|
HC BIOPSY VESTIBULE MOUTH
|
Facility
|
IP
|
$1,404.54
|
|
|
Service Code
|
CPT 40808
|
| Hospital Charge Code |
76100460
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,053.40 |
| Max. Negotiated Rate |
$1,404.54 |
| Rate for Payer: Aetna Commercial |
$1,264.09
|
| Rate for Payer: ASR ASR |
$1,362.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,153.41
|
| Rate for Payer: BCN Commercial |
$1,153.41
|
| Rate for Payer: Cash Price |
$1,123.63
|
| Rate for Payer: Cofinity Commercial |
$1,320.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,123.63
|
| Rate for Payer: Healthscope Commercial |
$1,362.40
|
| Rate for Payer: Healthscope Whirlpool |
$1,404.54
|
| Rate for Payer: Mclaren Commercial |
$1,264.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,193.86
|
| Rate for Payer: Nomi Health Commercial |
$1,151.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,053.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,236.00
|
|
|
HC BIOPSY VULVA PERINEUM ONE LESN
|
Facility
|
OP
|
$888.30
|
|
|
Service Code
|
CPT 56605
|
| Hospital Charge Code |
76100201
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$479.98 |
| Max. Negotiated Rate |
$1,422.50 |
| Rate for Payer: Aetna Commercial |
$799.47
|
| Rate for Payer: Aetna Medicare |
$917.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,147.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,147.17
|
| Rate for Payer: ASR ASR |
$861.65
|
| Rate for Payer: BCBS Complete |
$504.02
|
| Rate for Payer: BCBS MAPPO |
$917.74
|
| Rate for Payer: BCBS Trust/PPO |
$732.40
|
| Rate for Payer: BCN Commercial |
$732.40
|
| Rate for Payer: BCN Medicare Advantage |
$917.74
|
| Rate for Payer: Cash Price |
$710.64
|
| Rate for Payer: Cash Price |
$710.64
|
| Rate for Payer: Cofinity Commercial |
$835.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$710.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$917.74
|
| Rate for Payer: Healthscope Commercial |
$861.65
|
| Rate for Payer: Healthscope Whirlpool |
$888.30
|
| Rate for Payer: Humana Choice PPO Medicare |
$917.74
|
| Rate for Payer: Mclaren Commercial |
$799.47
|
| Rate for Payer: Mclaren Medicaid |
$917.74
|
| Rate for Payer: Mclaren Medicare |
$917.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$963.63
|
| Rate for Payer: Meridian Medicaid |
$504.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,055.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,009.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$755.05
|
| Rate for Payer: Nomi Health Commercial |
$728.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$666.23
|
| Rate for Payer: PACE Medicare |
$871.85
|
| Rate for Payer: PACE SWMI |
$917.74
|
| Rate for Payer: PHP Commercial |
$1,009.51
|
| Rate for Payer: PHP Medicaid |
$491.91
|
| Rate for Payer: PHP Medicare Advantage |
$917.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$479.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$782.82
|
| Rate for Payer: Priority Health Medicare |
$917.74
|
| Rate for Payer: Priority Health Narrow Network |
$626.25
|
| Rate for Payer: Railroad Medicare Medicare |
$917.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$781.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$917.74
|
| Rate for Payer: UHC Exchange |
$1,422.50
|
| Rate for Payer: UHC Medicaid |
$479.98
|
| Rate for Payer: UHCCP DNSP |
$917.74
|
| Rate for Payer: UHCCP Medicaid |
$479.98
|
| Rate for Payer: VA VA |
$917.74
|
|
|
HC BIOPSY VULVA PERINEUM ONE LESN
|
Facility
|
IP
|
$888.30
|
|
|
Service Code
|
CPT 56605
|
| Hospital Charge Code |
76100201
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$666.23 |
| Max. Negotiated Rate |
$888.30 |
| Rate for Payer: Aetna Commercial |
$799.47
|
| Rate for Payer: ASR ASR |
$861.65
|
| Rate for Payer: BCBS Trust/PPO |
$729.47
|
| Rate for Payer: BCN Commercial |
$729.47
|
| Rate for Payer: Cash Price |
$710.64
|
| Rate for Payer: Cofinity Commercial |
$835.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$710.64
|
| Rate for Payer: Healthscope Commercial |
$861.65
|
| Rate for Payer: Healthscope Whirlpool |
$888.30
|
| Rate for Payer: Mclaren Commercial |
$799.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$755.05
|
| Rate for Payer: Nomi Health Commercial |
$728.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$666.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$781.70
|
|
|
HC BIOTINIDASE
|
Facility
|
IP
|
$69.71
|
|
|
Service Code
|
CPT 82261
|
| Hospital Charge Code |
30100119
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$52.28 |
| Max. Negotiated Rate |
$69.71 |
| Rate for Payer: Aetna Commercial |
$62.74
|
| Rate for Payer: ASR ASR |
$67.62
|
| Rate for Payer: BCBS Trust/PPO |
$57.25
|
| Rate for Payer: BCN Commercial |
$57.25
|
| Rate for Payer: Cash Price |
$55.77
|
| Rate for Payer: Cofinity Commercial |
$65.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.77
|
| Rate for Payer: Healthscope Commercial |
$67.62
|
| Rate for Payer: Healthscope Whirlpool |
$69.71
|
| Rate for Payer: Mclaren Commercial |
$62.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.25
|
| Rate for Payer: Nomi Health Commercial |
$57.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$61.34
|
|
|
HC BIOTINIDASE
|
Facility
|
OP
|
$69.71
|
|
|
Service Code
|
CPT 82261
|
| Hospital Charge Code |
30100119
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.82 |
| Max. Negotiated Rate |
$69.71 |
| Rate for Payer: Aetna Commercial |
$62.74
|
| 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 |
$67.62
|
| Rate for Payer: BCBS Complete |
$9.27
|
| Rate for Payer: BCBS MAPPO |
$16.87
|
| Rate for Payer: BCBS Trust/PPO |
$57.48
|
| Rate for Payer: BCN Commercial |
$57.48
|
| Rate for Payer: BCN Medicare Advantage |
$16.87
|
| Rate for Payer: Cash Price |
$55.77
|
| Rate for Payer: Cash Price |
$55.77
|
| Rate for Payer: Cofinity Commercial |
$65.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.87
|
| Rate for Payer: Healthscope Commercial |
$67.62
|
| Rate for Payer: Healthscope Whirlpool |
$69.71
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.87
|
| Rate for Payer: Mclaren Commercial |
$62.74
|
| Rate for Payer: Mclaren Medicaid |
$16.87
|
| 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 |
$9.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.25
|
| Rate for Payer: Nomi Health Commercial |
$57.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.28
|
| Rate for Payer: 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 |
$8.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$61.08
|
| Rate for Payer: Priority Health Medicare |
$16.87
|
| Rate for Payer: Priority Health Narrow Network |
$48.87
|
| Rate for Payer: Railroad Medicare Medicare |
$16.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$61.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$16.87
|
| Rate for Payer: UHC Exchange |
$26.15
|
| Rate for Payer: UHC Medicaid |
$8.82
|
| Rate for Payer: UHCCP DNSP |
$16.87
|
| Rate for Payer: UHCCP Medicaid |
$8.82
|
| Rate for Payer: VA VA |
$16.87
|
|
|
HC BIOTRONIK DUAL PACEMAKER
|
Facility
|
OP
|
$9,824.34
|
|
|
Service Code
|
HCPCS C1785
|
| Hospital Charge Code |
27500002
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$3,635.01 |
| Max. Negotiated Rate |
$9,824.34 |
| Rate for Payer: Aetna Commercial |
$8,841.91
|
| Rate for Payer: Aetna Medicare |
$3,635.01
|
| Rate for Payer: ASR ASR |
$9,529.61
|
| Rate for Payer: BCBS Complete |
$3,929.74
|
| Rate for Payer: BCBS Trust/PPO |
$8,100.17
|
| Rate for Payer: BCN Commercial |
$8,100.17
|
| Rate for Payer: Cash Price |
$7,859.47
|
| Rate for Payer: Cofinity Commercial |
$9,234.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,859.47
|
| Rate for Payer: Healthscope Commercial |
$9,529.61
|
| Rate for Payer: Healthscope Whirlpool |
$9,824.34
|
| Rate for Payer: Mclaren Commercial |
$8,841.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,859.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,350.69
|
| Rate for Payer: Nomi Health Commercial |
$8,055.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,368.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$8,608.09
|
| Rate for Payer: Priority Health Narrow Network |
$6,886.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8,645.42
|
|
|
HC BIOTRONIK DUAL PACEMAKER
|
Facility
|
IP
|
$9,824.34
|
|
|
Service Code
|
HCPCS C1785
|
| Hospital Charge Code |
27500002
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$7,368.26 |
| Max. Negotiated Rate |
$9,824.34 |
| Rate for Payer: Aetna Commercial |
$8,841.91
|
| Rate for Payer: ASR ASR |
$9,529.61
|
| Rate for Payer: BCBS Trust/PPO |
$8,067.75
|
| Rate for Payer: BCN Commercial |
$8,067.75
|
| Rate for Payer: Cash Price |
$7,859.47
|
| Rate for Payer: Cofinity Commercial |
$9,234.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,859.47
|
| Rate for Payer: Healthscope Commercial |
$9,529.61
|
| Rate for Payer: Healthscope Whirlpool |
$9,824.34
|
| Rate for Payer: Mclaren Commercial |
$8,841.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,350.69
|
| Rate for Payer: Nomi Health Commercial |
$8,055.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,368.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8,645.42
|
|
|
HC BIPAL BIOPSY FORCEPS
|
Facility
|
OP
|
$1,792.06
|
|
| Hospital Charge Code |
27200113
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$663.06 |
| Max. Negotiated Rate |
$1,792.06 |
| Rate for Payer: Aetna Commercial |
$1,612.85
|
| Rate for Payer: Aetna Medicare |
$663.06
|
| Rate for Payer: ASR ASR |
$1,738.30
|
| Rate for Payer: BCBS Complete |
$716.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,477.55
|
| Rate for Payer: BCN Commercial |
$1,477.55
|
| Rate for Payer: Cash Price |
$1,433.65
|
| Rate for Payer: Cofinity Commercial |
$1,684.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,433.65
|
| Rate for Payer: Healthscope Commercial |
$1,738.30
|
| Rate for Payer: Healthscope Whirlpool |
$1,792.06
|
| Rate for Payer: Mclaren Commercial |
$1,612.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,433.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,523.25
|
| Rate for Payer: Nomi Health Commercial |
$1,469.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,344.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,570.20
|
| Rate for Payer: Priority Health Narrow Network |
$1,256.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,577.01
|
|
|
HC BIPAL BIOPSY FORCEPS
|
Facility
|
IP
|
$1,792.06
|
|
| Hospital Charge Code |
27200113
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,344.05 |
| Max. Negotiated Rate |
$1,792.06 |
| Rate for Payer: Aetna Commercial |
$1,612.85
|
| Rate for Payer: ASR ASR |
$1,738.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,471.64
|
| Rate for Payer: BCN Commercial |
$1,471.64
|
| Rate for Payer: Cash Price |
$1,433.65
|
| Rate for Payer: Cofinity Commercial |
$1,684.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,433.65
|
| Rate for Payer: Healthscope Commercial |
$1,738.30
|
| Rate for Payer: Healthscope Whirlpool |
$1,792.06
|
| Rate for Payer: Mclaren Commercial |
$1,612.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,523.25
|
| Rate for Payer: Nomi Health Commercial |
$1,469.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,344.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,577.01
|
|
|
HC BIPAP / CPAP PER DAY
|
Facility
|
IP
|
$892.61
|
|
|
Service Code
|
CPT 94660
|
| Hospital Charge Code |
41000008
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$669.46 |
| Max. Negotiated Rate |
$892.61 |
| Rate for Payer: Aetna Commercial |
$803.35
|
| Rate for Payer: ASR ASR |
$865.83
|
| Rate for Payer: BCBS Trust/PPO |
$733.01
|
| Rate for Payer: BCN Commercial |
$733.01
|
| Rate for Payer: Cash Price |
$714.09
|
| Rate for Payer: Cofinity Commercial |
$839.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$714.09
|
| Rate for Payer: Healthscope Commercial |
$865.83
|
| Rate for Payer: Healthscope Whirlpool |
$892.61
|
| Rate for Payer: Mclaren Commercial |
$803.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$758.72
|
| Rate for Payer: Nomi Health Commercial |
$731.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$669.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$785.50
|
|
|
HC BIPAP / CPAP PER DAY
|
Facility
|
OP
|
$892.61
|
|
|
Service Code
|
CPT 94660
|
| Hospital Charge Code |
41000008
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$114.11 |
| Max. Negotiated Rate |
$2,071.28 |
| Rate for Payer: Aetna Commercial |
$803.35
|
| Rate for Payer: Aetna Medicare |
$218.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$272.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$272.74
|
| Rate for Payer: ASR ASR |
$865.83
|
| Rate for Payer: BCBS Complete |
$119.83
|
| Rate for Payer: BCBS MAPPO |
$218.19
|
| Rate for Payer: BCBS Trust/PPO |
$735.96
|
| Rate for Payer: BCN Commercial |
$735.96
|
| Rate for Payer: BCN Medicare Advantage |
$218.19
|
| Rate for Payer: Cash Price |
$714.09
|
| Rate for Payer: Cash Price |
$714.09
|
| Rate for Payer: Cofinity Commercial |
$839.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$714.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$218.19
|
| Rate for Payer: Healthscope Commercial |
$865.83
|
| Rate for Payer: Healthscope Whirlpool |
$892.61
|
| Rate for Payer: Humana Choice PPO Medicare |
$218.19
|
| Rate for Payer: Mclaren Commercial |
$803.35
|
| Rate for Payer: Mclaren Medicaid |
$218.19
|
| Rate for Payer: Mclaren Medicare |
$218.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$229.10
|
| Rate for Payer: Meridian Medicaid |
$119.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$250.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$240.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$758.72
|
| Rate for Payer: Nomi Health Commercial |
$731.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$669.46
|
| Rate for Payer: PACE Medicare |
$207.28
|
| Rate for Payer: PACE SWMI |
$218.19
|
| Rate for Payer: PHP Commercial |
$240.01
|
| Rate for Payer: PHP Medicaid |
$116.95
|
| Rate for Payer: PHP Medicare Advantage |
$218.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,071.28
|
| Rate for Payer: Priority Health Medicare |
$218.19
|
| Rate for Payer: Priority Health Narrow Network |
$1,657.03
|
| Rate for Payer: Railroad Medicare Medicare |
$218.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$785.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$218.19
|
| Rate for Payer: UHC Exchange |
$338.19
|
| Rate for Payer: UHC Medicaid |
$114.11
|
| Rate for Payer: UHCCP DNSP |
$218.19
|
| Rate for Payer: UHCCP Medicaid |
$114.11
|
| Rate for Payer: VA VA |
$218.19
|
|
|
HC BIRCH IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200029
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.43 |
| Max. Negotiated Rate |
$25.90 |
| Rate for Payer: Aetna Commercial |
$23.31
|
| Rate for Payer: ASR ASR |
$25.12
|
| Rate for Payer: BCBS Trust/PPO |
$21.27
|
| Rate for Payer: BCN Commercial |
$21.27
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$24.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$25.12
|
| Rate for Payer: Healthscope Whirlpool |
$25.90
|
| Rate for Payer: Mclaren Commercial |
$23.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.79
|
|
|
HC BIRCH IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200029
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$25.90 |
| Rate for Payer: Aetna Commercial |
$23.31
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: ASR ASR |
$25.12
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$21.35
|
| Rate for Payer: BCN Commercial |
$21.35
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$24.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$25.12
|
| Rate for Payer: Healthscope Whirlpool |
$25.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$23.31
|
| Rate for Payer: Mclaren Medicaid |
$5.22
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$5.74
|
| Rate for Payer: PHP Medicaid |
$2.80
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$22.69
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$18.16
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP DNSP |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC BIVENTRICULAR DELIVERY SYSTEM
|
Facility
|
OP
|
$2,079.46
|
|
| Hospital Charge Code |
27200114
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$769.40 |
| Max. Negotiated Rate |
$2,079.46 |
| Rate for Payer: Aetna Commercial |
$1,871.51
|
| Rate for Payer: Aetna Medicare |
$769.40
|
| Rate for Payer: ASR ASR |
$2,017.08
|
| Rate for Payer: BCBS Complete |
$831.78
|
| Rate for Payer: BCBS Trust/PPO |
$1,714.51
|
| Rate for Payer: BCN Commercial |
$1,714.51
|
| Rate for Payer: Cash Price |
$1,663.57
|
| Rate for Payer: Cofinity Commercial |
$1,954.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,663.57
|
| Rate for Payer: Healthscope Commercial |
$2,017.08
|
| Rate for Payer: Healthscope Whirlpool |
$2,079.46
|
| Rate for Payer: Mclaren Commercial |
$1,871.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,663.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,767.54
|
| Rate for Payer: Nomi Health Commercial |
$1,705.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,559.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,822.02
|
| Rate for Payer: Priority Health Narrow Network |
$1,457.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,829.92
|
|
|
HC BIVENTRICULAR DELIVERY SYSTEM
|
Facility
|
IP
|
$2,079.46
|
|
| Hospital Charge Code |
27200114
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,559.60 |
| Max. Negotiated Rate |
$2,079.46 |
| Rate for Payer: Aetna Commercial |
$1,871.51
|
| Rate for Payer: ASR ASR |
$2,017.08
|
| Rate for Payer: BCBS Trust/PPO |
$1,707.65
|
| Rate for Payer: BCN Commercial |
$1,707.65
|
| Rate for Payer: Cash Price |
$1,663.57
|
| Rate for Payer: Cofinity Commercial |
$1,954.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,663.57
|
| Rate for Payer: Healthscope Commercial |
$2,017.08
|
| Rate for Payer: Healthscope Whirlpool |
$2,079.46
|
| Rate for Payer: Mclaren Commercial |
$1,871.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,767.54
|
| Rate for Payer: Nomi Health Commercial |
$1,705.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,559.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,829.92
|
|
|
HC BI V PACEMAKER
|
Facility
|
OP
|
$28,495.15
|
|
|
Service Code
|
HCPCS C2621
|
| Hospital Charge Code |
27500001
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$10,543.21 |
| Max. Negotiated Rate |
$28,495.15 |
| Rate for Payer: Aetna Commercial |
$25,645.63
|
| Rate for Payer: Aetna Medicare |
$10,543.21
|
| Rate for Payer: ASR ASR |
$27,640.30
|
| Rate for Payer: BCBS Complete |
$11,398.06
|
| Rate for Payer: BCBS Trust/PPO |
$23,494.25
|
| Rate for Payer: BCN Commercial |
$23,494.25
|
| Rate for Payer: Cash Price |
$22,796.12
|
| Rate for Payer: Cofinity Commercial |
$26,785.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22,796.12
|
| Rate for Payer: Healthscope Commercial |
$27,640.30
|
| Rate for Payer: Healthscope Whirlpool |
$28,495.15
|
| Rate for Payer: Mclaren Commercial |
$25,645.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22,796.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,220.88
|
| Rate for Payer: Nomi Health Commercial |
$23,366.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21,371.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$24,967.45
|
| Rate for Payer: Priority Health Narrow Network |
$19,975.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25,075.73
|
|
|
HC BI V PACEMAKER
|
Facility
|
IP
|
$28,495.15
|
|
|
Service Code
|
HCPCS C2621
|
| Hospital Charge Code |
27500001
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$21,371.36 |
| Max. Negotiated Rate |
$28,495.15 |
| Rate for Payer: Aetna Commercial |
$25,645.63
|
| Rate for Payer: ASR ASR |
$27,640.30
|
| Rate for Payer: BCBS Trust/PPO |
$23,400.22
|
| Rate for Payer: BCN Commercial |
$23,400.22
|
| Rate for Payer: Cash Price |
$22,796.12
|
| Rate for Payer: Cofinity Commercial |
$26,785.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22,796.12
|
| Rate for Payer: Healthscope Commercial |
$27,640.30
|
| Rate for Payer: Healthscope Whirlpool |
$28,495.15
|
| Rate for Payer: Mclaren Commercial |
$25,645.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,220.88
|
| Rate for Payer: Nomi Health Commercial |
$23,366.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21,371.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25,075.73
|
|
|
HC BK VIRUS PCR, QUANT
|
Facility
|
OP
|
$115.67
|
|
|
Service Code
|
CPT 87799
|
| Hospital Charge Code |
30600289
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$22.41 |
| Max. Negotiated Rate |
$115.67 |
| Rate for Payer: Aetna Commercial |
$104.10
|
| Rate for Payer: Aetna Medicare |
$42.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$53.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$53.55
|
| Rate for Payer: ASR ASR |
$112.20
|
| Rate for Payer: BCBS Complete |
$23.53
|
| Rate for Payer: BCBS MAPPO |
$42.84
|
| Rate for Payer: BCBS Trust/PPO |
$95.37
|
| Rate for Payer: BCN Commercial |
$95.37
|
| Rate for Payer: BCN Medicare Advantage |
$42.84
|
| Rate for Payer: Cash Price |
$92.54
|
| Rate for Payer: Cash Price |
$92.54
|
| Rate for Payer: Cofinity Commercial |
$108.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.84
|
| Rate for Payer: Healthscope Commercial |
$112.20
|
| Rate for Payer: Healthscope Whirlpool |
$115.67
|
| Rate for Payer: Humana Choice PPO Medicare |
$42.84
|
| Rate for Payer: Mclaren Commercial |
$104.10
|
| Rate for Payer: Mclaren Medicaid |
$42.84
|
| Rate for Payer: Mclaren Medicare |
$42.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.98
|
| Rate for Payer: Meridian Medicaid |
$23.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$49.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$47.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.32
|
| Rate for Payer: Nomi Health Commercial |
$94.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$86.75
|
| Rate for Payer: PACE Medicare |
$40.70
|
| Rate for Payer: PACE SWMI |
$42.84
|
| Rate for Payer: PHP Commercial |
$47.12
|
| Rate for Payer: PHP Medicaid |
$22.96
|
| Rate for Payer: PHP Medicare Advantage |
$42.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$101.35
|
| Rate for Payer: Priority Health Medicare |
$42.84
|
| Rate for Payer: Priority Health Narrow Network |
$81.08
|
| Rate for Payer: Railroad Medicare Medicare |
$42.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$101.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$42.84
|
| Rate for Payer: UHC Exchange |
$66.40
|
| Rate for Payer: UHC Medicaid |
$22.41
|
| Rate for Payer: UHCCP DNSP |
$42.84
|
| Rate for Payer: UHCCP Medicaid |
$22.41
|
| Rate for Payer: VA VA |
$42.84
|
|
|
HC BK VIRUS PCR, QUANT
|
Facility
|
IP
|
$115.67
|
|
|
Service Code
|
CPT 87799
|
| Hospital Charge Code |
30600289
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$86.75 |
| Max. Negotiated Rate |
$115.67 |
| Rate for Payer: Aetna Commercial |
$104.10
|
| Rate for Payer: ASR ASR |
$112.20
|
| Rate for Payer: BCBS Trust/PPO |
$94.99
|
| Rate for Payer: BCN Commercial |
$94.99
|
| Rate for Payer: Cash Price |
$92.54
|
| Rate for Payer: Cofinity Commercial |
$108.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.54
|
| Rate for Payer: Healthscope Commercial |
$112.20
|
| Rate for Payer: Healthscope Whirlpool |
$115.67
|
| Rate for Payer: Mclaren Commercial |
$104.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.32
|
| Rate for Payer: Nomi Health Commercial |
$94.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$86.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$101.79
|
|
|
HC BLADDER IRRIGATION
|
Facility
|
IP
|
$285.45
|
|
| Hospital Charge Code |
45000032
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$214.09 |
| Max. Negotiated Rate |
$285.45 |
| Rate for Payer: Aetna Commercial |
$256.90
|
| Rate for Payer: ASR ASR |
$276.89
|
| Rate for Payer: BCBS Trust/PPO |
$234.41
|
| Rate for Payer: BCN Commercial |
$234.41
|
| Rate for Payer: Cash Price |
$228.36
|
| Rate for Payer: Cofinity Commercial |
$268.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.36
|
| Rate for Payer: Healthscope Commercial |
$276.89
|
| Rate for Payer: Healthscope Whirlpool |
$285.45
|
| Rate for Payer: Mclaren Commercial |
$256.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$242.63
|
| Rate for Payer: Nomi Health Commercial |
$234.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$214.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$251.20
|
|
|
HC BLADDER IRRIGATION
|
Facility
|
OP
|
$285.45
|
|
| Hospital Charge Code |
45000032
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$105.62 |
| Max. Negotiated Rate |
$285.45 |
| Rate for Payer: Aetna Commercial |
$256.90
|
| Rate for Payer: Aetna Medicare |
$105.62
|
| Rate for Payer: ASR ASR |
$276.89
|
| Rate for Payer: BCBS Complete |
$114.18
|
| Rate for Payer: BCBS Trust/PPO |
$235.35
|
| Rate for Payer: BCN Commercial |
$235.35
|
| Rate for Payer: Cash Price |
$228.36
|
| Rate for Payer: Cofinity Commercial |
$268.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.36
|
| Rate for Payer: Healthscope Commercial |
$276.89
|
| Rate for Payer: Healthscope Whirlpool |
$285.45
|
| Rate for Payer: Mclaren Commercial |
$256.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$228.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$242.63
|
| Rate for Payer: Nomi Health Commercial |
$234.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$214.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$250.11
|
| Rate for Payer: Priority Health Narrow Network |
$200.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$251.20
|
|
|
HC BLADDER SCAN
|
Facility
|
OP
|
$156.20
|
|
|
Service Code
|
CPT 51798
|
| Hospital Charge Code |
45000006
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$30.74 |
| Max. Negotiated Rate |
$156.20 |
| Rate for Payer: Aetna Commercial |
$140.58
|
| Rate for Payer: Aetna Medicare |
$58.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$73.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$73.47
|
| Rate for Payer: ASR ASR |
$151.51
|
| Rate for Payer: BCBS Complete |
$32.28
|
| Rate for Payer: BCBS MAPPO |
$58.78
|
| Rate for Payer: BCBS Trust/PPO |
$128.79
|
| Rate for Payer: BCN Commercial |
$128.79
|
| Rate for Payer: BCN Medicare Advantage |
$58.78
|
| Rate for Payer: Cash Price |
$124.96
|
| Rate for Payer: Cash Price |
$124.96
|
| Rate for Payer: Cofinity Commercial |
$146.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.78
|
| Rate for Payer: Healthscope Commercial |
$151.51
|
| Rate for Payer: Healthscope Whirlpool |
$156.20
|
| Rate for Payer: Humana Choice PPO Medicare |
$58.78
|
| Rate for Payer: Mclaren Commercial |
$140.58
|
| Rate for Payer: Mclaren Medicaid |
$58.78
|
| Rate for Payer: Mclaren Medicare |
$58.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.72
|
| Rate for Payer: Meridian Medicaid |
$32.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$67.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$64.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132.77
|
| Rate for Payer: Nomi Health Commercial |
$128.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.15
|
| Rate for Payer: PACE Medicare |
$55.84
|
| Rate for Payer: PACE SWMI |
$58.78
|
| Rate for Payer: PHP Commercial |
$64.66
|
| Rate for Payer: PHP Medicaid |
$31.51
|
| Rate for Payer: PHP Medicare Advantage |
$58.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$136.86
|
| Rate for Payer: Priority Health Medicare |
$58.78
|
| Rate for Payer: Priority Health Narrow Network |
$109.50
|
| Rate for Payer: Railroad Medicare Medicare |
$58.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$137.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$58.78
|
| Rate for Payer: UHC Exchange |
$91.11
|
| Rate for Payer: UHC Medicaid |
$30.74
|
| Rate for Payer: UHCCP DNSP |
$58.78
|
| Rate for Payer: UHCCP Medicaid |
$30.74
|
| Rate for Payer: VA VA |
$58.78
|
|
|
HC BLADDER SCAN
|
Facility
|
IP
|
$156.20
|
|
|
Service Code
|
CPT 51798
|
| Hospital Charge Code |
45000006
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$117.15 |
| Max. Negotiated Rate |
$156.20 |
| Rate for Payer: Aetna Commercial |
$140.58
|
| Rate for Payer: ASR ASR |
$151.51
|
| Rate for Payer: BCBS Trust/PPO |
$128.27
|
| Rate for Payer: BCN Commercial |
$128.27
|
| Rate for Payer: Cash Price |
$124.96
|
| Rate for Payer: Cofinity Commercial |
$146.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.96
|
| Rate for Payer: Healthscope Commercial |
$151.51
|
| Rate for Payer: Healthscope Whirlpool |
$156.20
|
| Rate for Payer: Mclaren Commercial |
$140.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132.77
|
| Rate for Payer: Nomi Health Commercial |
$128.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$137.46
|
|
|
HC BLASTOMYCES ABS BY COMP FIX
|
Facility
|
OP
|
$78.03
|
|
|
Service Code
|
CPT 86612
|
| Hospital Charge Code |
30200230
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.75 |
| Max. Negotiated Rate |
$78.03 |
| Rate for Payer: Aetna Commercial |
$70.23
|
| Rate for Payer: Aetna Medicare |
$12.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.12
|
| Rate for Payer: ASR ASR |
$75.69
|
| Rate for Payer: BCBS Complete |
$7.08
|
| Rate for Payer: BCBS MAPPO |
$12.90
|
| Rate for Payer: BCBS Trust/PPO |
$64.34
|
| Rate for Payer: BCN Commercial |
$64.34
|
| Rate for Payer: BCN Medicare Advantage |
$12.90
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Commercial |
$73.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.90
|
| Rate for Payer: Healthscope Commercial |
$75.69
|
| Rate for Payer: Healthscope Whirlpool |
$78.03
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.90
|
| Rate for Payer: Mclaren Commercial |
$70.23
|
| Rate for Payer: Mclaren Medicaid |
$12.90
|
| Rate for Payer: Mclaren Medicare |
$12.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.54
|
| Rate for Payer: Meridian Medicaid |
$7.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Nomi Health Commercial |
$63.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.52
|
| Rate for Payer: PACE Medicare |
$12.26
|
| Rate for Payer: PACE SWMI |
$12.90
|
| Rate for Payer: PHP Commercial |
$14.19
|
| Rate for Payer: PHP Medicaid |
$6.91
|
| Rate for Payer: PHP Medicare Advantage |
$12.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$68.37
|
| Rate for Payer: Priority Health Medicare |
$12.90
|
| Rate for Payer: Priority Health Narrow Network |
$54.70
|
| Rate for Payer: Railroad Medicare Medicare |
$12.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$68.67
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.90
|
| Rate for Payer: UHC Exchange |
$20.00
|
| Rate for Payer: UHC Medicaid |
$6.75
|
| Rate for Payer: UHCCP DNSP |
$12.90
|
| Rate for Payer: UHCCP Medicaid |
$6.75
|
| Rate for Payer: VA VA |
$12.90
|
|
|
HC BLASTOMYCES ABS BY COMP FIX
|
Facility
|
IP
|
$78.03
|
|
|
Service Code
|
CPT 86612
|
| Hospital Charge Code |
30200230
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$58.52 |
| Max. Negotiated Rate |
$78.03 |
| Rate for Payer: Aetna Commercial |
$70.23
|
| Rate for Payer: ASR ASR |
$75.69
|
| Rate for Payer: BCBS Trust/PPO |
$64.08
|
| Rate for Payer: BCN Commercial |
$64.08
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Commercial |
$73.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Healthscope Commercial |
$75.69
|
| Rate for Payer: Healthscope Whirlpool |
$78.03
|
| Rate for Payer: Mclaren Commercial |
$70.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Nomi Health Commercial |
$63.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$68.67
|
|
