|
HC ARTHROGRAM SACROILIAC
|
Facility
|
IP
|
$937.71
|
|
|
Service Code
|
CPT 27096
|
| Hospital Charge Code |
36100585
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$609.51 |
| Max. Negotiated Rate |
$937.71 |
| Rate for Payer: Aetna Commercial |
$843.94
|
| Rate for Payer: ASR ASR |
$909.58
|
| Rate for Payer: ASR Commercial |
$909.58
|
| Rate for Payer: BCBS Trust/PPO |
$764.14
|
| Rate for Payer: BCN Commercial |
$727.01
|
| Rate for Payer: Cash Price |
$750.17
|
| Rate for Payer: Cofinity Commercial |
$881.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$750.17
|
| Rate for Payer: Healthscope Commercial |
$937.71
|
| Rate for Payer: Healthscope Whirlpool |
$909.58
|
| Rate for Payer: Mclaren Commercial |
$843.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$797.05
|
| Rate for Payer: Nomi Health Commercial |
$768.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$609.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$825.18
|
|
|
HC ARTHROGRAM SACROILIAC BIL
|
Facility
|
IP
|
$1,068.81
|
|
|
Service Code
|
CPT 27096
|
| Hospital Charge Code |
36100586
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$694.73 |
| Max. Negotiated Rate |
$1,068.81 |
| Rate for Payer: Aetna Commercial |
$961.93
|
| Rate for Payer: ASR ASR |
$1,036.75
|
| Rate for Payer: ASR Commercial |
$1,036.75
|
| Rate for Payer: BCBS Trust/PPO |
$870.97
|
| Rate for Payer: BCN Commercial |
$828.65
|
| Rate for Payer: Cash Price |
$855.05
|
| Rate for Payer: Cofinity Commercial |
$1,004.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$855.05
|
| Rate for Payer: Healthscope Commercial |
$1,068.81
|
| Rate for Payer: Healthscope Whirlpool |
$1,036.75
|
| Rate for Payer: Mclaren Commercial |
$961.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$908.49
|
| Rate for Payer: Nomi Health Commercial |
$876.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$694.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$940.55
|
|
|
HC ARTHROGRAM SACROILIAC BIL
|
Facility
|
OP
|
$1,068.81
|
|
|
Service Code
|
CPT 27096
|
| Hospital Charge Code |
36100586
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$427.52 |
| Max. Negotiated Rate |
$1,147.41 |
| Rate for Payer: Aetna Commercial |
$961.93
|
| Rate for Payer: Aetna Medicare |
$534.40
|
| Rate for Payer: ASR ASR |
$1,036.75
|
| Rate for Payer: ASR Commercial |
$1,036.75
|
| Rate for Payer: BCBS Complete |
$427.52
|
| Rate for Payer: BCBS Trust/PPO |
$875.25
|
| Rate for Payer: BCN Commercial |
$828.65
|
| Rate for Payer: Cash Price |
$855.05
|
| Rate for Payer: Cash Price |
$855.05
|
| Rate for Payer: Cofinity Commercial |
$1,004.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$855.05
|
| Rate for Payer: Healthscope Commercial |
$1,068.81
|
| Rate for Payer: Healthscope Whirlpool |
$1,036.75
|
| Rate for Payer: Mclaren Commercial |
$961.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$908.49
|
| Rate for Payer: Nomi Health Commercial |
$876.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$694.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,147.41
|
| Rate for Payer: Priority Health Narrow Network |
$917.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$940.55
|
|
|
HC ARTHROTOMY W/EXP, DRAIN, REMOVAL FB METACARPOPHALANGEAL JT EACH
|
Facility
|
IP
|
$1,816.86
|
|
|
Service Code
|
CPT 26075
|
| Hospital Charge Code |
76100135
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,180.96 |
| Max. Negotiated Rate |
$1,816.86 |
| Rate for Payer: Aetna Commercial |
$1,635.17
|
| Rate for Payer: ASR ASR |
$1,762.35
|
| Rate for Payer: ASR Commercial |
$1,762.35
|
| Rate for Payer: BCBS Trust/PPO |
$1,480.56
|
| Rate for Payer: BCN Commercial |
$1,408.61
|
| Rate for Payer: Cash Price |
$1,453.49
|
| Rate for Payer: Cofinity Commercial |
$1,707.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,453.49
|
| Rate for Payer: Healthscope Commercial |
$1,816.86
|
| Rate for Payer: Healthscope Whirlpool |
$1,762.35
|
| Rate for Payer: Mclaren Commercial |
$1,635.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,544.33
|
| Rate for Payer: Nomi Health Commercial |
$1,489.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,180.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,598.84
|
|
|
HC ARTHROTOMY W/EXP, DRAIN, REMOVAL FB METACARPOPHALANGEAL JT EACH
|
Facility
|
OP
|
$1,816.86
|
|
|
Service Code
|
CPT 26075
|
| Hospital Charge Code |
76100135
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,180.96 |
| Max. Negotiated Rate |
$4,927.45 |
| Rate for Payer: Aetna Commercial |
$1,635.17
|
| Rate for Payer: Aetna Medicare |
$3,179.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,973.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,973.75
|
| Rate for Payer: ASR ASR |
$1,762.35
|
| Rate for Payer: ASR Commercial |
$1,762.35
|
| Rate for Payer: BCBS Complete |
$1,789.14
|
| Rate for Payer: BCBS MAPPO |
$3,179.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,487.83
|
| Rate for Payer: BCN Commercial |
$1,408.61
|
| Rate for Payer: BCN Medicare Advantage |
$3,179.00
|
| Rate for Payer: Cash Price |
$1,453.49
|
| Rate for Payer: Cash Price |
$1,453.49
|
| Rate for Payer: Cofinity Commercial |
$1,707.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,453.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,179.00
|
| Rate for Payer: Healthscope Commercial |
$1,816.86
|
| Rate for Payer: Healthscope Whirlpool |
$1,762.35
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,179.00
|
| Rate for Payer: Mclaren Commercial |
$1,635.17
|
| Rate for Payer: Mclaren Medicaid |
$1,703.94
|
| Rate for Payer: Mclaren Medicare |
$3,179.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,337.95
|
| Rate for Payer: Meridian Medicaid |
$1,789.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,655.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,544.33
|
| Rate for Payer: Nomi Health Commercial |
$1,489.83
|
| Rate for Payer: PACE Medicare |
$3,020.05
|
| Rate for Payer: PACE SWMI |
$3,179.00
|
| Rate for Payer: PHP Commercial |
$3,496.90
|
| Rate for Payer: PHP Medicaid |
$1,703.94
|
| Rate for Payer: PHP Medicare Advantage |
$3,179.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,703.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,180.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,591.93
|
| Rate for Payer: Priority Health Medicare |
$3,179.00
|
| Rate for Payer: Priority Health Narrow Network |
$1,273.62
|
| Rate for Payer: Railroad Medicare Medicare |
$3,179.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,598.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,179.00
|
| Rate for Payer: UHC Exchange |
$4,927.45
|
| Rate for Payer: UHC Medicare Advantage |
$3,179.00
|
| Rate for Payer: UHCCP DNSP |
$3,179.00
|
| Rate for Payer: UHCCP Medicaid |
$1,703.94
|
| Rate for Payer: VA VA |
$3,179.00
|
|
|
HC ARTHRT EXPL DRAIN RMV FOREIGN BODY FINGER JT
|
Facility
|
IP
|
$4,096.99
|
|
|
Service Code
|
CPT 26080
|
| Hospital Charge Code |
76100373
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,663.04 |
| Max. Negotiated Rate |
$4,096.99 |
| Rate for Payer: Aetna Commercial |
$3,687.29
|
| Rate for Payer: ASR ASR |
$3,974.08
|
| Rate for Payer: ASR Commercial |
$3,974.08
|
| Rate for Payer: BCBS Trust/PPO |
$3,338.64
|
| Rate for Payer: BCN Commercial |
$3,176.40
|
| Rate for Payer: Cash Price |
$3,277.59
|
| Rate for Payer: Cofinity Commercial |
$3,851.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,277.59
|
| Rate for Payer: Healthscope Commercial |
$4,096.99
|
| Rate for Payer: Healthscope Whirlpool |
$3,974.08
|
| Rate for Payer: Mclaren Commercial |
$3,687.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,482.44
|
| Rate for Payer: Nomi Health Commercial |
$3,359.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,663.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,605.35
|
|
|
HC ARTHRT EXPL DRAIN RMV FOREIGN BODY FINGER JT
|
Facility
|
OP
|
$4,096.99
|
|
|
Service Code
|
CPT 26080
|
| Hospital Charge Code |
76100373
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$840.47 |
| Max. Negotiated Rate |
$4,096.99 |
| Rate for Payer: Aetna Commercial |
$3,687.29
|
| Rate for Payer: Aetna Medicare |
$1,568.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,960.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,960.06
|
| Rate for Payer: ASR ASR |
$3,974.08
|
| Rate for Payer: ASR Commercial |
$3,974.08
|
| Rate for Payer: BCBS Complete |
$882.50
|
| Rate for Payer: BCBS MAPPO |
$1,568.05
|
| Rate for Payer: BCBS Trust/PPO |
$3,355.03
|
| Rate for Payer: BCN Commercial |
$3,176.40
|
| Rate for Payer: BCN Medicare Advantage |
$1,568.05
|
| Rate for Payer: Cash Price |
$3,277.59
|
| Rate for Payer: Cash Price |
$3,277.59
|
| Rate for Payer: Cofinity Commercial |
$3,851.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,277.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,568.05
|
| Rate for Payer: Healthscope Commercial |
$4,096.99
|
| Rate for Payer: Healthscope Whirlpool |
$3,974.08
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,568.05
|
| Rate for Payer: Mclaren Commercial |
$3,687.29
|
| Rate for Payer: Mclaren Medicaid |
$840.47
|
| Rate for Payer: Mclaren Medicare |
$1,568.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,646.45
|
| Rate for Payer: Meridian Medicaid |
$882.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,803.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,482.44
|
| Rate for Payer: Nomi Health Commercial |
$3,359.53
|
| Rate for Payer: PACE Medicare |
$1,489.65
|
| Rate for Payer: PACE SWMI |
$1,568.05
|
| Rate for Payer: PHP Commercial |
$1,724.86
|
| Rate for Payer: PHP Medicaid |
$840.47
|
| Rate for Payer: PHP Medicare Advantage |
$1,568.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$840.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,663.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,589.78
|
| Rate for Payer: Priority Health Medicare |
$1,568.05
|
| Rate for Payer: Priority Health Narrow Network |
$2,871.99
|
| Rate for Payer: Railroad Medicare Medicare |
$1,568.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,605.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,568.05
|
| Rate for Payer: UHC Exchange |
$2,430.48
|
| Rate for Payer: UHC Medicare Advantage |
$1,568.05
|
| Rate for Payer: UHCCP DNSP |
$1,568.05
|
| Rate for Payer: UHCCP Medicaid |
$840.47
|
| Rate for Payer: VA VA |
$1,568.05
|
|
|
HC ART IMG UNILAT LOWER EXTREMITY
|
Facility
|
OP
|
$922.21
|
|
|
Service Code
|
CPT 93926
|
| Hospital Charge Code |
92100012
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$55.85 |
| Max. Negotiated Rate |
$922.21 |
| Rate for Payer: Aetna Commercial |
$829.99
|
| Rate for Payer: Aetna Medicare |
$104.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.24
|
| Rate for Payer: ASR ASR |
$894.54
|
| Rate for Payer: ASR Commercial |
$894.54
|
| Rate for Payer: BCBS Complete |
$58.64
|
| Rate for Payer: BCBS MAPPO |
$104.19
|
| Rate for Payer: BCBS Trust/PPO |
$755.20
|
| Rate for Payer: BCN Commercial |
$714.99
|
| Rate for Payer: BCN Medicare Advantage |
$104.19
|
| Rate for Payer: Cash Price |
$737.77
|
| Rate for Payer: Cash Price |
$737.77
|
| Rate for Payer: Cofinity Commercial |
$866.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$737.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.19
|
| Rate for Payer: Healthscope Commercial |
$922.21
|
| Rate for Payer: Healthscope Whirlpool |
$894.54
|
| Rate for Payer: Humana Choice PPO Medicare |
$104.19
|
| Rate for Payer: Mclaren Commercial |
$829.99
|
| Rate for Payer: Mclaren Medicaid |
$55.85
|
| Rate for Payer: Mclaren Medicare |
$104.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.40
|
| Rate for Payer: Meridian Medicaid |
$58.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$783.88
|
| Rate for Payer: Nomi Health Commercial |
$756.21
|
| Rate for Payer: PACE Medicare |
$98.98
|
| Rate for Payer: PACE SWMI |
$104.19
|
| Rate for Payer: PHP Commercial |
$114.61
|
| Rate for Payer: PHP Medicaid |
$55.85
|
| Rate for Payer: PHP Medicare Advantage |
$104.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$599.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$808.04
|
| Rate for Payer: Priority Health Medicare |
$104.19
|
| Rate for Payer: Priority Health Narrow Network |
$646.47
|
| Rate for Payer: Railroad Medicare Medicare |
$104.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$811.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$104.19
|
| Rate for Payer: UHC Exchange |
$161.49
|
| Rate for Payer: UHC Medicare Advantage |
$104.19
|
| Rate for Payer: UHCCP DNSP |
$104.19
|
| Rate for Payer: UHCCP Medicaid |
$55.85
|
| Rate for Payer: VA VA |
$104.19
|
|
|
HC ART IMG UNILAT LOWER EXTREMITY
|
Facility
|
IP
|
$922.21
|
|
|
Service Code
|
CPT 93926
|
| Hospital Charge Code |
92100012
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$599.44 |
| Max. Negotiated Rate |
$922.21 |
| Rate for Payer: Aetna Commercial |
$829.99
|
| Rate for Payer: ASR ASR |
$894.54
|
| Rate for Payer: ASR Commercial |
$894.54
|
| Rate for Payer: BCBS Trust/PPO |
$751.51
|
| Rate for Payer: BCN Commercial |
$714.99
|
| Rate for Payer: Cash Price |
$737.77
|
| Rate for Payer: Cofinity Commercial |
$866.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$737.77
|
| Rate for Payer: Healthscope Commercial |
$922.21
|
| Rate for Payer: Healthscope Whirlpool |
$894.54
|
| Rate for Payer: Mclaren Commercial |
$829.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$783.88
|
| Rate for Payer: Nomi Health Commercial |
$756.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$599.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$811.54
|
|
|
HC ART IMG UNILAT UPPER EXTREM
|
Facility
|
IP
|
$756.35
|
|
|
Service Code
|
CPT 93931
|
| Hospital Charge Code |
92100009
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$491.63 |
| Max. Negotiated Rate |
$756.35 |
| Rate for Payer: Aetna Commercial |
$680.72
|
| Rate for Payer: ASR ASR |
$733.66
|
| Rate for Payer: ASR Commercial |
$733.66
|
| Rate for Payer: BCBS Trust/PPO |
$616.35
|
| Rate for Payer: BCN Commercial |
$586.40
|
| Rate for Payer: Cash Price |
$605.08
|
| Rate for Payer: Cofinity Commercial |
$710.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$605.08
|
| Rate for Payer: Healthscope Commercial |
$756.35
|
| Rate for Payer: Healthscope Whirlpool |
$733.66
|
| Rate for Payer: Mclaren Commercial |
$680.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$642.90
|
| Rate for Payer: Nomi Health Commercial |
$620.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$491.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$665.59
|
|
|
HC ART IMG UNILAT UPPER EXTREM
|
Facility
|
OP
|
$756.35
|
|
|
Service Code
|
CPT 93931
|
| Hospital Charge Code |
92100009
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$55.85 |
| Max. Negotiated Rate |
$756.35 |
| Rate for Payer: Aetna Commercial |
$680.72
|
| Rate for Payer: Aetna Medicare |
$104.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.24
|
| Rate for Payer: ASR ASR |
$733.66
|
| Rate for Payer: ASR Commercial |
$733.66
|
| Rate for Payer: BCBS Complete |
$58.64
|
| Rate for Payer: BCBS MAPPO |
$104.19
|
| Rate for Payer: BCBS Trust/PPO |
$619.38
|
| Rate for Payer: BCN Commercial |
$586.40
|
| Rate for Payer: BCN Medicare Advantage |
$104.19
|
| Rate for Payer: Cash Price |
$605.08
|
| Rate for Payer: Cash Price |
$605.08
|
| Rate for Payer: Cofinity Commercial |
$710.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$605.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.19
|
| Rate for Payer: Healthscope Commercial |
$756.35
|
| Rate for Payer: Healthscope Whirlpool |
$733.66
|
| Rate for Payer: Humana Choice PPO Medicare |
$104.19
|
| Rate for Payer: Mclaren Commercial |
$680.72
|
| Rate for Payer: Mclaren Medicaid |
$55.85
|
| Rate for Payer: Mclaren Medicare |
$104.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.40
|
| Rate for Payer: Meridian Medicaid |
$58.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$642.90
|
| Rate for Payer: Nomi Health Commercial |
$620.21
|
| Rate for Payer: PACE Medicare |
$98.98
|
| Rate for Payer: PACE SWMI |
$104.19
|
| Rate for Payer: PHP Commercial |
$114.61
|
| Rate for Payer: PHP Medicaid |
$55.85
|
| Rate for Payer: PHP Medicare Advantage |
$104.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$491.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$662.71
|
| Rate for Payer: Priority Health Medicare |
$104.19
|
| Rate for Payer: Priority Health Narrow Network |
$530.20
|
| Rate for Payer: Railroad Medicare Medicare |
$104.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$665.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$104.19
|
| Rate for Payer: UHC Exchange |
$161.49
|
| Rate for Payer: UHC Medicare Advantage |
$104.19
|
| Rate for Payer: UHCCP DNSP |
$104.19
|
| Rate for Payer: UHCCP Medicaid |
$55.85
|
| Rate for Payer: VA VA |
$104.19
|
|
|
HC ART&VEN TRANSCATH THROMBOLYSIS
|
Facility
|
OP
|
$4,644.53
|
|
|
Service Code
|
CPT 37213
|
| Hospital Charge Code |
36100373
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,606.62 |
| Max. Negotiated Rate |
$4,779.98 |
| Rate for Payer: Aetna Commercial |
$4,180.08
|
| Rate for Payer: Aetna Medicare |
$3,083.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,854.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,854.82
|
| Rate for Payer: ASR ASR |
$4,505.19
|
| Rate for Payer: ASR Commercial |
$4,505.19
|
| Rate for Payer: BCBS Complete |
$1,735.60
|
| Rate for Payer: BCBS MAPPO |
$3,083.86
|
| Rate for Payer: BCBS Trust/PPO |
$3,803.41
|
| Rate for Payer: BCN Commercial |
$3,600.90
|
| Rate for Payer: BCN Medicare Advantage |
$3,083.86
|
| Rate for Payer: Cash Price |
$3,715.62
|
| Rate for Payer: Cash Price |
$3,715.62
|
| Rate for Payer: Cofinity Commercial |
$4,365.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,715.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,083.86
|
| Rate for Payer: Healthscope Commercial |
$4,644.53
|
| Rate for Payer: Healthscope Whirlpool |
$4,505.19
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,083.86
|
| Rate for Payer: Mclaren Commercial |
$4,180.08
|
| Rate for Payer: Mclaren Medicaid |
$1,652.95
|
| Rate for Payer: Mclaren Medicare |
$3,083.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,238.05
|
| Rate for Payer: Meridian Medicaid |
$1,735.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,546.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,947.85
|
| Rate for Payer: Nomi Health Commercial |
$3,808.51
|
| Rate for Payer: PACE Medicare |
$2,929.67
|
| Rate for Payer: PACE SWMI |
$3,083.86
|
| Rate for Payer: PHP Commercial |
$3,392.25
|
| Rate for Payer: PHP Medicaid |
$1,652.95
|
| Rate for Payer: PHP Medicare Advantage |
$3,083.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,652.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,018.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,008.27
|
| Rate for Payer: Priority Health Medicare |
$3,083.86
|
| Rate for Payer: Priority Health Narrow Network |
$1,606.62
|
| Rate for Payer: Railroad Medicare Medicare |
$3,083.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,087.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,083.86
|
| Rate for Payer: UHC Exchange |
$4,779.98
|
| Rate for Payer: UHC Medicare Advantage |
$3,083.86
|
| Rate for Payer: UHCCP DNSP |
$3,083.86
|
| Rate for Payer: UHCCP Medicaid |
$1,652.95
|
| Rate for Payer: VA VA |
$3,083.86
|
|
|
HC ART&VEN TRANSCATH THROMBOLYSIS
|
Facility
|
IP
|
$4,644.53
|
|
|
Service Code
|
CPT 37213
|
| Hospital Charge Code |
36100373
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,018.94 |
| Max. Negotiated Rate |
$4,644.53 |
| Rate for Payer: Aetna Commercial |
$4,180.08
|
| Rate for Payer: ASR ASR |
$4,505.19
|
| Rate for Payer: ASR Commercial |
$4,505.19
|
| Rate for Payer: BCBS Trust/PPO |
$3,784.83
|
| Rate for Payer: BCN Commercial |
$3,600.90
|
| Rate for Payer: Cash Price |
$3,715.62
|
| Rate for Payer: Cofinity Commercial |
$4,365.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,715.62
|
| Rate for Payer: Healthscope Commercial |
$4,644.53
|
| Rate for Payer: Healthscope Whirlpool |
$4,505.19
|
| Rate for Payer: Mclaren Commercial |
$4,180.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,947.85
|
| Rate for Payer: Nomi Health Commercial |
$3,808.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,018.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,087.19
|
|
|
HC ASMT VERTEBRAL FX VIA DXA
|
Facility
|
IP
|
$195.66
|
|
|
Service Code
|
CPT 77086
|
| Hospital Charge Code |
32000302
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$127.18 |
| Max. Negotiated Rate |
$195.66 |
| Rate for Payer: Aetna Commercial |
$176.09
|
| Rate for Payer: ASR ASR |
$189.79
|
| Rate for Payer: ASR Commercial |
$189.79
|
| Rate for Payer: BCBS Trust/PPO |
$159.44
|
| Rate for Payer: BCN Commercial |
$151.70
|
| Rate for Payer: Cash Price |
$156.53
|
| Rate for Payer: Cofinity Commercial |
$183.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$156.53
|
| Rate for Payer: Healthscope Commercial |
$195.66
|
| Rate for Payer: Healthscope Whirlpool |
$189.79
|
| Rate for Payer: Mclaren Commercial |
$176.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$166.31
|
| Rate for Payer: Nomi Health Commercial |
$160.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$127.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$172.18
|
|
|
HC ASMT VERTEBRAL FX VIA DXA
|
Facility
|
OP
|
$195.66
|
|
|
Service Code
|
CPT 77086
|
| Hospital Charge Code |
32000302
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$46.24 |
| Max. Negotiated Rate |
$195.66 |
| Rate for Payer: Aetna Commercial |
$176.09
|
| Rate for Payer: Aetna Medicare |
$86.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.84
|
| Rate for Payer: ASR ASR |
$189.79
|
| Rate for Payer: ASR Commercial |
$189.79
|
| Rate for Payer: BCBS Complete |
$48.55
|
| Rate for Payer: BCBS MAPPO |
$86.27
|
| Rate for Payer: BCBS Trust/PPO |
$160.23
|
| Rate for Payer: BCN Commercial |
$151.70
|
| Rate for Payer: BCN Medicare Advantage |
$86.27
|
| Rate for Payer: Cash Price |
$156.53
|
| Rate for Payer: Cash Price |
$156.53
|
| Rate for Payer: Cofinity Commercial |
$183.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$156.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.27
|
| Rate for Payer: Healthscope Commercial |
$195.66
|
| Rate for Payer: Healthscope Whirlpool |
$189.79
|
| Rate for Payer: Humana Choice PPO Medicare |
$86.27
|
| Rate for Payer: Mclaren Commercial |
$176.09
|
| Rate for Payer: Mclaren Medicaid |
$46.24
|
| Rate for Payer: Mclaren Medicare |
$86.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.58
|
| Rate for Payer: Meridian Medicaid |
$48.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$166.31
|
| Rate for Payer: Nomi Health Commercial |
$160.44
|
| Rate for Payer: PACE Medicare |
$81.96
|
| Rate for Payer: PACE SWMI |
$86.27
|
| Rate for Payer: PHP Commercial |
$94.90
|
| Rate for Payer: PHP Medicaid |
$46.24
|
| Rate for Payer: PHP Medicare Advantage |
$86.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$127.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$171.44
|
| Rate for Payer: Priority Health Medicare |
$86.27
|
| Rate for Payer: Priority Health Narrow Network |
$137.16
|
| Rate for Payer: Railroad Medicare Medicare |
$86.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$172.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.27
|
| Rate for Payer: UHC Exchange |
$133.72
|
| Rate for Payer: UHC Medicare Advantage |
$86.27
|
| Rate for Payer: UHCCP DNSP |
$86.27
|
| Rate for Payer: UHCCP Medicaid |
$46.24
|
| Rate for Payer: VA VA |
$86.27
|
|
|
HC ASP AND OR INJ RENAL CYST OR PELVIS
|
Facility
|
IP
|
$1,234.97
|
|
|
Service Code
|
CPT 50390
|
| Hospital Charge Code |
36100242
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$802.73 |
| Max. Negotiated Rate |
$1,234.97 |
| Rate for Payer: Aetna Commercial |
$1,111.47
|
| Rate for Payer: ASR ASR |
$1,197.92
|
| Rate for Payer: ASR Commercial |
$1,197.92
|
| Rate for Payer: BCBS Trust/PPO |
$1,006.38
|
| Rate for Payer: BCN Commercial |
$957.47
|
| Rate for Payer: Cash Price |
$987.98
|
| Rate for Payer: Cofinity Commercial |
$1,160.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$987.98
|
| Rate for Payer: Healthscope Commercial |
$1,234.97
|
| Rate for Payer: Healthscope Whirlpool |
$1,197.92
|
| Rate for Payer: Mclaren Commercial |
$1,111.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,049.72
|
| Rate for Payer: Nomi Health Commercial |
$1,012.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$802.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,086.77
|
|
|
HC ASP AND OR INJ RENAL CYST OR PELVIS
|
Facility
|
OP
|
$1,234.97
|
|
|
Service Code
|
CPT 50390
|
| Hospital Charge Code |
36100242
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$369.50 |
| Max. Negotiated Rate |
$1,234.97 |
| Rate for Payer: Aetna Commercial |
$1,111.47
|
| Rate for Payer: Aetna Medicare |
$689.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$861.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$861.70
|
| Rate for Payer: ASR ASR |
$1,197.92
|
| Rate for Payer: ASR Commercial |
$1,197.92
|
| Rate for Payer: BCBS Complete |
$387.97
|
| Rate for Payer: BCBS MAPPO |
$689.36
|
| Rate for Payer: BCBS Trust/PPO |
$1,011.32
|
| Rate for Payer: BCN Commercial |
$957.47
|
| Rate for Payer: BCN Medicare Advantage |
$689.36
|
| Rate for Payer: Cash Price |
$987.98
|
| Rate for Payer: Cash Price |
$987.98
|
| Rate for Payer: Cofinity Commercial |
$1,160.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$987.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$689.36
|
| Rate for Payer: Healthscope Commercial |
$1,234.97
|
| Rate for Payer: Healthscope Whirlpool |
$1,197.92
|
| Rate for Payer: Humana Choice PPO Medicare |
$689.36
|
| Rate for Payer: Mclaren Commercial |
$1,111.47
|
| Rate for Payer: Mclaren Medicaid |
$369.50
|
| Rate for Payer: Mclaren Medicare |
$689.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$723.83
|
| Rate for Payer: Meridian Medicaid |
$387.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$792.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,049.72
|
| Rate for Payer: Nomi Health Commercial |
$1,012.68
|
| Rate for Payer: PACE Medicare |
$654.89
|
| Rate for Payer: PACE SWMI |
$689.36
|
| Rate for Payer: PHP Commercial |
$758.30
|
| Rate for Payer: PHP Medicaid |
$369.50
|
| Rate for Payer: PHP Medicare Advantage |
$689.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$802.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,082.08
|
| Rate for Payer: Priority Health Medicare |
$689.36
|
| Rate for Payer: Priority Health Narrow Network |
$865.71
|
| Rate for Payer: Railroad Medicare Medicare |
$689.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,086.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$689.36
|
| Rate for Payer: UHC Exchange |
$1,068.51
|
| Rate for Payer: UHC Medicare Advantage |
$689.36
|
| Rate for Payer: UHCCP DNSP |
$689.36
|
| Rate for Payer: UHCCP Medicaid |
$369.50
|
| Rate for Payer: VA VA |
$689.36
|
|
|
HC ASPERGILLIS IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200028
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$25.39 |
| Rate for Payer: Aetna Commercial |
$22.85
|
| Rate for Payer: ASR ASR |
$24.63
|
| Rate for Payer: ASR Commercial |
$24.63
|
| Rate for Payer: BCBS Trust/PPO |
$20.69
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$23.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$25.39
|
| Rate for Payer: Healthscope Whirlpool |
$24.63
|
| Rate for Payer: Mclaren Commercial |
$22.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.34
|
|
|
HC ASPERGILLIS IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200028
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$25.39 |
| Rate for Payer: Aetna Commercial |
$22.85
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: ASR ASR |
$24.63
|
| Rate for Payer: ASR Commercial |
$24.63
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$20.79
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$23.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$25.39
|
| Rate for Payer: Healthscope Whirlpool |
$24.63
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$22.85
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$5.74
|
| Rate for Payer: PHP Medicaid |
$2.80
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.25
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$17.80
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP DNSP |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.80
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC ASPERGILLUS ANTIBODIES
|
Facility
|
IP
|
$46.82
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
30200221
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$30.43 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$42.14
|
| Rate for Payer: ASR ASR |
$45.42
|
| Rate for Payer: ASR Commercial |
$45.42
|
| Rate for Payer: BCBS Trust/PPO |
$38.15
|
| Rate for Payer: BCN Commercial |
$36.30
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Commercial |
$44.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Healthscope Whirlpool |
$45.42
|
| Rate for Payer: Mclaren Commercial |
$42.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.80
|
| Rate for Payer: Nomi Health Commercial |
$38.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$41.20
|
|
|
HC ASPERGILLUS ANTIBODIES
|
Facility
|
OP
|
$46.82
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
30200221
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.07 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$42.14
|
| Rate for Payer: Aetna Medicare |
$15.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.81
|
| Rate for Payer: ASR ASR |
$45.42
|
| Rate for Payer: ASR Commercial |
$45.42
|
| Rate for Payer: BCBS Complete |
$8.47
|
| Rate for Payer: BCBS MAPPO |
$15.05
|
| Rate for Payer: BCBS Trust/PPO |
$38.34
|
| Rate for Payer: BCN Commercial |
$36.30
|
| Rate for Payer: BCN Medicare Advantage |
$15.05
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Commercial |
$44.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.05
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Healthscope Whirlpool |
$45.42
|
| Rate for Payer: Humana Choice PPO Medicare |
$15.05
|
| Rate for Payer: Mclaren Commercial |
$42.14
|
| Rate for Payer: Mclaren Medicaid |
$8.07
|
| Rate for Payer: Mclaren Medicare |
$15.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.80
|
| Rate for Payer: Meridian Medicaid |
$8.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.80
|
| Rate for Payer: Nomi Health Commercial |
$38.39
|
| Rate for Payer: PACE Medicare |
$14.30
|
| Rate for Payer: PACE SWMI |
$15.05
|
| Rate for Payer: PHP Commercial |
$16.56
|
| Rate for Payer: PHP Medicaid |
$8.07
|
| Rate for Payer: PHP Medicare Advantage |
$15.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$41.02
|
| Rate for Payer: Priority Health Medicare |
$15.05
|
| Rate for Payer: Priority Health Narrow Network |
$32.82
|
| Rate for Payer: Railroad Medicare Medicare |
$15.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$41.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.05
|
| Rate for Payer: UHC Exchange |
$23.33
|
| Rate for Payer: UHC Medicare Advantage |
$15.05
|
| Rate for Payer: UHCCP DNSP |
$15.05
|
| Rate for Payer: UHCCP Medicaid |
$8.07
|
| Rate for Payer: VA VA |
$15.05
|
|
|
HC ASPERGILLUS ANTIBODIES CMPT
|
Facility
|
IP
|
$40.58
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
30200222
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$26.38 |
| Max. Negotiated Rate |
$40.58 |
| Rate for Payer: Aetna Commercial |
$36.52
|
| Rate for Payer: ASR ASR |
$39.36
|
| Rate for Payer: ASR Commercial |
$39.36
|
| Rate for Payer: BCBS Trust/PPO |
$33.07
|
| Rate for Payer: BCN Commercial |
$31.46
|
| Rate for Payer: Cash Price |
$32.46
|
| Rate for Payer: Cofinity Commercial |
$38.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.46
|
| Rate for Payer: Healthscope Commercial |
$40.58
|
| Rate for Payer: Healthscope Whirlpool |
$39.36
|
| Rate for Payer: Mclaren Commercial |
$36.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.49
|
| Rate for Payer: Nomi Health Commercial |
$33.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$35.71
|
|
|
HC ASPERGILLUS ANTIBODIES CMPT
|
Facility
|
OP
|
$40.58
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
30200222
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.07 |
| Max. Negotiated Rate |
$40.58 |
| Rate for Payer: Aetna Commercial |
$36.52
|
| Rate for Payer: Aetna Medicare |
$15.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.81
|
| Rate for Payer: ASR ASR |
$39.36
|
| Rate for Payer: ASR Commercial |
$39.36
|
| Rate for Payer: BCBS Complete |
$8.47
|
| Rate for Payer: BCBS MAPPO |
$15.05
|
| Rate for Payer: BCBS Trust/PPO |
$33.23
|
| Rate for Payer: BCN Commercial |
$31.46
|
| Rate for Payer: BCN Medicare Advantage |
$15.05
|
| Rate for Payer: Cash Price |
$32.46
|
| Rate for Payer: Cash Price |
$32.46
|
| Rate for Payer: Cofinity Commercial |
$38.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.05
|
| Rate for Payer: Healthscope Commercial |
$40.58
|
| Rate for Payer: Healthscope Whirlpool |
$39.36
|
| Rate for Payer: Humana Choice PPO Medicare |
$15.05
|
| Rate for Payer: Mclaren Commercial |
$36.52
|
| Rate for Payer: Mclaren Medicaid |
$8.07
|
| Rate for Payer: Mclaren Medicare |
$15.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.80
|
| Rate for Payer: Meridian Medicaid |
$8.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.49
|
| Rate for Payer: Nomi Health Commercial |
$33.28
|
| Rate for Payer: PACE Medicare |
$14.30
|
| Rate for Payer: PACE SWMI |
$15.05
|
| Rate for Payer: PHP Commercial |
$16.56
|
| Rate for Payer: PHP Medicaid |
$8.07
|
| Rate for Payer: PHP Medicare Advantage |
$15.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$35.56
|
| Rate for Payer: Priority Health Medicare |
$15.05
|
| Rate for Payer: Priority Health Narrow Network |
$28.45
|
| Rate for Payer: Railroad Medicare Medicare |
$15.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$35.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.05
|
| Rate for Payer: UHC Exchange |
$23.33
|
| Rate for Payer: UHC Medicare Advantage |
$15.05
|
| Rate for Payer: UHCCP DNSP |
$15.05
|
| Rate for Payer: UHCCP Medicaid |
$8.07
|
| Rate for Payer: VA VA |
$15.05
|
|
|
HC ASPERGILLUS ANTIGEN
|
Facility
|
OP
|
$83.64
|
|
|
Service Code
|
CPT 87305
|
| Hospital Charge Code |
30600135
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.42 |
| Max. Negotiated Rate |
$83.64 |
| Rate for Payer: Aetna Commercial |
$75.28
|
| Rate for Payer: Aetna Medicare |
$11.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.98
|
| Rate for Payer: ASR ASR |
$81.13
|
| Rate for Payer: ASR Commercial |
$81.13
|
| Rate for Payer: BCBS Complete |
$6.74
|
| Rate for Payer: BCBS MAPPO |
$11.98
|
| Rate for Payer: BCBS Trust/PPO |
$68.49
|
| Rate for Payer: BCN Commercial |
$64.85
|
| Rate for Payer: BCN Medicare Advantage |
$11.98
|
| Rate for Payer: Cash Price |
$66.91
|
| Rate for Payer: Cash Price |
$66.91
|
| Rate for Payer: Cofinity Commercial |
$78.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.98
|
| Rate for Payer: Healthscope Commercial |
$83.64
|
| Rate for Payer: Healthscope Whirlpool |
$81.13
|
| Rate for Payer: Humana Choice PPO Medicare |
$11.98
|
| Rate for Payer: Mclaren Commercial |
$75.28
|
| Rate for Payer: Mclaren Medicaid |
$6.42
|
| Rate for Payer: Mclaren Medicare |
$11.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.58
|
| Rate for Payer: Meridian Medicaid |
$6.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.09
|
| Rate for Payer: Nomi Health Commercial |
$68.58
|
| Rate for Payer: PACE Medicare |
$11.38
|
| Rate for Payer: PACE SWMI |
$11.98
|
| Rate for Payer: PHP Commercial |
$13.18
|
| Rate for Payer: PHP Medicaid |
$6.42
|
| Rate for Payer: PHP Medicare Advantage |
$11.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.37
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$73.29
|
| Rate for Payer: Priority Health Medicare |
$11.98
|
| Rate for Payer: Priority Health Narrow Network |
$58.63
|
| Rate for Payer: Railroad Medicare Medicare |
$11.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$73.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.98
|
| Rate for Payer: UHC Exchange |
$18.57
|
| Rate for Payer: UHC Medicare Advantage |
$11.98
|
| Rate for Payer: UHCCP DNSP |
$11.98
|
| Rate for Payer: UHCCP Medicaid |
$6.42
|
| Rate for Payer: VA VA |
$11.98
|
|
|
HC ASPERGILLUS ANTIGEN
|
Facility
|
IP
|
$83.64
|
|
|
Service Code
|
CPT 87305
|
| Hospital Charge Code |
30600135
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$54.37 |
| Max. Negotiated Rate |
$83.64 |
| Rate for Payer: Aetna Commercial |
$75.28
|
| Rate for Payer: ASR ASR |
$81.13
|
| Rate for Payer: ASR Commercial |
$81.13
|
| Rate for Payer: BCBS Trust/PPO |
$68.16
|
| Rate for Payer: BCN Commercial |
$64.85
|
| Rate for Payer: Cash Price |
$66.91
|
| Rate for Payer: Cofinity Commercial |
$78.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.91
|
| Rate for Payer: Healthscope Commercial |
$83.64
|
| Rate for Payer: Healthscope Whirlpool |
$81.13
|
| Rate for Payer: Mclaren Commercial |
$75.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.09
|
| Rate for Payer: Nomi Health Commercial |
$68.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$73.60
|
|
