|
HC ADMIN RSV MONOC ANTB IM INJ
|
Facility
|
IP
|
$84.70
|
|
|
Service Code
|
CPT 96381
|
| Hospital Charge Code |
77100066
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$55.06 |
| Max. Negotiated Rate |
$84.70 |
| Rate for Payer: Aetna Commercial |
$76.23
|
| Rate for Payer: ASR ASR |
$82.16
|
| Rate for Payer: ASR Commercial |
$82.16
|
| Rate for Payer: BCBS Trust/PPO |
$69.02
|
| Rate for Payer: BCN Commercial |
$65.67
|
| Rate for Payer: Cash Price |
$67.76
|
| Rate for Payer: Cofinity Commercial |
$79.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.76
|
| Rate for Payer: Healthscope Commercial |
$84.70
|
| Rate for Payer: Healthscope Whirlpool |
$82.16
|
| Rate for Payer: Mclaren Commercial |
$76.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.00
|
| Rate for Payer: Nomi Health Commercial |
$69.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$74.54
|
|
|
HC ADMIN RSV MONOC ANTB IM W/COUNSELING
|
Facility
|
IP
|
$84.70
|
|
|
Service Code
|
CPT 96380
|
| Hospital Charge Code |
77100065
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$55.06 |
| Max. Negotiated Rate |
$84.70 |
| Rate for Payer: Aetna Commercial |
$76.23
|
| Rate for Payer: ASR ASR |
$82.16
|
| Rate for Payer: ASR Commercial |
$82.16
|
| Rate for Payer: BCBS Trust/PPO |
$69.02
|
| Rate for Payer: BCN Commercial |
$65.67
|
| Rate for Payer: Cash Price |
$67.76
|
| Rate for Payer: Cofinity Commercial |
$79.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.76
|
| Rate for Payer: Healthscope Commercial |
$84.70
|
| Rate for Payer: Healthscope Whirlpool |
$82.16
|
| Rate for Payer: Mclaren Commercial |
$76.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.00
|
| Rate for Payer: Nomi Health Commercial |
$69.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$74.54
|
|
|
HC ADMIN RSV MONOC ANTB IM W/COUNSELING
|
Facility
|
OP
|
$84.70
|
|
|
Service Code
|
CPT 96380
|
| Hospital Charge Code |
77100065
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$33.88 |
| Max. Negotiated Rate |
$84.70 |
| Rate for Payer: Aetna Commercial |
$76.23
|
| Rate for Payer: Aetna Medicare |
$42.35
|
| Rate for Payer: ASR ASR |
$82.16
|
| Rate for Payer: ASR Commercial |
$82.16
|
| Rate for Payer: BCBS Complete |
$33.88
|
| Rate for Payer: BCBS Trust/PPO |
$69.36
|
| Rate for Payer: BCN Commercial |
$65.67
|
| Rate for Payer: Cash Price |
$67.76
|
| Rate for Payer: Cofinity Commercial |
$79.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.76
|
| Rate for Payer: Healthscope Commercial |
$84.70
|
| Rate for Payer: Healthscope Whirlpool |
$82.16
|
| Rate for Payer: Mclaren Commercial |
$76.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.00
|
| Rate for Payer: Nomi Health Commercial |
$69.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$74.21
|
| Rate for Payer: Priority Health Narrow Network |
$59.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$74.54
|
|
|
HC ADMIN TOCILIZUMAB COVID 19 1ST DOSE
|
Facility
|
OP
|
$534.77
|
|
|
Service Code
|
HCPCS M0249
|
| Hospital Charge Code |
77100044
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$236.59 |
| Max. Negotiated Rate |
$684.15 |
| Rate for Payer: Aetna Commercial |
$481.29
|
| Rate for Payer: Aetna Medicare |
$441.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$551.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$551.74
|
| Rate for Payer: ASR ASR |
$518.73
|
| Rate for Payer: ASR Commercial |
$518.73
|
| Rate for Payer: BCBS Complete |
$248.41
|
| Rate for Payer: BCBS MAPPO |
$441.39
|
| Rate for Payer: BCBS Trust/PPO |
$437.92
|
| Rate for Payer: BCN Commercial |
$414.61
|
| Rate for Payer: BCN Medicare Advantage |
$441.39
|
| Rate for Payer: Cash Price |
$427.82
|
| Rate for Payer: Cash Price |
$427.82
|
| Rate for Payer: Cofinity Commercial |
$502.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$427.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$441.39
|
| Rate for Payer: Healthscope Commercial |
$534.77
|
| Rate for Payer: Healthscope Whirlpool |
$518.73
|
| Rate for Payer: Humana Choice PPO Medicare |
$441.39
|
| Rate for Payer: Mclaren Commercial |
$481.29
|
| Rate for Payer: Mclaren Medicaid |
$236.59
|
| Rate for Payer: Mclaren Medicare |
$441.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$463.46
|
| Rate for Payer: Meridian Medicaid |
$248.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$507.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$454.55
|
| Rate for Payer: Nomi Health Commercial |
$438.51
|
| Rate for Payer: PACE Medicare |
$419.32
|
| Rate for Payer: PACE SWMI |
$441.39
|
| Rate for Payer: PHP Commercial |
$485.53
|
| Rate for Payer: PHP Medicaid |
$236.59
|
| Rate for Payer: PHP Medicare Advantage |
$441.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$236.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$347.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$468.57
|
| Rate for Payer: Priority Health Medicare |
$441.39
|
| Rate for Payer: Priority Health Narrow Network |
$374.87
|
| Rate for Payer: Railroad Medicare Medicare |
$441.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$470.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$441.39
|
| Rate for Payer: UHC Exchange |
$684.15
|
| Rate for Payer: UHC Medicare Advantage |
$441.39
|
| Rate for Payer: UHCCP DNSP |
$441.39
|
| Rate for Payer: UHCCP Medicaid |
$236.59
|
| Rate for Payer: VA VA |
$441.39
|
|
|
HC ADMIN TOCILIZUMAB COVID 19 1ST DOSE
|
Facility
|
IP
|
$534.77
|
|
|
Service Code
|
HCPCS M0249
|
| Hospital Charge Code |
77100044
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$347.60 |
| Max. Negotiated Rate |
$534.77 |
| Rate for Payer: Aetna Commercial |
$481.29
|
| Rate for Payer: ASR ASR |
$518.73
|
| Rate for Payer: ASR Commercial |
$518.73
|
| Rate for Payer: BCBS Trust/PPO |
$435.78
|
| Rate for Payer: BCN Commercial |
$414.61
|
| Rate for Payer: Cash Price |
$427.82
|
| Rate for Payer: Cofinity Commercial |
$502.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$427.82
|
| Rate for Payer: Healthscope Commercial |
$534.77
|
| Rate for Payer: Healthscope Whirlpool |
$518.73
|
| Rate for Payer: Mclaren Commercial |
$481.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$454.55
|
| Rate for Payer: Nomi Health Commercial |
$438.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$347.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$470.60
|
|
|
HC ADMIN TOCILIZUMAB COVID 19 2ND DOSE
|
Facility
|
IP
|
$534.77
|
|
|
Service Code
|
HCPCS M0250
|
| Hospital Charge Code |
77100045
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$347.60 |
| Max. Negotiated Rate |
$534.77 |
| Rate for Payer: Aetna Commercial |
$481.29
|
| Rate for Payer: ASR ASR |
$518.73
|
| Rate for Payer: ASR Commercial |
$518.73
|
| Rate for Payer: BCBS Trust/PPO |
$435.78
|
| Rate for Payer: BCN Commercial |
$414.61
|
| Rate for Payer: Cash Price |
$427.82
|
| Rate for Payer: Cofinity Commercial |
$502.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$427.82
|
| Rate for Payer: Healthscope Commercial |
$534.77
|
| Rate for Payer: Healthscope Whirlpool |
$518.73
|
| Rate for Payer: Mclaren Commercial |
$481.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$454.55
|
| Rate for Payer: Nomi Health Commercial |
$438.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$347.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$470.60
|
|
|
HC ADMIN TOCILIZUMAB COVID 19 2ND DOSE
|
Facility
|
OP
|
$534.77
|
|
|
Service Code
|
HCPCS M0250
|
| Hospital Charge Code |
77100045
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$236.59 |
| Max. Negotiated Rate |
$684.15 |
| Rate for Payer: Aetna Commercial |
$481.29
|
| Rate for Payer: Aetna Medicare |
$441.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$551.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$551.74
|
| Rate for Payer: ASR ASR |
$518.73
|
| Rate for Payer: ASR Commercial |
$518.73
|
| Rate for Payer: BCBS Complete |
$248.41
|
| Rate for Payer: BCBS MAPPO |
$441.39
|
| Rate for Payer: BCBS Trust/PPO |
$437.92
|
| Rate for Payer: BCN Commercial |
$414.61
|
| Rate for Payer: BCN Medicare Advantage |
$441.39
|
| Rate for Payer: Cash Price |
$427.82
|
| Rate for Payer: Cash Price |
$427.82
|
| Rate for Payer: Cofinity Commercial |
$502.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$427.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$441.39
|
| Rate for Payer: Healthscope Commercial |
$534.77
|
| Rate for Payer: Healthscope Whirlpool |
$518.73
|
| Rate for Payer: Humana Choice PPO Medicare |
$441.39
|
| Rate for Payer: Mclaren Commercial |
$481.29
|
| Rate for Payer: Mclaren Medicaid |
$236.59
|
| Rate for Payer: Mclaren Medicare |
$441.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$463.46
|
| Rate for Payer: Meridian Medicaid |
$248.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$507.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$454.55
|
| Rate for Payer: Nomi Health Commercial |
$438.51
|
| Rate for Payer: PACE Medicare |
$419.32
|
| Rate for Payer: PACE SWMI |
$441.39
|
| Rate for Payer: PHP Commercial |
$485.53
|
| Rate for Payer: PHP Medicaid |
$236.59
|
| Rate for Payer: PHP Medicare Advantage |
$441.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$236.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$347.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$468.57
|
| Rate for Payer: Priority Health Medicare |
$441.39
|
| Rate for Payer: Priority Health Narrow Network |
$374.87
|
| Rate for Payer: Railroad Medicare Medicare |
$441.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$470.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$441.39
|
| Rate for Payer: UHC Exchange |
$684.15
|
| Rate for Payer: UHC Medicare Advantage |
$441.39
|
| Rate for Payer: UHCCP DNSP |
$441.39
|
| Rate for Payer: UHCCP Medicaid |
$236.59
|
| Rate for Payer: VA VA |
$441.39
|
|
|
HC ADMN SARSCOV2 VACC 1 DOSE
|
Facility
|
OP
|
$84.70
|
|
|
Service Code
|
CPT 90480
|
| Hospital Charge Code |
77100064
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$21.80 |
| Max. Negotiated Rate |
$84.70 |
| Rate for Payer: Aetna Commercial |
$76.23
|
| Rate for Payer: Aetna Medicare |
$40.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$50.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$50.85
|
| Rate for Payer: ASR ASR |
$82.16
|
| Rate for Payer: ASR Commercial |
$82.16
|
| Rate for Payer: BCBS Complete |
$22.89
|
| Rate for Payer: BCBS MAPPO |
$40.68
|
| Rate for Payer: BCBS Trust/PPO |
$69.36
|
| Rate for Payer: BCN Commercial |
$65.67
|
| Rate for Payer: BCN Medicare Advantage |
$40.68
|
| Rate for Payer: Cash Price |
$67.76
|
| Rate for Payer: Cash Price |
$67.76
|
| Rate for Payer: Cofinity Commercial |
$79.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.68
|
| Rate for Payer: Healthscope Commercial |
$84.70
|
| Rate for Payer: Healthscope Whirlpool |
$82.16
|
| Rate for Payer: Humana Choice PPO Medicare |
$40.68
|
| Rate for Payer: Mclaren Commercial |
$76.23
|
| Rate for Payer: Mclaren Medicaid |
$21.80
|
| Rate for Payer: Mclaren Medicare |
$40.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.71
|
| Rate for Payer: Meridian Medicaid |
$22.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.00
|
| Rate for Payer: Nomi Health Commercial |
$69.45
|
| Rate for Payer: PACE Medicare |
$38.65
|
| Rate for Payer: PACE SWMI |
$40.68
|
| Rate for Payer: PHP Commercial |
$44.75
|
| Rate for Payer: PHP Medicaid |
$21.80
|
| Rate for Payer: PHP Medicare Advantage |
$40.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$74.21
|
| Rate for Payer: Priority Health Medicare |
$40.68
|
| Rate for Payer: Priority Health Narrow Network |
$59.37
|
| Rate for Payer: Railroad Medicare Medicare |
$40.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$74.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$40.68
|
| Rate for Payer: UHC Exchange |
$63.05
|
| Rate for Payer: UHC Medicare Advantage |
$40.68
|
| Rate for Payer: UHCCP DNSP |
$40.68
|
| Rate for Payer: UHCCP Medicaid |
$21.80
|
| Rate for Payer: VA VA |
$40.68
|
|
|
HC ADMN SARSCOV2 VACC 1 DOSE
|
Facility
|
IP
|
$84.70
|
|
|
Service Code
|
CPT 90480
|
| Hospital Charge Code |
77100064
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$55.06 |
| Max. Negotiated Rate |
$84.70 |
| Rate for Payer: Aetna Commercial |
$76.23
|
| Rate for Payer: ASR ASR |
$82.16
|
| Rate for Payer: ASR Commercial |
$82.16
|
| Rate for Payer: BCBS Trust/PPO |
$69.02
|
| Rate for Payer: BCN Commercial |
$65.67
|
| Rate for Payer: Cash Price |
$67.76
|
| Rate for Payer: Cofinity Commercial |
$79.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.76
|
| Rate for Payer: Healthscope Commercial |
$84.70
|
| Rate for Payer: Healthscope Whirlpool |
$82.16
|
| Rate for Payer: Mclaren Commercial |
$76.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.00
|
| Rate for Payer: Nomi Health Commercial |
$69.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$74.54
|
|
|
HC ADMU OBSERVATION PER HOUR
|
Facility
|
IP
|
$145.08
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200020
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$94.30 |
| Max. Negotiated Rate |
$145.08 |
| Rate for Payer: Aetna Commercial |
$130.57
|
| Rate for Payer: ASR ASR |
$140.73
|
| Rate for Payer: ASR Commercial |
$140.73
|
| Rate for Payer: BCBS Trust/PPO |
$118.23
|
| Rate for Payer: BCN Commercial |
$112.48
|
| Rate for Payer: Cash Price |
$116.06
|
| Rate for Payer: Cofinity Commercial |
$136.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.06
|
| Rate for Payer: Healthscope Commercial |
$145.08
|
| Rate for Payer: Healthscope Whirlpool |
$140.73
|
| Rate for Payer: Mclaren Commercial |
$130.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.32
|
| Rate for Payer: Nomi Health Commercial |
$118.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$127.67
|
|
|
HC ADMU OBSERVATION PER HOUR
|
Facility
|
OP
|
$145.08
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200020
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$49.38 |
| Max. Negotiated Rate |
$145.08 |
| Rate for Payer: Aetna Commercial |
$130.57
|
| Rate for Payer: Aetna Medicare |
$72.54
|
| Rate for Payer: ASR ASR |
$140.73
|
| Rate for Payer: ASR Commercial |
$140.73
|
| Rate for Payer: BCBS Complete |
$58.03
|
| Rate for Payer: BCBS Trust/PPO |
$118.81
|
| Rate for Payer: BCN Commercial |
$112.48
|
| Rate for Payer: Cash Price |
$116.06
|
| Rate for Payer: Cash Price |
$116.06
|
| Rate for Payer: Cofinity Commercial |
$136.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.06
|
| Rate for Payer: Healthscope Commercial |
$145.08
|
| Rate for Payer: Healthscope Whirlpool |
$140.73
|
| Rate for Payer: Mclaren Commercial |
$130.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.32
|
| Rate for Payer: Nomi Health Commercial |
$118.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$61.72
|
| Rate for Payer: Priority Health Narrow Network |
$49.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$127.67
|
|
|
HC ADRENOCORTICOTROPIC HORMONE
|
Facility
|
IP
|
$63.18
|
|
|
Service Code
|
CPT 82024
|
| Hospital Charge Code |
30100071
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$41.07 |
| Max. Negotiated Rate |
$63.18 |
| Rate for Payer: Aetna Commercial |
$56.86
|
| Rate for Payer: ASR ASR |
$61.28
|
| Rate for Payer: ASR Commercial |
$61.28
|
| Rate for Payer: BCBS Trust/PPO |
$51.49
|
| Rate for Payer: BCN Commercial |
$48.98
|
| Rate for Payer: Cash Price |
$50.54
|
| Rate for Payer: Cofinity Commercial |
$59.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.54
|
| Rate for Payer: Healthscope Commercial |
$63.18
|
| Rate for Payer: Healthscope Whirlpool |
$61.28
|
| Rate for Payer: Mclaren Commercial |
$56.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.70
|
| Rate for Payer: Nomi Health Commercial |
$51.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$55.60
|
|
|
HC ADRENOCORTICOTROPIC HORMONE
|
Facility
|
OP
|
$63.18
|
|
|
Service Code
|
CPT 82024
|
| Hospital Charge Code |
30100071
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.70 |
| Max. Negotiated Rate |
$211.37 |
| Rate for Payer: Aetna Commercial |
$56.86
|
| Rate for Payer: Aetna Medicare |
$38.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48.28
|
| Rate for Payer: ASR ASR |
$61.28
|
| Rate for Payer: ASR Commercial |
$61.28
|
| Rate for Payer: BCBS Complete |
$21.74
|
| Rate for Payer: BCBS MAPPO |
$38.62
|
| Rate for Payer: BCBS Trust/PPO |
$51.74
|
| Rate for Payer: BCN Commercial |
$48.98
|
| Rate for Payer: BCN Medicare Advantage |
$38.62
|
| Rate for Payer: Cash Price |
$50.54
|
| Rate for Payer: Cash Price |
$50.54
|
| Rate for Payer: Cofinity Commercial |
$59.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.62
|
| Rate for Payer: Healthscope Commercial |
$63.18
|
| Rate for Payer: Healthscope Whirlpool |
$61.28
|
| Rate for Payer: Humana Choice PPO Medicare |
$38.62
|
| Rate for Payer: Mclaren Commercial |
$56.86
|
| Rate for Payer: Mclaren Medicaid |
$20.70
|
| Rate for Payer: Mclaren Medicare |
$38.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.55
|
| Rate for Payer: Meridian Medicaid |
$21.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.70
|
| Rate for Payer: Nomi Health Commercial |
$51.81
|
| Rate for Payer: PACE Medicare |
$36.69
|
| Rate for Payer: PACE SWMI |
$38.62
|
| Rate for Payer: PHP Commercial |
$42.48
|
| Rate for Payer: PHP Medicaid |
$20.70
|
| Rate for Payer: PHP Medicare Advantage |
$38.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$211.37
|
| Rate for Payer: Priority Health Medicare |
$38.62
|
| Rate for Payer: Priority Health Narrow Network |
$169.10
|
| Rate for Payer: Railroad Medicare Medicare |
$38.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$55.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.62
|
| Rate for Payer: UHC Exchange |
$59.86
|
| Rate for Payer: UHC Medicare Advantage |
$38.62
|
| Rate for Payer: UHCCP DNSP |
$38.62
|
| Rate for Payer: UHCCP Medicaid |
$20.70
|
| Rate for Payer: VA VA |
$38.62
|
|
|
HC ADULTERANT SURVEY URINE
|
Facility
|
IP
|
$15.30
|
|
|
Service Code
|
CPT 81005
|
| Hospital Charge Code |
30700010
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$9.94 |
| Max. Negotiated Rate |
$15.30 |
| Rate for Payer: Aetna Commercial |
$13.77
|
| Rate for Payer: ASR ASR |
$14.84
|
| Rate for Payer: ASR Commercial |
$14.84
|
| Rate for Payer: BCBS Trust/PPO |
$12.47
|
| Rate for Payer: BCN Commercial |
$11.86
|
| Rate for Payer: Cash Price |
$12.24
|
| Rate for Payer: Cofinity Commercial |
$14.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.24
|
| Rate for Payer: Healthscope Commercial |
$15.30
|
| Rate for Payer: Healthscope Whirlpool |
$14.84
|
| Rate for Payer: Mclaren Commercial |
$13.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.00
|
| Rate for Payer: Nomi Health Commercial |
$12.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$13.46
|
|
|
HC ADULTERANT SURVEY URINE
|
Facility
|
OP
|
$15.30
|
|
|
Service Code
|
CPT 81005
|
| Hospital Charge Code |
30700010
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$1.16 |
| Max. Negotiated Rate |
$15.30 |
| Rate for Payer: Aetna Commercial |
$13.77
|
| Rate for Payer: Aetna Medicare |
$2.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.71
|
| Rate for Payer: ASR ASR |
$14.84
|
| Rate for Payer: ASR Commercial |
$14.84
|
| Rate for Payer: BCBS Complete |
$1.22
|
| Rate for Payer: BCBS MAPPO |
$2.17
|
| Rate for Payer: BCBS Trust/PPO |
$12.53
|
| Rate for Payer: BCN Commercial |
$11.86
|
| Rate for Payer: BCN Medicare Advantage |
$2.17
|
| Rate for Payer: Cash Price |
$12.24
|
| Rate for Payer: Cash Price |
$12.24
|
| Rate for Payer: Cofinity Commercial |
$14.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.17
|
| Rate for Payer: Healthscope Commercial |
$15.30
|
| Rate for Payer: Healthscope Whirlpool |
$14.84
|
| Rate for Payer: Humana Choice PPO Medicare |
$2.17
|
| Rate for Payer: Mclaren Commercial |
$13.77
|
| Rate for Payer: Mclaren Medicaid |
$1.16
|
| Rate for Payer: Mclaren Medicare |
$2.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.28
|
| Rate for Payer: Meridian Medicaid |
$1.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.00
|
| Rate for Payer: Nomi Health Commercial |
$12.55
|
| Rate for Payer: PACE Medicare |
$2.06
|
| Rate for Payer: PACE SWMI |
$2.17
|
| Rate for Payer: PHP Commercial |
$2.39
|
| Rate for Payer: PHP Medicaid |
$1.16
|
| Rate for Payer: PHP Medicare Advantage |
$2.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.41
|
| Rate for Payer: Priority Health Medicare |
$2.17
|
| Rate for Payer: Priority Health Narrow Network |
$10.73
|
| Rate for Payer: Railroad Medicare Medicare |
$2.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$13.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.17
|
| Rate for Payer: UHC Exchange |
$3.36
|
| Rate for Payer: UHC Medicare Advantage |
$2.17
|
| Rate for Payer: UHCCP DNSP |
$2.17
|
| Rate for Payer: UHCCP Medicaid |
$1.16
|
| Rate for Payer: VA VA |
$2.17
|
|
|
HC ADVANCE CARE PLANNING EA ADDL 30 MIN
|
Facility
|
IP
|
$33.29
|
|
|
Service Code
|
CPT 99498
|
| Hospital Charge Code |
51000091
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$21.64 |
| Max. Negotiated Rate |
$33.29 |
| Rate for Payer: Aetna Commercial |
$29.96
|
| Rate for Payer: ASR ASR |
$32.29
|
| Rate for Payer: ASR Commercial |
$32.29
|
| Rate for Payer: BCBS Trust/PPO |
$27.13
|
| Rate for Payer: BCN Commercial |
$25.81
|
| Rate for Payer: Cash Price |
$26.63
|
| Rate for Payer: Cofinity Commercial |
$31.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.63
|
| Rate for Payer: Healthscope Commercial |
$33.29
|
| Rate for Payer: Healthscope Whirlpool |
$32.29
|
| Rate for Payer: Mclaren Commercial |
$29.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.30
|
| Rate for Payer: Nomi Health Commercial |
$27.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$29.30
|
|
|
HC ADVANCE CARE PLANNING EA ADDL 30 MIN
|
Facility
|
OP
|
$33.29
|
|
|
Service Code
|
CPT 99498
|
| Hospital Charge Code |
51000091
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$13.32 |
| Max. Negotiated Rate |
$33.29 |
| Rate for Payer: Aetna Commercial |
$29.96
|
| Rate for Payer: Aetna Medicare |
$16.64
|
| Rate for Payer: ASR ASR |
$32.29
|
| Rate for Payer: ASR Commercial |
$32.29
|
| Rate for Payer: BCBS Complete |
$13.32
|
| Rate for Payer: BCBS Trust/PPO |
$27.26
|
| Rate for Payer: BCN Commercial |
$25.81
|
| Rate for Payer: Cash Price |
$26.63
|
| Rate for Payer: Cofinity Commercial |
$31.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.63
|
| Rate for Payer: Healthscope Commercial |
$33.29
|
| Rate for Payer: Healthscope Whirlpool |
$32.29
|
| Rate for Payer: Mclaren Commercial |
$29.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.30
|
| Rate for Payer: Nomi Health Commercial |
$27.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$29.17
|
| Rate for Payer: Priority Health Narrow Network |
$23.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$29.30
|
|
|
HC ADVANCE CARE PLANNING FIRST 30 MIN
|
Facility
|
IP
|
$33.29
|
|
|
Service Code
|
CPT 99497
|
| Hospital Charge Code |
51000090
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$21.64 |
| Max. Negotiated Rate |
$33.29 |
| Rate for Payer: Aetna Commercial |
$29.96
|
| Rate for Payer: ASR ASR |
$32.29
|
| Rate for Payer: ASR Commercial |
$32.29
|
| Rate for Payer: BCBS Trust/PPO |
$27.13
|
| Rate for Payer: BCN Commercial |
$25.81
|
| Rate for Payer: Cash Price |
$26.63
|
| Rate for Payer: Cofinity Commercial |
$31.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.63
|
| Rate for Payer: Healthscope Commercial |
$33.29
|
| Rate for Payer: Healthscope Whirlpool |
$32.29
|
| Rate for Payer: Mclaren Commercial |
$29.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.30
|
| Rate for Payer: Nomi Health Commercial |
$27.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$29.30
|
|
|
HC ADVANCE CARE PLANNING FIRST 30 MIN
|
Facility
|
OP
|
$33.29
|
|
|
Service Code
|
CPT 99497
|
| Hospital Charge Code |
51000090
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$21.64 |
| Max. Negotiated Rate |
$140.48 |
| Rate for Payer: Aetna Commercial |
$29.96
|
| Rate for Payer: Aetna Medicare |
$90.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$113.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$113.29
|
| Rate for Payer: ASR ASR |
$32.29
|
| Rate for Payer: ASR Commercial |
$32.29
|
| Rate for Payer: BCBS Complete |
$51.01
|
| Rate for Payer: BCBS MAPPO |
$90.63
|
| Rate for Payer: BCBS Trust/PPO |
$27.26
|
| Rate for Payer: BCN Commercial |
$25.81
|
| Rate for Payer: BCN Medicare Advantage |
$90.63
|
| Rate for Payer: Cash Price |
$26.63
|
| Rate for Payer: Cash Price |
$26.63
|
| Rate for Payer: Cofinity Commercial |
$31.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$90.63
|
| Rate for Payer: Healthscope Commercial |
$33.29
|
| Rate for Payer: Healthscope Whirlpool |
$32.29
|
| Rate for Payer: Humana Choice PPO Medicare |
$90.63
|
| Rate for Payer: Mclaren Commercial |
$29.96
|
| Rate for Payer: Mclaren Medicaid |
$48.58
|
| Rate for Payer: Mclaren Medicare |
$90.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$95.16
|
| Rate for Payer: Meridian Medicaid |
$51.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$104.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.30
|
| Rate for Payer: Nomi Health Commercial |
$27.30
|
| Rate for Payer: PACE Medicare |
$86.10
|
| Rate for Payer: PACE SWMI |
$90.63
|
| Rate for Payer: PHP Commercial |
$99.69
|
| Rate for Payer: PHP Medicaid |
$48.58
|
| Rate for Payer: PHP Medicare Advantage |
$90.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$29.17
|
| Rate for Payer: Priority Health Medicare |
$90.63
|
| Rate for Payer: Priority Health Narrow Network |
$23.34
|
| Rate for Payer: Railroad Medicare Medicare |
$90.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$29.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$90.63
|
| Rate for Payer: UHC Exchange |
$140.48
|
| Rate for Payer: UHC Medicare Advantage |
$90.63
|
| Rate for Payer: UHCCP DNSP |
$90.63
|
| Rate for Payer: UHCCP Medicaid |
$48.58
|
| Rate for Payer: VA VA |
$90.63
|
|
|
HC AEP HEARING STATUS DETER BROADBAND STIMULI I&R
|
Facility
|
OP
|
$161.16
|
|
|
Service Code
|
CPT 92651
|
| Hospital Charge Code |
76100497
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$104.75 |
| Max. Negotiated Rate |
$472.90 |
| Rate for Payer: Aetna Commercial |
$145.04
|
| Rate for Payer: Aetna Medicare |
$305.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$381.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$381.38
|
| Rate for Payer: ASR ASR |
$156.33
|
| Rate for Payer: ASR Commercial |
$156.33
|
| Rate for Payer: BCBS Complete |
$171.71
|
| Rate for Payer: BCBS MAPPO |
$305.10
|
| Rate for Payer: BCBS Trust/PPO |
$131.97
|
| Rate for Payer: BCN Commercial |
$124.95
|
| Rate for Payer: BCN Medicare Advantage |
$305.10
|
| Rate for Payer: Cash Price |
$128.93
|
| Rate for Payer: Cash Price |
$128.93
|
| Rate for Payer: Cofinity Commercial |
$151.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.10
|
| Rate for Payer: Healthscope Commercial |
$161.16
|
| Rate for Payer: Healthscope Whirlpool |
$156.33
|
| Rate for Payer: Humana Choice PPO Medicare |
$305.10
|
| Rate for Payer: Mclaren Commercial |
$145.04
|
| Rate for Payer: Mclaren Medicaid |
$163.53
|
| Rate for Payer: Mclaren Medicare |
$305.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$320.36
|
| Rate for Payer: Meridian Medicaid |
$171.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$350.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.99
|
| Rate for Payer: Nomi Health Commercial |
$132.15
|
| Rate for Payer: PACE Medicare |
$289.84
|
| Rate for Payer: PACE SWMI |
$305.10
|
| Rate for Payer: PHP Commercial |
$335.61
|
| Rate for Payer: PHP Medicaid |
$163.53
|
| Rate for Payer: PHP Medicare Advantage |
$305.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$163.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$141.21
|
| Rate for Payer: Priority Health Medicare |
$305.10
|
| Rate for Payer: Priority Health Narrow Network |
$112.97
|
| Rate for Payer: Railroad Medicare Medicare |
$305.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$141.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$305.10
|
| Rate for Payer: UHC Exchange |
$472.90
|
| Rate for Payer: UHC Medicare Advantage |
$305.10
|
| Rate for Payer: UHCCP DNSP |
$305.10
|
| Rate for Payer: UHCCP Medicaid |
$163.53
|
| Rate for Payer: VA VA |
$305.10
|
|
|
HC AEP HEARING STATUS DETER BROADBAND STIMULI I&R
|
Facility
|
IP
|
$161.16
|
|
|
Service Code
|
CPT 92651
|
| Hospital Charge Code |
76100497
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$104.75 |
| Max. Negotiated Rate |
$161.16 |
| Rate for Payer: Aetna Commercial |
$145.04
|
| Rate for Payer: ASR ASR |
$156.33
|
| Rate for Payer: ASR Commercial |
$156.33
|
| Rate for Payer: BCBS Trust/PPO |
$131.33
|
| Rate for Payer: BCN Commercial |
$124.95
|
| Rate for Payer: Cash Price |
$128.93
|
| Rate for Payer: Cofinity Commercial |
$151.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.93
|
| Rate for Payer: Healthscope Commercial |
$161.16
|
| Rate for Payer: Healthscope Whirlpool |
$156.33
|
| Rate for Payer: Mclaren Commercial |
$145.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.99
|
| Rate for Payer: Nomi Health Commercial |
$132.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$141.82
|
|
|
HC AEP THRESHOLD ESTIMATION MLT FREQUENCIES I&R
|
Facility
|
OP
|
$286.62
|
|
|
Service Code
|
CPT 92652
|
| Hospital Charge Code |
47100401
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$163.53 |
| Max. Negotiated Rate |
$472.90 |
| Rate for Payer: Aetna Commercial |
$257.96
|
| Rate for Payer: Aetna Medicare |
$305.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$381.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$381.38
|
| Rate for Payer: ASR ASR |
$278.02
|
| Rate for Payer: ASR Commercial |
$278.02
|
| Rate for Payer: BCBS Complete |
$171.71
|
| Rate for Payer: BCBS MAPPO |
$305.10
|
| Rate for Payer: BCBS Trust/PPO |
$234.71
|
| Rate for Payer: BCN Commercial |
$222.22
|
| Rate for Payer: BCN Medicare Advantage |
$305.10
|
| Rate for Payer: Cash Price |
$229.30
|
| Rate for Payer: Cash Price |
$229.30
|
| Rate for Payer: Cofinity Commercial |
$269.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.10
|
| Rate for Payer: Healthscope Commercial |
$286.62
|
| Rate for Payer: Healthscope Whirlpool |
$278.02
|
| Rate for Payer: Humana Choice PPO Medicare |
$305.10
|
| Rate for Payer: Mclaren Commercial |
$257.96
|
| Rate for Payer: Mclaren Medicaid |
$163.53
|
| Rate for Payer: Mclaren Medicare |
$305.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$320.36
|
| Rate for Payer: Meridian Medicaid |
$171.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$350.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$243.63
|
| Rate for Payer: Nomi Health Commercial |
$235.03
|
| Rate for Payer: PACE Medicare |
$289.84
|
| Rate for Payer: PACE SWMI |
$305.10
|
| Rate for Payer: PHP Commercial |
$335.61
|
| Rate for Payer: PHP Medicaid |
$163.53
|
| Rate for Payer: PHP Medicare Advantage |
$305.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$163.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$186.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$251.14
|
| Rate for Payer: Priority Health Medicare |
$305.10
|
| Rate for Payer: Priority Health Narrow Network |
$200.92
|
| Rate for Payer: Railroad Medicare Medicare |
$305.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$252.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$305.10
|
| Rate for Payer: UHC Exchange |
$472.90
|
| Rate for Payer: UHC Medicare Advantage |
$305.10
|
| Rate for Payer: UHCCP DNSP |
$305.10
|
| Rate for Payer: UHCCP Medicaid |
$163.53
|
| Rate for Payer: VA VA |
$305.10
|
|
|
HC AEP THRESHOLD ESTIMATION MLT FREQUENCIES I&R
|
Facility
|
IP
|
$286.62
|
|
|
Service Code
|
CPT 92652
|
| Hospital Charge Code |
47100401
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$186.30 |
| Max. Negotiated Rate |
$286.62 |
| Rate for Payer: Aetna Commercial |
$257.96
|
| Rate for Payer: ASR ASR |
$278.02
|
| Rate for Payer: ASR Commercial |
$278.02
|
| Rate for Payer: BCBS Trust/PPO |
$233.57
|
| Rate for Payer: BCN Commercial |
$222.22
|
| Rate for Payer: Cash Price |
$229.30
|
| Rate for Payer: Cofinity Commercial |
$269.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.30
|
| Rate for Payer: Healthscope Commercial |
$286.62
|
| Rate for Payer: Healthscope Whirlpool |
$278.02
|
| Rate for Payer: Mclaren Commercial |
$257.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$243.63
|
| Rate for Payer: Nomi Health Commercial |
$235.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$186.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$252.23
|
|
|
HC AEROBIKA
|
Facility
|
IP
|
$150.27
|
|
| Hospital Charge Code |
27000612
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$97.68 |
| Max. Negotiated Rate |
$150.27 |
| Rate for Payer: Aetna Commercial |
$135.24
|
| Rate for Payer: ASR ASR |
$145.76
|
| Rate for Payer: ASR Commercial |
$145.76
|
| Rate for Payer: BCBS Trust/PPO |
$122.46
|
| Rate for Payer: BCN Commercial |
$116.50
|
| Rate for Payer: Cash Price |
$120.22
|
| Rate for Payer: Cofinity Commercial |
$141.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.22
|
| Rate for Payer: Healthscope Commercial |
$150.27
|
| Rate for Payer: Healthscope Whirlpool |
$145.76
|
| Rate for Payer: Mclaren Commercial |
$135.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$127.73
|
| Rate for Payer: Nomi Health Commercial |
$123.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$97.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$132.24
|
|
|
HC AEROBIKA
|
Facility
|
OP
|
$150.27
|
|
| Hospital Charge Code |
27000612
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$60.11 |
| Max. Negotiated Rate |
$150.27 |
| Rate for Payer: Aetna Commercial |
$135.24
|
| Rate for Payer: Aetna Medicare |
$75.14
|
| Rate for Payer: ASR ASR |
$145.76
|
| Rate for Payer: ASR Commercial |
$145.76
|
| Rate for Payer: BCBS Complete |
$60.11
|
| Rate for Payer: BCBS Trust/PPO |
$123.06
|
| Rate for Payer: BCN Commercial |
$116.50
|
| Rate for Payer: Cash Price |
$120.22
|
| Rate for Payer: Cofinity Commercial |
$141.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.22
|
| Rate for Payer: Healthscope Commercial |
$150.27
|
| Rate for Payer: Healthscope Whirlpool |
$145.76
|
| Rate for Payer: Mclaren Commercial |
$135.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$127.73
|
| Rate for Payer: Nomi Health Commercial |
$123.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$97.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$131.67
|
| Rate for Payer: Priority Health Narrow Network |
$105.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$132.24
|
|
