|
HC ARBOVIRUS T LOUIS CMPT
|
Facility
|
IP
|
$26.01
|
|
|
Service Code
|
CPT 86653
|
| Hospital Charge Code |
30200390
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.91 |
| Max. Negotiated Rate |
$26.01 |
| Rate for Payer: Aetna Commercial |
$23.41
|
| Rate for Payer: ASR ASR |
$25.23
|
| Rate for Payer: ASR Commercial |
$25.23
|
| Rate for Payer: BCBS Trust/PPO |
$21.20
|
| Rate for Payer: BCN Commercial |
$20.17
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$24.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$26.01
|
| Rate for Payer: Healthscope Whirlpool |
$25.23
|
| Rate for Payer: Mclaren Commercial |
$23.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: Nomi Health Commercial |
$21.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.89
|
|
|
HC ARBOVIRUS T LOUIS CMPT
|
Facility
|
OP
|
$26.01
|
|
|
Service Code
|
CPT 86653
|
| Hospital Charge Code |
30200390
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.07 |
| Max. Negotiated Rate |
$26.01 |
| Rate for Payer: Aetna Commercial |
$23.41
|
| Rate for Payer: Aetna Medicare |
$13.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.49
|
| Rate for Payer: ASR ASR |
$25.23
|
| Rate for Payer: ASR Commercial |
$25.23
|
| Rate for Payer: BCBS Complete |
$7.42
|
| Rate for Payer: BCBS MAPPO |
$13.19
|
| Rate for Payer: BCBS Trust/PPO |
$21.30
|
| Rate for Payer: BCN Commercial |
$20.17
|
| Rate for Payer: BCN Medicare Advantage |
$13.19
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$24.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.19
|
| Rate for Payer: Healthscope Commercial |
$26.01
|
| Rate for Payer: Healthscope Whirlpool |
$25.23
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.19
|
| Rate for Payer: Mclaren Commercial |
$23.41
|
| Rate for Payer: Mclaren Medicaid |
$7.07
|
| Rate for Payer: Mclaren Medicare |
$13.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.85
|
| Rate for Payer: Meridian Medicaid |
$7.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: Nomi Health Commercial |
$21.33
|
| Rate for Payer: PACE Medicare |
$12.53
|
| Rate for Payer: PACE SWMI |
$13.19
|
| Rate for Payer: PHP Commercial |
$14.51
|
| Rate for Payer: PHP Medicaid |
$7.07
|
| Rate for Payer: PHP Medicare Advantage |
$13.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.79
|
| Rate for Payer: Priority Health Medicare |
$13.19
|
| Rate for Payer: Priority Health Narrow Network |
$18.23
|
| Rate for Payer: Railroad Medicare Medicare |
$13.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.19
|
| Rate for Payer: UHC Exchange |
$20.44
|
| Rate for Payer: UHC Medicare Advantage |
$13.19
|
| Rate for Payer: UHCCP DNSP |
$13.19
|
| Rate for Payer: UHCCP Medicaid |
$7.07
|
| Rate for Payer: VA VA |
$13.19
|
|
|
HC ARBOVIRUS W EQUINE CMPT
|
Facility
|
IP
|
$26.01
|
|
|
Service Code
|
CPT 86654
|
| Hospital Charge Code |
30200391
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.91 |
| Max. Negotiated Rate |
$26.01 |
| Rate for Payer: Aetna Commercial |
$23.41
|
| Rate for Payer: ASR ASR |
$25.23
|
| Rate for Payer: ASR Commercial |
$25.23
|
| Rate for Payer: BCBS Trust/PPO |
$21.20
|
| Rate for Payer: BCN Commercial |
$20.17
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$24.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$26.01
|
| Rate for Payer: Healthscope Whirlpool |
$25.23
|
| Rate for Payer: Mclaren Commercial |
$23.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: Nomi Health Commercial |
$21.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.89
|
|
|
HC ARBOVIRUS W EQUINE CMPT
|
Facility
|
OP
|
$26.01
|
|
|
Service Code
|
CPT 86654
|
| Hospital Charge Code |
30200391
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.07 |
| Max. Negotiated Rate |
$26.01 |
| Rate for Payer: Aetna Commercial |
$23.41
|
| Rate for Payer: Aetna Medicare |
$13.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.49
|
| Rate for Payer: ASR ASR |
$25.23
|
| Rate for Payer: ASR Commercial |
$25.23
|
| Rate for Payer: BCBS Complete |
$7.42
|
| Rate for Payer: BCBS MAPPO |
$13.19
|
| Rate for Payer: BCBS Trust/PPO |
$21.30
|
| Rate for Payer: BCN Commercial |
$20.17
|
| Rate for Payer: BCN Medicare Advantage |
$13.19
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$24.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.19
|
| Rate for Payer: Healthscope Commercial |
$26.01
|
| Rate for Payer: Healthscope Whirlpool |
$25.23
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.19
|
| Rate for Payer: Mclaren Commercial |
$23.41
|
| Rate for Payer: Mclaren Medicaid |
$7.07
|
| Rate for Payer: Mclaren Medicare |
$13.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.85
|
| Rate for Payer: Meridian Medicaid |
$7.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: Nomi Health Commercial |
$21.33
|
| Rate for Payer: PACE Medicare |
$12.53
|
| Rate for Payer: PACE SWMI |
$13.19
|
| Rate for Payer: PHP Commercial |
$14.51
|
| Rate for Payer: PHP Medicaid |
$7.07
|
| Rate for Payer: PHP Medicare Advantage |
$13.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.79
|
| Rate for Payer: Priority Health Medicare |
$13.19
|
| Rate for Payer: Priority Health Narrow Network |
$18.23
|
| Rate for Payer: Railroad Medicare Medicare |
$13.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.19
|
| Rate for Payer: UHC Exchange |
$20.44
|
| Rate for Payer: UHC Medicare Advantage |
$13.19
|
| Rate for Payer: UHCCP DNSP |
$13.19
|
| Rate for Payer: UHCCP Medicaid |
$7.07
|
| Rate for Payer: VA VA |
$13.19
|
|
|
HC ARCTIC SUN TORSO/LEG PADS
|
Facility
|
IP
|
$2,580.84
|
|
| Hospital Charge Code |
27000610
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,677.55 |
| Max. Negotiated Rate |
$2,580.84 |
| Rate for Payer: Aetna Commercial |
$2,322.76
|
| Rate for Payer: ASR ASR |
$2,503.41
|
| Rate for Payer: ASR Commercial |
$2,503.41
|
| Rate for Payer: BCBS Trust/PPO |
$2,103.13
|
| Rate for Payer: BCN Commercial |
$2,000.93
|
| Rate for Payer: Cash Price |
$2,064.67
|
| Rate for Payer: Cofinity Commercial |
$2,425.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,064.67
|
| Rate for Payer: Healthscope Commercial |
$2,580.84
|
| Rate for Payer: Healthscope Whirlpool |
$2,503.41
|
| Rate for Payer: Mclaren Commercial |
$2,322.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,193.71
|
| Rate for Payer: Nomi Health Commercial |
$2,116.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,677.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,271.14
|
|
|
HC ARCTIC SUN TORSO/LEG PADS
|
Facility
|
OP
|
$2,580.84
|
|
| Hospital Charge Code |
27000610
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,032.34 |
| Max. Negotiated Rate |
$2,580.84 |
| Rate for Payer: Aetna Commercial |
$2,322.76
|
| Rate for Payer: Aetna Medicare |
$1,290.42
|
| Rate for Payer: ASR ASR |
$2,503.41
|
| Rate for Payer: ASR Commercial |
$2,503.41
|
| Rate for Payer: BCBS Complete |
$1,032.34
|
| Rate for Payer: BCBS Trust/PPO |
$2,113.45
|
| Rate for Payer: BCN Commercial |
$2,000.93
|
| Rate for Payer: Cash Price |
$2,064.67
|
| Rate for Payer: Cofinity Commercial |
$2,425.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,064.67
|
| Rate for Payer: Healthscope Commercial |
$2,580.84
|
| Rate for Payer: Healthscope Whirlpool |
$2,503.41
|
| Rate for Payer: Mclaren Commercial |
$2,322.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,193.71
|
| Rate for Payer: Nomi Health Commercial |
$2,116.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,677.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,261.33
|
| Rate for Payer: Priority Health Narrow Network |
$1,809.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,271.14
|
|
|
HC ARCTIC SUN UNIVERSAL PAD
|
Facility
|
OP
|
$1,118.37
|
|
| Hospital Charge Code |
27000617
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$447.35 |
| Max. Negotiated Rate |
$1,118.37 |
| Rate for Payer: Aetna Commercial |
$1,006.53
|
| Rate for Payer: Aetna Medicare |
$559.18
|
| Rate for Payer: ASR ASR |
$1,084.82
|
| Rate for Payer: ASR Commercial |
$1,084.82
|
| Rate for Payer: BCBS Complete |
$447.35
|
| Rate for Payer: BCBS Trust/PPO |
$915.83
|
| Rate for Payer: BCN Commercial |
$867.07
|
| Rate for Payer: Cash Price |
$894.70
|
| Rate for Payer: Cofinity Commercial |
$1,051.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$894.70
|
| Rate for Payer: Healthscope Commercial |
$1,118.37
|
| Rate for Payer: Healthscope Whirlpool |
$1,084.82
|
| Rate for Payer: Mclaren Commercial |
$1,006.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$950.61
|
| Rate for Payer: Nomi Health Commercial |
$917.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$726.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$979.92
|
| Rate for Payer: Priority Health Narrow Network |
$783.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$984.17
|
|
|
HC ARCTIC SUN UNIVERSAL PAD
|
Facility
|
IP
|
$1,118.37
|
|
| Hospital Charge Code |
27000617
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$726.94 |
| Max. Negotiated Rate |
$1,118.37 |
| Rate for Payer: Aetna Commercial |
$1,006.53
|
| Rate for Payer: ASR ASR |
$1,084.82
|
| Rate for Payer: ASR Commercial |
$1,084.82
|
| Rate for Payer: BCBS Trust/PPO |
$911.36
|
| Rate for Payer: BCN Commercial |
$867.07
|
| Rate for Payer: Cash Price |
$894.70
|
| Rate for Payer: Cofinity Commercial |
$1,051.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$894.70
|
| Rate for Payer: Healthscope Commercial |
$1,118.37
|
| Rate for Payer: Healthscope Whirlpool |
$1,084.82
|
| Rate for Payer: Mclaren Commercial |
$1,006.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$950.61
|
| Rate for Payer: Nomi Health Commercial |
$917.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$726.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$984.17
|
|
|
HC ARGON PLASMA COAGULATION
|
Facility
|
IP
|
$1,860.09
|
|
| Hospital Charge Code |
36000007
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,209.06 |
| Max. Negotiated Rate |
$1,860.09 |
| Rate for Payer: Aetna Commercial |
$1,674.08
|
| Rate for Payer: ASR ASR |
$1,804.29
|
| Rate for Payer: ASR Commercial |
$1,804.29
|
| Rate for Payer: BCBS Trust/PPO |
$1,515.79
|
| Rate for Payer: BCN Commercial |
$1,442.13
|
| Rate for Payer: Cash Price |
$1,488.07
|
| Rate for Payer: Cofinity Commercial |
$1,748.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,488.07
|
| Rate for Payer: Healthscope Commercial |
$1,860.09
|
| Rate for Payer: Healthscope Whirlpool |
$1,804.29
|
| Rate for Payer: Mclaren Commercial |
$1,674.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,581.08
|
| Rate for Payer: Nomi Health Commercial |
$1,525.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,209.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,636.88
|
|
|
HC ARGON PLASMA COAGULATION
|
Facility
|
OP
|
$1,860.09
|
|
| Hospital Charge Code |
36000007
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$744.04 |
| Max. Negotiated Rate |
$1,860.09 |
| Rate for Payer: Aetna Commercial |
$1,674.08
|
| Rate for Payer: Aetna Medicare |
$930.04
|
| Rate for Payer: ASR ASR |
$1,804.29
|
| Rate for Payer: ASR Commercial |
$1,804.29
|
| Rate for Payer: BCBS Complete |
$744.04
|
| Rate for Payer: BCBS Trust/PPO |
$1,523.23
|
| Rate for Payer: BCN Commercial |
$1,442.13
|
| Rate for Payer: Cash Price |
$1,488.07
|
| Rate for Payer: Cofinity Commercial |
$1,748.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,488.07
|
| Rate for Payer: Healthscope Commercial |
$1,860.09
|
| Rate for Payer: Healthscope Whirlpool |
$1,804.29
|
| Rate for Payer: Mclaren Commercial |
$1,674.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,581.08
|
| Rate for Payer: Nomi Health Commercial |
$1,525.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,209.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,629.81
|
| Rate for Payer: Priority Health Narrow Network |
$1,303.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,636.88
|
|
|
HC ARISTA HEMOSTAT
|
Facility
|
IP
|
$1,141.67
|
|
| Hospital Charge Code |
27200111
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$742.09 |
| Max. Negotiated Rate |
$1,141.67 |
| Rate for Payer: Aetna Commercial |
$1,027.50
|
| Rate for Payer: ASR ASR |
$1,107.42
|
| Rate for Payer: ASR Commercial |
$1,107.42
|
| Rate for Payer: BCBS Trust/PPO |
$930.35
|
| Rate for Payer: BCN Commercial |
$885.14
|
| Rate for Payer: Cash Price |
$913.34
|
| Rate for Payer: Cofinity Commercial |
$1,073.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$913.34
|
| Rate for Payer: Healthscope Commercial |
$1,141.67
|
| Rate for Payer: Healthscope Whirlpool |
$1,107.42
|
| Rate for Payer: Mclaren Commercial |
$1,027.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$970.42
|
| Rate for Payer: Nomi Health Commercial |
$936.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$742.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,004.67
|
|
|
HC ARISTA HEMOSTAT
|
Facility
|
OP
|
$1,141.67
|
|
| Hospital Charge Code |
27200111
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$456.67 |
| Max. Negotiated Rate |
$1,141.67 |
| Rate for Payer: Aetna Commercial |
$1,027.50
|
| Rate for Payer: Aetna Medicare |
$570.84
|
| Rate for Payer: ASR ASR |
$1,107.42
|
| Rate for Payer: ASR Commercial |
$1,107.42
|
| Rate for Payer: BCBS Complete |
$456.67
|
| Rate for Payer: BCBS Trust/PPO |
$934.91
|
| Rate for Payer: BCN Commercial |
$885.14
|
| Rate for Payer: Cash Price |
$913.34
|
| Rate for Payer: Cofinity Commercial |
$1,073.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$913.34
|
| Rate for Payer: Healthscope Commercial |
$1,141.67
|
| Rate for Payer: Healthscope Whirlpool |
$1,107.42
|
| Rate for Payer: Mclaren Commercial |
$1,027.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$970.42
|
| Rate for Payer: Nomi Health Commercial |
$936.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$742.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,000.33
|
| Rate for Payer: Priority Health Narrow Network |
$800.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,004.67
|
|
|
HC ARRAY COMPARATIVE GENOMIC ACGH
|
Facility
|
IP
|
$1,597.01
|
|
|
Service Code
|
CPT 81228
|
| Hospital Charge Code |
31000094
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$1,038.06 |
| Max. Negotiated Rate |
$1,597.01 |
| Rate for Payer: Aetna Commercial |
$1,437.31
|
| Rate for Payer: ASR ASR |
$1,549.10
|
| Rate for Payer: ASR Commercial |
$1,549.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,301.40
|
| Rate for Payer: BCN Commercial |
$1,238.16
|
| Rate for Payer: Cash Price |
$1,277.61
|
| Rate for Payer: Cofinity Commercial |
$1,501.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,277.61
|
| Rate for Payer: Healthscope Commercial |
$1,597.01
|
| Rate for Payer: Healthscope Whirlpool |
$1,549.10
|
| Rate for Payer: Mclaren Commercial |
$1,437.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,357.46
|
| Rate for Payer: Nomi Health Commercial |
$1,309.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,038.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,405.37
|
|
|
HC ARRAY COMPARATIVE GENOMIC ACGH
|
Facility
|
OP
|
$1,597.01
|
|
|
Service Code
|
CPT 81228
|
| Hospital Charge Code |
31000094
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$482.40 |
| Max. Negotiated Rate |
$1,597.01 |
| Rate for Payer: Aetna Commercial |
$1,437.31
|
| Rate for Payer: Aetna Medicare |
$900.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,125.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,125.00
|
| Rate for Payer: ASR ASR |
$1,549.10
|
| Rate for Payer: ASR Commercial |
$1,549.10
|
| Rate for Payer: BCBS Complete |
$506.52
|
| Rate for Payer: BCBS MAPPO |
$900.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,307.79
|
| Rate for Payer: BCN Commercial |
$1,238.16
|
| Rate for Payer: BCN Medicare Advantage |
$900.00
|
| Rate for Payer: Cash Price |
$1,277.61
|
| Rate for Payer: Cash Price |
$1,277.61
|
| Rate for Payer: Cofinity Commercial |
$1,501.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,277.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$900.00
|
| Rate for Payer: Healthscope Commercial |
$1,597.01
|
| Rate for Payer: Healthscope Whirlpool |
$1,549.10
|
| Rate for Payer: Humana Choice PPO Medicare |
$900.00
|
| Rate for Payer: Mclaren Commercial |
$1,437.31
|
| Rate for Payer: Mclaren Medicaid |
$482.40
|
| Rate for Payer: Mclaren Medicare |
$900.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$945.00
|
| Rate for Payer: Meridian Medicaid |
$506.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,035.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,357.46
|
| Rate for Payer: Nomi Health Commercial |
$1,309.55
|
| Rate for Payer: PACE Medicare |
$855.00
|
| Rate for Payer: PACE SWMI |
$900.00
|
| Rate for Payer: PHP Commercial |
$990.00
|
| Rate for Payer: PHP Medicaid |
$482.40
|
| Rate for Payer: PHP Medicare Advantage |
$900.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$482.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,038.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,399.30
|
| Rate for Payer: Priority Health Medicare |
$900.00
|
| Rate for Payer: Priority Health Narrow Network |
$1,119.50
|
| Rate for Payer: Railroad Medicare Medicare |
$900.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,405.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$900.00
|
| Rate for Payer: UHC Exchange |
$1,395.00
|
| Rate for Payer: UHC Medicare Advantage |
$900.00
|
| Rate for Payer: UHCCP DNSP |
$900.00
|
| Rate for Payer: UHCCP Medicaid |
$482.40
|
| Rate for Payer: VA VA |
$900.00
|
|
|
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 |
$918.25 |
| 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 |
$918.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,243.18
|
|
|
HC ARRAY COMPARATIVE GENOMIC CMPT
|
Facility
|
OP
|
$1,412.70
|
|
|
Service Code
|
CPT 88399
|
| Hospital Charge Code |
31000061
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$27.93 |
| Max. Negotiated Rate |
$1,412.70 |
| Rate for Payer: Aetna Commercial |
$1,271.43
|
| Rate for Payer: Aetna Medicare |
$52.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$65.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$65.14
|
| Rate for Payer: ASR ASR |
$1,370.32
|
| Rate for Payer: ASR Commercial |
$1,370.32
|
| Rate for Payer: BCBS Complete |
$29.33
|
| Rate for Payer: BCBS MAPPO |
$52.11
|
| Rate for Payer: BCBS Trust/PPO |
$1,156.86
|
| Rate for Payer: BCN Commercial |
$1,095.27
|
| Rate for Payer: BCN Medicare Advantage |
$52.11
|
| Rate for Payer: Cash Price |
$1,130.16
|
| 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: Health Alliance Plan Medicare Advantage |
$52.11
|
| Rate for Payer: Healthscope Commercial |
$1,412.70
|
| Rate for Payer: Healthscope Whirlpool |
$1,370.32
|
| Rate for Payer: Humana Choice PPO Medicare |
$52.11
|
| Rate for Payer: Mclaren Commercial |
$1,271.43
|
| Rate for Payer: Mclaren Medicaid |
$27.93
|
| Rate for Payer: Mclaren Medicare |
$52.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$54.72
|
| Rate for Payer: Meridian Medicaid |
$29.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,200.80
|
| Rate for Payer: Nomi Health Commercial |
$1,158.41
|
| Rate for Payer: PACE Medicare |
$49.50
|
| Rate for Payer: PACE SWMI |
$52.11
|
| Rate for Payer: PHP Commercial |
$57.32
|
| Rate for Payer: PHP Medicaid |
$27.93
|
| Rate for Payer: PHP Medicare Advantage |
$52.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$918.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,237.81
|
| Rate for Payer: Priority Health Medicare |
$52.11
|
| Rate for Payer: Priority Health Narrow Network |
$990.30
|
| Rate for Payer: Railroad Medicare Medicare |
$52.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,243.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$52.11
|
| Rate for Payer: UHC Exchange |
$80.77
|
| Rate for Payer: UHC Medicare Advantage |
$52.11
|
| Rate for Payer: UHCCP DNSP |
$52.11
|
| Rate for Payer: UHCCP Medicaid |
$27.93
|
| Rate for Payer: VA VA |
$52.11
|
|
|
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
|
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 |
$171.77
|
| Rate for Payer: Priority Health Medicare |
$18.97
|
| Rate for Payer: Priority Health Narrow Network |
$137.42
|
| 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 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 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 |
$114.24 |
| 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 |
$100.10
|
| Rate for Payer: Priority Health Medicare |
$18.97
|
| Rate for Payer: Priority Health Narrow Network |
$80.08
|
| 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 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 |
$65.28 |
| 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 |
$57.20
|
| Rate for Payer: Priority Health Medicare |
$18.97
|
| Rate for Payer: Priority Health Narrow Network |
$45.76
|
| 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 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 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 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 |
$226.35
|
| 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 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 |
$126.36 |
| Max. Negotiated Rate |
$1,588.11 |
| Rate for Payer: Aetna Commercial |
$1,429.30
|
| Rate for Payer: Aetna Medicare |
$235.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$294.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$294.68
|
| Rate for Payer: ASR ASR |
$1,540.47
|
| Rate for Payer: ASR Commercial |
$1,540.47
|
| Rate for Payer: BCBS Complete |
$132.67
|
| Rate for Payer: BCBS MAPPO |
$235.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,300.50
|
| Rate for Payer: BCN Commercial |
$1,231.26
|
| Rate for Payer: BCN Medicare Advantage |
$235.74
|
| 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 |
$235.74
|
| Rate for Payer: Healthscope Commercial |
$1,588.11
|
| Rate for Payer: Healthscope Whirlpool |
$1,540.47
|
| Rate for Payer: Humana Choice PPO Medicare |
$235.74
|
| Rate for Payer: Mclaren Commercial |
$1,429.30
|
| Rate for Payer: Mclaren Medicaid |
$126.36
|
| Rate for Payer: Mclaren Medicare |
$235.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.53
|
| Rate for Payer: Meridian Medicaid |
$132.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$271.10
|
| 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 |
$223.95
|
| Rate for Payer: PACE SWMI |
$235.74
|
| Rate for Payer: PHP Commercial |
$259.31
|
| Rate for Payer: PHP Medicaid |
$126.36
|
| Rate for Payer: PHP Medicare Advantage |
$235.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.36
|
| 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 |
$235.74
|
| Rate for Payer: Priority Health Narrow Network |
$1,113.27
|
| Rate for Payer: Railroad Medicare Medicare |
$235.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,397.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.74
|
| Rate for Payer: UHC Exchange |
$365.40
|
| Rate for Payer: UHC Medicare Advantage |
$235.74
|
| Rate for Payer: UHCCP DNSP |
$235.74
|
| Rate for Payer: UHCCP Medicaid |
$126.36
|
| Rate for Payer: VA VA |
$235.74
|
|
