|
HC AUD VERTICAL ELECTRODE USE
|
Facility
|
IP
|
$56.21
|
|
|
Service Code
|
CPT 92547
|
| Hospital Charge Code |
47100004
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$42.16 |
| Max. Negotiated Rate |
$56.21 |
| Rate for Payer: Aetna Commercial |
$50.59
|
| Rate for Payer: ASR ASR |
$54.52
|
| Rate for Payer: BCBS Trust/PPO |
$46.16
|
| Rate for Payer: BCN Commercial |
$46.16
|
| Rate for Payer: Cash Price |
$44.97
|
| Rate for Payer: Cofinity Commercial |
$52.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.97
|
| Rate for Payer: Healthscope Commercial |
$54.52
|
| Rate for Payer: Healthscope Whirlpool |
$56.21
|
| Rate for Payer: Mclaren Commercial |
$50.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.78
|
| Rate for Payer: Nomi Health Commercial |
$46.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$49.46
|
|
|
HC AUD VERTICAL ELECTRODE USE
|
Facility
|
OP
|
$56.21
|
|
|
Service Code
|
CPT 92547
|
| Hospital Charge Code |
47100004
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$20.80 |
| Max. Negotiated Rate |
$56.21 |
| Rate for Payer: Aetna Commercial |
$50.59
|
| Rate for Payer: Aetna Medicare |
$20.80
|
| Rate for Payer: ASR ASR |
$54.52
|
| Rate for Payer: BCBS Complete |
$22.48
|
| Rate for Payer: BCBS Trust/PPO |
$46.35
|
| Rate for Payer: BCN Commercial |
$46.35
|
| Rate for Payer: Cash Price |
$44.97
|
| Rate for Payer: Cofinity Commercial |
$52.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.97
|
| Rate for Payer: Healthscope Commercial |
$54.52
|
| Rate for Payer: Healthscope Whirlpool |
$56.21
|
| Rate for Payer: Mclaren Commercial |
$50.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.78
|
| Rate for Payer: Nomi Health Commercial |
$46.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$49.25
|
| Rate for Payer: Priority Health Narrow Network |
$39.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$49.46
|
|
|
HC AUD VESTIBULAR EVAL BASIC
|
Facility
|
OP
|
$472.72
|
|
|
Service Code
|
CPT 92540
|
| Hospital Charge Code |
47100005
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$112.52 |
| Max. Negotiated Rate |
$472.72 |
| Rate for Payer: Aetna Commercial |
$425.45
|
| Rate for Payer: Aetna Medicare |
$215.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$268.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$268.94
|
| Rate for Payer: ASR ASR |
$458.54
|
| Rate for Payer: BCBS Complete |
$118.16
|
| Rate for Payer: BCBS MAPPO |
$215.15
|
| Rate for Payer: BCBS Trust/PPO |
$389.76
|
| Rate for Payer: BCN Commercial |
$389.76
|
| Rate for Payer: BCN Medicare Advantage |
$215.15
|
| Rate for Payer: Cash Price |
$378.18
|
| Rate for Payer: Cash Price |
$378.18
|
| Rate for Payer: Cofinity Commercial |
$444.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$378.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$215.15
|
| Rate for Payer: Healthscope Commercial |
$458.54
|
| Rate for Payer: Healthscope Whirlpool |
$472.72
|
| Rate for Payer: Humana Choice PPO Medicare |
$215.15
|
| Rate for Payer: Mclaren Commercial |
$425.45
|
| Rate for Payer: Mclaren Medicaid |
$215.15
|
| Rate for Payer: Mclaren Medicare |
$215.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$225.91
|
| Rate for Payer: Meridian Medicaid |
$118.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$247.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$236.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$401.81
|
| Rate for Payer: Nomi Health Commercial |
$387.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$354.54
|
| Rate for Payer: PACE Medicare |
$204.39
|
| Rate for Payer: PACE SWMI |
$215.15
|
| Rate for Payer: PHP Commercial |
$236.66
|
| Rate for Payer: PHP Medicaid |
$115.32
|
| Rate for Payer: PHP Medicare Advantage |
$215.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$414.20
|
| Rate for Payer: Priority Health Medicare |
$215.15
|
| Rate for Payer: Priority Health Narrow Network |
$331.38
|
| Rate for Payer: Railroad Medicare Medicare |
$215.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$415.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$215.15
|
| Rate for Payer: UHC Exchange |
$333.48
|
| Rate for Payer: UHC Medicaid |
$112.52
|
| Rate for Payer: UHCCP DNSP |
$215.15
|
| Rate for Payer: UHCCP Medicaid |
$112.52
|
| Rate for Payer: VA VA |
$215.15
|
|
|
HC AUD VESTIBULAR EVAL BASIC
|
Facility
|
IP
|
$472.72
|
|
|
Service Code
|
CPT 92540
|
| Hospital Charge Code |
47100005
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$354.54 |
| Max. Negotiated Rate |
$472.72 |
| Rate for Payer: Aetna Commercial |
$425.45
|
| Rate for Payer: ASR ASR |
$458.54
|
| Rate for Payer: BCBS Trust/PPO |
$388.20
|
| Rate for Payer: BCN Commercial |
$388.20
|
| Rate for Payer: Cash Price |
$378.18
|
| Rate for Payer: Cofinity Commercial |
$444.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$378.18
|
| Rate for Payer: Healthscope Commercial |
$458.54
|
| Rate for Payer: Healthscope Whirlpool |
$472.72
|
| Rate for Payer: Mclaren Commercial |
$425.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$401.81
|
| Rate for Payer: Nomi Health Commercial |
$387.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$354.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$415.99
|
|
|
HC AUTOIMMUNE DIABETES CMPT
|
Facility
|
IP
|
$44.00
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
30200522
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$33.00 |
| 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 |
$36.13
|
| Rate for Payer: BCN Commercial |
$36.13
|
| 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 |
$42.68
|
| Rate for Payer: Healthscope Whirlpool |
$44.00
|
| Rate for Payer: Mclaren Commercial |
$39.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.40
|
| Rate for Payer: Nomi Health Commercial |
$36.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$38.72
|
|
|
HC AUTOIMMUNE DIABETES CMPT
|
Facility
|
OP
|
$44.00
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
30200522
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.33 |
| Max. Negotiated Rate |
$44.00 |
| Rate for Payer: Aetna Commercial |
$39.60
|
| Rate for Payer: Aetna Medicare |
$23.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.46
|
| Rate for Payer: ASR ASR |
$42.68
|
| Rate for Payer: BCBS Complete |
$12.94
|
| Rate for Payer: BCBS MAPPO |
$23.57
|
| Rate for Payer: BCBS Trust/PPO |
$36.28
|
| Rate for Payer: BCN Commercial |
$36.28
|
| Rate for Payer: BCN Medicare Advantage |
$23.57
|
| 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 |
$23.57
|
| Rate for Payer: Healthscope Commercial |
$42.68
|
| Rate for Payer: Healthscope Whirlpool |
$44.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$23.57
|
| Rate for Payer: Mclaren Commercial |
$39.60
|
| Rate for Payer: Mclaren Medicaid |
$23.57
|
| Rate for Payer: Mclaren Medicare |
$23.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.75
|
| Rate for Payer: Meridian Medicaid |
$12.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$25.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.40
|
| Rate for Payer: Nomi Health Commercial |
$36.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.00
|
| Rate for Payer: PACE Medicare |
$22.39
|
| Rate for Payer: PACE SWMI |
$23.57
|
| Rate for Payer: PHP Commercial |
$25.93
|
| Rate for Payer: PHP Medicaid |
$12.63
|
| Rate for Payer: PHP Medicare Advantage |
$23.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$38.55
|
| Rate for Payer: Priority Health Medicare |
$23.57
|
| Rate for Payer: Priority Health Narrow Network |
$30.84
|
| Rate for Payer: Railroad Medicare Medicare |
$23.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$38.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$23.57
|
| Rate for Payer: UHC Exchange |
$36.53
|
| Rate for Payer: UHC Medicaid |
$12.33
|
| Rate for Payer: UHCCP DNSP |
$23.57
|
| Rate for Payer: UHCCP Medicaid |
$12.33
|
| Rate for Payer: VA VA |
$23.57
|
|
|
HC AUTOLOGOUS UNIT
|
Facility
|
OP
|
$841.79
|
|
|
Service Code
|
HCPCS P9021
|
| Hospital Charge Code |
39000040
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$76.80 |
| Max. Negotiated Rate |
$841.79 |
| Rate for Payer: Aetna Commercial |
$757.61
|
| Rate for Payer: Aetna Medicare |
$146.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$183.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$183.56
|
| Rate for Payer: ASR ASR |
$816.54
|
| Rate for Payer: BCBS Complete |
$80.65
|
| Rate for Payer: BCBS MAPPO |
$146.85
|
| Rate for Payer: BCBS Trust/PPO |
$694.06
|
| Rate for Payer: BCN Commercial |
$694.06
|
| Rate for Payer: BCN Medicare Advantage |
$146.85
|
| Rate for Payer: Cash Price |
$673.43
|
| Rate for Payer: Cash Price |
$673.43
|
| Rate for Payer: Cofinity Commercial |
$791.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$673.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$146.85
|
| Rate for Payer: Healthscope Commercial |
$816.54
|
| Rate for Payer: Healthscope Whirlpool |
$841.79
|
| Rate for Payer: Humana Choice PPO Medicare |
$146.85
|
| Rate for Payer: Mclaren Commercial |
$757.61
|
| Rate for Payer: Mclaren Medicaid |
$146.85
|
| Rate for Payer: Mclaren Medicare |
$146.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$154.19
|
| Rate for Payer: Meridian Medicaid |
$80.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$168.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$161.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$715.52
|
| Rate for Payer: Nomi Health Commercial |
$690.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$631.34
|
| Rate for Payer: PACE Medicare |
$139.51
|
| Rate for Payer: PACE SWMI |
$146.85
|
| Rate for Payer: PHP Commercial |
$161.53
|
| Rate for Payer: PHP Medicaid |
$78.71
|
| Rate for Payer: PHP Medicare Advantage |
$146.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$737.58
|
| Rate for Payer: Priority Health Medicare |
$146.85
|
| Rate for Payer: Priority Health Narrow Network |
$590.09
|
| Rate for Payer: Railroad Medicare Medicare |
$146.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$740.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$146.85
|
| Rate for Payer: UHC Exchange |
$227.62
|
| Rate for Payer: UHC Medicaid |
$76.80
|
| Rate for Payer: UHCCP DNSP |
$146.85
|
| Rate for Payer: UHCCP Medicaid |
$76.80
|
| Rate for Payer: VA VA |
$146.85
|
|
|
HC AUTOLOGOUS UNIT
|
Facility
|
IP
|
$841.79
|
|
|
Service Code
|
HCPCS P9021
|
| Hospital Charge Code |
39000040
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$631.34 |
| Max. Negotiated Rate |
$841.79 |
| Rate for Payer: Aetna Commercial |
$757.61
|
| Rate for Payer: ASR ASR |
$816.54
|
| Rate for Payer: BCBS Trust/PPO |
$691.28
|
| Rate for Payer: BCN Commercial |
$691.28
|
| Rate for Payer: Cash Price |
$673.43
|
| Rate for Payer: Cofinity Commercial |
$791.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$673.43
|
| Rate for Payer: Healthscope Commercial |
$816.54
|
| Rate for Payer: Healthscope Whirlpool |
$841.79
|
| Rate for Payer: Mclaren Commercial |
$757.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$715.52
|
| Rate for Payer: Nomi Health Commercial |
$690.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$631.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$740.78
|
|
|
HC AUTONOMIC FUNC ADRENERGIC
|
Facility
|
IP
|
$185.16
|
|
|
Service Code
|
CPT 95922
|
| Hospital Charge Code |
92000007
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$138.87 |
| Max. Negotiated Rate |
$185.16 |
| Rate for Payer: Aetna Commercial |
$166.64
|
| Rate for Payer: ASR ASR |
$179.61
|
| Rate for Payer: BCBS Trust/PPO |
$152.05
|
| Rate for Payer: BCN Commercial |
$152.05
|
| Rate for Payer: Cash Price |
$148.13
|
| Rate for Payer: Cofinity Commercial |
$174.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$148.13
|
| Rate for Payer: Healthscope Commercial |
$179.61
|
| Rate for Payer: Healthscope Whirlpool |
$185.16
|
| Rate for Payer: Mclaren Commercial |
$166.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$157.39
|
| Rate for Payer: Nomi Health Commercial |
$151.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$138.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$162.94
|
|
|
HC AUTONOMIC FUNC ADRENERGIC
|
Facility
|
OP
|
$185.16
|
|
|
Service Code
|
CPT 95922
|
| Hospital Charge Code |
92000007
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$69.33 |
| Max. Negotiated Rate |
$205.48 |
| Rate for Payer: Aetna Commercial |
$166.64
|
| Rate for Payer: Aetna Medicare |
$132.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$165.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$165.71
|
| Rate for Payer: ASR ASR |
$179.61
|
| Rate for Payer: BCBS Complete |
$72.81
|
| Rate for Payer: BCBS MAPPO |
$132.57
|
| Rate for Payer: BCBS Trust/PPO |
$152.66
|
| Rate for Payer: BCN Commercial |
$152.66
|
| Rate for Payer: BCN Medicare Advantage |
$132.57
|
| Rate for Payer: Cash Price |
$148.13
|
| Rate for Payer: Cash Price |
$148.13
|
| Rate for Payer: Cofinity Commercial |
$174.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$148.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.57
|
| Rate for Payer: Healthscope Commercial |
$179.61
|
| Rate for Payer: Healthscope Whirlpool |
$185.16
|
| Rate for Payer: Humana Choice PPO Medicare |
$132.57
|
| Rate for Payer: Mclaren Commercial |
$166.64
|
| Rate for Payer: Mclaren Medicaid |
$132.57
|
| Rate for Payer: Mclaren Medicare |
$132.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$139.20
|
| Rate for Payer: Meridian Medicaid |
$72.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$145.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$157.39
|
| Rate for Payer: Nomi Health Commercial |
$151.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$138.87
|
| Rate for Payer: PACE Medicare |
$125.94
|
| Rate for Payer: PACE SWMI |
$132.57
|
| Rate for Payer: PHP Commercial |
$145.83
|
| Rate for Payer: PHP Medicaid |
$71.06
|
| Rate for Payer: PHP Medicare Advantage |
$132.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$162.24
|
| Rate for Payer: Priority Health Medicare |
$132.57
|
| Rate for Payer: Priority Health Narrow Network |
$129.80
|
| Rate for Payer: Railroad Medicare Medicare |
$132.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$162.94
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$132.57
|
| Rate for Payer: UHC Exchange |
$205.48
|
| Rate for Payer: UHC Medicaid |
$69.33
|
| Rate for Payer: UHCCP DNSP |
$132.57
|
| Rate for Payer: UHCCP Medicaid |
$69.33
|
| Rate for Payer: VA VA |
$132.57
|
|
|
HC AUTONOMIC FUNC CARDIO INNERVAT
|
Facility
|
OP
|
$370.31
|
|
|
Service Code
|
CPT 95921
|
| Hospital Charge Code |
92000006
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$67.05 |
| Max. Negotiated Rate |
$370.31 |
| Rate for Payer: Aetna Commercial |
$333.28
|
| Rate for Payer: Aetna Medicare |
$128.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$160.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$160.26
|
| Rate for Payer: ASR ASR |
$359.20
|
| Rate for Payer: BCBS Complete |
$70.41
|
| Rate for Payer: BCBS MAPPO |
$128.21
|
| Rate for Payer: BCBS Trust/PPO |
$305.32
|
| Rate for Payer: BCN Commercial |
$305.32
|
| Rate for Payer: BCN Medicare Advantage |
$128.21
|
| Rate for Payer: Cash Price |
$296.25
|
| Rate for Payer: Cash Price |
$296.25
|
| Rate for Payer: Cofinity Commercial |
$348.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$296.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.21
|
| Rate for Payer: Healthscope Commercial |
$359.20
|
| Rate for Payer: Healthscope Whirlpool |
$370.31
|
| Rate for Payer: Humana Choice PPO Medicare |
$128.21
|
| Rate for Payer: Mclaren Commercial |
$333.28
|
| Rate for Payer: Mclaren Medicaid |
$128.21
|
| Rate for Payer: Mclaren Medicare |
$128.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$134.62
|
| Rate for Payer: Meridian Medicaid |
$70.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$147.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$141.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$314.76
|
| Rate for Payer: Nomi Health Commercial |
$303.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$277.73
|
| Rate for Payer: PACE Medicare |
$121.80
|
| Rate for Payer: PACE SWMI |
$128.21
|
| Rate for Payer: PHP Commercial |
$141.03
|
| Rate for Payer: PHP Medicaid |
$68.72
|
| Rate for Payer: PHP Medicare Advantage |
$128.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$324.47
|
| Rate for Payer: Priority Health Medicare |
$128.21
|
| Rate for Payer: Priority Health Narrow Network |
$259.59
|
| Rate for Payer: Railroad Medicare Medicare |
$128.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$325.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$128.21
|
| Rate for Payer: UHC Exchange |
$198.73
|
| Rate for Payer: UHC Medicaid |
$67.05
|
| Rate for Payer: UHCCP DNSP |
$128.21
|
| Rate for Payer: UHCCP Medicaid |
$67.05
|
| Rate for Payer: VA VA |
$128.21
|
|
|
HC AUTONOMIC FUNC CARDIO INNERVAT
|
Facility
|
IP
|
$370.31
|
|
|
Service Code
|
CPT 95921
|
| Hospital Charge Code |
92000006
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$277.73 |
| Max. Negotiated Rate |
$370.31 |
| Rate for Payer: Aetna Commercial |
$333.28
|
| Rate for Payer: ASR ASR |
$359.20
|
| Rate for Payer: BCBS Trust/PPO |
$304.10
|
| Rate for Payer: BCN Commercial |
$304.10
|
| Rate for Payer: Cash Price |
$296.25
|
| Rate for Payer: Cofinity Commercial |
$348.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$296.25
|
| Rate for Payer: Healthscope Commercial |
$359.20
|
| Rate for Payer: Healthscope Whirlpool |
$370.31
|
| Rate for Payer: Mclaren Commercial |
$333.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$314.76
|
| Rate for Payer: Nomi Health Commercial |
$303.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$277.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$325.87
|
|
|
HC AUTONOMIC FUNC QSART
|
Facility
|
IP
|
$370.31
|
|
|
Service Code
|
CPT 95923
|
| Hospital Charge Code |
92000008
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$277.73 |
| Max. Negotiated Rate |
$370.31 |
| Rate for Payer: Aetna Commercial |
$333.28
|
| Rate for Payer: ASR ASR |
$359.20
|
| Rate for Payer: BCBS Trust/PPO |
$304.10
|
| Rate for Payer: BCN Commercial |
$304.10
|
| Rate for Payer: Cash Price |
$296.25
|
| Rate for Payer: Cofinity Commercial |
$348.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$296.25
|
| Rate for Payer: Healthscope Commercial |
$359.20
|
| Rate for Payer: Healthscope Whirlpool |
$370.31
|
| Rate for Payer: Mclaren Commercial |
$333.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$314.76
|
| Rate for Payer: Nomi Health Commercial |
$303.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$277.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$325.87
|
|
|
HC AUTONOMIC FUNC QSART
|
Facility
|
OP
|
$370.31
|
|
|
Service Code
|
CPT 95923
|
| Hospital Charge Code |
92000008
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$69.33 |
| Max. Negotiated Rate |
$370.31 |
| Rate for Payer: Aetna Commercial |
$333.28
|
| Rate for Payer: Aetna Medicare |
$132.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$165.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$165.71
|
| Rate for Payer: ASR ASR |
$359.20
|
| Rate for Payer: BCBS Complete |
$72.81
|
| Rate for Payer: BCBS MAPPO |
$132.57
|
| Rate for Payer: BCBS Trust/PPO |
$305.32
|
| Rate for Payer: BCN Commercial |
$305.32
|
| Rate for Payer: BCN Medicare Advantage |
$132.57
|
| Rate for Payer: Cash Price |
$296.25
|
| Rate for Payer: Cash Price |
$296.25
|
| Rate for Payer: Cofinity Commercial |
$348.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$296.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.57
|
| Rate for Payer: Healthscope Commercial |
$359.20
|
| Rate for Payer: Healthscope Whirlpool |
$370.31
|
| Rate for Payer: Humana Choice PPO Medicare |
$132.57
|
| Rate for Payer: Mclaren Commercial |
$333.28
|
| Rate for Payer: Mclaren Medicaid |
$132.57
|
| Rate for Payer: Mclaren Medicare |
$132.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$139.20
|
| Rate for Payer: Meridian Medicaid |
$72.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$145.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$314.76
|
| Rate for Payer: Nomi Health Commercial |
$303.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$277.73
|
| Rate for Payer: PACE Medicare |
$125.94
|
| Rate for Payer: PACE SWMI |
$132.57
|
| Rate for Payer: PHP Commercial |
$145.83
|
| Rate for Payer: PHP Medicaid |
$71.06
|
| Rate for Payer: PHP Medicare Advantage |
$132.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$324.47
|
| Rate for Payer: Priority Health Medicare |
$132.57
|
| Rate for Payer: Priority Health Narrow Network |
$259.59
|
| Rate for Payer: Railroad Medicare Medicare |
$132.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$325.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$132.57
|
| Rate for Payer: UHC Exchange |
$205.48
|
| Rate for Payer: UHC Medicaid |
$69.33
|
| Rate for Payer: UHCCP DNSP |
$132.57
|
| Rate for Payer: UHCCP Medicaid |
$69.33
|
| Rate for Payer: VA VA |
$132.57
|
|
|
HC AUTONOMIC W/O QSART
|
Facility
|
IP
|
$529.01
|
|
|
Service Code
|
CPT 95924
|
| Hospital Charge Code |
92000012
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$396.76 |
| Max. Negotiated Rate |
$529.01 |
| Rate for Payer: Aetna Commercial |
$476.11
|
| Rate for Payer: ASR ASR |
$513.14
|
| Rate for Payer: BCBS Trust/PPO |
$434.42
|
| Rate for Payer: BCN Commercial |
$434.42
|
| Rate for Payer: Cash Price |
$423.21
|
| Rate for Payer: Cofinity Commercial |
$497.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$423.21
|
| Rate for Payer: Healthscope Commercial |
$513.14
|
| Rate for Payer: Healthscope Whirlpool |
$529.01
|
| Rate for Payer: Mclaren Commercial |
$476.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$449.66
|
| Rate for Payer: Nomi Health Commercial |
$433.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$396.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$465.53
|
|
|
HC AUTONOMIC W/O QSART
|
Facility
|
OP
|
$529.01
|
|
|
Service Code
|
CPT 95924
|
| Hospital Charge Code |
92000012
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$80.61 |
| Max. Negotiated Rate |
$529.01 |
| Rate for Payer: Aetna Commercial |
$476.11
|
| Rate for Payer: Aetna Medicare |
$215.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$268.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$268.94
|
| Rate for Payer: ASR ASR |
$513.14
|
| Rate for Payer: BCBS Complete |
$118.16
|
| Rate for Payer: BCBS MAPPO |
$215.15
|
| Rate for Payer: BCBS Trust/PPO |
$436.17
|
| Rate for Payer: BCN Commercial |
$436.17
|
| Rate for Payer: BCN Medicare Advantage |
$215.15
|
| Rate for Payer: Cash Price |
$423.21
|
| Rate for Payer: Cash Price |
$423.21
|
| Rate for Payer: Cofinity Commercial |
$497.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$423.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$215.15
|
| Rate for Payer: Healthscope Commercial |
$513.14
|
| Rate for Payer: Healthscope Whirlpool |
$529.01
|
| Rate for Payer: Humana Choice PPO Medicare |
$215.15
|
| Rate for Payer: Mclaren Commercial |
$476.11
|
| Rate for Payer: Mclaren Medicaid |
$215.15
|
| Rate for Payer: Mclaren Medicare |
$215.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$225.91
|
| Rate for Payer: Meridian Medicaid |
$118.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$247.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$236.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$449.66
|
| Rate for Payer: Nomi Health Commercial |
$433.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$396.76
|
| Rate for Payer: PACE Medicare |
$204.39
|
| Rate for Payer: PACE SWMI |
$215.15
|
| Rate for Payer: PHP Commercial |
$236.66
|
| Rate for Payer: PHP Medicaid |
$115.32
|
| Rate for Payer: PHP Medicare Advantage |
$215.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$100.77
|
| Rate for Payer: Priority Health Medicare |
$215.15
|
| Rate for Payer: Priority Health Narrow Network |
$80.61
|
| Rate for Payer: Railroad Medicare Medicare |
$215.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$465.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$215.15
|
| Rate for Payer: UHC Exchange |
$333.48
|
| Rate for Payer: UHC Medicaid |
$112.52
|
| Rate for Payer: UHCCP DNSP |
$215.15
|
| Rate for Payer: UHCCP Medicaid |
$112.52
|
| Rate for Payer: VA VA |
$215.15
|
|
|
HC AVULSION OF NAIL PLATE
|
Facility
|
OP
|
$326.34
|
|
|
Service Code
|
CPT 11730
|
| Hospital Charge Code |
76100045
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$104.55 |
| Max. Negotiated Rate |
$326.34 |
| Rate for Payer: Aetna Commercial |
$293.71
|
| Rate for Payer: Aetna Medicare |
$199.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$249.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$249.89
|
| Rate for Payer: ASR ASR |
$316.55
|
| Rate for Payer: BCBS Complete |
$109.79
|
| Rate for Payer: BCBS MAPPO |
$199.91
|
| Rate for Payer: BCBS Trust/PPO |
$269.07
|
| Rate for Payer: BCN Commercial |
$269.07
|
| Rate for Payer: BCN Medicare Advantage |
$199.91
|
| Rate for Payer: Cash Price |
$261.07
|
| Rate for Payer: Cash Price |
$261.07
|
| Rate for Payer: Cofinity Commercial |
$306.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$261.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$199.91
|
| Rate for Payer: Healthscope Commercial |
$316.55
|
| Rate for Payer: Healthscope Whirlpool |
$326.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$199.91
|
| Rate for Payer: Mclaren Commercial |
$293.71
|
| Rate for Payer: Mclaren Medicaid |
$199.91
|
| Rate for Payer: Mclaren Medicare |
$199.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$209.91
|
| Rate for Payer: Meridian Medicaid |
$109.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$229.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$219.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$277.39
|
| Rate for Payer: Nomi Health Commercial |
$267.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$244.75
|
| Rate for Payer: PACE Medicare |
$189.91
|
| Rate for Payer: PACE SWMI |
$199.91
|
| Rate for Payer: PHP Commercial |
$219.90
|
| Rate for Payer: PHP Medicaid |
$107.15
|
| Rate for Payer: PHP Medicare Advantage |
$199.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$194.96
|
| Rate for Payer: Priority Health Medicare |
$199.91
|
| Rate for Payer: Priority Health Narrow Network |
$155.97
|
| Rate for Payer: Railroad Medicare Medicare |
$199.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$287.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$199.91
|
| Rate for Payer: UHC Exchange |
$309.86
|
| Rate for Payer: UHC Medicaid |
$104.55
|
| Rate for Payer: UHCCP DNSP |
$199.91
|
| Rate for Payer: UHCCP Medicaid |
$104.55
|
| Rate for Payer: VA VA |
$199.91
|
|
|
HC AVULSION OF NAIL PLATE
|
Facility
|
IP
|
$326.34
|
|
|
Service Code
|
CPT 11730
|
| Hospital Charge Code |
76100045
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$244.75 |
| Max. Negotiated Rate |
$326.34 |
| Rate for Payer: Aetna Commercial |
$293.71
|
| Rate for Payer: ASR ASR |
$316.55
|
| Rate for Payer: BCBS Trust/PPO |
$267.99
|
| Rate for Payer: BCN Commercial |
$267.99
|
| Rate for Payer: Cash Price |
$261.07
|
| Rate for Payer: Cofinity Commercial |
$306.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$261.07
|
| Rate for Payer: Healthscope Commercial |
$316.55
|
| Rate for Payer: Healthscope Whirlpool |
$326.34
|
| Rate for Payer: Mclaren Commercial |
$293.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$277.39
|
| Rate for Payer: Nomi Health Commercial |
$267.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$244.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$287.18
|
|
|
HC BACITRACIN 1 OZ
|
Facility
|
OP
|
$8.29
|
|
| Hospital Charge Code |
27100006
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$3.07 |
| Max. Negotiated Rate |
$8.29 |
| Rate for Payer: Aetna Commercial |
$7.46
|
| Rate for Payer: Aetna Medicare |
$3.07
|
| Rate for Payer: ASR ASR |
$8.04
|
| Rate for Payer: BCBS Complete |
$3.32
|
| Rate for Payer: BCBS Trust/PPO |
$6.84
|
| Rate for Payer: BCN Commercial |
$6.84
|
| Rate for Payer: Cash Price |
$6.63
|
| Rate for Payer: Cofinity Commercial |
$7.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.63
|
| Rate for Payer: Healthscope Commercial |
$8.04
|
| Rate for Payer: Healthscope Whirlpool |
$8.29
|
| Rate for Payer: Mclaren Commercial |
$7.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.05
|
| Rate for Payer: Nomi Health Commercial |
$6.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$7.26
|
| Rate for Payer: Priority Health Narrow Network |
$5.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7.30
|
|
|
HC BACITRACIN 1 OZ
|
Facility
|
IP
|
$8.29
|
|
| Hospital Charge Code |
27100006
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$6.22 |
| Max. Negotiated Rate |
$8.29 |
| Rate for Payer: Aetna Commercial |
$7.46
|
| Rate for Payer: ASR ASR |
$8.04
|
| Rate for Payer: BCBS Trust/PPO |
$6.81
|
| Rate for Payer: BCN Commercial |
$6.81
|
| Rate for Payer: Cash Price |
$6.63
|
| Rate for Payer: Cofinity Commercial |
$7.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.63
|
| Rate for Payer: Healthscope Commercial |
$8.04
|
| Rate for Payer: Healthscope Whirlpool |
$8.29
|
| Rate for Payer: Mclaren Commercial |
$7.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.05
|
| Rate for Payer: Nomi Health Commercial |
$6.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7.30
|
|
|
HC BACITRACIN 4 OZ
|
Facility
|
OP
|
$31.60
|
|
| Hospital Charge Code |
27100007
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$11.69 |
| Max. Negotiated Rate |
$31.60 |
| Rate for Payer: Aetna Commercial |
$28.44
|
| Rate for Payer: Aetna Medicare |
$11.69
|
| Rate for Payer: ASR ASR |
$30.65
|
| Rate for Payer: BCBS Complete |
$12.64
|
| Rate for Payer: BCBS Trust/PPO |
$26.05
|
| Rate for Payer: BCN Commercial |
$26.05
|
| Rate for Payer: Cash Price |
$25.28
|
| Rate for Payer: Cofinity Commercial |
$29.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.28
|
| Rate for Payer: Healthscope Commercial |
$30.65
|
| Rate for Payer: Healthscope Whirlpool |
$31.60
|
| Rate for Payer: Mclaren Commercial |
$28.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.86
|
| Rate for Payer: Nomi Health Commercial |
$25.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$27.69
|
| Rate for Payer: Priority Health Narrow Network |
$22.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.81
|
|
|
HC BACITRACIN 4 OZ
|
Facility
|
IP
|
$31.60
|
|
| Hospital Charge Code |
27100007
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$23.70 |
| Max. Negotiated Rate |
$31.60 |
| Rate for Payer: Aetna Commercial |
$28.44
|
| Rate for Payer: ASR ASR |
$30.65
|
| Rate for Payer: BCBS Trust/PPO |
$25.95
|
| Rate for Payer: BCN Commercial |
$25.95
|
| Rate for Payer: Cash Price |
$25.28
|
| Rate for Payer: Cofinity Commercial |
$29.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.28
|
| Rate for Payer: Healthscope Commercial |
$30.65
|
| Rate for Payer: Healthscope Whirlpool |
$31.60
|
| Rate for Payer: Mclaren Commercial |
$28.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.86
|
| Rate for Payer: Nomi Health Commercial |
$25.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.81
|
|
|
HC BACK SCREEN
|
Facility
|
IP
|
$53.06
|
|
| Hospital Charge Code |
42000047
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$39.80 |
| Max. Negotiated Rate |
$53.06 |
| Rate for Payer: Aetna Commercial |
$47.75
|
| Rate for Payer: ASR ASR |
$51.47
|
| Rate for Payer: BCBS Trust/PPO |
$43.57
|
| Rate for Payer: BCN Commercial |
$43.57
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$49.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Healthscope Commercial |
$51.47
|
| Rate for Payer: Healthscope Whirlpool |
$53.06
|
| Rate for Payer: Mclaren Commercial |
$47.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.69
|
|
|
HC BACK SCREEN
|
Facility
|
OP
|
$53.06
|
|
| Hospital Charge Code |
42000047
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$19.63 |
| Max. Negotiated Rate |
$53.06 |
| Rate for Payer: Aetna Commercial |
$47.75
|
| Rate for Payer: Aetna Medicare |
$19.63
|
| Rate for Payer: ASR ASR |
$51.47
|
| Rate for Payer: BCBS Complete |
$21.22
|
| Rate for Payer: BCBS Trust/PPO |
$43.75
|
| Rate for Payer: BCN Commercial |
$43.75
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$49.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Healthscope Commercial |
$51.47
|
| Rate for Payer: Healthscope Whirlpool |
$53.06
|
| Rate for Payer: Mclaren Commercial |
$47.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$46.49
|
| Rate for Payer: Priority Health Narrow Network |
$37.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.69
|
|
|
HC BACK SCREEN, VBISD
|
Facility
|
IP
|
$69.71
|
|
| Hospital Charge Code |
43000014
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$52.28 |
| Max. Negotiated Rate |
$69.71 |
| Rate for Payer: Aetna Commercial |
$62.74
|
| Rate for Payer: ASR ASR |
$67.62
|
| Rate for Payer: BCBS Trust/PPO |
$57.25
|
| Rate for Payer: BCN Commercial |
$57.25
|
| Rate for Payer: Cash Price |
$55.77
|
| Rate for Payer: Cofinity Commercial |
$65.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.77
|
| Rate for Payer: Healthscope Commercial |
$67.62
|
| Rate for Payer: Healthscope Whirlpool |
$69.71
|
| Rate for Payer: Mclaren Commercial |
$62.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.25
|
| Rate for Payer: Nomi Health Commercial |
$57.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$61.34
|
|
