|
HC CRYOPRECIPITATE DIRECT
|
Facility
|
IP
|
$334.10
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000043
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$233.87 |
| Max. Negotiated Rate |
$334.10 |
| Rate for Payer: Aetna Commercial |
$300.69
|
| Rate for Payer: ASR ASR |
$324.08
|
| Rate for Payer: BCBS Trust/PPO |
$259.03
|
| Rate for Payer: BCN Commercial |
$259.03
|
| Rate for Payer: Cash Price |
$267.28
|
| Rate for Payer: Cofinity Commercial |
$314.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$267.28
|
| Rate for Payer: Healthscope Commercial |
$334.10
|
| Rate for Payer: Healthscope Whirlpool |
$324.08
|
| Rate for Payer: Mclaren Commercial |
$300.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$283.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$233.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$294.01
|
|
|
HC CRYOPRECIPITATE DIRECT
|
Facility
|
OP
|
$334.10
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000043
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$30.55 |
| Max. Negotiated Rate |
$334.10 |
| Rate for Payer: Aetna Commercial |
$300.69
|
| Rate for Payer: Aetna Medicare |
$55.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$69.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$69.81
|
| Rate for Payer: ASR ASR |
$324.08
|
| Rate for Payer: BCBS Complete |
$32.08
|
| Rate for Payer: BCBS MAPPO |
$55.85
|
| Rate for Payer: BCBS Trust/PPO |
$259.03
|
| Rate for Payer: BCN Commercial |
$259.03
|
| Rate for Payer: BCN Medicare Advantage |
$55.85
|
| Rate for Payer: Cash Price |
$267.28
|
| Rate for Payer: Cash Price |
$267.28
|
| Rate for Payer: Cofinity Commercial |
$314.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$267.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.85
|
| Rate for Payer: Healthscope Commercial |
$334.10
|
| Rate for Payer: Healthscope Whirlpool |
$324.08
|
| Rate for Payer: Humana Choice PPO Medicare |
$55.85
|
| Rate for Payer: Mclaren Commercial |
$300.69
|
| Rate for Payer: Mclaren Medicaid |
$30.55
|
| Rate for Payer: Mclaren Medicare |
$55.85
|
| Rate for Payer: Meridian Medicaid |
$32.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$58.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$64.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$283.98
|
| Rate for Payer: PACE Medicare |
$53.06
|
| Rate for Payer: PACE SWMI |
$55.85
|
| Rate for Payer: PHP Commercial |
$61.44
|
| Rate for Payer: PHP Medicaid |
$30.55
|
| Rate for Payer: PHP Medicare Advantage |
$55.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$233.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$87.14
|
| Rate for Payer: Priority Health Medicare |
$55.85
|
| Rate for Payer: Priority Health Narrow Network |
$69.71
|
| Rate for Payer: Railroad Medicare Medicare |
$55.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$294.01
|
| Rate for Payer: UHC Medicare Advantage |
$57.53
|
| Rate for Payer: VA VA |
$55.85
|
|
|
HC CRYOPRECIPITATE POOL
|
Facility
|
IP
|
$243.92
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000044
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$170.74 |
| Max. Negotiated Rate |
$243.92 |
| Rate for Payer: Aetna Commercial |
$219.53
|
| Rate for Payer: ASR ASR |
$236.60
|
| Rate for Payer: BCBS Trust/PPO |
$189.11
|
| Rate for Payer: BCN Commercial |
$189.11
|
| Rate for Payer: Cash Price |
$195.14
|
| Rate for Payer: Cofinity Commercial |
$229.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.14
|
| Rate for Payer: Healthscope Commercial |
$243.92
|
| Rate for Payer: Healthscope Whirlpool |
$236.60
|
| Rate for Payer: Mclaren Commercial |
$219.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$207.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$170.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$214.65
|
|
|
HC CRYOPRECIPITATE POOL
|
Facility
|
OP
|
$243.92
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000044
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$30.55 |
| Max. Negotiated Rate |
$243.92 |
| Rate for Payer: Aetna Commercial |
$219.53
|
| Rate for Payer: Aetna Medicare |
$55.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$69.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$69.81
|
| Rate for Payer: ASR ASR |
$236.60
|
| Rate for Payer: BCBS Complete |
$32.08
|
| Rate for Payer: BCBS MAPPO |
$55.85
|
| Rate for Payer: BCBS Trust/PPO |
$189.11
|
| Rate for Payer: BCN Commercial |
$189.11
|
| Rate for Payer: BCN Medicare Advantage |
$55.85
|
| Rate for Payer: Cash Price |
$195.14
|
| Rate for Payer: Cash Price |
$195.14
|
| Rate for Payer: Cofinity Commercial |
$229.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.85
|
| Rate for Payer: Healthscope Commercial |
$243.92
|
| Rate for Payer: Healthscope Whirlpool |
$236.60
|
| Rate for Payer: Humana Choice PPO Medicare |
$55.85
|
| Rate for Payer: Mclaren Commercial |
$219.53
|
| Rate for Payer: Mclaren Medicaid |
$30.55
|
| Rate for Payer: Mclaren Medicare |
$55.85
|
| Rate for Payer: Meridian Medicaid |
$32.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$58.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$64.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$207.33
|
| Rate for Payer: PACE Medicare |
$53.06
|
| Rate for Payer: PACE SWMI |
$55.85
|
| Rate for Payer: PHP Commercial |
$61.44
|
| Rate for Payer: PHP Medicaid |
$30.55
|
| Rate for Payer: PHP Medicare Advantage |
$55.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$170.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$87.14
|
| Rate for Payer: Priority Health Medicare |
$55.85
|
| Rate for Payer: Priority Health Narrow Network |
$69.71
|
| Rate for Payer: Railroad Medicare Medicare |
$55.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$214.65
|
| Rate for Payer: UHC Medicare Advantage |
$57.53
|
| Rate for Payer: VA VA |
$55.85
|
|
|
HC CRYOPRECIPITATE POOL CMPT1
|
Facility
|
IP
|
$243.92
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000045
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$170.74 |
| Max. Negotiated Rate |
$243.92 |
| Rate for Payer: Aetna Commercial |
$219.53
|
| Rate for Payer: ASR ASR |
$236.60
|
| Rate for Payer: BCBS Trust/PPO |
$189.11
|
| Rate for Payer: BCN Commercial |
$189.11
|
| Rate for Payer: Cash Price |
$195.14
|
| Rate for Payer: Cofinity Commercial |
$229.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.14
|
| Rate for Payer: Healthscope Commercial |
$243.92
|
| Rate for Payer: Healthscope Whirlpool |
$236.60
|
| Rate for Payer: Mclaren Commercial |
$219.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$207.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$170.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$214.65
|
|
|
HC CRYOPRECIPITATE POOL CMPT1
|
Facility
|
OP
|
$243.92
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000045
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$30.55 |
| Max. Negotiated Rate |
$243.92 |
| Rate for Payer: Aetna Commercial |
$219.53
|
| Rate for Payer: Aetna Medicare |
$55.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$69.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$69.81
|
| Rate for Payer: ASR ASR |
$236.60
|
| Rate for Payer: BCBS Complete |
$32.08
|
| Rate for Payer: BCBS MAPPO |
$55.85
|
| Rate for Payer: BCBS Trust/PPO |
$189.11
|
| Rate for Payer: BCN Commercial |
$189.11
|
| Rate for Payer: BCN Medicare Advantage |
$55.85
|
| Rate for Payer: Cash Price |
$195.14
|
| Rate for Payer: Cash Price |
$195.14
|
| Rate for Payer: Cofinity Commercial |
$229.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.85
|
| Rate for Payer: Healthscope Commercial |
$243.92
|
| Rate for Payer: Healthscope Whirlpool |
$236.60
|
| Rate for Payer: Humana Choice PPO Medicare |
$55.85
|
| Rate for Payer: Mclaren Commercial |
$219.53
|
| Rate for Payer: Mclaren Medicaid |
$30.55
|
| Rate for Payer: Mclaren Medicare |
$55.85
|
| Rate for Payer: Meridian Medicaid |
$32.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$58.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$64.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$207.33
|
| Rate for Payer: PACE Medicare |
$53.06
|
| Rate for Payer: PACE SWMI |
$55.85
|
| Rate for Payer: PHP Commercial |
$61.44
|
| Rate for Payer: PHP Medicaid |
$30.55
|
| Rate for Payer: PHP Medicare Advantage |
$55.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$170.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$87.14
|
| Rate for Payer: Priority Health Medicare |
$55.85
|
| Rate for Payer: Priority Health Narrow Network |
$69.71
|
| Rate for Payer: Railroad Medicare Medicare |
$55.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$214.65
|
| Rate for Payer: UHC Medicare Advantage |
$57.53
|
| Rate for Payer: VA VA |
$55.85
|
|
|
HC CRYOPRECIPITATE POOL CMPT2
|
Facility
|
OP
|
$243.92
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000046
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$30.55 |
| Max. Negotiated Rate |
$243.92 |
| Rate for Payer: Aetna Commercial |
$219.53
|
| Rate for Payer: Aetna Medicare |
$55.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$69.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$69.81
|
| Rate for Payer: ASR ASR |
$236.60
|
| Rate for Payer: BCBS Complete |
$32.08
|
| Rate for Payer: BCBS MAPPO |
$55.85
|
| Rate for Payer: BCBS Trust/PPO |
$189.11
|
| Rate for Payer: BCN Commercial |
$189.11
|
| Rate for Payer: BCN Medicare Advantage |
$55.85
|
| Rate for Payer: Cash Price |
$195.14
|
| Rate for Payer: Cash Price |
$195.14
|
| Rate for Payer: Cofinity Commercial |
$229.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.85
|
| Rate for Payer: Healthscope Commercial |
$243.92
|
| Rate for Payer: Healthscope Whirlpool |
$236.60
|
| Rate for Payer: Humana Choice PPO Medicare |
$55.85
|
| Rate for Payer: Mclaren Commercial |
$219.53
|
| Rate for Payer: Mclaren Medicaid |
$30.55
|
| Rate for Payer: Mclaren Medicare |
$55.85
|
| Rate for Payer: Meridian Medicaid |
$32.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$58.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$64.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$207.33
|
| Rate for Payer: PACE Medicare |
$53.06
|
| Rate for Payer: PACE SWMI |
$55.85
|
| Rate for Payer: PHP Commercial |
$61.44
|
| Rate for Payer: PHP Medicaid |
$30.55
|
| Rate for Payer: PHP Medicare Advantage |
$55.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$170.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$87.14
|
| Rate for Payer: Priority Health Medicare |
$55.85
|
| Rate for Payer: Priority Health Narrow Network |
$69.71
|
| Rate for Payer: Railroad Medicare Medicare |
$55.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$214.65
|
| Rate for Payer: UHC Medicare Advantage |
$57.53
|
| Rate for Payer: VA VA |
$55.85
|
|
|
HC CRYOPRECIPITATE POOL CMPT2
|
Facility
|
IP
|
$243.92
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000046
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$170.74 |
| Max. Negotiated Rate |
$243.92 |
| Rate for Payer: Aetna Commercial |
$219.53
|
| Rate for Payer: ASR ASR |
$236.60
|
| Rate for Payer: BCBS Trust/PPO |
$189.11
|
| Rate for Payer: BCN Commercial |
$189.11
|
| Rate for Payer: Cash Price |
$195.14
|
| Rate for Payer: Cofinity Commercial |
$229.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.14
|
| Rate for Payer: Healthscope Commercial |
$243.92
|
| Rate for Payer: Healthscope Whirlpool |
$236.60
|
| Rate for Payer: Mclaren Commercial |
$219.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$207.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$170.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$214.65
|
|
|
HC CRYOPRECIPITATE POOL CMPT3
|
Facility
|
IP
|
$243.92
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000047
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$170.74 |
| Max. Negotiated Rate |
$243.92 |
| Rate for Payer: Aetna Commercial |
$219.53
|
| Rate for Payer: ASR ASR |
$236.60
|
| Rate for Payer: BCBS Trust/PPO |
$189.11
|
| Rate for Payer: BCN Commercial |
$189.11
|
| Rate for Payer: Cash Price |
$195.14
|
| Rate for Payer: Cofinity Commercial |
$229.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.14
|
| Rate for Payer: Healthscope Commercial |
$243.92
|
| Rate for Payer: Healthscope Whirlpool |
$236.60
|
| Rate for Payer: Mclaren Commercial |
$219.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$207.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$170.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$214.65
|
|
|
HC CRYOPRECIPITATE POOL CMPT3
|
Facility
|
OP
|
$243.92
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000047
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$30.55 |
| Max. Negotiated Rate |
$243.92 |
| Rate for Payer: Aetna Commercial |
$219.53
|
| Rate for Payer: Aetna Medicare |
$55.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$69.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$69.81
|
| Rate for Payer: ASR ASR |
$236.60
|
| Rate for Payer: BCBS Complete |
$32.08
|
| Rate for Payer: BCBS MAPPO |
$55.85
|
| Rate for Payer: BCBS Trust/PPO |
$189.11
|
| Rate for Payer: BCN Commercial |
$189.11
|
| Rate for Payer: BCN Medicare Advantage |
$55.85
|
| Rate for Payer: Cash Price |
$195.14
|
| Rate for Payer: Cash Price |
$195.14
|
| Rate for Payer: Cofinity Commercial |
$229.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.85
|
| Rate for Payer: Healthscope Commercial |
$243.92
|
| Rate for Payer: Healthscope Whirlpool |
$236.60
|
| Rate for Payer: Humana Choice PPO Medicare |
$55.85
|
| Rate for Payer: Mclaren Commercial |
$219.53
|
| Rate for Payer: Mclaren Medicaid |
$30.55
|
| Rate for Payer: Mclaren Medicare |
$55.85
|
| Rate for Payer: Meridian Medicaid |
$32.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$58.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$64.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$207.33
|
| Rate for Payer: PACE Medicare |
$53.06
|
| Rate for Payer: PACE SWMI |
$55.85
|
| Rate for Payer: PHP Commercial |
$61.44
|
| Rate for Payer: PHP Medicaid |
$30.55
|
| Rate for Payer: PHP Medicare Advantage |
$55.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$170.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$87.14
|
| Rate for Payer: Priority Health Medicare |
$55.85
|
| Rate for Payer: Priority Health Narrow Network |
$69.71
|
| Rate for Payer: Railroad Medicare Medicare |
$55.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$214.65
|
| Rate for Payer: UHC Medicare Advantage |
$57.53
|
| Rate for Payer: VA VA |
$55.85
|
|
|
HC CRYOPRECIPITATE POOL CMPT4
|
Facility
|
OP
|
$243.92
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000048
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$30.55 |
| Max. Negotiated Rate |
$243.92 |
| Rate for Payer: Aetna Commercial |
$219.53
|
| Rate for Payer: Aetna Medicare |
$55.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$69.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$69.81
|
| Rate for Payer: ASR ASR |
$236.60
|
| Rate for Payer: BCBS Complete |
$32.08
|
| Rate for Payer: BCBS MAPPO |
$55.85
|
| Rate for Payer: BCBS Trust/PPO |
$189.11
|
| Rate for Payer: BCN Commercial |
$189.11
|
| Rate for Payer: BCN Medicare Advantage |
$55.85
|
| Rate for Payer: Cash Price |
$195.14
|
| Rate for Payer: Cash Price |
$195.14
|
| Rate for Payer: Cofinity Commercial |
$229.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.85
|
| Rate for Payer: Healthscope Commercial |
$243.92
|
| Rate for Payer: Healthscope Whirlpool |
$236.60
|
| Rate for Payer: Humana Choice PPO Medicare |
$55.85
|
| Rate for Payer: Mclaren Commercial |
$219.53
|
| Rate for Payer: Mclaren Medicaid |
$30.55
|
| Rate for Payer: Mclaren Medicare |
$55.85
|
| Rate for Payer: Meridian Medicaid |
$32.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$58.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$64.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$207.33
|
| Rate for Payer: PACE Medicare |
$53.06
|
| Rate for Payer: PACE SWMI |
$55.85
|
| Rate for Payer: PHP Commercial |
$61.44
|
| Rate for Payer: PHP Medicaid |
$30.55
|
| Rate for Payer: PHP Medicare Advantage |
$55.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$170.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$87.14
|
| Rate for Payer: Priority Health Medicare |
$55.85
|
| Rate for Payer: Priority Health Narrow Network |
$69.71
|
| Rate for Payer: Railroad Medicare Medicare |
$55.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$214.65
|
| Rate for Payer: UHC Medicare Advantage |
$57.53
|
| Rate for Payer: VA VA |
$55.85
|
|
|
HC CRYOPRECIPITATE POOL CMPT4
|
Facility
|
IP
|
$243.92
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000048
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$170.74 |
| Max. Negotiated Rate |
$243.92 |
| Rate for Payer: Aetna Commercial |
$219.53
|
| Rate for Payer: ASR ASR |
$236.60
|
| Rate for Payer: BCBS Trust/PPO |
$189.11
|
| Rate for Payer: BCN Commercial |
$189.11
|
| Rate for Payer: Cash Price |
$195.14
|
| Rate for Payer: Cofinity Commercial |
$229.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.14
|
| Rate for Payer: Healthscope Commercial |
$243.92
|
| Rate for Payer: Healthscope Whirlpool |
$236.60
|
| Rate for Payer: Mclaren Commercial |
$219.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$207.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$170.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$214.65
|
|
|
HC CRYOSURGERY ANAL LESION(S)
|
Facility
|
IP
|
$542.50
|
|
|
Service Code
|
CPT 46916
|
| Hospital Charge Code |
76100353
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$379.75 |
| Max. Negotiated Rate |
$542.50 |
| Rate for Payer: Aetna Commercial |
$488.25
|
| Rate for Payer: ASR ASR |
$526.22
|
| Rate for Payer: BCBS Trust/PPO |
$420.60
|
| Rate for Payer: BCN Commercial |
$420.60
|
| Rate for Payer: Cash Price |
$434.00
|
| Rate for Payer: Cofinity Commercial |
$509.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$434.00
|
| Rate for Payer: Healthscope Commercial |
$542.50
|
| Rate for Payer: Healthscope Whirlpool |
$526.22
|
| Rate for Payer: Mclaren Commercial |
$488.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$461.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$379.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$477.40
|
|
|
HC CRYOSURGERY ANAL LESION(S)
|
Facility
|
OP
|
$542.50
|
|
|
Service Code
|
CPT 46916
|
| Hospital Charge Code |
76100353
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$97.34 |
| Max. Negotiated Rate |
$542.50 |
| Rate for Payer: Aetna Commercial |
$488.25
|
| Rate for Payer: Aetna Medicare |
$177.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$222.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$222.44
|
| Rate for Payer: ASR ASR |
$526.22
|
| Rate for Payer: BCBS Complete |
$102.21
|
| Rate for Payer: BCBS MAPPO |
$177.95
|
| Rate for Payer: BCBS Trust/PPO |
$420.60
|
| Rate for Payer: BCN Commercial |
$420.60
|
| Rate for Payer: BCN Medicare Advantage |
$177.95
|
| Rate for Payer: Cash Price |
$434.00
|
| Rate for Payer: Cash Price |
$434.00
|
| Rate for Payer: Cofinity Commercial |
$509.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$434.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.95
|
| Rate for Payer: Healthscope Commercial |
$542.50
|
| Rate for Payer: Healthscope Whirlpool |
$526.22
|
| Rate for Payer: Humana Choice PPO Medicare |
$177.95
|
| Rate for Payer: Mclaren Commercial |
$488.25
|
| Rate for Payer: Mclaren Medicaid |
$97.34
|
| Rate for Payer: Mclaren Medicare |
$177.95
|
| Rate for Payer: Meridian Medicaid |
$102.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$186.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$204.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$461.12
|
| Rate for Payer: PACE Medicare |
$169.05
|
| Rate for Payer: PACE SWMI |
$177.95
|
| Rate for Payer: PHP Commercial |
$195.74
|
| Rate for Payer: PHP Medicaid |
$97.34
|
| Rate for Payer: PHP Medicare Advantage |
$177.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$97.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$379.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$493.68
|
| Rate for Payer: Priority Health Medicare |
$177.95
|
| Rate for Payer: Priority Health Narrow Network |
$385.18
|
| Rate for Payer: Railroad Medicare Medicare |
$177.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$477.40
|
| Rate for Payer: UHC Medicare Advantage |
$183.29
|
| Rate for Payer: VA VA |
$177.95
|
|
|
HC CRYPTOCOCCAL ANTIGEN FLUID
|
Facility
|
OP
|
$45.90
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30200210
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.79 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$41.31
|
| Rate for Payer: Aetna Medicare |
$16.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.09
|
| Rate for Payer: ASR ASR |
$44.52
|
| Rate for Payer: BCBS Complete |
$9.23
|
| Rate for Payer: BCBS MAPPO |
$16.07
|
| Rate for Payer: BCBS Trust/PPO |
$35.59
|
| Rate for Payer: BCN Commercial |
$35.59
|
| Rate for Payer: BCN Medicare Advantage |
$16.07
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cofinity Commercial |
$43.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.07
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Healthscope Whirlpool |
$44.52
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.07
|
| Rate for Payer: Mclaren Commercial |
$41.31
|
| Rate for Payer: Mclaren Medicaid |
$8.79
|
| Rate for Payer: Mclaren Medicare |
$16.07
|
| Rate for Payer: Meridian Medicaid |
$9.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.02
|
| Rate for Payer: PACE Medicare |
$15.27
|
| Rate for Payer: PACE SWMI |
$16.07
|
| Rate for Payer: PHP Commercial |
$17.68
|
| Rate for Payer: PHP Medicaid |
$8.79
|
| Rate for Payer: PHP Medicare Advantage |
$16.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34.89
|
| Rate for Payer: Priority Health Medicare |
$16.07
|
| Rate for Payer: Priority Health Narrow Network |
$27.91
|
| Rate for Payer: Railroad Medicare Medicare |
$16.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.39
|
| Rate for Payer: UHC Medicare Advantage |
$16.55
|
| Rate for Payer: VA VA |
$16.07
|
|
|
HC CRYPTOCOCCAL ANTIGEN FLUID
|
Facility
|
IP
|
$45.90
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30200210
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$32.13 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$41.31
|
| Rate for Payer: ASR ASR |
$44.52
|
| Rate for Payer: BCBS Trust/PPO |
$35.59
|
| Rate for Payer: BCN Commercial |
$35.59
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cofinity Commercial |
$43.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.72
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Healthscope Whirlpool |
$44.52
|
| Rate for Payer: Mclaren Commercial |
$41.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.39
|
|
|
HC CRYPTOCOCCUS NEOFORMANS GATTII
|
Facility
|
IP
|
$51.00
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600265
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$35.70 |
| Max. Negotiated Rate |
$51.00 |
| Rate for Payer: Aetna Commercial |
$45.90
|
| Rate for Payer: ASR ASR |
$49.47
|
| Rate for Payer: BCBS Trust/PPO |
$39.54
|
| Rate for Payer: BCN Commercial |
$39.54
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$47.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Healthscope Commercial |
$51.00
|
| Rate for Payer: Healthscope Whirlpool |
$49.47
|
| Rate for Payer: Mclaren Commercial |
$45.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.88
|
|
|
HC CRYPTOCOCCUS NEOFORMANS GATTII
|
Facility
|
OP
|
$51.00
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600265
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.19 |
| Max. Negotiated Rate |
$51.00 |
| Rate for Payer: Aetna Commercial |
$45.90
|
| Rate for Payer: Aetna Medicare |
$35.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: ASR ASR |
$49.47
|
| Rate for Payer: BCBS Complete |
$20.16
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$39.54
|
| Rate for Payer: BCN Commercial |
$39.54
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$47.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$51.00
|
| Rate for Payer: Healthscope Whirlpool |
$49.47
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$45.90
|
| Rate for Payer: Mclaren Medicaid |
$19.19
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Medicaid |
$20.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$38.60
|
| Rate for Payer: PHP Medicaid |
$19.19
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$46.41
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$36.21
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.88
|
| Rate for Payer: UHC Medicare Advantage |
$36.14
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC CRYPTOSPORIDIUM SCREEN
|
Facility
|
IP
|
$44.88
|
|
|
Service Code
|
CPT 87328
|
| Hospital Charge Code |
30600120
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$31.42 |
| Max. Negotiated Rate |
$44.88 |
| Rate for Payer: Aetna Commercial |
$40.39
|
| Rate for Payer: ASR ASR |
$43.53
|
| Rate for Payer: BCBS Trust/PPO |
$34.80
|
| Rate for Payer: BCN Commercial |
$34.80
|
| Rate for Payer: Cash Price |
$35.90
|
| Rate for Payer: Cofinity Commercial |
$42.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.90
|
| Rate for Payer: Healthscope Commercial |
$44.88
|
| Rate for Payer: Healthscope Whirlpool |
$43.53
|
| Rate for Payer: Mclaren Commercial |
$40.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$38.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$39.49
|
|
|
HC CRYPTOSPORIDIUM SCREEN
|
Facility
|
OP
|
$44.88
|
|
|
Service Code
|
CPT 87328
|
| Hospital Charge Code |
30600120
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.56 |
| Max. Negotiated Rate |
$57.98 |
| Rate for Payer: Aetna Commercial |
$40.39
|
| Rate for Payer: Aetna Medicare |
$13.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.28
|
| Rate for Payer: ASR ASR |
$43.53
|
| Rate for Payer: BCBS Complete |
$7.94
|
| Rate for Payer: BCBS MAPPO |
$13.82
|
| Rate for Payer: BCBS Trust/PPO |
$34.80
|
| Rate for Payer: BCN Commercial |
$34.80
|
| Rate for Payer: BCN Medicare Advantage |
$13.82
|
| Rate for Payer: Cash Price |
$35.90
|
| Rate for Payer: Cash Price |
$35.90
|
| Rate for Payer: Cofinity Commercial |
$42.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.82
|
| Rate for Payer: Healthscope Commercial |
$44.88
|
| Rate for Payer: Healthscope Whirlpool |
$43.53
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.82
|
| Rate for Payer: Mclaren Commercial |
$40.39
|
| Rate for Payer: Mclaren Medicaid |
$7.56
|
| Rate for Payer: Mclaren Medicare |
$13.82
|
| Rate for Payer: Meridian Medicaid |
$7.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$38.15
|
| Rate for Payer: PACE Medicare |
$13.13
|
| Rate for Payer: PACE SWMI |
$13.82
|
| Rate for Payer: PHP Commercial |
$15.20
|
| Rate for Payer: PHP Medicaid |
$7.56
|
| Rate for Payer: PHP Medicare Advantage |
$13.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$57.98
|
| Rate for Payer: Priority Health Medicare |
$13.82
|
| Rate for Payer: Priority Health Narrow Network |
$46.38
|
| Rate for Payer: Railroad Medicare Medicare |
$13.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$39.49
|
| Rate for Payer: UHC Medicare Advantage |
$14.23
|
| Rate for Payer: VA VA |
$13.82
|
|
|
HC CRYSTALS BODY FLUID
|
Facility
|
IP
|
$46.31
|
|
|
Service Code
|
CPT 89060
|
| Hospital Charge Code |
30000002
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$32.42 |
| Max. Negotiated Rate |
$46.31 |
| Rate for Payer: Aetna Commercial |
$41.68
|
| Rate for Payer: ASR ASR |
$44.92
|
| Rate for Payer: BCBS Trust/PPO |
$35.90
|
| Rate for Payer: BCN Commercial |
$35.90
|
| Rate for Payer: Cash Price |
$37.05
|
| Rate for Payer: Cofinity Commercial |
$43.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.05
|
| Rate for Payer: Healthscope Commercial |
$46.31
|
| Rate for Payer: Healthscope Whirlpool |
$44.92
|
| Rate for Payer: Mclaren Commercial |
$41.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.75
|
|
|
HC CRYSTALS BODY FLUID
|
Facility
|
OP
|
$46.31
|
|
|
Service Code
|
CPT 89060
|
| Hospital Charge Code |
30000002
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.01 |
| Max. Negotiated Rate |
$46.31 |
| Rate for Payer: Aetna Commercial |
$41.68
|
| Rate for Payer: Aetna Medicare |
$7.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.16
|
| Rate for Payer: ASR ASR |
$44.92
|
| Rate for Payer: BCBS Complete |
$4.21
|
| Rate for Payer: BCBS MAPPO |
$7.33
|
| Rate for Payer: BCBS Trust/PPO |
$35.90
|
| Rate for Payer: BCN Commercial |
$35.90
|
| Rate for Payer: BCN Medicare Advantage |
$7.33
|
| Rate for Payer: Cash Price |
$37.05
|
| Rate for Payer: Cash Price |
$37.05
|
| Rate for Payer: Cofinity Commercial |
$43.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.33
|
| Rate for Payer: Healthscope Commercial |
$46.31
|
| Rate for Payer: Healthscope Whirlpool |
$44.92
|
| Rate for Payer: Humana Choice PPO Medicare |
$7.33
|
| Rate for Payer: Mclaren Commercial |
$41.68
|
| Rate for Payer: Mclaren Medicaid |
$4.01
|
| Rate for Payer: Mclaren Medicare |
$7.33
|
| Rate for Payer: Meridian Medicaid |
$4.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.36
|
| Rate for Payer: PACE Medicare |
$6.96
|
| Rate for Payer: PACE SWMI |
$7.33
|
| Rate for Payer: PHP Commercial |
$8.06
|
| Rate for Payer: PHP Medicaid |
$4.01
|
| Rate for Payer: PHP Medicare Advantage |
$7.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$36.95
|
| Rate for Payer: Priority Health Medicare |
$7.33
|
| Rate for Payer: Priority Health Narrow Network |
$29.56
|
| Rate for Payer: Railroad Medicare Medicare |
$7.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.75
|
| Rate for Payer: UHC Medicare Advantage |
$7.55
|
| Rate for Payer: VA VA |
$7.33
|
|
|
HC C-SECTION (OB SURGERY)
|
Facility
|
OP
|
$2,937.41
|
|
| Hospital Charge Code |
36000024
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,174.96 |
| Max. Negotiated Rate |
$2,937.41 |
| Rate for Payer: Aetna Commercial |
$2,643.67
|
| Rate for Payer: ASR ASR |
$2,849.29
|
| Rate for Payer: BCBS Complete |
$1,174.96
|
| Rate for Payer: BCBS Trust/PPO |
$2,277.37
|
| Rate for Payer: BCN Commercial |
$2,277.37
|
| Rate for Payer: Cash Price |
$2,349.93
|
| Rate for Payer: Cofinity Commercial |
$2,761.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,349.93
|
| Rate for Payer: Healthscope Commercial |
$2,937.41
|
| Rate for Payer: Healthscope Whirlpool |
$2,849.29
|
| Rate for Payer: Mclaren Commercial |
$2,643.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,496.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,056.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,673.04
|
| Rate for Payer: Priority Health Narrow Network |
$2,085.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,584.92
|
|
|
HC C-SECTION (OB SURGERY)
|
Facility
|
IP
|
$2,937.41
|
|
| Hospital Charge Code |
36000024
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,056.19 |
| Max. Negotiated Rate |
$2,937.41 |
| Rate for Payer: Aetna Commercial |
$2,643.67
|
| Rate for Payer: ASR ASR |
$2,849.29
|
| Rate for Payer: BCBS Trust/PPO |
$2,277.37
|
| Rate for Payer: BCN Commercial |
$2,277.37
|
| Rate for Payer: Cash Price |
$2,349.93
|
| Rate for Payer: Cofinity Commercial |
$2,761.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,349.93
|
| Rate for Payer: Healthscope Commercial |
$2,937.41
|
| Rate for Payer: Healthscope Whirlpool |
$2,849.29
|
| Rate for Payer: Mclaren Commercial |
$2,643.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,496.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,056.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,584.92
|
|
|
HC C-SECTION W/STERIL (OB SURGERY
|
Facility
|
OP
|
$3,607.43
|
|
| Hospital Charge Code |
36000025
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,442.97 |
| Max. Negotiated Rate |
$3,607.43 |
| Rate for Payer: Aetna Commercial |
$3,246.69
|
| Rate for Payer: ASR ASR |
$3,499.21
|
| Rate for Payer: BCBS Complete |
$1,442.97
|
| Rate for Payer: BCBS Trust/PPO |
$2,796.84
|
| Rate for Payer: BCN Commercial |
$2,796.84
|
| Rate for Payer: Cash Price |
$2,885.94
|
| Rate for Payer: Cofinity Commercial |
$3,390.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,885.94
|
| Rate for Payer: Healthscope Commercial |
$3,607.43
|
| Rate for Payer: Healthscope Whirlpool |
$3,499.21
|
| Rate for Payer: Mclaren Commercial |
$3,246.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,066.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,525.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,282.76
|
| Rate for Payer: Priority Health Narrow Network |
$2,561.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,174.54
|
|
