|
HC ACUTE MYELOID LEUKEMIA FISH CMPT2
|
Facility
|
OP
|
$91.80
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31100026
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$27.44 |
| Max. Negotiated Rate |
$91.80 |
| Rate for Payer: Aetna Commercial |
$82.62
|
| Rate for Payer: Aetna Medicare |
$51.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$63.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$63.99
|
| Rate for Payer: ASR ASR |
$89.05
|
| Rate for Payer: ASR Commercial |
$89.05
|
| Rate for Payer: BCBS Complete |
$28.81
|
| Rate for Payer: BCBS MAPPO |
$51.19
|
| Rate for Payer: BCBS Trust/PPO |
$75.18
|
| Rate for Payer: BCN Commercial |
$71.17
|
| Rate for Payer: BCN Medicare Advantage |
$51.19
|
| Rate for Payer: Cash Price |
$73.44
|
| Rate for Payer: Cash Price |
$73.44
|
| Rate for Payer: Cofinity Commercial |
$86.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.19
|
| Rate for Payer: Healthscope Commercial |
$91.80
|
| Rate for Payer: Healthscope Whirlpool |
$89.05
|
| Rate for Payer: Humana Choice PPO Medicare |
$51.19
|
| Rate for Payer: Mclaren Commercial |
$82.62
|
| Rate for Payer: Mclaren Medicaid |
$27.44
|
| Rate for Payer: Mclaren Medicare |
$51.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.75
|
| Rate for Payer: Meridian Medicaid |
$28.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.03
|
| Rate for Payer: Nomi Health Commercial |
$75.28
|
| Rate for Payer: PACE Medicare |
$48.63
|
| Rate for Payer: PACE SWMI |
$51.19
|
| Rate for Payer: PHP Commercial |
$56.31
|
| Rate for Payer: PHP Medicaid |
$27.44
|
| Rate for Payer: PHP Medicare Advantage |
$51.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.67
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$80.44
|
| Rate for Payer: Priority Health Medicare |
$51.19
|
| Rate for Payer: Priority Health Narrow Network |
$64.35
|
| Rate for Payer: Railroad Medicare Medicare |
$51.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$80.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$51.19
|
| Rate for Payer: UHC Exchange |
$79.34
|
| Rate for Payer: UHC Medicare Advantage |
$51.19
|
| Rate for Payer: UHCCP DNSP |
$51.19
|
| Rate for Payer: UHCCP Medicaid |
$27.44
|
| Rate for Payer: VA VA |
$51.19
|
|
|
HC ACUTE RENAL DIALYSIS
|
Facility
|
OP
|
$785.70
|
|
|
Service Code
|
CPT 90935
|
| Hospital Charge Code |
82000001
|
|
Hospital Revenue Code
|
881
|
| Min. Negotiated Rate |
$365.78 |
| Max. Negotiated Rate |
$1,057.75 |
| Rate for Payer: Aetna Commercial |
$707.13
|
| Rate for Payer: Aetna Medicare |
$682.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$853.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$853.02
|
| Rate for Payer: ASR ASR |
$762.13
|
| Rate for Payer: ASR Commercial |
$762.13
|
| Rate for Payer: BCBS Complete |
$384.07
|
| Rate for Payer: BCBS MAPPO |
$682.42
|
| Rate for Payer: BCBS Trust/PPO |
$643.41
|
| Rate for Payer: BCN Commercial |
$609.15
|
| Rate for Payer: BCN Medicare Advantage |
$682.42
|
| Rate for Payer: Cash Price |
$628.56
|
| Rate for Payer: Cash Price |
$628.56
|
| Rate for Payer: Cofinity Commercial |
$738.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$628.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$682.42
|
| Rate for Payer: Healthscope Commercial |
$785.70
|
| Rate for Payer: Healthscope Whirlpool |
$762.13
|
| Rate for Payer: Humana Choice PPO Medicare |
$682.42
|
| Rate for Payer: Mclaren Commercial |
$707.13
|
| Rate for Payer: Mclaren Medicaid |
$365.78
|
| Rate for Payer: Mclaren Medicare |
$682.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$716.54
|
| Rate for Payer: Meridian Medicaid |
$384.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$784.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$667.85
|
| Rate for Payer: Nomi Health Commercial |
$644.27
|
| Rate for Payer: PACE Medicare |
$648.30
|
| Rate for Payer: PACE SWMI |
$682.42
|
| Rate for Payer: PHP Commercial |
$750.66
|
| Rate for Payer: PHP Medicaid |
$365.78
|
| Rate for Payer: PHP Medicare Advantage |
$682.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$365.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$510.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$688.43
|
| Rate for Payer: Priority Health Medicare |
$682.42
|
| Rate for Payer: Priority Health Narrow Network |
$550.78
|
| Rate for Payer: Railroad Medicare Medicare |
$682.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$691.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$682.42
|
| Rate for Payer: UHC Exchange |
$1,057.75
|
| Rate for Payer: UHC Medicare Advantage |
$682.42
|
| Rate for Payer: UHCCP DNSP |
$682.42
|
| Rate for Payer: UHCCP Medicaid |
$365.78
|
| Rate for Payer: VA VA |
$682.42
|
|
|
HC ACUTE RENAL DIALYSIS
|
Facility
|
IP
|
$785.70
|
|
|
Service Code
|
CPT 90935
|
| Hospital Charge Code |
82000001
|
|
Hospital Revenue Code
|
881
|
| Min. Negotiated Rate |
$510.70 |
| Max. Negotiated Rate |
$785.70 |
| Rate for Payer: Aetna Commercial |
$707.13
|
| Rate for Payer: ASR ASR |
$762.13
|
| Rate for Payer: ASR Commercial |
$762.13
|
| Rate for Payer: BCBS Trust/PPO |
$640.27
|
| Rate for Payer: BCN Commercial |
$609.15
|
| Rate for Payer: Cash Price |
$628.56
|
| Rate for Payer: Cofinity Commercial |
$738.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$628.56
|
| Rate for Payer: Healthscope Commercial |
$785.70
|
| Rate for Payer: Healthscope Whirlpool |
$762.13
|
| Rate for Payer: Mclaren Commercial |
$707.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$667.85
|
| Rate for Payer: Nomi Health Commercial |
$644.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$510.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$691.42
|
|
|
HC ACYLCARNITINES
|
Facility
|
OP
|
$76.50
|
|
|
Service Code
|
CPT 82017
|
| Hospital Charge Code |
30100070
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.04 |
| Max. Negotiated Rate |
$76.50 |
| Rate for Payer: Aetna Commercial |
$68.85
|
| Rate for Payer: Aetna Medicare |
$16.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.09
|
| Rate for Payer: ASR ASR |
$74.20
|
| Rate for Payer: ASR Commercial |
$74.20
|
| Rate for Payer: BCBS Complete |
$9.49
|
| Rate for Payer: BCBS MAPPO |
$16.87
|
| Rate for Payer: BCBS Trust/PPO |
$62.65
|
| Rate for Payer: BCN Commercial |
$59.31
|
| Rate for Payer: BCN Medicare Advantage |
$16.87
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$71.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.87
|
| Rate for Payer: Healthscope Commercial |
$76.50
|
| Rate for Payer: Healthscope Whirlpool |
$74.20
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.87
|
| Rate for Payer: Mclaren Commercial |
$68.85
|
| Rate for Payer: Mclaren Medicaid |
$9.04
|
| Rate for Payer: Mclaren Medicare |
$16.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.71
|
| Rate for Payer: Meridian Medicaid |
$9.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.03
|
| Rate for Payer: Nomi Health Commercial |
$62.73
|
| Rate for Payer: PACE Medicare |
$16.03
|
| Rate for Payer: PACE SWMI |
$16.87
|
| Rate for Payer: PHP Commercial |
$18.56
|
| Rate for Payer: PHP Medicaid |
$9.04
|
| Rate for Payer: PHP Medicare Advantage |
$16.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$67.03
|
| Rate for Payer: Priority Health Medicare |
$16.87
|
| Rate for Payer: Priority Health Narrow Network |
$53.63
|
| Rate for Payer: Railroad Medicare Medicare |
$16.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$67.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.87
|
| Rate for Payer: UHC Exchange |
$26.15
|
| Rate for Payer: UHC Medicare Advantage |
$16.87
|
| Rate for Payer: UHCCP DNSP |
$16.87
|
| Rate for Payer: UHCCP Medicaid |
$9.04
|
| Rate for Payer: VA VA |
$16.87
|
|
|
HC ACYLCARNITINES
|
Facility
|
IP
|
$76.50
|
|
|
Service Code
|
CPT 82017
|
| Hospital Charge Code |
30100070
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$49.73 |
| Max. Negotiated Rate |
$76.50 |
| Rate for Payer: Aetna Commercial |
$68.85
|
| Rate for Payer: ASR ASR |
$74.20
|
| Rate for Payer: ASR Commercial |
$74.20
|
| Rate for Payer: BCBS Trust/PPO |
$62.34
|
| Rate for Payer: BCN Commercial |
$59.31
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$71.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Healthscope Commercial |
$76.50
|
| Rate for Payer: Healthscope Whirlpool |
$74.20
|
| Rate for Payer: Mclaren Commercial |
$68.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.03
|
| Rate for Payer: Nomi Health Commercial |
$62.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$67.32
|
|
|
HC ADALIMUMAB AB, S
|
Facility
|
IP
|
$206.04
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100666
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$133.93 |
| Max. Negotiated Rate |
$206.04 |
| Rate for Payer: Aetna Commercial |
$185.44
|
| Rate for Payer: ASR ASR |
$199.86
|
| Rate for Payer: ASR Commercial |
$199.86
|
| Rate for Payer: BCBS Trust/PPO |
$167.90
|
| Rate for Payer: BCN Commercial |
$159.74
|
| Rate for Payer: Cash Price |
$164.83
|
| Rate for Payer: Cofinity Commercial |
$193.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$164.83
|
| Rate for Payer: Healthscope Commercial |
$206.04
|
| Rate for Payer: Healthscope Whirlpool |
$199.86
|
| Rate for Payer: Mclaren Commercial |
$185.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$175.13
|
| Rate for Payer: Nomi Health Commercial |
$168.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$181.32
|
|
|
HC ADALIMUMAB AB, S
|
Facility
|
OP
|
$206.04
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100666
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.26 |
| Max. Negotiated Rate |
$206.04 |
| Rate for Payer: Aetna Commercial |
$185.44
|
| Rate for Payer: Aetna Medicare |
$17.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.59
|
| Rate for Payer: ASR ASR |
$199.86
|
| Rate for Payer: ASR Commercial |
$199.86
|
| Rate for Payer: BCBS Complete |
$9.72
|
| Rate for Payer: BCBS MAPPO |
$17.27
|
| Rate for Payer: BCBS Trust/PPO |
$168.73
|
| Rate for Payer: BCN Commercial |
$159.74
|
| Rate for Payer: BCN Medicare Advantage |
$17.27
|
| Rate for Payer: Cash Price |
$164.83
|
| Rate for Payer: Cash Price |
$164.83
|
| Rate for Payer: Cofinity Commercial |
$193.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$164.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.27
|
| Rate for Payer: Healthscope Commercial |
$206.04
|
| Rate for Payer: Healthscope Whirlpool |
$199.86
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.27
|
| Rate for Payer: Mclaren Commercial |
$185.44
|
| Rate for Payer: Mclaren Medicaid |
$9.26
|
| Rate for Payer: Mclaren Medicare |
$17.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.13
|
| Rate for Payer: Meridian Medicaid |
$9.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$175.13
|
| Rate for Payer: Nomi Health Commercial |
$168.95
|
| Rate for Payer: PACE Medicare |
$16.41
|
| Rate for Payer: PACE SWMI |
$17.27
|
| Rate for Payer: PHP Commercial |
$19.00
|
| Rate for Payer: PHP Medicaid |
$9.26
|
| Rate for Payer: PHP Medicare Advantage |
$17.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$180.53
|
| Rate for Payer: Priority Health Medicare |
$17.27
|
| Rate for Payer: Priority Health Narrow Network |
$144.43
|
| Rate for Payer: Railroad Medicare Medicare |
$17.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$181.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.27
|
| Rate for Payer: UHC Exchange |
$26.77
|
| Rate for Payer: UHC Medicare Advantage |
$17.27
|
| Rate for Payer: UHCCP DNSP |
$17.27
|
| Rate for Payer: UHCCP Medicaid |
$9.26
|
| Rate for Payer: VA VA |
$17.27
|
|
|
HC ADALIMUMAB, S
|
Facility
|
OP
|
$300.90
|
|
|
Service Code
|
CPT 80145
|
| Hospital Charge Code |
30100704
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.67 |
| Max. Negotiated Rate |
$300.90 |
| Rate for Payer: Aetna Commercial |
$270.81
|
| Rate for Payer: Aetna Medicare |
$38.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48.21
|
| Rate for Payer: ASR ASR |
$291.87
|
| Rate for Payer: ASR Commercial |
$291.87
|
| Rate for Payer: BCBS Complete |
$21.71
|
| Rate for Payer: BCBS MAPPO |
$38.57
|
| Rate for Payer: BCBS Trust/PPO |
$246.41
|
| Rate for Payer: BCN Commercial |
$233.29
|
| Rate for Payer: BCN Medicare Advantage |
$38.57
|
| Rate for Payer: Cash Price |
$240.72
|
| Rate for Payer: Cash Price |
$240.72
|
| Rate for Payer: Cofinity Commercial |
$282.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$240.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.57
|
| Rate for Payer: Healthscope Commercial |
$300.90
|
| Rate for Payer: Healthscope Whirlpool |
$291.87
|
| Rate for Payer: Humana Choice PPO Medicare |
$38.57
|
| Rate for Payer: Mclaren Commercial |
$270.81
|
| Rate for Payer: Mclaren Medicaid |
$20.67
|
| Rate for Payer: Mclaren Medicare |
$38.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.50
|
| Rate for Payer: Meridian Medicaid |
$21.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$255.76
|
| Rate for Payer: Nomi Health Commercial |
$246.74
|
| Rate for Payer: PACE Medicare |
$36.64
|
| Rate for Payer: PACE SWMI |
$38.57
|
| Rate for Payer: PHP Commercial |
$42.43
|
| Rate for Payer: PHP Medicaid |
$20.67
|
| Rate for Payer: PHP Medicare Advantage |
$38.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$195.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$263.65
|
| Rate for Payer: Priority Health Medicare |
$38.57
|
| Rate for Payer: Priority Health Narrow Network |
$210.93
|
| Rate for Payer: Railroad Medicare Medicare |
$38.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$264.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.57
|
| Rate for Payer: UHC Exchange |
$59.78
|
| Rate for Payer: UHC Medicare Advantage |
$38.57
|
| Rate for Payer: UHCCP DNSP |
$38.57
|
| Rate for Payer: UHCCP Medicaid |
$20.67
|
| Rate for Payer: VA VA |
$38.57
|
|
|
HC ADALIMUMAB, S
|
Facility
|
IP
|
$300.90
|
|
|
Service Code
|
CPT 80145
|
| Hospital Charge Code |
30100704
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$195.59 |
| Max. Negotiated Rate |
$300.90 |
| Rate for Payer: Aetna Commercial |
$270.81
|
| Rate for Payer: ASR ASR |
$291.87
|
| Rate for Payer: ASR Commercial |
$291.87
|
| Rate for Payer: BCBS Trust/PPO |
$245.20
|
| Rate for Payer: BCN Commercial |
$233.29
|
| Rate for Payer: Cash Price |
$240.72
|
| Rate for Payer: Cofinity Commercial |
$282.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$240.72
|
| Rate for Payer: Healthscope Commercial |
$300.90
|
| Rate for Payer: Healthscope Whirlpool |
$291.87
|
| Rate for Payer: Mclaren Commercial |
$270.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$255.76
|
| Rate for Payer: Nomi Health Commercial |
$246.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$195.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$264.79
|
|
|
HC ADAMTS13 ACTIVITY AND INHIBITOR PROFILE, PLASMA
|
Facility
|
OP
|
$160.75
|
|
|
Service Code
|
CPT 85397
|
| Hospital Charge Code |
30500106
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$16.54 |
| Max. Negotiated Rate |
$160.75 |
| Rate for Payer: Aetna Commercial |
$144.68
|
| Rate for Payer: Aetna Medicare |
$30.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$38.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$38.58
|
| Rate for Payer: ASR ASR |
$155.93
|
| Rate for Payer: ASR Commercial |
$155.93
|
| Rate for Payer: BCBS Complete |
$17.37
|
| Rate for Payer: BCBS MAPPO |
$30.86
|
| Rate for Payer: BCBS Trust/PPO |
$131.64
|
| Rate for Payer: BCN Commercial |
$124.63
|
| Rate for Payer: BCN Medicare Advantage |
$30.86
|
| Rate for Payer: Cash Price |
$128.60
|
| Rate for Payer: Cash Price |
$128.60
|
| Rate for Payer: Cofinity Commercial |
$151.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.86
|
| Rate for Payer: Healthscope Commercial |
$160.75
|
| Rate for Payer: Healthscope Whirlpool |
$155.93
|
| Rate for Payer: Humana Choice PPO Medicare |
$30.86
|
| Rate for Payer: Mclaren Commercial |
$144.68
|
| Rate for Payer: Mclaren Medicaid |
$16.54
|
| Rate for Payer: Mclaren Medicare |
$30.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.40
|
| Rate for Payer: Meridian Medicaid |
$17.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.64
|
| Rate for Payer: Nomi Health Commercial |
$131.81
|
| Rate for Payer: PACE Medicare |
$29.32
|
| Rate for Payer: PACE SWMI |
$30.86
|
| Rate for Payer: PHP Commercial |
$33.95
|
| Rate for Payer: PHP Medicaid |
$16.54
|
| Rate for Payer: PHP Medicare Advantage |
$30.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.49
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$140.85
|
| Rate for Payer: Priority Health Medicare |
$30.86
|
| Rate for Payer: Priority Health Narrow Network |
$112.69
|
| Rate for Payer: Railroad Medicare Medicare |
$30.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$141.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.86
|
| Rate for Payer: UHC Exchange |
$47.83
|
| Rate for Payer: UHC Medicare Advantage |
$30.86
|
| Rate for Payer: UHCCP DNSP |
$30.86
|
| Rate for Payer: UHCCP Medicaid |
$16.54
|
| Rate for Payer: VA VA |
$30.86
|
|
|
HC ADAMTS13 ACTIVITY AND INHIBITOR PROFILE, PLASMA
|
Facility
|
IP
|
$160.75
|
|
|
Service Code
|
CPT 85397
|
| Hospital Charge Code |
30500106
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$104.49 |
| Max. Negotiated Rate |
$160.75 |
| Rate for Payer: Aetna Commercial |
$144.68
|
| Rate for Payer: ASR ASR |
$155.93
|
| Rate for Payer: ASR Commercial |
$155.93
|
| Rate for Payer: BCBS Trust/PPO |
$131.00
|
| Rate for Payer: BCN Commercial |
$124.63
|
| Rate for Payer: Cash Price |
$128.60
|
| Rate for Payer: Cofinity Commercial |
$151.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.60
|
| Rate for Payer: Healthscope Commercial |
$160.75
|
| Rate for Payer: Healthscope Whirlpool |
$155.93
|
| Rate for Payer: Mclaren Commercial |
$144.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.64
|
| Rate for Payer: Nomi Health Commercial |
$131.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$141.46
|
|
|
HC ADAMTS 13 ANTIBODY
|
Facility
|
OP
|
$180.54
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30000056
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.26 |
| Max. Negotiated Rate |
$180.54 |
| Rate for Payer: Aetna Commercial |
$162.49
|
| Rate for Payer: Aetna Medicare |
$17.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.59
|
| Rate for Payer: ASR ASR |
$175.12
|
| Rate for Payer: ASR Commercial |
$175.12
|
| Rate for Payer: BCBS Complete |
$9.72
|
| Rate for Payer: BCBS MAPPO |
$17.27
|
| Rate for Payer: BCBS Trust/PPO |
$147.84
|
| Rate for Payer: BCN Commercial |
$139.97
|
| Rate for Payer: BCN Medicare Advantage |
$17.27
|
| Rate for Payer: Cash Price |
$144.43
|
| Rate for Payer: Cash Price |
$144.43
|
| Rate for Payer: Cofinity Commercial |
$169.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$144.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.27
|
| Rate for Payer: Healthscope Commercial |
$180.54
|
| Rate for Payer: Healthscope Whirlpool |
$175.12
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.27
|
| Rate for Payer: Mclaren Commercial |
$162.49
|
| Rate for Payer: Mclaren Medicaid |
$9.26
|
| Rate for Payer: Mclaren Medicare |
$17.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.13
|
| Rate for Payer: Meridian Medicaid |
$9.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$153.46
|
| Rate for Payer: Nomi Health Commercial |
$148.04
|
| Rate for Payer: PACE Medicare |
$16.41
|
| Rate for Payer: PACE SWMI |
$17.27
|
| Rate for Payer: PHP Commercial |
$19.00
|
| Rate for Payer: PHP Medicaid |
$9.26
|
| Rate for Payer: PHP Medicare Advantage |
$17.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$117.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$158.19
|
| Rate for Payer: Priority Health Medicare |
$17.27
|
| Rate for Payer: Priority Health Narrow Network |
$126.56
|
| Rate for Payer: Railroad Medicare Medicare |
$17.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$158.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.27
|
| Rate for Payer: UHC Exchange |
$26.77
|
| Rate for Payer: UHC Medicare Advantage |
$17.27
|
| Rate for Payer: UHCCP DNSP |
$17.27
|
| Rate for Payer: UHCCP Medicaid |
$9.26
|
| Rate for Payer: VA VA |
$17.27
|
|
|
HC ADAMTS 13 ANTIBODY
|
Facility
|
IP
|
$180.54
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30000056
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$117.35 |
| Max. Negotiated Rate |
$180.54 |
| Rate for Payer: Aetna Commercial |
$162.49
|
| Rate for Payer: ASR ASR |
$175.12
|
| Rate for Payer: ASR Commercial |
$175.12
|
| Rate for Payer: BCBS Trust/PPO |
$147.12
|
| Rate for Payer: BCN Commercial |
$139.97
|
| Rate for Payer: Cash Price |
$144.43
|
| Rate for Payer: Cofinity Commercial |
$169.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$144.43
|
| Rate for Payer: Healthscope Commercial |
$180.54
|
| Rate for Payer: Healthscope Whirlpool |
$175.12
|
| Rate for Payer: Mclaren Commercial |
$162.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$153.46
|
| Rate for Payer: Nomi Health Commercial |
$148.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$117.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$158.88
|
|
|
HC ADAMTS 13 INHIBITOR
|
Facility
|
OP
|
$151.90
|
|
|
Service Code
|
CPT 85335
|
| Hospital Charge Code |
30000055
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$151.90 |
| Rate for Payer: Aetna Commercial |
$136.71
|
| Rate for Payer: Aetna Medicare |
$12.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.09
|
| Rate for Payer: ASR ASR |
$147.34
|
| Rate for Payer: ASR Commercial |
$147.34
|
| Rate for Payer: BCBS Complete |
$7.24
|
| Rate for Payer: BCBS MAPPO |
$12.87
|
| Rate for Payer: BCBS Trust/PPO |
$124.39
|
| Rate for Payer: BCN Commercial |
$117.77
|
| Rate for Payer: BCN Medicare Advantage |
$12.87
|
| Rate for Payer: Cash Price |
$121.52
|
| Rate for Payer: Cash Price |
$121.52
|
| Rate for Payer: Cofinity Commercial |
$142.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$121.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.87
|
| Rate for Payer: Healthscope Commercial |
$151.90
|
| Rate for Payer: Healthscope Whirlpool |
$147.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.87
|
| Rate for Payer: Mclaren Commercial |
$136.71
|
| Rate for Payer: Mclaren Medicaid |
$6.90
|
| Rate for Payer: Mclaren Medicare |
$12.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.51
|
| Rate for Payer: Meridian Medicaid |
$7.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$129.12
|
| Rate for Payer: Nomi Health Commercial |
$124.56
|
| Rate for Payer: PACE Medicare |
$12.23
|
| Rate for Payer: PACE SWMI |
$12.87
|
| Rate for Payer: PHP Commercial |
$14.16
|
| Rate for Payer: PHP Medicaid |
$6.90
|
| Rate for Payer: PHP Medicare Advantage |
$12.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$133.09
|
| Rate for Payer: Priority Health Medicare |
$12.87
|
| Rate for Payer: Priority Health Narrow Network |
$106.48
|
| Rate for Payer: Railroad Medicare Medicare |
$12.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$133.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.87
|
| Rate for Payer: UHC Exchange |
$19.95
|
| Rate for Payer: UHC Medicare Advantage |
$12.87
|
| Rate for Payer: UHCCP DNSP |
$12.87
|
| Rate for Payer: UHCCP Medicaid |
$6.90
|
| Rate for Payer: VA VA |
$12.87
|
|
|
HC ADAMTS 13 INHIBITOR
|
Facility
|
IP
|
$151.90
|
|
|
Service Code
|
CPT 85335
|
| Hospital Charge Code |
30000055
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$98.73 |
| Max. Negotiated Rate |
$151.90 |
| Rate for Payer: Aetna Commercial |
$136.71
|
| Rate for Payer: ASR ASR |
$147.34
|
| Rate for Payer: ASR Commercial |
$147.34
|
| Rate for Payer: BCBS Trust/PPO |
$123.78
|
| Rate for Payer: BCN Commercial |
$117.77
|
| Rate for Payer: Cash Price |
$121.52
|
| Rate for Payer: Cofinity Commercial |
$142.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$121.52
|
| Rate for Payer: Healthscope Commercial |
$151.90
|
| Rate for Payer: Healthscope Whirlpool |
$147.34
|
| Rate for Payer: Mclaren Commercial |
$136.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$129.12
|
| Rate for Payer: Nomi Health Commercial |
$124.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$133.67
|
|
|
HC ADAMTS ACTIVITY AND INHIB PROFILE
|
Facility
|
OP
|
$160.75
|
|
|
Service Code
|
CPT 85397
|
| Hospital Charge Code |
30500103
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$16.54 |
| Max. Negotiated Rate |
$160.75 |
| Rate for Payer: Aetna Commercial |
$144.68
|
| Rate for Payer: Aetna Medicare |
$30.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$38.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$38.58
|
| Rate for Payer: ASR ASR |
$155.93
|
| Rate for Payer: ASR Commercial |
$155.93
|
| Rate for Payer: BCBS Complete |
$17.37
|
| Rate for Payer: BCBS MAPPO |
$30.86
|
| Rate for Payer: BCBS Trust/PPO |
$131.64
|
| Rate for Payer: BCN Commercial |
$124.63
|
| Rate for Payer: BCN Medicare Advantage |
$30.86
|
| Rate for Payer: Cash Price |
$128.60
|
| Rate for Payer: Cash Price |
$128.60
|
| Rate for Payer: Cofinity Commercial |
$151.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.86
|
| Rate for Payer: Healthscope Commercial |
$160.75
|
| Rate for Payer: Healthscope Whirlpool |
$155.93
|
| Rate for Payer: Humana Choice PPO Medicare |
$30.86
|
| Rate for Payer: Mclaren Commercial |
$144.68
|
| Rate for Payer: Mclaren Medicaid |
$16.54
|
| Rate for Payer: Mclaren Medicare |
$30.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.40
|
| Rate for Payer: Meridian Medicaid |
$17.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.64
|
| Rate for Payer: Nomi Health Commercial |
$131.81
|
| Rate for Payer: PACE Medicare |
$29.32
|
| Rate for Payer: PACE SWMI |
$30.86
|
| Rate for Payer: PHP Commercial |
$33.95
|
| Rate for Payer: PHP Medicaid |
$16.54
|
| Rate for Payer: PHP Medicare Advantage |
$30.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.49
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$140.85
|
| Rate for Payer: Priority Health Medicare |
$30.86
|
| Rate for Payer: Priority Health Narrow Network |
$112.69
|
| Rate for Payer: Railroad Medicare Medicare |
$30.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$141.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.86
|
| Rate for Payer: UHC Exchange |
$47.83
|
| Rate for Payer: UHC Medicare Advantage |
$30.86
|
| Rate for Payer: UHCCP DNSP |
$30.86
|
| Rate for Payer: UHCCP Medicaid |
$16.54
|
| Rate for Payer: VA VA |
$30.86
|
|
|
HC ADAMTS ACTIVITY AND INHIB PROFILE
|
Facility
|
IP
|
$160.75
|
|
|
Service Code
|
CPT 85397
|
| Hospital Charge Code |
30500103
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$104.49 |
| Max. Negotiated Rate |
$160.75 |
| Rate for Payer: Aetna Commercial |
$144.68
|
| Rate for Payer: ASR ASR |
$155.93
|
| Rate for Payer: ASR Commercial |
$155.93
|
| Rate for Payer: BCBS Trust/PPO |
$131.00
|
| Rate for Payer: BCN Commercial |
$124.63
|
| Rate for Payer: Cash Price |
$128.60
|
| Rate for Payer: Cofinity Commercial |
$151.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.60
|
| Rate for Payer: Healthscope Commercial |
$160.75
|
| Rate for Payer: Healthscope Whirlpool |
$155.93
|
| Rate for Payer: Mclaren Commercial |
$144.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.64
|
| Rate for Payer: Nomi Health Commercial |
$131.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$141.46
|
|
|
HC ADAPT BARRIER RING
|
Facility
|
OP
|
$8.86
|
|
| Hospital Charge Code |
27100020
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.54 |
| Max. Negotiated Rate |
$8.86 |
| Rate for Payer: Aetna Commercial |
$7.97
|
| Rate for Payer: Aetna Medicare |
$4.43
|
| Rate for Payer: ASR ASR |
$8.59
|
| Rate for Payer: ASR Commercial |
$8.59
|
| Rate for Payer: BCBS Complete |
$3.54
|
| Rate for Payer: BCBS Trust/PPO |
$7.26
|
| Rate for Payer: BCN Commercial |
$6.87
|
| Rate for Payer: Cash Price |
$7.09
|
| Rate for Payer: Cofinity Commercial |
$8.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.09
|
| Rate for Payer: Healthscope Commercial |
$8.86
|
| Rate for Payer: Healthscope Whirlpool |
$8.59
|
| Rate for Payer: Mclaren Commercial |
$7.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.53
|
| Rate for Payer: Nomi Health Commercial |
$7.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7.76
|
| Rate for Payer: Priority Health Narrow Network |
$6.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7.80
|
|
|
HC ADAPT BARRIER RING
|
Facility
|
IP
|
$8.86
|
|
| Hospital Charge Code |
27100020
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$5.76 |
| Max. Negotiated Rate |
$8.86 |
| Rate for Payer: Aetna Commercial |
$7.97
|
| Rate for Payer: ASR ASR |
$8.59
|
| Rate for Payer: ASR Commercial |
$8.59
|
| Rate for Payer: BCBS Trust/PPO |
$7.22
|
| Rate for Payer: BCN Commercial |
$6.87
|
| Rate for Payer: Cash Price |
$7.09
|
| Rate for Payer: Cofinity Commercial |
$8.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.09
|
| Rate for Payer: Healthscope Commercial |
$8.86
|
| Rate for Payer: Healthscope Whirlpool |
$8.59
|
| Rate for Payer: Mclaren Commercial |
$7.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.53
|
| Rate for Payer: Nomi Health Commercial |
$7.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7.80
|
|
|
HC ADAPTER PERFUSION STERILE
|
Facility
|
OP
|
$91.80
|
|
| Hospital Charge Code |
27000677
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$36.72 |
| Max. Negotiated Rate |
$91.80 |
| Rate for Payer: Aetna Commercial |
$82.62
|
| Rate for Payer: Aetna Medicare |
$45.90
|
| Rate for Payer: ASR ASR |
$89.05
|
| Rate for Payer: ASR Commercial |
$89.05
|
| Rate for Payer: BCBS Complete |
$36.72
|
| Rate for Payer: BCBS Trust/PPO |
$75.18
|
| Rate for Payer: BCN Commercial |
$71.17
|
| Rate for Payer: Cash Price |
$73.44
|
| Rate for Payer: Cofinity Commercial |
$86.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.44
|
| Rate for Payer: Healthscope Commercial |
$91.80
|
| Rate for Payer: Healthscope Whirlpool |
$89.05
|
| Rate for Payer: Mclaren Commercial |
$82.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.03
|
| Rate for Payer: Nomi Health Commercial |
$75.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.67
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$80.44
|
| Rate for Payer: Priority Health Narrow Network |
$64.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$80.78
|
|
|
HC ADAPTER PERFUSION STERILE
|
Facility
|
IP
|
$91.80
|
|
| Hospital Charge Code |
27000677
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$59.67 |
| Max. Negotiated Rate |
$91.80 |
| Rate for Payer: Aetna Commercial |
$82.62
|
| Rate for Payer: ASR ASR |
$89.05
|
| Rate for Payer: ASR Commercial |
$89.05
|
| Rate for Payer: BCBS Trust/PPO |
$74.81
|
| Rate for Payer: BCN Commercial |
$71.17
|
| Rate for Payer: Cash Price |
$73.44
|
| Rate for Payer: Cofinity Commercial |
$86.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.44
|
| Rate for Payer: Healthscope Commercial |
$91.80
|
| Rate for Payer: Healthscope Whirlpool |
$89.05
|
| Rate for Payer: Mclaren Commercial |
$82.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.03
|
| Rate for Payer: Nomi Health Commercial |
$75.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$80.78
|
|
|
HC ADAPTOR PERFUSION
|
Facility
|
OP
|
$12.24
|
|
| Hospital Charge Code |
27000264
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.90 |
| Max. Negotiated Rate |
$12.24 |
| Rate for Payer: Aetna Commercial |
$11.02
|
| Rate for Payer: Aetna Medicare |
$6.12
|
| Rate for Payer: ASR ASR |
$11.87
|
| Rate for Payer: ASR Commercial |
$11.87
|
| Rate for Payer: BCBS Complete |
$4.90
|
| Rate for Payer: BCBS Trust/PPO |
$10.02
|
| Rate for Payer: BCN Commercial |
$9.49
|
| Rate for Payer: Cash Price |
$9.79
|
| Rate for Payer: Cofinity Commercial |
$11.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.79
|
| Rate for Payer: Healthscope Commercial |
$12.24
|
| Rate for Payer: Healthscope Whirlpool |
$11.87
|
| Rate for Payer: Mclaren Commercial |
$11.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.40
|
| Rate for Payer: Nomi Health Commercial |
$10.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10.72
|
| Rate for Payer: Priority Health Narrow Network |
$8.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10.77
|
|
|
HC ADAPTOR PERFUSION
|
Facility
|
IP
|
$12.24
|
|
| Hospital Charge Code |
27000264
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.96 |
| Max. Negotiated Rate |
$12.24 |
| Rate for Payer: Aetna Commercial |
$11.02
|
| Rate for Payer: ASR ASR |
$11.87
|
| Rate for Payer: ASR Commercial |
$11.87
|
| Rate for Payer: BCBS Trust/PPO |
$9.97
|
| Rate for Payer: BCN Commercial |
$9.49
|
| Rate for Payer: Cash Price |
$9.79
|
| Rate for Payer: Cofinity Commercial |
$11.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.79
|
| Rate for Payer: Healthscope Commercial |
$12.24
|
| Rate for Payer: Healthscope Whirlpool |
$11.87
|
| Rate for Payer: Mclaren Commercial |
$11.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.40
|
| Rate for Payer: Nomi Health Commercial |
$10.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10.77
|
|
|
HC ADD. ABLATION
|
Facility
|
IP
|
$8,902.00
|
|
|
Service Code
|
CPT 93655
|
| Hospital Charge Code |
48100093
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,786.30 |
| Max. Negotiated Rate |
$8,902.00 |
| Rate for Payer: Aetna Commercial |
$8,011.80
|
| Rate for Payer: ASR ASR |
$8,634.94
|
| Rate for Payer: ASR Commercial |
$8,634.94
|
| Rate for Payer: BCBS Trust/PPO |
$7,254.24
|
| Rate for Payer: BCN Commercial |
$6,901.72
|
| Rate for Payer: Cash Price |
$7,121.60
|
| Rate for Payer: Cofinity Commercial |
$8,367.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,121.60
|
| Rate for Payer: Healthscope Commercial |
$8,902.00
|
| Rate for Payer: Healthscope Whirlpool |
$8,634.94
|
| Rate for Payer: Mclaren Commercial |
$8,011.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,566.70
|
| Rate for Payer: Nomi Health Commercial |
$7,299.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,786.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,833.76
|
|
|
HC ADD. ABLATION
|
Facility
|
OP
|
$8,902.00
|
|
|
Service Code
|
CPT 93655
|
| Hospital Charge Code |
48100093
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,560.80 |
| Max. Negotiated Rate |
$8,902.00 |
| Rate for Payer: Aetna Commercial |
$8,011.80
|
| Rate for Payer: Aetna Medicare |
$4,451.00
|
| Rate for Payer: ASR ASR |
$8,634.94
|
| Rate for Payer: ASR Commercial |
$8,634.94
|
| Rate for Payer: BCBS Complete |
$3,560.80
|
| Rate for Payer: BCBS Trust/PPO |
$7,289.85
|
| Rate for Payer: BCN Commercial |
$6,901.72
|
| Rate for Payer: Cash Price |
$7,121.60
|
| Rate for Payer: Cofinity Commercial |
$8,367.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,121.60
|
| Rate for Payer: Healthscope Commercial |
$8,902.00
|
| Rate for Payer: Healthscope Whirlpool |
$8,634.94
|
| Rate for Payer: Mclaren Commercial |
$8,011.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,566.70
|
| Rate for Payer: Nomi Health Commercial |
$7,299.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,786.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,799.93
|
| Rate for Payer: Priority Health Narrow Network |
$6,240.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,833.76
|
|
