|
HC BIL DIAG BONE MARROW ASP
|
Facility
|
IP
|
$3,316.28
|
|
|
Service Code
|
CPT 38220
|
| Hospital Charge Code |
76100292
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,487.21 |
| Max. Negotiated Rate |
$3,316.28 |
| Rate for Payer: Aetna Commercial |
$2,984.65
|
| Rate for Payer: ASR ASR |
$3,216.79
|
| Rate for Payer: BCBS Trust/PPO |
$2,723.33
|
| Rate for Payer: BCN Commercial |
$2,723.33
|
| Rate for Payer: Cash Price |
$2,653.02
|
| Rate for Payer: Cofinity Commercial |
$3,117.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,653.02
|
| Rate for Payer: Healthscope Commercial |
$3,216.79
|
| Rate for Payer: Healthscope Whirlpool |
$3,316.28
|
| Rate for Payer: Mclaren Commercial |
$2,984.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,818.84
|
| Rate for Payer: Nomi Health Commercial |
$2,719.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,487.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,918.33
|
|
|
HC BIL DIAG BONE MARROW ASP
|
Facility
|
OP
|
$3,316.28
|
|
|
Service Code
|
CPT 38220
|
| Hospital Charge Code |
76100292
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$860.68 |
| Max. Negotiated Rate |
$3,316.28 |
| Rate for Payer: Aetna Commercial |
$2,984.65
|
| Rate for Payer: Aetna Medicare |
$1,645.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: ASR ASR |
$3,216.79
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$2,734.27
|
| Rate for Payer: BCN Commercial |
$2,734.27
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$2,653.02
|
| Rate for Payer: Cash Price |
$2,653.02
|
| Rate for Payer: Cofinity Commercial |
$3,117.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,653.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$3,216.79
|
| Rate for Payer: Healthscope Whirlpool |
$3,316.28
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,645.66
|
| Rate for Payer: Mclaren Commercial |
$2,984.65
|
| Rate for Payer: Mclaren Medicaid |
$1,645.66
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$903.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,818.84
|
| Rate for Payer: Nomi Health Commercial |
$2,719.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,487.21
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$1,810.23
|
| Rate for Payer: PHP Medicaid |
$882.07
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,905.72
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health Narrow Network |
$2,324.71
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,918.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Exchange |
$2,550.77
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP DNSP |
$1,645.66
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
HC BIL DIAG BONE MARROW ASP AND BX
|
Facility
|
IP
|
$3,158.15
|
|
|
Service Code
|
CPT 38222
|
| Hospital Charge Code |
76100294
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,368.61 |
| Max. Negotiated Rate |
$3,158.15 |
| Rate for Payer: Aetna Commercial |
$2,842.34
|
| Rate for Payer: ASR ASR |
$3,063.41
|
| Rate for Payer: BCBS Trust/PPO |
$2,593.47
|
| Rate for Payer: BCN Commercial |
$2,593.47
|
| Rate for Payer: Cash Price |
$2,526.52
|
| Rate for Payer: Cofinity Commercial |
$2,968.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,526.52
|
| Rate for Payer: Healthscope Commercial |
$3,063.41
|
| Rate for Payer: Healthscope Whirlpool |
$3,158.15
|
| Rate for Payer: Mclaren Commercial |
$2,842.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,684.43
|
| Rate for Payer: Nomi Health Commercial |
$2,589.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,368.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,779.17
|
|
|
HC BIL DIAG BONE MARROW ASP AND BX
|
Facility
|
OP
|
$3,158.15
|
|
|
Service Code
|
CPT 38222
|
| Hospital Charge Code |
76100294
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,361.15 |
| Max. Negotiated Rate |
$4,486.12 |
| Rate for Payer: Aetna Commercial |
$2,842.34
|
| Rate for Payer: Aetna Medicare |
$2,894.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,617.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,617.84
|
| Rate for Payer: ASR ASR |
$3,063.41
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS Trust/PPO |
$2,603.89
|
| Rate for Payer: BCN Commercial |
$2,603.89
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: Cash Price |
$2,526.52
|
| Rate for Payer: Cash Price |
$2,526.52
|
| Rate for Payer: Cofinity Commercial |
$2,968.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,526.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Healthscope Commercial |
$3,063.41
|
| Rate for Payer: Healthscope Whirlpool |
$3,158.15
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,894.27
|
| Rate for Payer: Mclaren Commercial |
$2,842.34
|
| Rate for Payer: Mclaren Medicaid |
$2,894.27
|
| Rate for Payer: Mclaren Medicare |
$2,894.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,038.98
|
| Rate for Payer: Meridian Medicaid |
$1,589.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,328.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,183.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,684.43
|
| Rate for Payer: Nomi Health Commercial |
$2,589.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,368.61
|
| Rate for Payer: PACE Medicare |
$2,749.56
|
| Rate for Payer: PACE SWMI |
$2,894.27
|
| Rate for Payer: PHP Commercial |
$3,183.70
|
| Rate for Payer: PHP Medicaid |
$1,551.33
|
| Rate for Payer: PHP Medicare Advantage |
$2,894.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,513.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,701.44
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health Narrow Network |
$1,361.15
|
| Rate for Payer: Railroad Medicare Medicare |
$2,894.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,779.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,894.27
|
| Rate for Payer: UHC Exchange |
$4,486.12
|
| Rate for Payer: UHC Medicaid |
$1,513.70
|
| Rate for Payer: UHCCP DNSP |
$2,894.27
|
| Rate for Payer: UHCCP Medicaid |
$1,513.70
|
| Rate for Payer: VA VA |
$2,894.27
|
|
|
HC BIL DIAG BONE MARROW BX
|
Facility
|
OP
|
$3,158.15
|
|
|
Service Code
|
CPT 38221
|
| Hospital Charge Code |
76100293
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$498.74 |
| Max. Negotiated Rate |
$3,158.15 |
| Rate for Payer: Aetna Commercial |
$2,842.34
|
| Rate for Payer: Aetna Medicare |
$1,645.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: ASR ASR |
$3,063.41
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$2,603.89
|
| Rate for Payer: BCN Commercial |
$2,603.89
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$2,526.52
|
| Rate for Payer: Cash Price |
$2,526.52
|
| Rate for Payer: Cofinity Commercial |
$2,968.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,526.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$3,063.41
|
| Rate for Payer: Healthscope Whirlpool |
$3,158.15
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,645.66
|
| Rate for Payer: Mclaren Commercial |
$2,842.34
|
| Rate for Payer: Mclaren Medicaid |
$1,645.66
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$903.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,684.43
|
| Rate for Payer: Nomi Health Commercial |
$2,589.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,368.61
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$1,810.23
|
| Rate for Payer: PHP Medicaid |
$882.07
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$623.43
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health Narrow Network |
$498.74
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,779.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Exchange |
$2,550.77
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP DNSP |
$1,645.66
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
HC BIL DIAG BONE MARROW BX
|
Facility
|
IP
|
$3,158.15
|
|
|
Service Code
|
CPT 38221
|
| Hospital Charge Code |
76100293
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,368.61 |
| Max. Negotiated Rate |
$3,158.15 |
| Rate for Payer: Aetna Commercial |
$2,842.34
|
| Rate for Payer: ASR ASR |
$3,063.41
|
| Rate for Payer: BCBS Trust/PPO |
$2,593.47
|
| Rate for Payer: BCN Commercial |
$2,593.47
|
| Rate for Payer: Cash Price |
$2,526.52
|
| Rate for Payer: Cofinity Commercial |
$2,968.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,526.52
|
| Rate for Payer: Healthscope Commercial |
$3,063.41
|
| Rate for Payer: Healthscope Whirlpool |
$3,158.15
|
| Rate for Payer: Mclaren Commercial |
$2,842.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,684.43
|
| Rate for Payer: Nomi Health Commercial |
$2,589.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,368.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,779.17
|
|
|
HC BILE ACIDS TOTAL
|
Facility
|
OP
|
$53.06
|
|
|
Service Code
|
CPT 82239
|
| Hospital Charge Code |
30100116
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.95 |
| Max. Negotiated Rate |
$53.06 |
| Rate for Payer: Aetna Commercial |
$47.75
|
| Rate for Payer: Aetna Medicare |
$17.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.40
|
| Rate for Payer: ASR ASR |
$51.47
|
| Rate for Payer: BCBS Complete |
$9.40
|
| Rate for Payer: BCBS MAPPO |
$17.12
|
| Rate for Payer: BCBS Trust/PPO |
$43.75
|
| Rate for Payer: BCN Commercial |
$43.75
|
| Rate for Payer: BCN Medicare Advantage |
$17.12
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$49.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.12
|
| Rate for Payer: Healthscope Commercial |
$51.47
|
| Rate for Payer: Healthscope Whirlpool |
$53.06
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.12
|
| Rate for Payer: Mclaren Commercial |
$47.75
|
| Rate for Payer: Mclaren Medicaid |
$17.12
|
| Rate for Payer: Mclaren Medicare |
$17.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.98
|
| Rate for Payer: Meridian Medicaid |
$9.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PACE Medicare |
$16.26
|
| Rate for Payer: PACE SWMI |
$17.12
|
| Rate for Payer: PHP Commercial |
$18.83
|
| Rate for Payer: PHP Medicaid |
$9.18
|
| Rate for Payer: PHP Medicare Advantage |
$17.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$46.49
|
| Rate for Payer: Priority Health Medicare |
$17.12
|
| Rate for Payer: Priority Health Narrow Network |
$37.20
|
| Rate for Payer: Railroad Medicare Medicare |
$17.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17.12
|
| Rate for Payer: UHC Exchange |
$26.54
|
| Rate for Payer: UHC Medicaid |
$8.95
|
| Rate for Payer: UHCCP DNSP |
$17.12
|
| Rate for Payer: UHCCP Medicaid |
$8.95
|
| Rate for Payer: VA VA |
$17.12
|
|
|
HC BILE ACIDS TOTAL
|
Facility
|
IP
|
$53.06
|
|
|
Service Code
|
CPT 82239
|
| Hospital Charge Code |
30100116
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$39.80 |
| Max. Negotiated Rate |
$53.06 |
| Rate for Payer: Aetna Commercial |
$47.75
|
| Rate for Payer: ASR ASR |
$51.47
|
| Rate for Payer: BCBS Trust/PPO |
$43.57
|
| Rate for Payer: BCN Commercial |
$43.57
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$49.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Healthscope Commercial |
$51.47
|
| Rate for Payer: Healthscope Whirlpool |
$53.06
|
| Rate for Payer: Mclaren Commercial |
$47.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.69
|
|
|
HC BILE BODY FLUID
|
Facility
|
OP
|
$39.43
|
|
|
Service Code
|
CPT 81005
|
| Hospital Charge Code |
30700007
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$1.13 |
| Max. Negotiated Rate |
$39.43 |
| Rate for Payer: Aetna Commercial |
$35.49
|
| 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 |
$38.25
|
| Rate for Payer: BCBS Complete |
$1.19
|
| Rate for Payer: BCBS MAPPO |
$2.17
|
| Rate for Payer: BCBS Trust/PPO |
$32.51
|
| Rate for Payer: BCN Commercial |
$32.51
|
| Rate for Payer: BCN Medicare Advantage |
$2.17
|
| Rate for Payer: Cash Price |
$31.54
|
| Rate for Payer: Cash Price |
$31.54
|
| Rate for Payer: Cofinity Commercial |
$37.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.17
|
| Rate for Payer: Healthscope Commercial |
$38.25
|
| Rate for Payer: Healthscope Whirlpool |
$39.43
|
| Rate for Payer: Humana Choice PPO Medicare |
$2.17
|
| Rate for Payer: Mclaren Commercial |
$35.49
|
| Rate for Payer: Mclaren Medicaid |
$2.17
|
| 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 |
$1.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$2.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.52
|
| Rate for Payer: Nomi Health Commercial |
$32.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.57
|
| 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 |
$1.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$34.55
|
| Rate for Payer: Priority Health Medicare |
$2.17
|
| Rate for Payer: Priority Health Narrow Network |
$27.64
|
| Rate for Payer: Railroad Medicare Medicare |
$2.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$34.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2.17
|
| Rate for Payer: UHC Exchange |
$3.36
|
| Rate for Payer: UHC Medicaid |
$1.13
|
| Rate for Payer: UHCCP DNSP |
$2.17
|
| Rate for Payer: UHCCP Medicaid |
$1.13
|
| Rate for Payer: VA VA |
$2.17
|
|
|
HC BILE BODY FLUID
|
Facility
|
IP
|
$39.43
|
|
|
Service Code
|
CPT 81005
|
| Hospital Charge Code |
30700007
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$29.57 |
| Max. Negotiated Rate |
$39.43 |
| Rate for Payer: Aetna Commercial |
$35.49
|
| Rate for Payer: ASR ASR |
$38.25
|
| Rate for Payer: BCBS Trust/PPO |
$32.38
|
| Rate for Payer: BCN Commercial |
$32.38
|
| Rate for Payer: Cash Price |
$31.54
|
| Rate for Payer: Cofinity Commercial |
$37.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.54
|
| Rate for Payer: Healthscope Commercial |
$38.25
|
| Rate for Payer: Healthscope Whirlpool |
$39.43
|
| Rate for Payer: Mclaren Commercial |
$35.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.52
|
| Rate for Payer: Nomi Health Commercial |
$32.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$34.70
|
|
|
HC BILIARY BRUSH BIOPSY
|
Facility
|
OP
|
$4,149.40
|
|
|
Service Code
|
CPT 47552
|
| Hospital Charge Code |
36100207
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,908.73 |
| Max. Negotiated Rate |
$9,998.34 |
| Rate for Payer: Aetna Commercial |
$3,734.46
|
| Rate for Payer: Aetna Medicare |
$6,450.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,063.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,063.18
|
| Rate for Payer: ASR ASR |
$4,024.92
|
| Rate for Payer: BCBS Complete |
$3,542.64
|
| Rate for Payer: BCBS MAPPO |
$6,450.54
|
| Rate for Payer: BCBS Trust/PPO |
$3,421.18
|
| Rate for Payer: BCN Commercial |
$3,421.18
|
| Rate for Payer: BCN Medicare Advantage |
$6,450.54
|
| Rate for Payer: Cash Price |
$3,319.52
|
| Rate for Payer: Cash Price |
$3,319.52
|
| Rate for Payer: Cofinity Commercial |
$3,900.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,319.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,450.54
|
| Rate for Payer: Healthscope Commercial |
$4,024.92
|
| Rate for Payer: Healthscope Whirlpool |
$4,149.40
|
| Rate for Payer: Humana Choice PPO Medicare |
$6,450.54
|
| Rate for Payer: Mclaren Commercial |
$3,734.46
|
| Rate for Payer: Mclaren Medicaid |
$6,450.54
|
| Rate for Payer: Mclaren Medicare |
$6,450.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,773.07
|
| Rate for Payer: Meridian Medicaid |
$3,542.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,418.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$7,095.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,526.99
|
| Rate for Payer: Nomi Health Commercial |
$3,402.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,112.05
|
| Rate for Payer: PACE Medicare |
$6,128.01
|
| Rate for Payer: PACE SWMI |
$6,450.54
|
| Rate for Payer: PHP Commercial |
$7,095.59
|
| Rate for Payer: PHP Medicaid |
$3,457.49
|
| Rate for Payer: PHP Medicare Advantage |
$6,450.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,373.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,635.70
|
| Rate for Payer: Priority Health Medicare |
$6,450.54
|
| Rate for Payer: Priority Health Narrow Network |
$2,908.73
|
| Rate for Payer: Railroad Medicare Medicare |
$6,450.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,651.47
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6,450.54
|
| Rate for Payer: UHC Exchange |
$9,998.34
|
| Rate for Payer: UHC Medicaid |
$3,373.63
|
| Rate for Payer: UHCCP DNSP |
$6,450.54
|
| Rate for Payer: UHCCP Medicaid |
$3,373.63
|
| Rate for Payer: VA VA |
$6,450.54
|
|
|
HC BILIARY BRUSH BIOPSY
|
Facility
|
IP
|
$4,149.40
|
|
|
Service Code
|
CPT 47552
|
| Hospital Charge Code |
36100207
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,112.05 |
| Max. Negotiated Rate |
$4,149.40 |
| Rate for Payer: Aetna Commercial |
$3,734.46
|
| Rate for Payer: ASR ASR |
$4,024.92
|
| Rate for Payer: BCBS Trust/PPO |
$3,407.49
|
| Rate for Payer: BCN Commercial |
$3,407.49
|
| Rate for Payer: Cash Price |
$3,319.52
|
| Rate for Payer: Cofinity Commercial |
$3,900.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,319.52
|
| Rate for Payer: Healthscope Commercial |
$4,024.92
|
| Rate for Payer: Healthscope Whirlpool |
$4,149.40
|
| Rate for Payer: Mclaren Commercial |
$3,734.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,526.99
|
| Rate for Payer: Nomi Health Commercial |
$3,402.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,112.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,651.47
|
|
|
HC BILIARY DRAINAGE
|
Facility
|
OP
|
$478.47
|
|
| Hospital Charge Code |
36000010
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$177.03 |
| Max. Negotiated Rate |
$478.47 |
| Rate for Payer: Aetna Commercial |
$430.62
|
| Rate for Payer: Aetna Medicare |
$177.03
|
| Rate for Payer: ASR ASR |
$464.12
|
| Rate for Payer: BCBS Complete |
$191.39
|
| Rate for Payer: BCBS Trust/PPO |
$394.50
|
| Rate for Payer: BCN Commercial |
$394.50
|
| Rate for Payer: Cash Price |
$382.78
|
| Rate for Payer: Cofinity Commercial |
$449.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$382.78
|
| Rate for Payer: Healthscope Commercial |
$464.12
|
| Rate for Payer: Healthscope Whirlpool |
$478.47
|
| Rate for Payer: Mclaren Commercial |
$430.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$382.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$406.70
|
| Rate for Payer: Nomi Health Commercial |
$392.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$358.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$419.24
|
| Rate for Payer: Priority Health Narrow Network |
$335.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$421.05
|
|
|
HC BILIARY DRAINAGE
|
Facility
|
IP
|
$478.47
|
|
| Hospital Charge Code |
36000010
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$358.85 |
| Max. Negotiated Rate |
$478.47 |
| Rate for Payer: Aetna Commercial |
$430.62
|
| Rate for Payer: ASR ASR |
$464.12
|
| Rate for Payer: BCBS Trust/PPO |
$392.92
|
| Rate for Payer: BCN Commercial |
$392.92
|
| Rate for Payer: Cash Price |
$382.78
|
| Rate for Payer: Cofinity Commercial |
$449.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$382.78
|
| Rate for Payer: Healthscope Commercial |
$464.12
|
| Rate for Payer: Healthscope Whirlpool |
$478.47
|
| Rate for Payer: Mclaren Commercial |
$430.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$406.70
|
| Rate for Payer: Nomi Health Commercial |
$392.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$358.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$421.05
|
|
|
HC BILIARY DUCT BALLOON DILATATIO
|
Facility
|
IP
|
$1,892.73
|
|
| Hospital Charge Code |
36000011
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,419.55 |
| Max. Negotiated Rate |
$1,892.73 |
| Rate for Payer: Aetna Commercial |
$1,703.46
|
| Rate for Payer: ASR ASR |
$1,835.95
|
| Rate for Payer: BCBS Trust/PPO |
$1,554.31
|
| Rate for Payer: BCN Commercial |
$1,554.31
|
| Rate for Payer: Cash Price |
$1,514.18
|
| Rate for Payer: Cofinity Commercial |
$1,779.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,514.18
|
| Rate for Payer: Healthscope Commercial |
$1,835.95
|
| Rate for Payer: Healthscope Whirlpool |
$1,892.73
|
| Rate for Payer: Mclaren Commercial |
$1,703.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,608.82
|
| Rate for Payer: Nomi Health Commercial |
$1,552.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,419.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,665.60
|
|
|
HC BILIARY DUCT BALLOON DILATATIO
|
Facility
|
OP
|
$1,892.73
|
|
| Hospital Charge Code |
36000011
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$700.31 |
| Max. Negotiated Rate |
$1,892.73 |
| Rate for Payer: Aetna Commercial |
$1,703.46
|
| Rate for Payer: Aetna Medicare |
$700.31
|
| Rate for Payer: ASR ASR |
$1,835.95
|
| Rate for Payer: BCBS Complete |
$757.09
|
| Rate for Payer: BCBS Trust/PPO |
$1,560.56
|
| Rate for Payer: BCN Commercial |
$1,560.56
|
| Rate for Payer: Cash Price |
$1,514.18
|
| Rate for Payer: Cofinity Commercial |
$1,779.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,514.18
|
| Rate for Payer: Healthscope Commercial |
$1,835.95
|
| Rate for Payer: Healthscope Whirlpool |
$1,892.73
|
| Rate for Payer: Mclaren Commercial |
$1,703.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,514.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,608.82
|
| Rate for Payer: Nomi Health Commercial |
$1,552.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,419.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,658.41
|
| Rate for Payer: Priority Health Narrow Network |
$1,326.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,665.60
|
|
|
HC BILIARY ENDO PERC VIA T-TUBE/OTHER TRACT W BX REMV CALCULI
|
Facility
|
IP
|
$29,386.20
|
|
|
Service Code
|
CPT 47554
|
| Hospital Charge Code |
36100633
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$22,039.65 |
| Max. Negotiated Rate |
$29,386.20 |
| Rate for Payer: Aetna Commercial |
$26,447.58
|
| Rate for Payer: ASR ASR |
$28,504.61
|
| Rate for Payer: BCBS Trust/PPO |
$24,131.95
|
| Rate for Payer: BCN Commercial |
$24,131.95
|
| Rate for Payer: Cash Price |
$23,508.96
|
| Rate for Payer: Cofinity Commercial |
$27,623.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,508.96
|
| Rate for Payer: Healthscope Commercial |
$28,504.61
|
| Rate for Payer: Healthscope Whirlpool |
$29,386.20
|
| Rate for Payer: Mclaren Commercial |
$26,447.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,978.27
|
| Rate for Payer: Nomi Health Commercial |
$24,096.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22,039.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25,859.86
|
|
|
HC BILIARY ENDO PERC VIA T-TUBE/OTHER TRACT W BX REMV CALCULI
|
Facility
|
OP
|
$29,386.20
|
|
|
Service Code
|
CPT 47554
|
| Hospital Charge Code |
36100633
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,539.41 |
| Max. Negotiated Rate |
$29,386.20 |
| Rate for Payer: Aetna Commercial |
$26,447.58
|
| Rate for Payer: Aetna Medicare |
$10,591.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,239.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,239.51
|
| Rate for Payer: ASR ASR |
$28,504.61
|
| Rate for Payer: BCBS Complete |
$5,816.91
|
| Rate for Payer: BCBS MAPPO |
$10,591.61
|
| Rate for Payer: BCBS Trust/PPO |
$24,228.92
|
| Rate for Payer: BCN Commercial |
$24,228.92
|
| Rate for Payer: BCN Medicare Advantage |
$10,591.61
|
| Rate for Payer: Cash Price |
$23,508.96
|
| Rate for Payer: Cash Price |
$23,508.96
|
| Rate for Payer: Cofinity Commercial |
$27,623.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,508.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,591.61
|
| Rate for Payer: Healthscope Commercial |
$28,504.61
|
| Rate for Payer: Healthscope Whirlpool |
$29,386.20
|
| Rate for Payer: Humana Choice PPO Medicare |
$10,591.61
|
| Rate for Payer: Mclaren Commercial |
$26,447.58
|
| Rate for Payer: Mclaren Medicaid |
$10,591.61
|
| Rate for Payer: Mclaren Medicare |
$10,591.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,121.19
|
| Rate for Payer: Meridian Medicaid |
$5,816.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,180.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$11,650.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,978.27
|
| Rate for Payer: Nomi Health Commercial |
$24,096.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22,039.65
|
| Rate for Payer: PACE Medicare |
$10,062.03
|
| Rate for Payer: PACE SWMI |
$10,591.61
|
| Rate for Payer: PHP Commercial |
$11,650.77
|
| Rate for Payer: PHP Medicaid |
$5,677.10
|
| Rate for Payer: PHP Medicare Advantage |
$10,591.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,539.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$25,748.19
|
| Rate for Payer: Priority Health Medicare |
$10,591.61
|
| Rate for Payer: Priority Health Narrow Network |
$20,599.73
|
| Rate for Payer: Railroad Medicare Medicare |
$10,591.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25,859.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$10,591.61
|
| Rate for Payer: UHC Exchange |
$16,417.00
|
| Rate for Payer: UHC Medicaid |
$5,539.41
|
| Rate for Payer: UHCCP DNSP |
$10,591.61
|
| Rate for Payer: UHCCP Medicaid |
$5,539.41
|
| Rate for Payer: VA VA |
$10,591.61
|
|
|
HC BILIARY ENDO PERC VIA T-TUBE/OTHER TRACT W BX SING OR MULTI
|
Facility
|
OP
|
$21,624.00
|
|
|
Service Code
|
CPT 47553
|
| Hospital Charge Code |
36100632
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,373.63 |
| Max. Negotiated Rate |
$21,624.00 |
| Rate for Payer: Aetna Commercial |
$19,461.60
|
| Rate for Payer: Aetna Medicare |
$6,450.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,063.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,063.18
|
| Rate for Payer: ASR ASR |
$20,975.28
|
| Rate for Payer: BCBS Complete |
$3,542.64
|
| Rate for Payer: BCBS MAPPO |
$6,450.54
|
| Rate for Payer: BCBS Trust/PPO |
$17,828.99
|
| Rate for Payer: BCN Commercial |
$17,828.99
|
| Rate for Payer: BCN Medicare Advantage |
$6,450.54
|
| Rate for Payer: Cash Price |
$17,299.20
|
| Rate for Payer: Cash Price |
$17,299.20
|
| Rate for Payer: Cofinity Commercial |
$20,326.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17,299.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,450.54
|
| Rate for Payer: Healthscope Commercial |
$20,975.28
|
| Rate for Payer: Healthscope Whirlpool |
$21,624.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$6,450.54
|
| Rate for Payer: Mclaren Commercial |
$19,461.60
|
| Rate for Payer: Mclaren Medicaid |
$6,450.54
|
| Rate for Payer: Mclaren Medicare |
$6,450.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,773.07
|
| Rate for Payer: Meridian Medicaid |
$3,542.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,418.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$7,095.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18,380.40
|
| Rate for Payer: Nomi Health Commercial |
$17,731.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16,218.00
|
| Rate for Payer: PACE Medicare |
$6,128.01
|
| Rate for Payer: PACE SWMI |
$6,450.54
|
| Rate for Payer: PHP Commercial |
$7,095.59
|
| Rate for Payer: PHP Medicaid |
$3,457.49
|
| Rate for Payer: PHP Medicare Advantage |
$6,450.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,373.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$18,946.95
|
| Rate for Payer: Priority Health Medicare |
$6,450.54
|
| Rate for Payer: Priority Health Narrow Network |
$15,158.42
|
| Rate for Payer: Railroad Medicare Medicare |
$6,450.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19,029.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6,450.54
|
| Rate for Payer: UHC Exchange |
$9,998.34
|
| Rate for Payer: UHC Medicaid |
$3,373.63
|
| Rate for Payer: UHCCP DNSP |
$6,450.54
|
| Rate for Payer: UHCCP Medicaid |
$3,373.63
|
| Rate for Payer: VA VA |
$6,450.54
|
|
|
HC BILIARY ENDO PERC VIA T-TUBE/OTHER TRACT W BX SING OR MULTI
|
Facility
|
IP
|
$21,624.00
|
|
|
Service Code
|
CPT 47553
|
| Hospital Charge Code |
36100632
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$16,218.00 |
| Max. Negotiated Rate |
$21,624.00 |
| Rate for Payer: Aetna Commercial |
$19,461.60
|
| Rate for Payer: ASR ASR |
$20,975.28
|
| Rate for Payer: BCBS Trust/PPO |
$17,757.63
|
| Rate for Payer: BCN Commercial |
$17,757.63
|
| Rate for Payer: Cash Price |
$17,299.20
|
| Rate for Payer: Cofinity Commercial |
$20,326.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17,299.20
|
| Rate for Payer: Healthscope Commercial |
$20,975.28
|
| Rate for Payer: Healthscope Whirlpool |
$21,624.00
|
| Rate for Payer: Mclaren Commercial |
$19,461.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18,380.40
|
| Rate for Payer: Nomi Health Commercial |
$17,731.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16,218.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19,029.12
|
|
|
HC BILIARY ENDO PERC VIA T-TUBE/OTHER TRACT W DIL OF BIL STRICT WO STENT
|
Facility
|
IP
|
$9,894.00
|
|
|
Service Code
|
CPT 47555
|
| Hospital Charge Code |
36100634
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,420.50 |
| Max. Negotiated Rate |
$9,894.00 |
| Rate for Payer: Aetna Commercial |
$8,904.60
|
| Rate for Payer: ASR ASR |
$9,597.18
|
| Rate for Payer: BCBS Trust/PPO |
$8,124.95
|
| Rate for Payer: BCN Commercial |
$8,124.95
|
| Rate for Payer: Cash Price |
$7,915.20
|
| Rate for Payer: Cofinity Commercial |
$9,300.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,915.20
|
| Rate for Payer: Healthscope Commercial |
$9,597.18
|
| Rate for Payer: Healthscope Whirlpool |
$9,894.00
|
| Rate for Payer: Mclaren Commercial |
$8,904.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,409.90
|
| Rate for Payer: Nomi Health Commercial |
$8,113.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,420.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8,706.72
|
|
|
HC BILIARY ENDO PERC VIA T-TUBE/OTHER TRACT W DIL OF BIL STRICT WO STENT
|
Facility
|
OP
|
$9,894.00
|
|
|
Service Code
|
CPT 47555
|
| Hospital Charge Code |
36100634
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,373.63 |
| Max. Negotiated Rate |
$9,998.34 |
| Rate for Payer: Aetna Commercial |
$8,904.60
|
| Rate for Payer: Aetna Medicare |
$6,450.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,063.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,063.18
|
| Rate for Payer: ASR ASR |
$9,597.18
|
| Rate for Payer: BCBS Complete |
$3,542.64
|
| Rate for Payer: BCBS MAPPO |
$6,450.54
|
| Rate for Payer: BCBS Trust/PPO |
$8,157.60
|
| Rate for Payer: BCN Commercial |
$8,157.60
|
| Rate for Payer: BCN Medicare Advantage |
$6,450.54
|
| Rate for Payer: Cash Price |
$7,915.20
|
| Rate for Payer: Cash Price |
$7,915.20
|
| Rate for Payer: Cofinity Commercial |
$9,300.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,915.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,450.54
|
| Rate for Payer: Healthscope Commercial |
$9,597.18
|
| Rate for Payer: Healthscope Whirlpool |
$9,894.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$6,450.54
|
| Rate for Payer: Mclaren Commercial |
$8,904.60
|
| Rate for Payer: Mclaren Medicaid |
$6,450.54
|
| Rate for Payer: Mclaren Medicare |
$6,450.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,773.07
|
| Rate for Payer: Meridian Medicaid |
$3,542.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,418.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$7,095.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,409.90
|
| Rate for Payer: Nomi Health Commercial |
$8,113.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,420.50
|
| Rate for Payer: PACE Medicare |
$6,128.01
|
| Rate for Payer: PACE SWMI |
$6,450.54
|
| Rate for Payer: PHP Commercial |
$7,095.59
|
| Rate for Payer: PHP Medicaid |
$3,457.49
|
| Rate for Payer: PHP Medicare Advantage |
$6,450.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,373.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$8,669.12
|
| Rate for Payer: Priority Health Medicare |
$6,450.54
|
| Rate for Payer: Priority Health Narrow Network |
$6,935.69
|
| Rate for Payer: Railroad Medicare Medicare |
$6,450.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8,706.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6,450.54
|
| Rate for Payer: UHC Exchange |
$9,998.34
|
| Rate for Payer: UHC Medicaid |
$3,373.63
|
| Rate for Payer: UHCCP DNSP |
$6,450.54
|
| Rate for Payer: UHCCP Medicaid |
$3,373.63
|
| Rate for Payer: VA VA |
$6,450.54
|
|
|
HC BILIRUBIN DIRECT
|
Facility
|
OP
|
$21.23
|
|
|
Service Code
|
CPT 82248
|
| Hospital Charge Code |
30100118
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.63 |
| Max. Negotiated Rate |
$21.23 |
| Rate for Payer: Aetna Commercial |
$19.11
|
| Rate for Payer: Aetna Medicare |
$5.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.28
|
| Rate for Payer: ASR ASR |
$20.59
|
| Rate for Payer: BCBS Complete |
$2.76
|
| Rate for Payer: BCBS MAPPO |
$5.02
|
| Rate for Payer: BCBS Trust/PPO |
$17.50
|
| Rate for Payer: BCN Commercial |
$17.50
|
| Rate for Payer: BCN Medicare Advantage |
$5.02
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Commercial |
$19.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.02
|
| Rate for Payer: Healthscope Commercial |
$20.59
|
| Rate for Payer: Healthscope Whirlpool |
$21.23
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.02
|
| Rate for Payer: Mclaren Commercial |
$19.11
|
| Rate for Payer: Mclaren Medicaid |
$5.02
|
| Rate for Payer: Mclaren Medicare |
$5.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.27
|
| Rate for Payer: Meridian Medicaid |
$2.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Nomi Health Commercial |
$17.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: PACE Medicare |
$4.77
|
| Rate for Payer: PACE SWMI |
$5.02
|
| Rate for Payer: PHP Commercial |
$5.52
|
| Rate for Payer: PHP Medicaid |
$2.69
|
| Rate for Payer: PHP Medicare Advantage |
$5.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$16.96
|
| Rate for Payer: Priority Health Medicare |
$5.02
|
| Rate for Payer: Priority Health Narrow Network |
$13.57
|
| Rate for Payer: Railroad Medicare Medicare |
$5.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.02
|
| Rate for Payer: UHC Exchange |
$7.78
|
| Rate for Payer: UHC Medicaid |
$2.63
|
| Rate for Payer: UHCCP DNSP |
$5.02
|
| Rate for Payer: UHCCP Medicaid |
$2.63
|
| Rate for Payer: VA VA |
$5.02
|
|
|
HC BILIRUBIN DIRECT
|
Facility
|
IP
|
$21.23
|
|
|
Service Code
|
CPT 82248
|
| Hospital Charge Code |
30100118
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.92 |
| Max. Negotiated Rate |
$21.23 |
| Rate for Payer: Aetna Commercial |
$19.11
|
| Rate for Payer: ASR ASR |
$20.59
|
| Rate for Payer: BCBS Trust/PPO |
$17.43
|
| Rate for Payer: BCN Commercial |
$17.43
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Commercial |
$19.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Healthscope Commercial |
$20.59
|
| Rate for Payer: Healthscope Whirlpool |
$21.23
|
| Rate for Payer: Mclaren Commercial |
$19.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Nomi Health Commercial |
$17.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.68
|
|
|
HC BILIRUBIN TOTAL
|
Facility
|
IP
|
$21.23
|
|
|
Service Code
|
CPT 82247
|
| Hospital Charge Code |
30100117
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.92 |
| Max. Negotiated Rate |
$21.23 |
| Rate for Payer: Aetna Commercial |
$19.11
|
| Rate for Payer: ASR ASR |
$20.59
|
| Rate for Payer: BCBS Trust/PPO |
$17.43
|
| Rate for Payer: BCN Commercial |
$17.43
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Commercial |
$19.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Healthscope Commercial |
$20.59
|
| Rate for Payer: Healthscope Whirlpool |
$21.23
|
| Rate for Payer: Mclaren Commercial |
$19.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Nomi Health Commercial |
$17.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.68
|
|
