Payer: PACE Medicare |
$11.79
|
| Rate for Payer: PACE SWMI |
$12.41
|
| Rate for Payer: PHP Commercial |
$13.65
|
| Rate for Payer: PHP Medicaid |
$6.79
|
| Rate for Payer: PHP Medicare Advantage |
$12.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$61.57
|
| Rate for Payer: Priority Health Medicare |
$12.41
|
| Rate for Payer: Priority Health Narrow Network |
$49.26
|
| Rate for Payer: Railroad Medicare Medicare |
$12.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$38.72
|
| Rate for Payer: UHC Medicare Advantage |
$12.78
|
| Rate for Payer: VA VA |
$12.41
|
|
|
HC COPPER SERUM
|
Facility
|
IP
|
$44.00
|
|
|
Service Code
|
CPT 82525
|
| Hospital Charge Code |
30100170
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$30.80 |
| Max. Negotiated Rate |
$44.00 |
| Rate for Payer: Aetna Commercial |
$39.60
|
| Rate for Payer: ASR ASR |
$42.68
|
| Rate for Payer: BCBS Trust/PPO |
$34.11
|
| Rate for Payer: BCN Commercial |
$34.11
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cofinity Commercial |
$41.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.20
|
| Rate for Payer: Healthscope Commercial |
$44.00
|
| Rate for Payer: Healthscope Whirlpool |
$42.68
|
| Rate for Payer: Mclaren Commercial |
$39.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$37.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$38.72
|
|
|
HC COPPER URINE
|
Facility
|
OP
|
$62.00
|
|
|
Service Code
|
CPT 82525
|
| Hospital Charge Code |
30100171
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.79 |
| Max. Negotiated Rate |
$62.00 |
| Rate for Payer: Aetna Commercial |
$55.80
|
| Rate for Payer: Aetna Medicare |
$12.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.51
|
| Rate for Payer: ASR ASR |
$60.14
|
| Rate for Payer: BCBS Complete |
$7.13
|
| Rate for Payer: BCBS MAPPO |
$12.41
|
| Rate for Payer: BCBS Trust/PPO |
$48.07
|
| Rate for Payer: BCN Commercial |
$48.07
|
| Rate for Payer: BCN Medicare Advantage |
$12.41
|
| Rate for Payer: Cash Price |
$49.60
|
| Rate for Payer: Cash Price |
$49.60
|
| Rate for Payer: Cofinity Commercial |
$58.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.41
|
| Rate for Payer: Healthscope Commercial |
$62.00
|
| Rate for Payer: Healthscope Whirlpool |
$60.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.41
|
| Rate for Payer: Mclaren Commercial |
$55.80
|
| Rate for Payer: Mclaren Medicaid |
$6.79
|
| Rate for Payer: Mclaren Medicare |
$12.41
|
| Rate for Payer: Meridian Medicaid |
$7.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.70
|
| Rate for Payer: PACE Medicare |
$11.79
|
| Rate for Payer: PACE SWMI |
$12.41
|
| Rate for Payer: PHP Commercial |
$13.65
|
| Rate for Payer: PHP Medicaid |
$6.79
|
| Rate for Payer: PHP Medicare Advantage |
$12.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$61.57
|
| Rate for Payer: Priority Health Medicare |
$12.41
|
| Rate for Payer: Priority Health Narrow Network |
$49.26
|
| Rate for Payer: Railroad Medicare Medicare |
$12.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$54.56
|
| Rate for Payer: UHC Medicare Advantage |
$12.78
|
| Rate for Payer: VA VA |
$12.41
|
|
|
HC COPPER URINE
|
Facility
|
IP
|
$62.00
|
|
|
Service Code
|
CPT 82525
|
| Hospital Charge Code |
30100171
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$43.40 |
| Max. Negotiated Rate |
$62.00 |
| Rate for Payer: Aetna Commercial |
$55.80
|
| Rate for Payer: ASR ASR |
$60.14
|
| Rate for Payer: BCBS Trust/PPO |
$48.07
|
| Rate for Payer: BCN Commercial |
$48.07
|
| Rate for Payer: Cash Price |
$49.60
|
| Rate for Payer: Cofinity Commercial |
$58.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.60
|
| Rate for Payer: Healthscope Commercial |
$62.00
|
| Rate for Payer: Healthscope Whirlpool |
$60.14
|
| Rate for Payer: Mclaren Commercial |
$55.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$54.56
|
|
|
HC CORDIS CATHETER
|
Facility
|
OP
|
$192.76
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200021
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$77.10 |
| Max. Negotiated Rate |
$192.76 |
| Rate for Payer: Aetna Commercial |
$173.48
|
| Rate for Payer: ASR ASR |
$186.98
|
| Rate for Payer: BCBS Complete |
$77.10
|
| Rate for Payer: BCBS Trust/PPO |
$149.45
|
| Rate for Payer: BCN Commercial |
$149.45
|
| Rate for Payer: Cash Price |
$154.21
|
| Rate for Payer: Cofinity Commercial |
$181.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$154.21
|
| Rate for Payer: Healthscope Commercial |
$192.76
|
| Rate for Payer: Healthscope Whirlpool |
$186.98
|
| Rate for Payer: Mclaren Commercial |
$173.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$163.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$134.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$175.41
|
| Rate for Payer: Priority Health Narrow Network |
$136.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$169.63
|
|
|
HC CORDIS CATHETER
|
Facility
|
IP
|
$192.76
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200021
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$134.93 |
| Max. Negotiated Rate |
$192.76 |
| Rate for Payer: Aetna Commercial |
$173.48
|
| Rate for Payer: ASR ASR |
$186.98
|
| Rate for Payer: BCBS Trust/PPO |
$149.45
|
| Rate for Payer: BCN Commercial |
$149.45
|
| Rate for Payer: Cash Price |
$154.21
|
| Rate for Payer: Cofinity Commercial |
$181.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$154.21
|
| Rate for Payer: Healthscope Commercial |
$192.76
|
| Rate for Payer: Healthscope Whirlpool |
$186.98
|
| Rate for Payer: Mclaren Commercial |
$173.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$163.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$134.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$169.63
|
|
|
HC CORDIS PERIPHERAL STENT
|
Facility
|
IP
|
$3,739.66
|
|
|
Service Code
|
HCPCS C1876
|
| Hospital Charge Code |
27800006
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,617.76 |
| Max. Negotiated Rate |
$3,739.66 |
| Rate for Payer: Aetna Commercial |
$3,365.69
|
| Rate for Payer: ASR ASR |
$3,627.47
|
| Rate for Payer: BCBS Trust/PPO |
$2,899.36
|
| Rate for Payer: BCN Commercial |
$2,899.36
|
| Rate for Payer: Cash Price |
$2,991.73
|
| Rate for Payer: Cofinity Commercial |
$3,515.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,991.73
|
| Rate for Payer: Healthscope Commercial |
$3,739.66
|
| Rate for Payer: Healthscope Whirlpool |
$3,627.47
|
| Rate for Payer: Mclaren Commercial |
$3,365.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,178.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,617.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,290.90
|
|
|
HC CORDIS PERIPHERAL STENT
|
Facility
|
OP
|
$3,739.66
|
|
|
Service Code
|
HCPCS C1876
|
| Hospital Charge Code |
27800006
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,495.86 |
| Max. Negotiated Rate |
$3,739.66 |
| Rate for Payer: Aetna Commercial |
$3,365.69
|
| Rate for Payer: ASR ASR |
$3,627.47
|
| Rate for Payer: BCBS Complete |
$1,495.86
|
| Rate for Payer: BCBS Trust/PPO |
$2,899.36
|
| Rate for Payer: BCN Commercial |
$2,899.36
|
| Rate for Payer: Cash Price |
$2,991.73
|
| Rate for Payer: Cofinity Commercial |
$3,515.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,991.73
|
| Rate for Payer: Healthscope Commercial |
$3,739.66
|
| Rate for Payer: Healthscope Whirlpool |
$3,627.47
|
| Rate for Payer: Mclaren Commercial |
$3,365.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,178.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,617.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,403.09
|
| Rate for Payer: Priority Health Narrow Network |
$2,655.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,290.90
|
|
|
HC COREWELL DRUG ANALYSIS
|
Facility
|
OP
|
$92.68
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100740
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.99 |
| Max. Negotiated Rate |
$92.68 |
| Rate for Payer: Aetna Commercial |
$83.41
|
| Rate for Payer: Aetna Medicare |
$62.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.68
|
| Rate for Payer: ASR ASR |
$89.90
|
| Rate for Payer: BCBS Complete |
$35.69
|
| Rate for Payer: BCBS MAPPO |
$62.14
|
| Rate for Payer: BCBS Trust/PPO |
$71.85
|
| Rate for Payer: BCN Commercial |
$71.85
|
| Rate for Payer: BCN Medicare Advantage |
$62.14
|
| Rate for Payer: Cash Price |
$74.14
|
| Rate for Payer: Cash Price |
$74.14
|
| Rate for Payer: Cofinity Commercial |
$87.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.14
|
| Rate for Payer: Healthscope Commercial |
$92.68
|
| Rate for Payer: Healthscope Whirlpool |
$89.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$62.14
|
| Rate for Payer: Mclaren Commercial |
$83.41
|
| Rate for Payer: Mclaren Medicaid |
$33.99
|
| Rate for Payer: Mclaren Medicare |
$62.14
|
| Rate for Payer: Meridian Medicaid |
$35.69
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$65.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$78.78
|
| Rate for Payer: PACE Medicare |
$59.03
|
| Rate for Payer: PACE SWMI |
$62.14
|
| Rate for Payer: PHP Commercial |
$68.35
|
| Rate for Payer: PHP Medicaid |
$33.99
|
| Rate for Payer: PHP Medicare Advantage |
$62.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$84.34
|
| Rate for Payer: Priority Health Medicare |
$62.14
|
| Rate for Payer: Priority Health Narrow Network |
$65.80
|
| Rate for Payer: Railroad Medicare Medicare |
$62.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$81.56
|
| Rate for Payer: UHC Medicare Advantage |
$64.00
|
| Rate for Payer: VA VA |
$62.14
|
|
|
HC COREWELL DRUG ANALYSIS
|
Facility
|
IP
|
$92.68
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100740
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$64.88 |
| Max. Negotiated Rate |
$92.68 |
| Rate for Payer: Aetna Commercial |
$83.41
|
| Rate for Payer: ASR ASR |
$89.90
|
| Rate for Payer: BCBS Trust/PPO |
$71.85
|
| Rate for Payer: BCN Commercial |
$71.85
|
| Rate for Payer: Cash Price |
$74.14
|
| Rate for Payer: Cofinity Commercial |
$87.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.14
|
| Rate for Payer: Healthscope Commercial |
$92.68
|
| Rate for Payer: Healthscope Whirlpool |
$89.90
|
| Rate for Payer: Mclaren Commercial |
$83.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$78.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$81.56
|
|
|
HC COREWELL DRUG ANALYSIS ALCOHOL
|
Facility
|
IP
|
$45.00
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
30100739
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.50 |
| Max. Negotiated Rate |
$45.00 |
| Rate for Payer: Aetna Commercial |
$40.50
|
| Rate for Payer: ASR ASR |
$43.65
|
| Rate for Payer: BCBS Trust/PPO |
$34.89
|
| Rate for Payer: BCN Commercial |
$34.89
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cofinity Commercial |
$42.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.00
|
| Rate for Payer: Healthscope Commercial |
$45.00
|
| Rate for Payer: Healthscope Whirlpool |
$43.65
|
| Rate for Payer: Mclaren Commercial |
$40.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$38.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$39.60
|
|
|
HC COREWELL DRUG ANALYSIS ALCOHOL
|
Facility
|
OP
|
$45.00
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
30100739
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.00 |
| Max. Negotiated Rate |
$45.00 |
| Rate for Payer: Aetna Commercial |
$40.50
|
| Rate for Payer: ASR ASR |
$43.65
|
| Rate for Payer: BCBS Complete |
$18.00
|
| Rate for Payer: BCBS Trust/PPO |
$34.89
|
| Rate for Payer: BCN Commercial |
$34.89
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cofinity Commercial |
$42.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.00
|
| Rate for Payer: Healthscope Commercial |
$45.00
|
| Rate for Payer: Healthscope Whirlpool |
$43.65
|
| Rate for Payer: Mclaren Commercial |
$40.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$38.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$40.95
|
| Rate for Payer: Priority Health Narrow Network |
$31.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$39.60
|
|
|
HC CORN IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200036
|
|
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 CORN IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200036
|
|
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 CORN POLLEN IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200081
|
|
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 CORN POLLEN IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200081
|
|
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 CORO ANGIOS W RHC
|
Facility
|
IP
|
$8,788.64
|
|
|
Service Code
|
CPT 93456
|
| Hospital Charge Code |
48100015
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$6,152.05 |
| Max. Negotiated Rate |
$8,788.64 |
| Rate for Payer: Aetna Commercial |
$7,909.78
|
| Rate for Payer: ASR ASR |
$8,524.98
|
| Rate for Payer: BCBS Trust/PPO |
$6,813.83
|
| Rate for Payer: BCN Commercial |
$6,813.83
|
| Rate for Payer: Cash Price |
$7,030.91
|
| Rate for Payer: Cofinity Commercial |
$8,261.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,030.91
|
| Rate for Payer: Healthscope Commercial |
$8,788.64
|
| Rate for Payer: Healthscope Whirlpool |
$8,524.98
|
| Rate for Payer: Mclaren Commercial |
$7,909.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,470.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,152.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,734.00
|
|
