|
HC BREATH HYDROGEN/METHANE TEST
|
Facility
|
IP
|
$370.36
|
|
|
Service Code
|
CPT 91065
|
| Hospital Charge Code |
75000012
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$277.77 |
| Max. Negotiated Rate |
$370.36 |
| Rate for Payer: Aetna Commercial |
$333.32
|
| Rate for Payer: ASR ASR |
$359.25
|
| Rate for Payer: BCBS Trust/PPO |
$304.14
|
| Rate for Payer: BCN Commercial |
$304.14
|
| Rate for Payer: Cash Price |
$296.29
|
| Rate for Payer: Cofinity Commercial |
$348.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$296.29
|
| Rate for Payer: Healthscope Commercial |
$359.25
|
| Rate for Payer: Healthscope Whirlpool |
$370.36
|
| Rate for Payer: Mclaren Commercial |
$333.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$314.81
|
| Rate for Payer: Nomi Health Commercial |
$303.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$277.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$325.92
|
|
|
HC BRIEF EMOTIONAL/BEHAVIORAL ASSESSMENT
|
Facility
|
IP
|
$25.97
|
|
|
Service Code
|
CPT 96127
|
| Hospital Charge Code |
91800002
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$19.48 |
| Max. Negotiated Rate |
$25.97 |
| Rate for Payer: Aetna Commercial |
$23.37
|
| Rate for Payer: ASR ASR |
$25.19
|
| Rate for Payer: BCBS Trust/PPO |
$21.33
|
| Rate for Payer: BCN Commercial |
$21.33
|
| Rate for Payer: Cash Price |
$20.78
|
| Rate for Payer: Cofinity Commercial |
$24.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.78
|
| Rate for Payer: Healthscope Commercial |
$25.19
|
| Rate for Payer: Healthscope Whirlpool |
$25.97
|
| Rate for Payer: Mclaren Commercial |
$23.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.07
|
| Rate for Payer: Nomi Health Commercial |
$21.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.85
|
|
|
HC BRIEF EMOTIONAL/BEHAVIORAL ASSESSMENT
|
Facility
|
OP
|
$25.97
|
|
|
Service Code
|
CPT 96127
|
| Hospital Charge Code |
91800002
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$18.20 |
| Max. Negotiated Rate |
$57.69 |
| Rate for Payer: Aetna Commercial |
$23.37
|
| Rate for Payer: Aetna Medicare |
$37.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$46.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$46.52
|
| Rate for Payer: ASR ASR |
$25.19
|
| Rate for Payer: BCBS Complete |
$20.44
|
| Rate for Payer: BCBS MAPPO |
$37.22
|
| Rate for Payer: BCBS Trust/PPO |
$21.41
|
| Rate for Payer: BCN Commercial |
$21.41
|
| Rate for Payer: BCN Medicare Advantage |
$37.22
|
| Rate for Payer: Cash Price |
$20.78
|
| Rate for Payer: Cash Price |
$20.78
|
| Rate for Payer: Cofinity Commercial |
$24.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.22
|
| Rate for Payer: Healthscope Commercial |
$25.19
|
| Rate for Payer: Healthscope Whirlpool |
$25.97
|
| Rate for Payer: Humana Choice PPO Medicare |
$37.22
|
| Rate for Payer: Mclaren Commercial |
$23.37
|
| Rate for Payer: Mclaren Medicaid |
$37.22
|
| Rate for Payer: Mclaren Medicare |
$37.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.08
|
| Rate for Payer: Meridian Medicaid |
$20.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$40.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.07
|
| Rate for Payer: Nomi Health Commercial |
$21.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.48
|
| Rate for Payer: PACE Medicare |
$35.36
|
| Rate for Payer: PACE SWMI |
$37.22
|
| Rate for Payer: PHP Commercial |
$40.94
|
| Rate for Payer: PHP Medicaid |
$19.95
|
| Rate for Payer: PHP Medicare Advantage |
$37.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$22.75
|
| Rate for Payer: Priority Health Medicare |
$37.22
|
| Rate for Payer: Priority Health Narrow Network |
$18.20
|
| Rate for Payer: Railroad Medicare Medicare |
$37.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$37.22
|
| Rate for Payer: UHC Exchange |
$57.69
|
| Rate for Payer: UHC Medicaid |
$19.47
|
| Rate for Payer: UHCCP DNSP |
$37.22
|
| Rate for Payer: UHCCP Medicaid |
$19.47
|
| Rate for Payer: VA VA |
$37.22
|
|
|
HC BRONCH CMPTR ASST IMAGE ADD ON
|
Facility
|
IP
|
$263.19
|
|
| Hospital Charge Code |
75000007
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$197.39 |
| Max. Negotiated Rate |
$263.19 |
| Rate for Payer: Aetna Commercial |
$236.87
|
| Rate for Payer: ASR ASR |
$255.29
|
| Rate for Payer: BCBS Trust/PPO |
$216.13
|
| Rate for Payer: BCN Commercial |
$216.13
|
| Rate for Payer: Cash Price |
$210.55
|
| Rate for Payer: Cofinity Commercial |
$247.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$210.55
|
| Rate for Payer: Healthscope Commercial |
$255.29
|
| Rate for Payer: Healthscope Whirlpool |
$263.19
|
| Rate for Payer: Mclaren Commercial |
$236.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$223.71
|
| Rate for Payer: Nomi Health Commercial |
$215.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$197.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$231.61
|
|
|
HC BRONCH CMPTR ASST IMAGE ADD ON
|
Facility
|
OP
|
$263.19
|
|
| Hospital Charge Code |
75000007
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$97.38 |
| Max. Negotiated Rate |
$263.19 |
| Rate for Payer: Aetna Commercial |
$236.87
|
| Rate for Payer: Aetna Medicare |
$97.38
|
| Rate for Payer: ASR ASR |
$255.29
|
| Rate for Payer: BCBS Complete |
$105.28
|
| Rate for Payer: BCBS Trust/PPO |
$217.00
|
| Rate for Payer: BCN Commercial |
$217.00
|
| Rate for Payer: Cash Price |
$210.55
|
| Rate for Payer: Cofinity Commercial |
$247.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$210.55
|
| Rate for Payer: Healthscope Commercial |
$255.29
|
| Rate for Payer: Healthscope Whirlpool |
$263.19
|
| Rate for Payer: Mclaren Commercial |
$236.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$210.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$223.71
|
| Rate for Payer: Nomi Health Commercial |
$215.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$197.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$230.61
|
| Rate for Payer: Priority Health Narrow Network |
$184.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$231.61
|
|
|
HC BRONCHIAL NAVIGATION
|
Facility
|
OP
|
$3,165.75
|
|
| Hospital Charge Code |
36000102
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,171.33 |
| Max. Negotiated Rate |
$3,165.75 |
| Rate for Payer: Aetna Commercial |
$2,849.18
|
| Rate for Payer: Aetna Medicare |
$1,171.33
|
| Rate for Payer: ASR ASR |
$3,070.78
|
| Rate for Payer: BCBS Complete |
$1,266.30
|
| Rate for Payer: BCBS Trust/PPO |
$2,610.16
|
| Rate for Payer: BCN Commercial |
$2,610.16
|
| Rate for Payer: Cash Price |
$2,532.60
|
| Rate for Payer: Cofinity Commercial |
$2,975.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,532.60
|
| Rate for Payer: Healthscope Commercial |
$3,070.78
|
| Rate for Payer: Healthscope Whirlpool |
$3,165.75
|
| Rate for Payer: Mclaren Commercial |
$2,849.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,532.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,690.89
|
| Rate for Payer: Nomi Health Commercial |
$2,595.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,374.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,773.83
|
| Rate for Payer: Priority Health Narrow Network |
$2,219.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,785.86
|
|
|
HC BRONCHIAL NAVIGATION
|
Facility
|
IP
|
$3,165.75
|
|
| Hospital Charge Code |
36000102
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,374.31 |
| Max. Negotiated Rate |
$3,165.75 |
| Rate for Payer: Aetna Commercial |
$2,849.18
|
| Rate for Payer: ASR ASR |
$3,070.78
|
| Rate for Payer: BCBS Trust/PPO |
$2,599.71
|
| Rate for Payer: BCN Commercial |
$2,599.71
|
| Rate for Payer: Cash Price |
$2,532.60
|
| Rate for Payer: Cofinity Commercial |
$2,975.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,532.60
|
| Rate for Payer: Healthscope Commercial |
$3,070.78
|
| Rate for Payer: Healthscope Whirlpool |
$3,165.75
|
| Rate for Payer: Mclaren Commercial |
$2,849.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,690.89
|
| Rate for Payer: Nomi Health Commercial |
$2,595.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,374.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,785.86
|
|
|
HC BRONCHO HYGIENE INITIAL
|
Facility
|
IP
|
$279.24
|
|
|
Service Code
|
CPT 94667
|
| Hospital Charge Code |
41000010
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$209.43 |
| Max. Negotiated Rate |
$279.24 |
| Rate for Payer: Aetna Commercial |
$251.32
|
| Rate for Payer: ASR ASR |
$270.86
|
| Rate for Payer: BCBS Trust/PPO |
$229.31
|
| Rate for Payer: BCN Commercial |
$229.31
|
| Rate for Payer: Cash Price |
$223.39
|
| Rate for Payer: Cofinity Commercial |
$262.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$223.39
|
| Rate for Payer: Healthscope Commercial |
$270.86
|
| Rate for Payer: Healthscope Whirlpool |
$279.24
|
| Rate for Payer: Mclaren Commercial |
$251.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$237.35
|
| Rate for Payer: Nomi Health Commercial |
$228.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$209.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$245.73
|
|
|
HC BRONCHO HYGIENE INITIAL
|
Facility
|
OP
|
$279.24
|
|
|
Service Code
|
CPT 94667
|
| Hospital Charge Code |
41000010
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$63.92 |
| Max. Negotiated Rate |
$279.24 |
| Rate for Payer: Aetna Commercial |
$251.32
|
| Rate for Payer: Aetna Medicare |
$132.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$165.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$165.71
|
| Rate for Payer: ASR ASR |
$270.86
|
| Rate for Payer: BCBS Complete |
$72.81
|
| Rate for Payer: BCBS MAPPO |
$132.57
|
| Rate for Payer: BCBS Trust/PPO |
$230.23
|
| Rate for Payer: BCN Commercial |
$230.23
|
| Rate for Payer: BCN Medicare Advantage |
$132.57
|
| Rate for Payer: Cash Price |
$223.39
|
| Rate for Payer: Cash Price |
$223.39
|
| Rate for Payer: Cofinity Commercial |
$262.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$223.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.57
|
| Rate for Payer: Healthscope Commercial |
$270.86
|
| Rate for Payer: Healthscope Whirlpool |
$279.24
|
| Rate for Payer: Humana Choice PPO Medicare |
$132.57
|
| Rate for Payer: Mclaren Commercial |
$251.32
|
| Rate for Payer: Mclaren Medicaid |
$132.57
|
| Rate for Payer: Mclaren Medicare |
$132.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$139.20
|
| Rate for Payer: Meridian Medicaid |
$72.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$145.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$237.35
|
| Rate for Payer: Nomi Health Commercial |
$228.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$209.43
|
| Rate for Payer: PACE Medicare |
$125.94
|
| Rate for Payer: PACE SWMI |
$132.57
|
| Rate for Payer: PHP Commercial |
$145.83
|
| Rate for Payer: PHP Medicaid |
$71.06
|
| Rate for Payer: PHP Medicare Advantage |
$132.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$79.89
|
| Rate for Payer: Priority Health Medicare |
$132.57
|
| Rate for Payer: Priority Health Narrow Network |
$63.92
|
| Rate for Payer: Railroad Medicare Medicare |
$132.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$245.73
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$132.57
|
| Rate for Payer: UHC Exchange |
$205.48
|
| Rate for Payer: UHC Medicaid |
$69.33
|
| Rate for Payer: UHCCP DNSP |
$132.57
|
| Rate for Payer: UHCCP Medicaid |
$69.33
|
| Rate for Payer: VA VA |
$132.57
|
|
|
HC BRONCHO HYGIENE SUBS
|
Facility
|
OP
|
$268.38
|
|
|
Service Code
|
CPT 94668
|
| Hospital Charge Code |
41000011
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$55.21 |
| Max. Negotiated Rate |
$268.38 |
| Rate for Payer: Aetna Commercial |
$241.54
|
| Rate for Payer: Aetna Medicare |
$132.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$165.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$165.71
|
| Rate for Payer: ASR ASR |
$260.33
|
| Rate for Payer: BCBS Complete |
$72.81
|
| Rate for Payer: BCBS MAPPO |
$132.57
|
| Rate for Payer: BCBS Trust/PPO |
$221.28
|
| Rate for Payer: BCN Commercial |
$221.28
|
| Rate for Payer: BCN Medicare Advantage |
$132.57
|
| Rate for Payer: Cash Price |
$214.70
|
| Rate for Payer: Cash Price |
$214.70
|
| Rate for Payer: Cofinity Commercial |
$252.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$214.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.57
|
| Rate for Payer: Healthscope Commercial |
$260.33
|
| Rate for Payer: Healthscope Whirlpool |
$268.38
|
| Rate for Payer: Humana Choice PPO Medicare |
$132.57
|
| Rate for Payer: Mclaren Commercial |
$241.54
|
| Rate for Payer: Mclaren Medicaid |
$132.57
|
| Rate for Payer: Mclaren Medicare |
$132.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$139.20
|
| Rate for Payer: Meridian Medicaid |
$72.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$145.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$228.12
|
| Rate for Payer: Nomi Health Commercial |
$220.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$201.28
|
| Rate for Payer: PACE Medicare |
$125.94
|
| Rate for Payer: PACE SWMI |
$132.57
|
| Rate for Payer: PHP Commercial |
$145.83
|
| Rate for Payer: PHP Medicaid |
$71.06
|
| Rate for Payer: PHP Medicare Advantage |
$132.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$69.02
|
| Rate for Payer: Priority Health Medicare |
$132.57
|
| Rate for Payer: Priority Health Narrow Network |
$55.21
|
| Rate for Payer: Railroad Medicare Medicare |
$132.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$236.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$132.57
|
| Rate for Payer: UHC Exchange |
$205.48
|
| Rate for Payer: UHC Medicaid |
$69.33
|
| Rate for Payer: UHCCP DNSP |
$132.57
|
| Rate for Payer: UHCCP Medicaid |
$69.33
|
| Rate for Payer: VA VA |
$132.57
|
|
|
HC BRONCHO HYGIENE SUBS
|
Facility
|
IP
|
$268.38
|
|
|
Service Code
|
CPT 94668
|
| Hospital Charge Code |
41000011
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$201.28 |
| Max. Negotiated Rate |
$268.38 |
| Rate for Payer: Aetna Commercial |
$241.54
|
| Rate for Payer: ASR ASR |
$260.33
|
| Rate for Payer: BCBS Trust/PPO |
$220.39
|
| Rate for Payer: BCN Commercial |
$220.39
|
| Rate for Payer: Cash Price |
$214.70
|
| Rate for Payer: Cofinity Commercial |
$252.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$214.70
|
| Rate for Payer: Healthscope Commercial |
$260.33
|
| Rate for Payer: Healthscope Whirlpool |
$268.38
|
| Rate for Payer: Mclaren Commercial |
$241.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$228.12
|
| Rate for Payer: Nomi Health Commercial |
$220.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$201.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$236.17
|
|
|
HC BRONCHOSCOPY
|
Facility
|
OP
|
$2,616.10
|
|
| Hospital Charge Code |
36000014
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$967.96 |
| Max. Negotiated Rate |
$2,616.10 |
| Rate for Payer: Aetna Commercial |
$2,354.49
|
| Rate for Payer: Aetna Medicare |
$967.96
|
| Rate for Payer: ASR ASR |
$2,537.62
|
| Rate for Payer: BCBS Complete |
$1,046.44
|
| Rate for Payer: BCBS Trust/PPO |
$2,156.97
|
| Rate for Payer: BCN Commercial |
$2,156.97
|
| Rate for Payer: Cash Price |
$2,092.88
|
| Rate for Payer: Cofinity Commercial |
$2,459.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,092.88
|
| Rate for Payer: Healthscope Commercial |
$2,537.62
|
| Rate for Payer: Healthscope Whirlpool |
$2,616.10
|
| Rate for Payer: Mclaren Commercial |
$2,354.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,092.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,223.68
|
| Rate for Payer: Nomi Health Commercial |
$2,145.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,962.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,292.23
|
| Rate for Payer: Priority Health Narrow Network |
$1,833.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,302.17
|
|
|
HC BRONCHOSCOPY
|
Facility
|
IP
|
$2,616.10
|
|
| Hospital Charge Code |
36000014
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,962.08 |
| Max. Negotiated Rate |
$2,616.10 |
| Rate for Payer: Aetna Commercial |
$2,354.49
|
| Rate for Payer: ASR ASR |
$2,537.62
|
| Rate for Payer: BCBS Trust/PPO |
$2,148.34
|
| Rate for Payer: BCN Commercial |
$2,148.34
|
| Rate for Payer: Cash Price |
$2,092.88
|
| Rate for Payer: Cofinity Commercial |
$2,459.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,092.88
|
| Rate for Payer: Healthscope Commercial |
$2,537.62
|
| Rate for Payer: Healthscope Whirlpool |
$2,616.10
|
| Rate for Payer: Mclaren Commercial |
$2,354.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,223.68
|
| Rate for Payer: Nomi Health Commercial |
$2,145.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,962.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,302.17
|
|
|
HC BRONCHOSCOPY W EBUS EXAM
|
Facility
|
OP
|
$3,241.58
|
|
| Hospital Charge Code |
36000015
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,199.38 |
| Max. Negotiated Rate |
$3,241.58 |
| Rate for Payer: Aetna Commercial |
$2,917.42
|
| Rate for Payer: Aetna Medicare |
$1,199.38
|
| Rate for Payer: ASR ASR |
$3,144.33
|
| Rate for Payer: BCBS Complete |
$1,296.63
|
| Rate for Payer: BCBS Trust/PPO |
$2,672.68
|
| Rate for Payer: BCN Commercial |
$2,672.68
|
| Rate for Payer: Cash Price |
$2,593.26
|
| Rate for Payer: Cofinity Commercial |
$3,047.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,593.26
|
| Rate for Payer: Healthscope Commercial |
$3,144.33
|
| Rate for Payer: Healthscope Whirlpool |
$3,241.58
|
| Rate for Payer: Mclaren Commercial |
$2,917.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,593.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,755.34
|
| Rate for Payer: Nomi Health Commercial |
$2,658.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,431.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,840.27
|
| Rate for Payer: Priority Health Narrow Network |
$2,272.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,852.59
|
|
|
HC BRONCHOSCOPY W EBUS EXAM
|
Facility
|
IP
|
$3,241.58
|
|
| Hospital Charge Code |
36000015
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,431.18 |
| Max. Negotiated Rate |
$3,241.58 |
| Rate for Payer: Aetna Commercial |
$2,917.42
|
| Rate for Payer: ASR ASR |
$3,144.33
|
| Rate for Payer: BCBS Trust/PPO |
$2,661.99
|
| Rate for Payer: BCN Commercial |
$2,661.99
|
| Rate for Payer: Cash Price |
$2,593.26
|
| Rate for Payer: Cofinity Commercial |
$3,047.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,593.26
|
| Rate for Payer: Healthscope Commercial |
$3,144.33
|
| Rate for Payer: Healthscope Whirlpool |
$3,241.58
|
| Rate for Payer: Mclaren Commercial |
$2,917.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,755.34
|
| Rate for Payer: Nomi Health Commercial |
$2,658.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,431.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,852.59
|
|
|
HC BRONCHOSPASM PROVOCATION (METHACHOLINE CHALLENGE)
|
Facility
|
IP
|
$722.85
|
|
|
Service Code
|
CPT 94070
|
| Hospital Charge Code |
46000003
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$542.14 |
| Max. Negotiated Rate |
$722.85 |
| Rate for Payer: Aetna Commercial |
$650.57
|
| Rate for Payer: ASR ASR |
$701.16
|
| Rate for Payer: BCBS Trust/PPO |
$593.60
|
| Rate for Payer: BCN Commercial |
$593.60
|
| Rate for Payer: Cash Price |
$578.28
|
| Rate for Payer: Cofinity Commercial |
$679.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$578.28
|
| Rate for Payer: Healthscope Commercial |
$701.16
|
| Rate for Payer: Healthscope Whirlpool |
$722.85
|
| Rate for Payer: Mclaren Commercial |
$650.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$614.42
|
| Rate for Payer: Nomi Health Commercial |
$592.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$542.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$636.11
|
|
|
HC BRONCHOSPASM PROVOCATION (METHACHOLINE CHALLENGE)
|
Facility
|
OP
|
$722.85
|
|
|
Service Code
|
CPT 94070
|
| Hospital Charge Code |
46000003
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$194.46 |
| Max. Negotiated Rate |
$722.85 |
| Rate for Payer: Aetna Commercial |
$650.57
|
| Rate for Payer: Aetna Medicare |
$371.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$464.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$464.77
|
| Rate for Payer: ASR ASR |
$701.16
|
| Rate for Payer: BCBS Complete |
$204.20
|
| Rate for Payer: BCBS MAPPO |
$371.82
|
| Rate for Payer: BCBS Trust/PPO |
$595.99
|
| Rate for Payer: BCN Commercial |
$595.99
|
| Rate for Payer: BCN Medicare Advantage |
$371.82
|
| Rate for Payer: Cash Price |
$578.28
|
| Rate for Payer: Cash Price |
$578.28
|
| Rate for Payer: Cofinity Commercial |
$679.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$578.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$371.82
|
| Rate for Payer: Healthscope Commercial |
$701.16
|
| Rate for Payer: Healthscope Whirlpool |
$722.85
|
| Rate for Payer: Humana Choice PPO Medicare |
$371.82
|
| Rate for Payer: Mclaren Commercial |
$650.57
|
| Rate for Payer: Mclaren Medicaid |
$371.82
|
| Rate for Payer: Mclaren Medicare |
$371.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$390.41
|
| Rate for Payer: Meridian Medicaid |
$204.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$427.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$409.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$614.42
|
| Rate for Payer: Nomi Health Commercial |
$592.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$542.14
|
| Rate for Payer: PACE Medicare |
$353.23
|
| Rate for Payer: PACE SWMI |
$371.82
|
| Rate for Payer: PHP Commercial |
$409.00
|
| Rate for Payer: PHP Medicaid |
$199.30
|
| Rate for Payer: PHP Medicare Advantage |
$371.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$194.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$633.36
|
| Rate for Payer: Priority Health Medicare |
$371.82
|
| Rate for Payer: Priority Health Narrow Network |
$506.72
|
| Rate for Payer: Railroad Medicare Medicare |
$371.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$636.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$371.82
|
| Rate for Payer: UHC Exchange |
$576.32
|
| Rate for Payer: UHC Medicaid |
$194.46
|
| Rate for Payer: UHCCP DNSP |
$371.82
|
| Rate for Payer: UHCCP Medicaid |
$194.46
|
| Rate for Payer: VA VA |
$371.82
|
|
|
HC BRUCELLA ANTIBODY
|
Facility
|
OP
|
$74.91
|
|
|
Service Code
|
CPT 86622
|
| Hospital Charge Code |
30200236
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.67 |
| Max. Negotiated Rate |
$183.99 |
| Rate for Payer: Aetna Commercial |
$67.42
|
| Rate for Payer: Aetna Medicare |
$8.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.16
|
| Rate for Payer: ASR ASR |
$72.66
|
| Rate for Payer: BCBS Complete |
$4.90
|
| Rate for Payer: BCBS MAPPO |
$8.93
|
| Rate for Payer: BCBS Trust/PPO |
$61.76
|
| Rate for Payer: BCN Commercial |
$61.76
|
| Rate for Payer: BCN Medicare Advantage |
$8.93
|
| Rate for Payer: Cash Price |
$59.93
|
| Rate for Payer: Cash Price |
$59.93
|
| Rate for Payer: Cofinity Commercial |
$70.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.93
|
| Rate for Payer: Healthscope Commercial |
$72.66
|
| Rate for Payer: Healthscope Whirlpool |
$74.91
|
| Rate for Payer: Humana Choice PPO Medicare |
$8.93
|
| Rate for Payer: Mclaren Commercial |
$67.42
|
| Rate for Payer: Mclaren Medicaid |
$8.93
|
| Rate for Payer: Mclaren Medicare |
$8.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.38
|
| Rate for Payer: Meridian Medicaid |
$4.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.67
|
| Rate for Payer: Nomi Health Commercial |
$61.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.18
|
| Rate for Payer: PACE Medicare |
$8.48
|
| Rate for Payer: PACE SWMI |
$8.93
|
| Rate for Payer: PHP Commercial |
$9.82
|
| Rate for Payer: PHP Medicaid |
$4.79
|
| Rate for Payer: PHP Medicare Advantage |
$8.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$183.99
|
| Rate for Payer: Priority Health Medicare |
$8.93
|
| Rate for Payer: Priority Health Narrow Network |
$147.19
|
| Rate for Payer: Railroad Medicare Medicare |
$8.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$65.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$8.93
|
| Rate for Payer: UHC Exchange |
$13.84
|
| Rate for Payer: UHC Medicaid |
$4.67
|
| Rate for Payer: UHCCP DNSP |
$8.93
|
| Rate for Payer: UHCCP Medicaid |
$4.67
|
| Rate for Payer: VA VA |
$8.93
|
|
|
HC BRUCELLA ANTIBODY
|
Facility
|
IP
|
$74.91
|
|
|
Service Code
|
CPT 86622
|
| Hospital Charge Code |
30200236
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$56.18 |
| Max. Negotiated Rate |
$74.91 |
| Rate for Payer: Aetna Commercial |
$67.42
|
| Rate for Payer: ASR ASR |
$72.66
|
| Rate for Payer: BCBS Trust/PPO |
$61.52
|
| Rate for Payer: BCN Commercial |
$61.52
|
| Rate for Payer: Cash Price |
$59.93
|
| Rate for Payer: Cofinity Commercial |
$70.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.93
|
| Rate for Payer: Healthscope Commercial |
$72.66
|
| Rate for Payer: Healthscope Whirlpool |
$74.91
|
| Rate for Payer: Mclaren Commercial |
$67.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.67
|
| Rate for Payer: Nomi Health Commercial |
$61.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$65.92
|
|
|
HC BRUCELLA ANTIBODY CMPT
|
Facility
|
IP
|
$74.91
|
|
|
Service Code
|
CPT 86622
|
| Hospital Charge Code |
30200238
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$56.18 |
| Max. Negotiated Rate |
$74.91 |
| Rate for Payer: Aetna Commercial |
$67.42
|
| Rate for Payer: ASR ASR |
$72.66
|
| Rate for Payer: BCBS Trust/PPO |
$61.52
|
| Rate for Payer: BCN Commercial |
$61.52
|
| Rate for Payer: Cash Price |
$59.93
|
| Rate for Payer: Cofinity Commercial |
$70.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.93
|
| Rate for Payer: Healthscope Commercial |
$72.66
|
| Rate for Payer: Healthscope Whirlpool |
$74.91
|
| Rate for Payer: Mclaren Commercial |
$67.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.67
|
| Rate for Payer: Nomi Health Commercial |
$61.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$65.92
|
|
|
HC BRUCELLA ANTIBODY CMPT
|
Facility
|
OP
|
$74.91
|
|
|
Service Code
|
CPT 86622
|
| Hospital Charge Code |
30200238
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.67 |
| Max. Negotiated Rate |
$183.99 |
| Rate for Payer: Aetna Commercial |
$67.42
|
| Rate for Payer: Aetna Medicare |
$8.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.16
|
| Rate for Payer: ASR ASR |
$72.66
|
| Rate for Payer: BCBS Complete |
$4.90
|
| Rate for Payer: BCBS MAPPO |
$8.93
|
| Rate for Payer: BCBS Trust/PPO |
$61.76
|
| Rate for Payer: BCN Commercial |
$61.76
|
| Rate for Payer: BCN Medicare Advantage |
$8.93
|
| Rate for Payer: Cash Price |
$59.93
|
| Rate for Payer: Cash Price |
$59.93
|
| Rate for Payer: Cofinity Commercial |
$70.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.93
|
| Rate for Payer: Healthscope Commercial |
$72.66
|
| Rate for Payer: Healthscope Whirlpool |
$74.91
|
| Rate for Payer: Humana Choice PPO Medicare |
$8.93
|
| Rate for Payer: Mclaren Commercial |
$67.42
|
| Rate for Payer: Mclaren Medicaid |
$8.93
|
| Rate for Payer: Mclaren Medicare |
$8.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.38
|
| Rate for Payer: Meridian Medicaid |
$4.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.67
|
| Rate for Payer: Nomi Health Commercial |
$61.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.18
|
| Rate for Payer: PACE Medicare |
$8.48
|
| Rate for Payer: PACE SWMI |
$8.93
|
| Rate for Payer: PHP Commercial |
$9.82
|
| Rate for Payer: PHP Medicaid |
$4.79
|
| Rate for Payer: PHP Medicare Advantage |
$8.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$183.99
|
| Rate for Payer: Priority Health Medicare |
$8.93
|
| Rate for Payer: Priority Health Narrow Network |
$147.19
|
| Rate for Payer: Railroad Medicare Medicare |
$8.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$65.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$8.93
|
| Rate for Payer: UHC Exchange |
$13.84
|
| Rate for Payer: UHC Medicaid |
$4.67
|
| Rate for Payer: UHCCP DNSP |
$8.93
|
| Rate for Payer: UHCCP Medicaid |
$4.67
|
| Rate for Payer: VA VA |
$8.93
|
|
|
HC BRUCELLA ANTIBODY CONFIRMATION
|
Facility
|
OP
|
$54.10
|
|
|
Service Code
|
CPT 86622
|
| Hospital Charge Code |
30200237
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.67 |
| Max. Negotiated Rate |
$183.99 |
| Rate for Payer: Aetna Commercial |
$48.69
|
| Rate for Payer: Aetna Medicare |
$8.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.16
|
| Rate for Payer: ASR ASR |
$52.48
|
| Rate for Payer: BCBS Complete |
$4.90
|
| Rate for Payer: BCBS MAPPO |
$8.93
|
| Rate for Payer: BCBS Trust/PPO |
$44.61
|
| Rate for Payer: BCN Commercial |
$44.61
|
| Rate for Payer: BCN Medicare Advantage |
$8.93
|
| Rate for Payer: Cash Price |
$43.28
|
| Rate for Payer: Cash Price |
$43.28
|
| Rate for Payer: Cofinity Commercial |
$50.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.93
|
| Rate for Payer: Healthscope Commercial |
$52.48
|
| Rate for Payer: Healthscope Whirlpool |
$54.10
|
| Rate for Payer: Humana Choice PPO Medicare |
$8.93
|
| Rate for Payer: Mclaren Commercial |
$48.69
|
| Rate for Payer: Mclaren Medicaid |
$8.93
|
| Rate for Payer: Mclaren Medicare |
$8.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.38
|
| Rate for Payer: Meridian Medicaid |
$4.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.98
|
| Rate for Payer: Nomi Health Commercial |
$44.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.58
|
| Rate for Payer: PACE Medicare |
$8.48
|
| Rate for Payer: PACE SWMI |
$8.93
|
| Rate for Payer: PHP Commercial |
$9.82
|
| Rate for Payer: PHP Medicaid |
$4.79
|
| Rate for Payer: PHP Medicare Advantage |
$8.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$183.99
|
| Rate for Payer: Priority Health Medicare |
$8.93
|
| Rate for Payer: Priority Health Narrow Network |
$147.19
|
| Rate for Payer: Railroad Medicare Medicare |
$8.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$47.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$8.93
|
| Rate for Payer: UHC Exchange |
$13.84
|
| Rate for Payer: UHC Medicaid |
$4.67
|
| Rate for Payer: UHCCP DNSP |
$8.93
|
| Rate for Payer: UHCCP Medicaid |
$4.67
|
| Rate for Payer: VA VA |
$8.93
|
|
|
HC BRUCELLA ANTIBODY CONFIRMATION
|
Facility
|
IP
|
$54.10
|
|
|
Service Code
|
CPT 86622
|
| Hospital Charge Code |
30200237
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$40.58 |
| Max. Negotiated Rate |
$54.10 |
| Rate for Payer: Aetna Commercial |
$48.69
|
| Rate for Payer: ASR ASR |
$52.48
|
| Rate for Payer: BCBS Trust/PPO |
$44.43
|
| Rate for Payer: BCN Commercial |
$44.43
|
| Rate for Payer: Cash Price |
$43.28
|
| Rate for Payer: Cofinity Commercial |
$50.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.28
|
| Rate for Payer: Healthscope Commercial |
$52.48
|
| Rate for Payer: Healthscope Whirlpool |
$54.10
|
| Rate for Payer: Mclaren Commercial |
$48.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.98
|
| Rate for Payer: Nomi Health Commercial |
$44.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$47.61
|
|
|
HC BUDESONIDE INHALATION SOLUTION
|
Facility
|
OP
|
$29.94
|
|
| Hospital Charge Code |
63700005
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$11.08 |
| Max. Negotiated Rate |
$29.94 |
| Rate for Payer: Aetna Commercial |
$26.95
|
| Rate for Payer: Aetna Medicare |
$11.08
|
| Rate for Payer: ASR ASR |
$29.04
|
| Rate for Payer: BCBS Complete |
$11.98
|
| Rate for Payer: BCBS Trust/PPO |
$24.69
|
| Rate for Payer: BCN Commercial |
$24.69
|
| Rate for Payer: Cash Price |
$23.95
|
| Rate for Payer: Cofinity Commercial |
$28.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.95
|
| Rate for Payer: Healthscope Commercial |
$29.04
|
| Rate for Payer: Healthscope Whirlpool |
$29.94
|
| Rate for Payer: Mclaren Commercial |
$26.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.45
|
| Rate for Payer: Nomi Health Commercial |
$24.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$26.23
|
| Rate for Payer: Priority Health Narrow Network |
$20.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.35
|
|
|
HC BUDESONIDE INHALATION SOLUTION
|
Facility
|
IP
|
$29.94
|
|
| Hospital Charge Code |
63700005
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$22.45 |
| Max. Negotiated Rate |
$29.94 |
| Rate for Payer: Aetna Commercial |
$26.95
|
| Rate for Payer: ASR ASR |
$29.04
|
| Rate for Payer: BCBS Trust/PPO |
$24.59
|
| Rate for Payer: BCN Commercial |
$24.59
|
| Rate for Payer: Cash Price |
$23.95
|
| Rate for Payer: Cofinity Commercial |
$28.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.95
|
| Rate for Payer: Healthscope Commercial |
$29.04
|
| Rate for Payer: Healthscope Whirlpool |
$29.94
|
| Rate for Payer: Mclaren Commercial |
$26.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.45
|
| Rate for Payer: Nomi Health Commercial |
$24.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.35
|
|
