|
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&VEN TRANSCATH THROMBOLYSIS
|
Facility
|
OP
|
$4,644.53
|
|
|
Service Code
|
CPT 37213
|
| Hospital Charge Code |
36100373
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,645.35 |
| Max. Negotiated Rate |
$4,758.02 |
| Rate for Payer: Aetna Commercial |
$4,180.08
|
| Rate for Payer: Aetna Medicare |
$3,069.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,837.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,837.11
|
| Rate for Payer: ASR ASR |
$4,505.19
|
| Rate for Payer: ASR Commercial |
$4,505.19
|
| Rate for Payer: BCBS Complete |
$1,727.62
|
| Rate for Payer: BCBS MAPPO |
$3,069.69
|
| Rate for Payer: BCBS Trust/PPO |
$3,803.41
|
| Rate for Payer: BCN Commercial |
$3,600.90
|
| Rate for Payer: BCN Medicare Advantage |
$3,069.69
|
| 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 |
$3,069.69
|
| Rate for Payer: Healthscope Commercial |
$4,644.53
|
| Rate for Payer: Healthscope Whirlpool |
$4,505.19
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,069.69
|
| Rate for Payer: Mclaren Commercial |
$4,180.08
|
| Rate for Payer: Mclaren Medicaid |
$1,645.35
|
| Rate for Payer: Mclaren Medicare |
$3,069.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,223.17
|
| Rate for Payer: Meridian Medicaid |
$1,727.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,530.14
|
| 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 |
$2,916.21
|
| Rate for Payer: PACE SWMI |
$3,069.69
|
| Rate for Payer: PHP Commercial |
$3,376.66
|
| Rate for Payer: PHP Medicaid |
$1,645.35
|
| Rate for Payer: PHP Medicare Advantage |
$3,069.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,018.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,069.54
|
| Rate for Payer: Priority Health Medicare |
$3,069.69
|
| Rate for Payer: Priority Health Narrow Network |
$3,255.82
|
| Rate for Payer: Railroad Medicare Medicare |
$3,069.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,087.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,069.69
|
| Rate for Payer: UHC Exchange |
$4,758.02
|
| Rate for Payer: UHC Medicare Advantage |
$3,069.69
|
| Rate for Payer: UHCCP DNSP |
$3,069.69
|
| Rate for Payer: UHCCP Medicaid |
$1,645.35
|
| Rate for Payer: VA VA |
$3,069.69
|
|
|
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
|
OP
|
$195.66
|
|
|
Service Code
|
CPT 77086
|
| Hospital Charge Code |
32000302
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$46.03 |
| Max. Negotiated Rate |
$195.66 |
| Rate for Payer: Aetna Commercial |
$176.09
|
| Rate for Payer: Aetna Medicare |
$85.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.34
|
| Rate for Payer: ASR ASR |
$189.79
|
| Rate for Payer: ASR Commercial |
$189.79
|
| Rate for Payer: BCBS Complete |
$48.33
|
| Rate for Payer: BCBS MAPPO |
$85.87
|
| Rate for Payer: BCBS Trust/PPO |
$160.23
|
| Rate for Payer: BCN Commercial |
$151.70
|
| Rate for Payer: BCN Medicare Advantage |
$85.87
|
| 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 |
$85.87
|
| Rate for Payer: Healthscope Commercial |
$195.66
|
| Rate for Payer: Healthscope Whirlpool |
$189.79
|
| Rate for Payer: Humana Choice PPO Medicare |
$85.87
|
| Rate for Payer: Mclaren Commercial |
$176.09
|
| Rate for Payer: Mclaren Medicaid |
$46.03
|
| Rate for Payer: Mclaren Medicare |
$85.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.16
|
| Rate for Payer: Meridian Medicaid |
$48.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$166.31
|
| Rate for Payer: Nomi Health Commercial |
$160.44
|
| Rate for Payer: PACE Medicare |
$81.58
|
| Rate for Payer: PACE SWMI |
$85.87
|
| Rate for Payer: PHP Commercial |
$94.46
|
| Rate for Payer: PHP Medicaid |
$46.03
|
| Rate for Payer: PHP Medicare Advantage |
$85.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.03
|
| 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 |
$85.87
|
| Rate for Payer: Priority Health Narrow Network |
$137.16
|
| Rate for Payer: Railroad Medicare Medicare |
$85.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$172.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.87
|
| Rate for Payer: UHC Exchange |
$133.10
|
| Rate for Payer: UHC Medicare Advantage |
$85.87
|
| Rate for Payer: UHCCP DNSP |
$85.87
|
| Rate for Payer: UHCCP Medicaid |
$46.03
|
| Rate for Payer: VA VA |
$85.87
|
|
|
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 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 |
$367.80 |
| Max. Negotiated Rate |
$1,234.97 |
| Rate for Payer: Aetna Commercial |
$1,111.47
|
| Rate for Payer: Aetna Medicare |
$686.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$857.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$857.75
|
| Rate for Payer: ASR ASR |
$1,197.92
|
| Rate for Payer: ASR Commercial |
$1,197.92
|
| Rate for Payer: BCBS Complete |
$386.19
|
| Rate for Payer: BCBS MAPPO |
$686.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,011.32
|
| Rate for Payer: BCN Commercial |
$957.47
|
| Rate for Payer: BCN Medicare Advantage |
$686.20
|
| 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 |
$686.20
|
| Rate for Payer: Healthscope Commercial |
$1,234.97
|
| Rate for Payer: Healthscope Whirlpool |
$1,197.92
|
| Rate for Payer: Humana Choice PPO Medicare |
$686.20
|
| Rate for Payer: Mclaren Commercial |
$1,111.47
|
| Rate for Payer: Mclaren Medicaid |
$367.80
|
| Rate for Payer: Mclaren Medicare |
$686.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$720.51
|
| Rate for Payer: Meridian Medicaid |
$386.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$789.13
|
| 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 |
$651.89
|
| Rate for Payer: PACE SWMI |
$686.20
|
| Rate for Payer: PHP Commercial |
$754.82
|
| Rate for Payer: PHP Medicaid |
$367.80
|
| Rate for Payer: PHP Medicare Advantage |
$686.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.80
|
| 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 |
$686.20
|
| Rate for Payer: Priority Health Narrow Network |
$865.71
|
| Rate for Payer: Railroad Medicare Medicare |
$686.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,086.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$686.20
|
| Rate for Payer: UHC Exchange |
$1,063.61
|
| Rate for Payer: UHC Medicare Advantage |
$686.20
|
| Rate for Payer: UHCCP DNSP |
$686.20
|
| Rate for Payer: UHCCP Medicaid |
$367.80
|
| Rate for Payer: VA VA |
$686.20
|
|
|
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 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 |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| 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 |
$16.55
|
| 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
|
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 |
$16.55
|
| 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 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 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
|
|
|
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 |
$14.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.97
|
| 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, BAL
|
Facility
|
OP
|
$90.78
|
|
|
Service Code
|
CPT 87305
|
| Hospital Charge Code |
30600290
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.42 |
| Max. Negotiated Rate |
$90.78 |
| Rate for Payer: Aetna Commercial |
$81.70
|
| Rate for Payer: Aetna Medicare |
$11.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.97
|
| Rate for Payer: ASR ASR |
$88.06
|
| Rate for Payer: ASR Commercial |
$88.06
|
| Rate for Payer: BCBS Complete |
$6.74
|
| Rate for Payer: BCBS MAPPO |
$11.98
|
| Rate for Payer: BCBS Trust/PPO |
$74.34
|
| Rate for Payer: BCN Commercial |
$70.38
|
| Rate for Payer: BCN Medicare Advantage |
$11.98
|
| Rate for Payer: Cash Price |
$72.62
|
| Rate for Payer: Cash Price |
$72.62
|
| Rate for Payer: Cofinity Commercial |
$85.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.98
|
| Rate for Payer: Healthscope Commercial |
$90.78
|
| Rate for Payer: Healthscope Whirlpool |
$88.06
|
| Rate for Payer: Humana Choice PPO Medicare |
$11.98
|
| Rate for Payer: Mclaren Commercial |
$81.70
|
| 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 |
$77.16
|
| Rate for Payer: Nomi Health Commercial |
$74.44
|
| 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 |
$59.01
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$79.54
|
| Rate for Payer: Priority Health Medicare |
$11.98
|
| Rate for Payer: Priority Health Narrow Network |
$63.64
|
| Rate for Payer: Railroad Medicare Medicare |
$11.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$79.89
|
| 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, BAL
|
Facility
|
IP
|
$90.78
|
|
|
Service Code
|
CPT 87305
|
| Hospital Charge Code |
30600290
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$59.01 |
| Max. Negotiated Rate |
$90.78 |
| Rate for Payer: Aetna Commercial |
$81.70
|
| Rate for Payer: ASR ASR |
$88.06
|
| Rate for Payer: ASR Commercial |
$88.06
|
| Rate for Payer: BCBS Trust/PPO |
$73.98
|
| Rate for Payer: BCN Commercial |
$70.38
|
| Rate for Payer: Cash Price |
$72.62
|
| Rate for Payer: Cofinity Commercial |
$85.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.62
|
| Rate for Payer: Healthscope Commercial |
$90.78
|
| Rate for Payer: Healthscope Whirlpool |
$88.06
|
| Rate for Payer: Mclaren Commercial |
$81.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77.16
|
| Rate for Payer: Nomi Health Commercial |
$74.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$79.89
|
|
|
HC ASPERGILLUS FUMIGATUS IGG AB
|
Facility
|
OP
|
$58.14
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
30200224
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.07 |
| Max. Negotiated Rate |
$58.14 |
| Rate for Payer: Aetna Commercial |
$52.33
|
| 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 |
$56.40
|
| Rate for Payer: ASR Commercial |
$56.40
|
| Rate for Payer: BCBS Complete |
$8.47
|
| Rate for Payer: BCBS MAPPO |
$15.05
|
| Rate for Payer: BCBS Trust/PPO |
$47.61
|
| Rate for Payer: BCN Commercial |
$45.08
|
| Rate for Payer: BCN Medicare Advantage |
$15.05
|
| Rate for Payer: Cash Price |
$46.51
|
| Rate for Payer: Cash Price |
$46.51
|
| Rate for Payer: Cofinity Commercial |
$54.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.05
|
| Rate for Payer: Healthscope Commercial |
$58.14
|
| Rate for Payer: Healthscope Whirlpool |
$56.40
|
| Rate for Payer: Humana Choice PPO Medicare |
$15.05
|
| Rate for Payer: Mclaren Commercial |
$52.33
|
| 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 |
$49.42
|
| Rate for Payer: Nomi Health Commercial |
$47.67
|
| Rate for Payer: PACE Medicare |
$14.30
|
| Rate for Payer: PACE SWMI |
$15.05
|
| Rate for Payer: PHP Commercial |
$16.55
|
| 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 |
$37.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$50.94
|
| Rate for Payer: Priority Health Medicare |
$15.05
|
| Rate for Payer: Priority Health Narrow Network |
$40.76
|
| Rate for Payer: Railroad Medicare Medicare |
$15.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$51.16
|
| 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 FUMIGATUS IGG AB
|
Facility
|
IP
|
$58.14
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
30200224
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$37.79 |
| Max. Negotiated Rate |
$58.14 |
| Rate for Payer: Aetna Commercial |
$52.33
|
| Rate for Payer: ASR ASR |
$56.40
|
| Rate for Payer: ASR Commercial |
$56.40
|
| Rate for Payer: BCBS Trust/PPO |
$47.38
|
| Rate for Payer: BCN Commercial |
$45.08
|
| Rate for Payer: Cash Price |
$46.51
|
| Rate for Payer: Cofinity Commercial |
$54.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.51
|
| Rate for Payer: Healthscope Commercial |
$58.14
|
| Rate for Payer: Healthscope Whirlpool |
$56.40
|
| Rate for Payer: Mclaren Commercial |
$52.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.42
|
| Rate for Payer: Nomi Health Commercial |
$47.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$51.16
|
|
|
HC ASP INTERVERTEBRAL DISC
|
Facility
|
IP
|
$843.49
|
|
|
Service Code
|
CPT 62267
|
| Hospital Charge Code |
36100297
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$548.27 |
| Max. Negotiated Rate |
$843.49 |
| Rate for Payer: Aetna Commercial |
$759.14
|
| Rate for Payer: ASR ASR |
$818.19
|
| Rate for Payer: ASR Commercial |
$818.19
|
| Rate for Payer: BCBS Trust/PPO |
$687.36
|
| Rate for Payer: BCN Commercial |
$653.96
|
| Rate for Payer: Cash Price |
$674.79
|
| Rate for Payer: Cofinity Commercial |
$792.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$674.79
|
| Rate for Payer: Healthscope Commercial |
$843.49
|
| Rate for Payer: Healthscope Whirlpool |
$818.19
|
| Rate for Payer: Mclaren Commercial |
$759.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$716.97
|
| Rate for Payer: Nomi Health Commercial |
$691.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$548.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$742.27
|
|
|
HC ASP INTERVERTEBRAL DISC
|
Facility
|
OP
|
$843.49
|
|
|
Service Code
|
CPT 62267
|
| Hospital Charge Code |
36100297
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$367.80 |
| Max. Negotiated Rate |
$1,063.61 |
| Rate for Payer: Aetna Commercial |
$759.14
|
| Rate for Payer: Aetna Medicare |
$686.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$857.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$857.75
|
| Rate for Payer: ASR ASR |
$818.19
|
| Rate for Payer: ASR Commercial |
$818.19
|
| Rate for Payer: BCBS Complete |
$386.19
|
| Rate for Payer: BCBS MAPPO |
$686.20
|
| Rate for Payer: BCBS Trust/PPO |
$690.73
|
| Rate for Payer: BCN Commercial |
$653.96
|
| Rate for Payer: BCN Medicare Advantage |
$686.20
|
| Rate for Payer: Cash Price |
$674.79
|
| Rate for Payer: Cash Price |
$674.79
|
| Rate for Payer: Cofinity Commercial |
$792.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$674.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$686.20
|
| Rate for Payer: Healthscope Commercial |
$843.49
|
| Rate for Payer: Healthscope Whirlpool |
$818.19
|
| Rate for Payer: Humana Choice PPO Medicare |
$686.20
|
| Rate for Payer: Mclaren Commercial |
$759.14
|
| Rate for Payer: Mclaren Medicaid |
$367.80
|
| Rate for Payer: Mclaren Medicare |
$686.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$720.51
|
| Rate for Payer: Meridian Medicaid |
$386.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$789.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$716.97
|
| Rate for Payer: Nomi Health Commercial |
$691.66
|
| Rate for Payer: PACE Medicare |
$651.89
|
| Rate for Payer: PACE SWMI |
$686.20
|
| Rate for Payer: PHP Commercial |
$754.82
|
| Rate for Payer: PHP Medicaid |
$367.80
|
| Rate for Payer: PHP Medicare Advantage |
$686.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$548.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$739.07
|
| Rate for Payer: Priority Health Medicare |
$686.20
|
| Rate for Payer: Priority Health Narrow Network |
$591.29
|
| Rate for Payer: Railroad Medicare Medicare |
$686.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$742.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$686.20
|
| Rate for Payer: UHC Exchange |
$1,063.61
|
| Rate for Payer: UHC Medicare Advantage |
$686.20
|
| Rate for Payer: UHCCP DNSP |
$686.20
|
| Rate for Payer: UHCCP Medicaid |
$367.80
|
| Rate for Payer: VA VA |
$686.20
|
|
|
HC ASPIRATE/INJ GANGLION CYST
|
Facility
|
OP
|
$386.21
|
|
|
Service Code
|
CPT 20612
|
| Hospital Charge Code |
76100209
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$154.31 |
| Max. Negotiated Rate |
$446.23 |
| Rate for Payer: Aetna Commercial |
$347.59
|
| Rate for Payer: Aetna Medicare |
$287.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$359.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$359.86
|
| Rate for Payer: ASR ASR |
$374.62
|
| Rate for Payer: ASR Commercial |
$374.62
|
| Rate for Payer: BCBS Complete |
$162.02
|
| Rate for Payer: BCBS MAPPO |
$287.89
|
| Rate for Payer: BCBS Trust/PPO |
$316.27
|
| Rate for Payer: BCN Commercial |
$299.43
|
| Rate for Payer: BCN Medicare Advantage |
$287.89
|
| Rate for Payer: Cash Price |
$308.97
|
| Rate for Payer: Cash Price |
$308.97
|
| Rate for Payer: Cofinity Commercial |
$363.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$308.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$287.89
|
| Rate for Payer: Healthscope Commercial |
$386.21
|
| Rate for Payer: Healthscope Whirlpool |
$374.62
|
| Rate for Payer: Humana Choice PPO Medicare |
$287.89
|
| Rate for Payer: Mclaren Commercial |
$347.59
|
| Rate for Payer: Mclaren Medicaid |
$154.31
|
| Rate for Payer: Mclaren Medicare |
$287.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$302.28
|
| Rate for Payer: Meridian Medicaid |
$162.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$331.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$328.28
|
| Rate for Payer: Nomi Health Commercial |
$316.69
|
| Rate for Payer: PACE Medicare |
$273.50
|
| Rate for Payer: PACE SWMI |
$287.89
|
| Rate for Payer: PHP Commercial |
$316.68
|
| Rate for Payer: PHP Medicaid |
$154.31
|
| Rate for Payer: PHP Medicare Advantage |
$287.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$154.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$251.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$338.40
|
| Rate for Payer: Priority Health Medicare |
$287.89
|
| Rate for Payer: Priority Health Narrow Network |
$270.73
|
| Rate for Payer: Railroad Medicare Medicare |
$287.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$339.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$287.89
|
| Rate for Payer: UHC Exchange |
$446.23
|
| Rate for Payer: UHC Medicare Advantage |
$287.89
|
| Rate for Payer: UHCCP DNSP |
$287.89
|
| Rate for Payer: UHCCP Medicaid |
$154.31
|
| Rate for Payer: VA VA |
$287.89
|
|
|
HC ASPIRATE/INJ GANGLION CYST
|
Facility
|
IP
|
$386.21
|
|
|
Service Code
|
CPT 20612
|
| Hospital Charge Code |
76100209
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$251.04 |
| Max. Negotiated Rate |
$386.21 |
| Rate for Payer: Aetna Commercial |
$347.59
|
| Rate for Payer: ASR ASR |
$374.62
|
| Rate for Payer: ASR Commercial |
$374.62
|
| Rate for Payer: BCBS Trust/PPO |
$314.72
|
| Rate for Payer: BCN Commercial |
$299.43
|
| Rate for Payer: Cash Price |
$308.97
|
| Rate for Payer: Cofinity Commercial |
$363.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$308.97
|
| Rate for Payer: Healthscope Commercial |
$386.21
|
| Rate for Payer: Healthscope Whirlpool |
$374.62
|
| Rate for Payer: Mclaren Commercial |
$347.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$328.28
|
| Rate for Payer: Nomi Health Commercial |
$316.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$251.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$339.86
|
|
|
HC ASPIRATION BLADDER WITH CATHETHER
|
Facility
|
IP
|
$3,128.23
|
|
|
Service Code
|
CPT 51102
|
| Hospital Charge Code |
36100250
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,033.35 |
| Max. Negotiated Rate |
$3,128.23 |
| Rate for Payer: Aetna Commercial |
$2,815.41
|
| Rate for Payer: ASR ASR |
$3,034.38
|
| Rate for Payer: ASR Commercial |
$3,034.38
|
| Rate for Payer: BCBS Trust/PPO |
$2,549.19
|
| Rate for Payer: BCN Commercial |
$2,425.32
|
| Rate for Payer: Cash Price |
$2,502.58
|
| Rate for Payer: Cofinity Commercial |
$2,940.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,502.58
|
| Rate for Payer: Healthscope Commercial |
$3,128.23
|
| Rate for Payer: Healthscope Whirlpool |
$3,034.38
|
| Rate for Payer: Mclaren Commercial |
$2,815.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,659.00
|
| Rate for Payer: Nomi Health Commercial |
$2,565.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,033.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,752.84
|
|
|
HC ASPIRATION BLADDER WITH CATHETHER
|
Facility
|
OP
|
$3,128.23
|
|
|
Service Code
|
CPT 51102
|
| Hospital Charge Code |
36100250
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,070.86 |
| Max. Negotiated Rate |
$3,128.23 |
| Rate for Payer: Aetna Commercial |
$2,815.41
|
| Rate for Payer: Aetna Medicare |
$1,997.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,497.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,497.34
|
| Rate for Payer: ASR ASR |
$3,034.38
|
| Rate for Payer: ASR Commercial |
$3,034.38
|
| Rate for Payer: BCBS Complete |
$1,124.40
|
| Rate for Payer: BCBS MAPPO |
$1,997.87
|
| Rate for Payer: BCBS Trust/PPO |
$2,561.71
|
| Rate for Payer: BCN Commercial |
$2,425.32
|
| Rate for Payer: BCN Medicare Advantage |
$1,997.87
|
| Rate for Payer: Cash Price |
$2,502.58
|
| Rate for Payer: Cash Price |
$2,502.58
|
| Rate for Payer: Cofinity Commercial |
$2,940.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,502.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,997.87
|
| Rate for Payer: Healthscope Commercial |
$3,128.23
|
| Rate for Payer: Healthscope Whirlpool |
$3,034.38
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,997.87
|
| Rate for Payer: Mclaren Commercial |
$2,815.41
|
| Rate for Payer: Mclaren Medicaid |
$1,070.86
|
| Rate for Payer: Mclaren Medicare |
$1,997.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,097.76
|
| Rate for Payer: Meridian Medicaid |
$1,124.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,297.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,659.00
|
| Rate for Payer: Nomi Health Commercial |
$2,565.15
|
| Rate for Payer: PACE Medicare |
$1,897.98
|
| Rate for Payer: PACE SWMI |
$1,997.87
|
| Rate for Payer: PHP Commercial |
$2,197.66
|
| Rate for Payer: PHP Medicaid |
$1,070.86
|
| Rate for Payer: PHP Medicare Advantage |
$1,997.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,070.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,033.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,740.96
|
| Rate for Payer: Priority Health Medicare |
$1,997.87
|
| Rate for Payer: Priority Health Narrow Network |
$2,192.89
|
| Rate for Payer: Railroad Medicare Medicare |
$1,997.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,752.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,997.87
|
| Rate for Payer: UHC Exchange |
$3,096.70
|
| Rate for Payer: UHC Medicare Advantage |
$1,997.87
|
| Rate for Payer: UHCCP DNSP |
$1,997.87
|
| Rate for Payer: UHCCP Medicaid |
$1,070.86
|
| Rate for Payer: VA VA |
$1,997.87
|
|
