|
HC ARRAY COMPARATIVE GENOMIC CMPT
|
Facility
|
IP
|
$1,412.70
|
|
|
Service Code
|
CPT 88399
|
| Hospital Charge Code |
31000061
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$918.26 |
| Max. Negotiated Rate |
$1,412.70 |
| Rate for Payer: Aetna Commercial |
$1,271.43
|
| Rate for Payer: ASR ASR |
$1,370.32
|
| Rate for Payer: ASR Commercial |
$1,370.32
|
| Rate for Payer: BCBS Trust/PPO |
$1,151.21
|
| Rate for Payer: BCN Commercial |
$1,095.27
|
| Rate for Payer: Cash Price |
$1,130.16
|
| Rate for Payer: Cofinity Commercial |
$1,327.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,130.16
|
| Rate for Payer: Healthscope Commercial |
$1,412.70
|
| Rate for Payer: Healthscope Whirlpool |
$1,370.32
|
| Rate for Payer: Mclaren Commercial |
$1,271.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,200.80
|
| Rate for Payer: Nomi Health Commercial |
$1,158.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$918.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,243.18
|
|
|
HC ARSENIC
|
Facility
|
OP
|
$196.04
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100108
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.17 |
| Max. Negotiated Rate |
$196.04 |
| Rate for Payer: Aetna Commercial |
$176.44
|
| Rate for Payer: Aetna Medicare |
$18.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.71
|
| Rate for Payer: ASR ASR |
$190.16
|
| Rate for Payer: ASR Commercial |
$190.16
|
| Rate for Payer: BCBS Complete |
$10.68
|
| Rate for Payer: BCBS MAPPO |
$18.97
|
| Rate for Payer: BCBS Trust/PPO |
$160.54
|
| Rate for Payer: BCN Commercial |
$151.99
|
| Rate for Payer: BCN Medicare Advantage |
$18.97
|
| Rate for Payer: Cash Price |
$156.83
|
| Rate for Payer: Cash Price |
$156.83
|
| Rate for Payer: Cofinity Commercial |
$184.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$156.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.97
|
| Rate for Payer: Healthscope Commercial |
$196.04
|
| Rate for Payer: Healthscope Whirlpool |
$190.16
|
| Rate for Payer: Humana Choice PPO Medicare |
$18.97
|
| Rate for Payer: Mclaren Commercial |
$176.44
|
| Rate for Payer: Mclaren Medicaid |
$10.17
|
| Rate for Payer: Mclaren Medicare |
$18.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.92
|
| Rate for Payer: Meridian Medicaid |
$10.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$166.63
|
| Rate for Payer: Nomi Health Commercial |
$160.75
|
| Rate for Payer: PACE Medicare |
$18.02
|
| Rate for Payer: PACE SWMI |
$18.97
|
| Rate for Payer: PHP Commercial |
$20.87
|
| Rate for Payer: PHP Medicaid |
$10.17
|
| Rate for Payer: PHP Medicare Advantage |
$18.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$127.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$118.59
|
| Rate for Payer: Priority Health Medicare |
$18.97
|
| Rate for Payer: Priority Health Narrow Network |
$94.87
|
| Rate for Payer: Railroad Medicare Medicare |
$18.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$172.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.97
|
| Rate for Payer: UHC Exchange |
$29.40
|
| Rate for Payer: UHC Medicare Advantage |
$18.97
|
| Rate for Payer: UHCCP DNSP |
$18.97
|
| Rate for Payer: UHCCP Medicaid |
$10.17
|
| Rate for Payer: VA VA |
$18.97
|
|
|
HC ARSENIC
|
Facility
|
IP
|
$196.04
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100108
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$127.43 |
| Max. Negotiated Rate |
$196.04 |
| Rate for Payer: Aetna Commercial |
$176.44
|
| Rate for Payer: ASR ASR |
$190.16
|
| Rate for Payer: ASR Commercial |
$190.16
|
| Rate for Payer: BCBS Trust/PPO |
$159.75
|
| Rate for Payer: BCN Commercial |
$151.99
|
| Rate for Payer: Cash Price |
$156.83
|
| Rate for Payer: Cofinity Commercial |
$184.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$156.83
|
| Rate for Payer: Healthscope Commercial |
$196.04
|
| Rate for Payer: Healthscope Whirlpool |
$190.16
|
| Rate for Payer: Mclaren Commercial |
$176.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$166.63
|
| Rate for Payer: Nomi Health Commercial |
$160.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$127.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$172.52
|
|
|
HC ARSENIC 24HR U
|
Facility
|
OP
|
$114.24
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100679
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.17 |
| Max. Negotiated Rate |
$118.59 |
| Rate for Payer: Aetna Commercial |
$102.82
|
| Rate for Payer: Aetna Medicare |
$18.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.71
|
| Rate for Payer: ASR ASR |
$110.81
|
| Rate for Payer: ASR Commercial |
$110.81
|
| Rate for Payer: BCBS Complete |
$10.68
|
| Rate for Payer: BCBS MAPPO |
$18.97
|
| Rate for Payer: BCBS Trust/PPO |
$93.55
|
| Rate for Payer: BCN Commercial |
$88.57
|
| Rate for Payer: BCN Medicare Advantage |
$18.97
|
| Rate for Payer: Cash Price |
$91.39
|
| Rate for Payer: Cash Price |
$91.39
|
| Rate for Payer: Cofinity Commercial |
$107.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.97
|
| Rate for Payer: Healthscope Commercial |
$114.24
|
| Rate for Payer: Healthscope Whirlpool |
$110.81
|
| Rate for Payer: Humana Choice PPO Medicare |
$18.97
|
| Rate for Payer: Mclaren Commercial |
$102.82
|
| Rate for Payer: Mclaren Medicaid |
$10.17
|
| Rate for Payer: Mclaren Medicare |
$18.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.92
|
| Rate for Payer: Meridian Medicaid |
$10.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.10
|
| Rate for Payer: Nomi Health Commercial |
$93.68
|
| Rate for Payer: PACE Medicare |
$18.02
|
| Rate for Payer: PACE SWMI |
$18.97
|
| Rate for Payer: PHP Commercial |
$20.87
|
| Rate for Payer: PHP Medicaid |
$10.17
|
| Rate for Payer: PHP Medicare Advantage |
$18.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$118.59
|
| Rate for Payer: Priority Health Medicare |
$18.97
|
| Rate for Payer: Priority Health Narrow Network |
$94.87
|
| Rate for Payer: Railroad Medicare Medicare |
$18.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$100.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.97
|
| Rate for Payer: UHC Exchange |
$29.40
|
| Rate for Payer: UHC Medicare Advantage |
$18.97
|
| Rate for Payer: UHCCP DNSP |
$18.97
|
| Rate for Payer: UHCCP Medicaid |
$10.17
|
| Rate for Payer: VA VA |
$18.97
|
|
|
HC ARSENIC 24HR U
|
Facility
|
IP
|
$114.24
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100679
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$74.26 |
| Max. Negotiated Rate |
$114.24 |
| Rate for Payer: Aetna Commercial |
$102.82
|
| Rate for Payer: ASR ASR |
$110.81
|
| Rate for Payer: ASR Commercial |
$110.81
|
| Rate for Payer: BCBS Trust/PPO |
$93.09
|
| Rate for Payer: BCN Commercial |
$88.57
|
| Rate for Payer: Cash Price |
$91.39
|
| Rate for Payer: Cofinity Commercial |
$107.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.39
|
| Rate for Payer: Healthscope Commercial |
$114.24
|
| Rate for Payer: Healthscope Whirlpool |
$110.81
|
| Rate for Payer: Mclaren Commercial |
$102.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.10
|
| Rate for Payer: Nomi Health Commercial |
$93.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$100.53
|
|
|
HC ARSENIC URINE
|
Facility
|
IP
|
$65.28
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100110
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$42.43 |
| Max. Negotiated Rate |
$65.28 |
| Rate for Payer: Aetna Commercial |
$58.75
|
| Rate for Payer: ASR ASR |
$63.32
|
| Rate for Payer: ASR Commercial |
$63.32
|
| Rate for Payer: BCBS Trust/PPO |
$53.20
|
| Rate for Payer: BCN Commercial |
$50.61
|
| Rate for Payer: Cash Price |
$52.22
|
| Rate for Payer: Cofinity Commercial |
$61.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.22
|
| Rate for Payer: Healthscope Commercial |
$65.28
|
| Rate for Payer: Healthscope Whirlpool |
$63.32
|
| Rate for Payer: Mclaren Commercial |
$58.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.49
|
| Rate for Payer: Nomi Health Commercial |
$53.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$57.45
|
|
|
HC ARSENIC URINE
|
Facility
|
OP
|
$65.28
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100110
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.17 |
| Max. Negotiated Rate |
$118.59 |
| Rate for Payer: Aetna Commercial |
$58.75
|
| Rate for Payer: Aetna Medicare |
$18.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.71
|
| Rate for Payer: ASR ASR |
$63.32
|
| Rate for Payer: ASR Commercial |
$63.32
|
| Rate for Payer: BCBS Complete |
$10.68
|
| Rate for Payer: BCBS MAPPO |
$18.97
|
| Rate for Payer: BCBS Trust/PPO |
$53.46
|
| Rate for Payer: BCN Commercial |
$50.61
|
| Rate for Payer: BCN Medicare Advantage |
$18.97
|
| Rate for Payer: Cash Price |
$52.22
|
| Rate for Payer: Cash Price |
$52.22
|
| Rate for Payer: Cofinity Commercial |
$61.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.97
|
| Rate for Payer: Healthscope Commercial |
$65.28
|
| Rate for Payer: Healthscope Whirlpool |
$63.32
|
| Rate for Payer: Humana Choice PPO Medicare |
$18.97
|
| Rate for Payer: Mclaren Commercial |
$58.75
|
| Rate for Payer: Mclaren Medicaid |
$10.17
|
| Rate for Payer: Mclaren Medicare |
$18.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.92
|
| Rate for Payer: Meridian Medicaid |
$10.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.49
|
| Rate for Payer: Nomi Health Commercial |
$53.53
|
| Rate for Payer: PACE Medicare |
$18.02
|
| Rate for Payer: PACE SWMI |
$18.97
|
| Rate for Payer: PHP Commercial |
$20.87
|
| Rate for Payer: PHP Medicaid |
$10.17
|
| Rate for Payer: PHP Medicare Advantage |
$18.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$118.59
|
| Rate for Payer: Priority Health Medicare |
$18.97
|
| Rate for Payer: Priority Health Narrow Network |
$94.87
|
| Rate for Payer: Railroad Medicare Medicare |
$18.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$57.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.97
|
| Rate for Payer: UHC Exchange |
$29.40
|
| Rate for Payer: UHC Medicare Advantage |
$18.97
|
| Rate for Payer: UHCCP DNSP |
$18.97
|
| Rate for Payer: UHCCP Medicaid |
$10.17
|
| Rate for Payer: VA VA |
$18.97
|
|
|
HC ART CATH INSERT
|
Facility
|
OP
|
$452.71
|
|
| Hospital Charge Code |
45000029
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$181.08 |
| Max. Negotiated Rate |
$452.71 |
| Rate for Payer: Aetna Commercial |
$407.44
|
| Rate for Payer: Aetna Medicare |
$226.36
|
| Rate for Payer: ASR ASR |
$439.13
|
| Rate for Payer: ASR Commercial |
$439.13
|
| Rate for Payer: BCBS Complete |
$181.08
|
| Rate for Payer: BCBS Trust/PPO |
$370.72
|
| Rate for Payer: BCN Commercial |
$350.99
|
| Rate for Payer: Cash Price |
$362.17
|
| Rate for Payer: Cofinity Commercial |
$425.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$362.17
|
| Rate for Payer: Healthscope Commercial |
$452.71
|
| Rate for Payer: Healthscope Whirlpool |
$439.13
|
| Rate for Payer: Mclaren Commercial |
$407.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$384.80
|
| Rate for Payer: Nomi Health Commercial |
$371.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$294.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$396.66
|
| Rate for Payer: Priority Health Narrow Network |
$317.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$398.38
|
|
|
HC ART CATH INSERT
|
Facility
|
IP
|
$452.71
|
|
| Hospital Charge Code |
45000029
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$294.26 |
| Max. Negotiated Rate |
$452.71 |
| Rate for Payer: Aetna Commercial |
$407.44
|
| Rate for Payer: ASR ASR |
$439.13
|
| Rate for Payer: ASR Commercial |
$439.13
|
| Rate for Payer: BCBS Trust/PPO |
$368.91
|
| Rate for Payer: BCN Commercial |
$350.99
|
| Rate for Payer: Cash Price |
$362.17
|
| Rate for Payer: Cofinity Commercial |
$425.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$362.17
|
| Rate for Payer: Healthscope Commercial |
$452.71
|
| Rate for Payer: Healthscope Whirlpool |
$439.13
|
| Rate for Payer: Mclaren Commercial |
$407.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$384.80
|
| Rate for Payer: Nomi Health Commercial |
$371.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$294.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$398.38
|
|
|
HC ARTERIAL DUPLEX IMAG BIL LOWER EXTREMITY
|
Facility
|
IP
|
$1,588.11
|
|
|
Service Code
|
CPT 93925
|
| Hospital Charge Code |
92100007
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$1,032.27 |
| Max. Negotiated Rate |
$1,588.11 |
| Rate for Payer: Aetna Commercial |
$1,429.30
|
| Rate for Payer: ASR ASR |
$1,540.47
|
| Rate for Payer: ASR Commercial |
$1,540.47
|
| Rate for Payer: BCBS Trust/PPO |
$1,294.15
|
| Rate for Payer: BCN Commercial |
$1,231.26
|
| Rate for Payer: Cash Price |
$1,270.49
|
| Rate for Payer: Cofinity Commercial |
$1,492.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,270.49
|
| Rate for Payer: Healthscope Commercial |
$1,588.11
|
| Rate for Payer: Healthscope Whirlpool |
$1,540.47
|
| Rate for Payer: Mclaren Commercial |
$1,429.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,349.89
|
| Rate for Payer: Nomi Health Commercial |
$1,302.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,032.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,397.54
|
|
|
HC ARTERIAL DUPLEX IMAG BIL LOWER EXTREMITY
|
Facility
|
OP
|
$1,588.11
|
|
|
Service Code
|
CPT 93925
|
| Hospital Charge Code |
92100007
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$126.94 |
| Max. Negotiated Rate |
$1,588.11 |
| Rate for Payer: Aetna Commercial |
$1,429.30
|
| Rate for Payer: Aetna Medicare |
$236.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$296.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$296.04
|
| Rate for Payer: ASR ASR |
$1,540.47
|
| Rate for Payer: ASR Commercial |
$1,540.47
|
| Rate for Payer: BCBS Complete |
$133.29
|
| Rate for Payer: BCBS MAPPO |
$236.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,300.50
|
| Rate for Payer: BCN Commercial |
$1,231.26
|
| Rate for Payer: BCN Medicare Advantage |
$236.83
|
| Rate for Payer: Cash Price |
$1,270.49
|
| Rate for Payer: Cash Price |
$1,270.49
|
| Rate for Payer: Cofinity Commercial |
$1,492.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,270.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.83
|
| Rate for Payer: Healthscope Commercial |
$1,588.11
|
| Rate for Payer: Healthscope Whirlpool |
$1,540.47
|
| Rate for Payer: Humana Choice PPO Medicare |
$236.83
|
| Rate for Payer: Mclaren Commercial |
$1,429.30
|
| Rate for Payer: Mclaren Medicaid |
$126.94
|
| Rate for Payer: Mclaren Medicare |
$236.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$248.67
|
| Rate for Payer: Meridian Medicaid |
$133.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$272.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,349.89
|
| Rate for Payer: Nomi Health Commercial |
$1,302.25
|
| Rate for Payer: PACE Medicare |
$224.99
|
| Rate for Payer: PACE SWMI |
$236.83
|
| Rate for Payer: PHP Commercial |
$260.51
|
| Rate for Payer: PHP Medicaid |
$126.94
|
| Rate for Payer: PHP Medicare Advantage |
$236.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,032.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,391.50
|
| Rate for Payer: Priority Health Medicare |
$236.83
|
| Rate for Payer: Priority Health Narrow Network |
$1,113.27
|
| Rate for Payer: Railroad Medicare Medicare |
$236.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,397.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$236.83
|
| Rate for Payer: UHC Exchange |
$367.09
|
| Rate for Payer: UHC Medicare Advantage |
$236.83
|
| Rate for Payer: UHCCP DNSP |
$236.83
|
| Rate for Payer: UHCCP Medicaid |
$126.94
|
| Rate for Payer: VA VA |
$236.83
|
|
|
HC ARTERIAL DUPLEX IMAG BIL UPPER EXTREMITY
|
Facility
|
OP
|
$1,308.89
|
|
|
Service Code
|
CPT 93930
|
| Hospital Charge Code |
92100008
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$126.94 |
| Max. Negotiated Rate |
$1,308.89 |
| Rate for Payer: Aetna Commercial |
$1,178.00
|
| Rate for Payer: Aetna Medicare |
$236.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$296.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$296.04
|
| Rate for Payer: ASR ASR |
$1,269.62
|
| Rate for Payer: ASR Commercial |
$1,269.62
|
| Rate for Payer: BCBS Complete |
$133.29
|
| Rate for Payer: BCBS MAPPO |
$236.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,071.85
|
| Rate for Payer: BCN Commercial |
$1,014.78
|
| Rate for Payer: BCN Medicare Advantage |
$236.83
|
| Rate for Payer: Cash Price |
$1,047.11
|
| Rate for Payer: Cash Price |
$1,047.11
|
| Rate for Payer: Cofinity Commercial |
$1,230.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,047.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.83
|
| Rate for Payer: Healthscope Commercial |
$1,308.89
|
| Rate for Payer: Healthscope Whirlpool |
$1,269.62
|
| Rate for Payer: Humana Choice PPO Medicare |
$236.83
|
| Rate for Payer: Mclaren Commercial |
$1,178.00
|
| Rate for Payer: Mclaren Medicaid |
$126.94
|
| Rate for Payer: Mclaren Medicare |
$236.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$248.67
|
| Rate for Payer: Meridian Medicaid |
$133.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$272.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,112.56
|
| Rate for Payer: Nomi Health Commercial |
$1,073.29
|
| Rate for Payer: PACE Medicare |
$224.99
|
| Rate for Payer: PACE SWMI |
$236.83
|
| Rate for Payer: PHP Commercial |
$260.51
|
| Rate for Payer: PHP Medicaid |
$126.94
|
| Rate for Payer: PHP Medicare Advantage |
$236.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$850.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,146.85
|
| Rate for Payer: Priority Health Medicare |
$236.83
|
| Rate for Payer: Priority Health Narrow Network |
$917.53
|
| Rate for Payer: Railroad Medicare Medicare |
$236.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,151.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$236.83
|
| Rate for Payer: UHC Exchange |
$367.09
|
| Rate for Payer: UHC Medicare Advantage |
$236.83
|
| Rate for Payer: UHCCP DNSP |
$236.83
|
| Rate for Payer: UHCCP Medicaid |
$126.94
|
| Rate for Payer: VA VA |
$236.83
|
|
|
HC ARTERIAL DUPLEX IMAG BIL UPPER EXTREMITY
|
Facility
|
IP
|
$1,308.89
|
|
|
Service Code
|
CPT 93930
|
| Hospital Charge Code |
92100008
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$850.78 |
| Max. Negotiated Rate |
$1,308.89 |
| Rate for Payer: Aetna Commercial |
$1,178.00
|
| Rate for Payer: ASR ASR |
$1,269.62
|
| Rate for Payer: ASR Commercial |
$1,269.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,066.61
|
| Rate for Payer: BCN Commercial |
$1,014.78
|
| Rate for Payer: Cash Price |
$1,047.11
|
| Rate for Payer: Cofinity Commercial |
$1,230.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,047.11
|
| Rate for Payer: Healthscope Commercial |
$1,308.89
|
| Rate for Payer: Healthscope Whirlpool |
$1,269.62
|
| Rate for Payer: Mclaren Commercial |
$1,178.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,112.56
|
| Rate for Payer: Nomi Health Commercial |
$1,073.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$850.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,151.82
|
|
|
HC ARTERIAL PUNCTURE
|
Facility
|
IP
|
$132.01
|
|
|
Service Code
|
CPT 36600
|
| Hospital Charge Code |
36100442
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$85.81 |
| Max. Negotiated Rate |
$132.01 |
| Rate for Payer: Aetna Commercial |
$118.81
|
| Rate for Payer: ASR ASR |
$128.05
|
| Rate for Payer: ASR Commercial |
$128.05
|
| Rate for Payer: BCBS Trust/PPO |
$107.57
|
| Rate for Payer: BCN Commercial |
$102.35
|
| Rate for Payer: Cash Price |
$105.61
|
| Rate for Payer: Cofinity Commercial |
$124.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.61
|
| Rate for Payer: Healthscope Commercial |
$132.01
|
| Rate for Payer: Healthscope Whirlpool |
$128.05
|
| Rate for Payer: Mclaren Commercial |
$118.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$112.21
|
| Rate for Payer: Nomi Health Commercial |
$108.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$116.17
|
|
|
HC ARTERIAL PUNCTURE
|
Facility
|
OP
|
$132.01
|
|
|
Service Code
|
CPT 36600
|
| Hospital Charge Code |
36100442
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$37.78 |
| Max. Negotiated Rate |
$195.75 |
| Rate for Payer: Aetna Commercial |
$118.81
|
| Rate for Payer: Aetna Medicare |
$126.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.86
|
| Rate for Payer: ASR ASR |
$128.05
|
| Rate for Payer: ASR Commercial |
$128.05
|
| Rate for Payer: BCBS Complete |
$71.08
|
| Rate for Payer: BCBS MAPPO |
$126.29
|
| Rate for Payer: BCBS Trust/PPO |
$108.10
|
| Rate for Payer: BCN Commercial |
$102.35
|
| Rate for Payer: BCN Medicare Advantage |
$126.29
|
| Rate for Payer: Cash Price |
$105.61
|
| Rate for Payer: Cash Price |
$105.61
|
| Rate for Payer: Cofinity Commercial |
$124.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.29
|
| Rate for Payer: Healthscope Commercial |
$132.01
|
| Rate for Payer: Healthscope Whirlpool |
$128.05
|
| Rate for Payer: Humana Choice PPO Medicare |
$126.29
|
| Rate for Payer: Mclaren Commercial |
$118.81
|
| Rate for Payer: Mclaren Medicaid |
$67.69
|
| Rate for Payer: Mclaren Medicare |
$126.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.60
|
| Rate for Payer: Meridian Medicaid |
$71.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$145.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$112.21
|
| Rate for Payer: Nomi Health Commercial |
$108.25
|
| Rate for Payer: PACE Medicare |
$119.98
|
| Rate for Payer: PACE SWMI |
$126.29
|
| Rate for Payer: PHP Commercial |
$138.92
|
| Rate for Payer: PHP Medicaid |
$67.69
|
| Rate for Payer: PHP Medicare Advantage |
$126.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$47.22
|
| Rate for Payer: Priority Health Medicare |
$126.29
|
| Rate for Payer: Priority Health Narrow Network |
$37.78
|
| Rate for Payer: Railroad Medicare Medicare |
$126.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$116.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$126.29
|
| Rate for Payer: UHC Exchange |
$195.75
|
| Rate for Payer: UHC Medicare Advantage |
$126.29
|
| Rate for Payer: UHCCP DNSP |
$126.29
|
| Rate for Payer: UHCCP Medicaid |
$67.69
|
| Rate for Payer: VA VA |
$126.29
|
|
|
HC ARTERIAL TRANSCATH THROMBOLYSIS
|
Facility
|
OP
|
$5,108.99
|
|
|
Service Code
|
CPT 37211
|
| Hospital Charge Code |
36100371
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$719.99 |
| Max. Negotiated Rate |
$8,209.42 |
| Rate for Payer: Aetna Commercial |
$4,598.09
|
| Rate for Payer: Aetna Medicare |
$5,296.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,620.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,620.50
|
| Rate for Payer: ASR ASR |
$4,955.72
|
| Rate for Payer: ASR Commercial |
$4,955.72
|
| Rate for Payer: BCBS Complete |
$2,980.81
|
| Rate for Payer: BCBS MAPPO |
$5,296.40
|
| Rate for Payer: BCBS Trust/PPO |
$4,183.75
|
| Rate for Payer: BCN Commercial |
$3,961.00
|
| Rate for Payer: BCN Medicare Advantage |
$5,296.40
|
| Rate for Payer: Cash Price |
$4,087.19
|
| Rate for Payer: Cash Price |
$4,087.19
|
| Rate for Payer: Cofinity Commercial |
$4,802.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,087.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,296.40
|
| Rate for Payer: Healthscope Commercial |
$5,108.99
|
| Rate for Payer: Healthscope Whirlpool |
$4,955.72
|
| Rate for Payer: Humana Choice PPO Medicare |
$5,296.40
|
| Rate for Payer: Mclaren Commercial |
$4,598.09
|
| Rate for Payer: Mclaren Medicaid |
$2,838.87
|
| Rate for Payer: Mclaren Medicare |
$5,296.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,561.22
|
| Rate for Payer: Meridian Medicaid |
$2,980.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,090.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,342.64
|
| Rate for Payer: Nomi Health Commercial |
$4,189.37
|
| Rate for Payer: PACE Medicare |
$5,031.58
|
| Rate for Payer: PACE SWMI |
$5,296.40
|
| Rate for Payer: PHP Commercial |
$5,826.04
|
| Rate for Payer: PHP Medicaid |
$2,838.87
|
| Rate for Payer: PHP Medicare Advantage |
$5,296.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,838.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,320.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$899.99
|
| Rate for Payer: Priority Health Medicare |
$5,296.40
|
| Rate for Payer: Priority Health Narrow Network |
$719.99
|
| Rate for Payer: Railroad Medicare Medicare |
$5,296.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,495.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,296.40
|
| Rate for Payer: UHC Exchange |
$8,209.42
|
| Rate for Payer: UHC Medicare Advantage |
$5,296.40
|
| Rate for Payer: UHCCP DNSP |
$5,296.40
|
| Rate for Payer: UHCCP Medicaid |
$2,838.87
|
| Rate for Payer: VA VA |
$5,296.40
|
|
|
HC ARTERIAL TRANSCATH THROMBOLYSIS
|
Facility
|
IP
|
$5,108.99
|
|
|
Service Code
|
CPT 37211
|
| Hospital Charge Code |
36100371
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,320.84 |
| Max. Negotiated Rate |
$5,108.99 |
| Rate for Payer: Aetna Commercial |
$4,598.09
|
| Rate for Payer: ASR ASR |
$4,955.72
|
| Rate for Payer: ASR Commercial |
$4,955.72
|
| Rate for Payer: BCBS Trust/PPO |
$4,163.32
|
| Rate for Payer: BCN Commercial |
$3,961.00
|
| Rate for Payer: Cash Price |
$4,087.19
|
| Rate for Payer: Cofinity Commercial |
$4,802.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,087.19
|
| Rate for Payer: Healthscope Commercial |
$5,108.99
|
| Rate for Payer: Healthscope Whirlpool |
$4,955.72
|
| Rate for Payer: Mclaren Commercial |
$4,598.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,342.64
|
| Rate for Payer: Nomi Health Commercial |
$4,189.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,320.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,495.91
|
|
|
HC ART FLOW LOWER COMPLETE
|
Facility
|
OP
|
$863.96
|
|
|
Service Code
|
CPT 93923
|
| Hospital Charge Code |
92100030
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$82.17 |
| Max. Negotiated Rate |
$863.96 |
| Rate for Payer: Aetna Commercial |
$777.56
|
| Rate for Payer: Aetna Medicare |
$153.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$191.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$191.62
|
| Rate for Payer: ASR ASR |
$838.04
|
| Rate for Payer: ASR Commercial |
$838.04
|
| Rate for Payer: BCBS Complete |
$86.28
|
| Rate for Payer: BCBS MAPPO |
$153.30
|
| Rate for Payer: BCBS Trust/PPO |
$707.50
|
| Rate for Payer: BCN Commercial |
$669.83
|
| Rate for Payer: BCN Medicare Advantage |
$153.30
|
| Rate for Payer: Cash Price |
$691.17
|
| Rate for Payer: Cash Price |
$691.17
|
| Rate for Payer: Cofinity Commercial |
$812.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$691.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.30
|
| Rate for Payer: Healthscope Commercial |
$863.96
|
| Rate for Payer: Healthscope Whirlpool |
$838.04
|
| Rate for Payer: Humana Choice PPO Medicare |
$153.30
|
| Rate for Payer: Mclaren Commercial |
$777.56
|
| Rate for Payer: Mclaren Medicaid |
$82.17
|
| Rate for Payer: Mclaren Medicare |
$153.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.96
|
| Rate for Payer: Meridian Medicaid |
$86.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$176.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$734.37
|
| Rate for Payer: Nomi Health Commercial |
$708.45
|
| Rate for Payer: PACE Medicare |
$145.64
|
| Rate for Payer: PACE SWMI |
$153.30
|
| Rate for Payer: PHP Commercial |
$168.63
|
| Rate for Payer: PHP Medicaid |
$82.17
|
| Rate for Payer: PHP Medicare Advantage |
$153.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$561.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$233.88
|
| Rate for Payer: Priority Health Medicare |
$153.30
|
| Rate for Payer: Priority Health Narrow Network |
$187.10
|
| Rate for Payer: Railroad Medicare Medicare |
$153.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$760.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.30
|
| Rate for Payer: UHC Exchange |
$237.62
|
| Rate for Payer: UHC Medicare Advantage |
$153.30
|
| Rate for Payer: UHCCP DNSP |
$153.30
|
| Rate for Payer: UHCCP Medicaid |
$82.17
|
| Rate for Payer: VA VA |
$153.30
|
|
|
HC ART FLOW LOWER COMPLETE
|
Facility
|
IP
|
$863.96
|
|
|
Service Code
|
CPT 93923
|
| Hospital Charge Code |
92100030
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$561.57 |
| Max. Negotiated Rate |
$863.96 |
| Rate for Payer: Aetna Commercial |
$777.56
|
| Rate for Payer: ASR ASR |
$838.04
|
| Rate for Payer: ASR Commercial |
$838.04
|
| Rate for Payer: BCBS Trust/PPO |
$704.04
|
| Rate for Payer: BCN Commercial |
$669.83
|
| Rate for Payer: Cash Price |
$691.17
|
| Rate for Payer: Cofinity Commercial |
$812.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$691.17
|
| Rate for Payer: Healthscope Commercial |
$863.96
|
| Rate for Payer: Healthscope Whirlpool |
$838.04
|
| Rate for Payer: Mclaren Commercial |
$777.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$734.37
|
| Rate for Payer: Nomi Health Commercial |
$708.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$561.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$760.28
|
|
|
HC ART FLOW LOWER LIMITED
|
Facility
|
OP
|
$724.60
|
|
|
Service Code
|
CPT 93922
|
| Hospital Charge Code |
92100019
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$67.69 |
| Max. Negotiated Rate |
$724.60 |
| Rate for Payer: Aetna Commercial |
$652.14
|
| Rate for Payer: Aetna Medicare |
$126.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.86
|
| Rate for Payer: ASR ASR |
$702.86
|
| Rate for Payer: ASR Commercial |
$702.86
|
| Rate for Payer: BCBS Complete |
$71.08
|
| Rate for Payer: BCBS MAPPO |
$126.29
|
| Rate for Payer: BCBS Trust/PPO |
$593.37
|
| Rate for Payer: BCN Commercial |
$561.78
|
| Rate for Payer: BCN Medicare Advantage |
$126.29
|
| Rate for Payer: Cash Price |
$579.68
|
| Rate for Payer: Cash Price |
$579.68
|
| Rate for Payer: Cofinity Commercial |
$681.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$579.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.29
|
| Rate for Payer: Healthscope Commercial |
$724.60
|
| Rate for Payer: Healthscope Whirlpool |
$702.86
|
| Rate for Payer: Humana Choice PPO Medicare |
$126.29
|
| Rate for Payer: Mclaren Commercial |
$652.14
|
| Rate for Payer: Mclaren Medicaid |
$67.69
|
| Rate for Payer: Mclaren Medicare |
$126.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.60
|
| Rate for Payer: Meridian Medicaid |
$71.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$145.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$615.91
|
| Rate for Payer: Nomi Health Commercial |
$594.17
|
| Rate for Payer: PACE Medicare |
$119.98
|
| Rate for Payer: PACE SWMI |
$126.29
|
| Rate for Payer: PHP Commercial |
$138.92
|
| Rate for Payer: PHP Medicaid |
$67.69
|
| Rate for Payer: PHP Medicare Advantage |
$126.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$470.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$207.53
|
| Rate for Payer: Priority Health Medicare |
$126.29
|
| Rate for Payer: Priority Health Narrow Network |
$166.02
|
| Rate for Payer: Railroad Medicare Medicare |
$126.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$637.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$126.29
|
| Rate for Payer: UHC Exchange |
$195.75
|
| Rate for Payer: UHC Medicare Advantage |
$126.29
|
| Rate for Payer: UHCCP DNSP |
$126.29
|
| Rate for Payer: UHCCP Medicaid |
$67.69
|
| Rate for Payer: VA VA |
$126.29
|
|
|
HC ART FLOW LOWER LIMITED
|
Facility
|
IP
|
$724.60
|
|
|
Service Code
|
CPT 93922
|
| Hospital Charge Code |
92100019
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$470.99 |
| Max. Negotiated Rate |
$724.60 |
| Rate for Payer: Aetna Commercial |
$652.14
|
| Rate for Payer: ASR ASR |
$702.86
|
| Rate for Payer: ASR Commercial |
$702.86
|
| Rate for Payer: BCBS Trust/PPO |
$590.48
|
| Rate for Payer: BCN Commercial |
$561.78
|
| Rate for Payer: Cash Price |
$579.68
|
| Rate for Payer: Cofinity Commercial |
$681.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$579.68
|
| Rate for Payer: Healthscope Commercial |
$724.60
|
| Rate for Payer: Healthscope Whirlpool |
$702.86
|
| Rate for Payer: Mclaren Commercial |
$652.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$615.91
|
| Rate for Payer: Nomi Health Commercial |
$594.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$470.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$637.65
|
|
|
HC ART FLOW UPPER COMPLETE
|
Facility
|
IP
|
$942.50
|
|
|
Service Code
|
CPT 93923
|
| Hospital Charge Code |
92100018
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$612.62 |
| Max. Negotiated Rate |
$942.50 |
| Rate for Payer: Aetna Commercial |
$848.25
|
| Rate for Payer: ASR ASR |
$914.22
|
| Rate for Payer: ASR Commercial |
$914.22
|
| Rate for Payer: BCBS Trust/PPO |
$768.04
|
| Rate for Payer: BCN Commercial |
$730.72
|
| Rate for Payer: Cash Price |
$754.00
|
| Rate for Payer: Cofinity Commercial |
$885.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$754.00
|
| Rate for Payer: Healthscope Commercial |
$942.50
|
| Rate for Payer: Healthscope Whirlpool |
$914.22
|
| Rate for Payer: Mclaren Commercial |
$848.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$801.12
|
| Rate for Payer: Nomi Health Commercial |
$772.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$612.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$829.40
|
|
|
HC ART FLOW UPPER COMPLETE
|
Facility
|
OP
|
$942.50
|
|
|
Service Code
|
CPT 93923
|
| Hospital Charge Code |
92100018
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$82.17 |
| Max. Negotiated Rate |
$942.50 |
| Rate for Payer: Aetna Commercial |
$848.25
|
| Rate for Payer: Aetna Medicare |
$153.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$191.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$191.62
|
| Rate for Payer: ASR ASR |
$914.22
|
| Rate for Payer: ASR Commercial |
$914.22
|
| Rate for Payer: BCBS Complete |
$86.28
|
| Rate for Payer: BCBS MAPPO |
$153.30
|
| Rate for Payer: BCBS Trust/PPO |
$771.81
|
| Rate for Payer: BCN Commercial |
$730.72
|
| Rate for Payer: BCN Medicare Advantage |
$153.30
|
| Rate for Payer: Cash Price |
$754.00
|
| Rate for Payer: Cash Price |
$754.00
|
| Rate for Payer: Cofinity Commercial |
$885.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$754.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.30
|
| Rate for Payer: Healthscope Commercial |
$942.50
|
| Rate for Payer: Healthscope Whirlpool |
$914.22
|
| Rate for Payer: Humana Choice PPO Medicare |
$153.30
|
| Rate for Payer: Mclaren Commercial |
$848.25
|
| Rate for Payer: Mclaren Medicaid |
$82.17
|
| Rate for Payer: Mclaren Medicare |
$153.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.96
|
| Rate for Payer: Meridian Medicaid |
$86.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$176.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$801.12
|
| Rate for Payer: Nomi Health Commercial |
$772.85
|
| Rate for Payer: PACE Medicare |
$145.64
|
| Rate for Payer: PACE SWMI |
$153.30
|
| Rate for Payer: PHP Commercial |
$168.63
|
| Rate for Payer: PHP Medicaid |
$82.17
|
| Rate for Payer: PHP Medicare Advantage |
$153.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$612.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$233.88
|
| Rate for Payer: Priority Health Medicare |
$153.30
|
| Rate for Payer: Priority Health Narrow Network |
$187.10
|
| Rate for Payer: Railroad Medicare Medicare |
$153.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$829.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.30
|
| Rate for Payer: UHC Exchange |
$237.62
|
| Rate for Payer: UHC Medicare Advantage |
$153.30
|
| Rate for Payer: UHCCP DNSP |
$153.30
|
| Rate for Payer: UHCCP Medicaid |
$82.17
|
| Rate for Payer: VA VA |
$153.30
|
|
|
HC ART FLOW UPPER LIMITED
|
Facility
|
OP
|
$790.47
|
|
|
Service Code
|
CPT 93922
|
| Hospital Charge Code |
92100031
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$67.69 |
| Max. Negotiated Rate |
$790.47 |
| Rate for Payer: Aetna Commercial |
$711.42
|
| Rate for Payer: Aetna Medicare |
$126.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.86
|
| Rate for Payer: ASR ASR |
$766.76
|
| Rate for Payer: ASR Commercial |
$766.76
|
| Rate for Payer: BCBS Complete |
$71.08
|
| Rate for Payer: BCBS MAPPO |
$126.29
|
| Rate for Payer: BCBS Trust/PPO |
$647.32
|
| Rate for Payer: BCN Commercial |
$612.85
|
| Rate for Payer: BCN Medicare Advantage |
$126.29
|
| Rate for Payer: Cash Price |
$632.38
|
| Rate for Payer: Cash Price |
$632.38
|
| Rate for Payer: Cofinity Commercial |
$743.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$632.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.29
|
| Rate for Payer: Healthscope Commercial |
$790.47
|
| Rate for Payer: Healthscope Whirlpool |
$766.76
|
| Rate for Payer: Humana Choice PPO Medicare |
$126.29
|
| Rate for Payer: Mclaren Commercial |
$711.42
|
| Rate for Payer: Mclaren Medicaid |
$67.69
|
| Rate for Payer: Mclaren Medicare |
$126.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.60
|
| Rate for Payer: Meridian Medicaid |
$71.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$145.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$671.90
|
| Rate for Payer: Nomi Health Commercial |
$648.19
|
| Rate for Payer: PACE Medicare |
$119.98
|
| Rate for Payer: PACE SWMI |
$126.29
|
| Rate for Payer: PHP Commercial |
$138.92
|
| Rate for Payer: PHP Medicaid |
$67.69
|
| Rate for Payer: PHP Medicare Advantage |
$126.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$513.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$207.53
|
| Rate for Payer: Priority Health Medicare |
$126.29
|
| Rate for Payer: Priority Health Narrow Network |
$166.02
|
| Rate for Payer: Railroad Medicare Medicare |
$126.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$695.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$126.29
|
| Rate for Payer: UHC Exchange |
$195.75
|
| Rate for Payer: UHC Medicare Advantage |
$126.29
|
| Rate for Payer: UHCCP DNSP |
$126.29
|
| Rate for Payer: UHCCP Medicaid |
$67.69
|
| Rate for Payer: VA VA |
$126.29
|
|
|
HC ART FLOW UPPER LIMITED
|
Facility
|
IP
|
$790.47
|
|
|
Service Code
|
CPT 93922
|
| Hospital Charge Code |
92100031
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$513.81 |
| Max. Negotiated Rate |
$790.47 |
| Rate for Payer: Aetna Commercial |
$711.42
|
| Rate for Payer: ASR ASR |
$766.76
|
| Rate for Payer: ASR Commercial |
$766.76
|
| Rate for Payer: BCBS Trust/PPO |
$644.15
|
| Rate for Payer: BCN Commercial |
$612.85
|
| Rate for Payer: Cash Price |
$632.38
|
| Rate for Payer: Cofinity Commercial |
$743.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$632.38
|
| Rate for Payer: Healthscope Commercial |
$790.47
|
| Rate for Payer: Healthscope Whirlpool |
$766.76
|
| Rate for Payer: Mclaren Commercial |
$711.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$671.90
|
| Rate for Payer: Nomi Health Commercial |
$648.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$513.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$695.61
|
|
