|
HC ATHERECT ABDOMINAL AORTA
|
Facility
|
IP
|
$14,889.58
|
|
|
Service Code
|
CPT 0236T
|
| Hospital Charge Code |
36100300
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9,678.23 |
| Max. Negotiated Rate |
$14,889.58 |
| Rate for Payer: Aetna Commercial |
$13,400.62
|
| Rate for Payer: ASR ASR |
$14,442.89
|
| Rate for Payer: ASR Commercial |
$14,442.89
|
| Rate for Payer: BCBS Trust/PPO |
$12,133.52
|
| Rate for Payer: BCN Commercial |
$11,543.89
|
| Rate for Payer: Cash Price |
$11,911.66
|
| Rate for Payer: Cofinity Commercial |
$13,996.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,911.66
|
| Rate for Payer: Healthscope Commercial |
$14,889.58
|
| Rate for Payer: Healthscope Whirlpool |
$14,442.89
|
| Rate for Payer: Mclaren Commercial |
$13,400.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,656.14
|
| Rate for Payer: Nomi Health Commercial |
$12,209.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,678.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$13,102.83
|
|
|
HC ATHERECT BRACHIOCEPHAL EA V
|
Facility
|
OP
|
$14,889.58
|
|
|
Service Code
|
CPT 0237T
|
| Hospital Charge Code |
36100301
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,955.64 |
| Max. Negotiated Rate |
$17,222.45 |
| Rate for Payer: Aetna Commercial |
$13,400.62
|
| Rate for Payer: Aetna Medicare |
$11,111.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,889.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,889.08
|
| Rate for Payer: ASR ASR |
$14,442.89
|
| Rate for Payer: ASR Commercial |
$14,442.89
|
| Rate for Payer: BCBS Complete |
$6,253.42
|
| Rate for Payer: BCBS MAPPO |
$11,111.26
|
| Rate for Payer: BCBS Trust/PPO |
$12,193.08
|
| Rate for Payer: BCN Commercial |
$11,543.89
|
| Rate for Payer: BCN Medicare Advantage |
$11,111.26
|
| Rate for Payer: Cash Price |
$11,911.66
|
| Rate for Payer: Cash Price |
$11,911.66
|
| Rate for Payer: Cofinity Commercial |
$13,996.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,911.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,111.26
|
| Rate for Payer: Healthscope Commercial |
$14,889.58
|
| Rate for Payer: Healthscope Whirlpool |
$14,442.89
|
| Rate for Payer: Humana Choice PPO Medicare |
$11,111.26
|
| Rate for Payer: Mclaren Commercial |
$13,400.62
|
| Rate for Payer: Mclaren Medicaid |
$5,955.64
|
| Rate for Payer: Mclaren Medicare |
$11,111.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,666.82
|
| Rate for Payer: Meridian Medicaid |
$6,253.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,777.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,656.14
|
| Rate for Payer: Nomi Health Commercial |
$12,209.46
|
| Rate for Payer: PACE Medicare |
$10,555.70
|
| Rate for Payer: PACE SWMI |
$11,111.26
|
| Rate for Payer: PHP Commercial |
$12,222.39
|
| Rate for Payer: PHP Medicaid |
$5,955.64
|
| Rate for Payer: PHP Medicare Advantage |
$11,111.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,955.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,678.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13,046.25
|
| Rate for Payer: Priority Health Medicare |
$11,111.26
|
| Rate for Payer: Priority Health Narrow Network |
$10,437.60
|
| Rate for Payer: Railroad Medicare Medicare |
$11,111.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$13,102.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,111.26
|
| Rate for Payer: UHC Exchange |
$17,222.45
|
| Rate for Payer: UHC Medicare Advantage |
$11,111.26
|
| Rate for Payer: UHCCP DNSP |
$11,111.26
|
| Rate for Payer: UHCCP Medicaid |
$5,955.64
|
| Rate for Payer: VA VA |
$11,111.26
|
|
|
HC ATHERECT BRACHIOCEPHAL EA V
|
Facility
|
IP
|
$14,889.58
|
|
|
Service Code
|
CPT 0237T
|
| Hospital Charge Code |
36100301
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9,678.23 |
| Max. Negotiated Rate |
$14,889.58 |
| Rate for Payer: Aetna Commercial |
$13,400.62
|
| Rate for Payer: ASR ASR |
$14,442.89
|
| Rate for Payer: ASR Commercial |
$14,442.89
|
| Rate for Payer: BCBS Trust/PPO |
$12,133.52
|
| Rate for Payer: BCN Commercial |
$11,543.89
|
| Rate for Payer: Cash Price |
$11,911.66
|
| Rate for Payer: Cofinity Commercial |
$13,996.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,911.66
|
| Rate for Payer: Healthscope Commercial |
$14,889.58
|
| Rate for Payer: Healthscope Whirlpool |
$14,442.89
|
| Rate for Payer: Mclaren Commercial |
$13,400.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,656.14
|
| Rate for Payer: Nomi Health Commercial |
$12,209.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,678.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$13,102.83
|
|
|
HC ATHERECT ILIAC ARTERY EA VE
|
Facility
|
IP
|
$12,085.44
|
|
|
Service Code
|
CPT 0238T
|
| Hospital Charge Code |
36100302
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,855.54 |
| Max. Negotiated Rate |
$12,085.44 |
| Rate for Payer: Aetna Commercial |
$10,876.90
|
| Rate for Payer: ASR ASR |
$11,722.88
|
| Rate for Payer: ASR Commercial |
$11,722.88
|
| Rate for Payer: BCBS Trust/PPO |
$9,848.43
|
| Rate for Payer: BCN Commercial |
$9,369.84
|
| Rate for Payer: Cash Price |
$9,668.35
|
| Rate for Payer: Cofinity Commercial |
$11,360.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,668.35
|
| Rate for Payer: Healthscope Commercial |
$12,085.44
|
| Rate for Payer: Healthscope Whirlpool |
$11,722.88
|
| Rate for Payer: Mclaren Commercial |
$10,876.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,272.62
|
| Rate for Payer: Nomi Health Commercial |
$9,910.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,855.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,635.19
|
|
|
HC ATHERECT ILIAC ARTERY EA VE
|
Facility
|
OP
|
$12,085.44
|
|
|
Service Code
|
CPT 0238T
|
| Hospital Charge Code |
36100302
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,855.54 |
| Max. Negotiated Rate |
$27,270.14 |
| Rate for Payer: Aetna Commercial |
$10,876.90
|
| Rate for Payer: Aetna Medicare |
$17,593.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21,992.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21,992.05
|
| Rate for Payer: ASR ASR |
$11,722.88
|
| Rate for Payer: ASR Commercial |
$11,722.88
|
| Rate for Payer: BCBS Complete |
$9,901.70
|
| Rate for Payer: BCBS MAPPO |
$17,593.64
|
| Rate for Payer: BCBS Trust/PPO |
$9,896.77
|
| Rate for Payer: BCN Commercial |
$9,369.84
|
| Rate for Payer: BCN Medicare Advantage |
$17,593.64
|
| Rate for Payer: Cash Price |
$9,668.35
|
| Rate for Payer: Cash Price |
$9,668.35
|
| Rate for Payer: Cofinity Commercial |
$11,360.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,668.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,593.64
|
| Rate for Payer: Healthscope Commercial |
$12,085.44
|
| Rate for Payer: Healthscope Whirlpool |
$11,722.88
|
| Rate for Payer: Humana Choice PPO Medicare |
$17,593.64
|
| Rate for Payer: Mclaren Commercial |
$10,876.90
|
| Rate for Payer: Mclaren Medicaid |
$9,430.19
|
| Rate for Payer: Mclaren Medicare |
$17,593.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18,473.32
|
| Rate for Payer: Meridian Medicaid |
$9,901.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20,232.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,272.62
|
| Rate for Payer: Nomi Health Commercial |
$9,910.06
|
| Rate for Payer: PACE Medicare |
$16,713.96
|
| Rate for Payer: PACE SWMI |
$17,593.64
|
| Rate for Payer: PHP Commercial |
$19,353.00
|
| Rate for Payer: PHP Medicaid |
$9,430.19
|
| Rate for Payer: PHP Medicare Advantage |
$17,593.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,430.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,855.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,589.26
|
| Rate for Payer: Priority Health Medicare |
$17,593.64
|
| Rate for Payer: Priority Health Narrow Network |
$8,471.89
|
| Rate for Payer: Railroad Medicare Medicare |
$17,593.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,635.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$17,593.64
|
| Rate for Payer: UHC Exchange |
$27,270.14
|
| Rate for Payer: UHC Medicare Advantage |
$17,593.64
|
| Rate for Payer: UHCCP DNSP |
$17,593.64
|
| Rate for Payer: UHCCP Medicaid |
$9,430.19
|
| Rate for Payer: VA VA |
$17,593.64
|
|
|
HC ATHERECTOMY RENAL ARTERY
|
Facility
|
IP
|
$12,970.49
|
|
|
Service Code
|
CPT 0234T
|
| Hospital Charge Code |
36100304
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,430.82 |
| Max. Negotiated Rate |
$12,970.49 |
| Rate for Payer: Aetna Commercial |
$11,673.44
|
| Rate for Payer: ASR ASR |
$12,581.38
|
| Rate for Payer: ASR Commercial |
$12,581.38
|
| Rate for Payer: BCBS Trust/PPO |
$10,569.65
|
| Rate for Payer: BCN Commercial |
$10,056.02
|
| Rate for Payer: Cash Price |
$10,376.39
|
| Rate for Payer: Cofinity Commercial |
$12,192.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,376.39
|
| Rate for Payer: Healthscope Commercial |
$12,970.49
|
| Rate for Payer: Healthscope Whirlpool |
$12,581.38
|
| Rate for Payer: Mclaren Commercial |
$11,673.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,024.92
|
| Rate for Payer: Nomi Health Commercial |
$10,635.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,430.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11,414.03
|
|
|
HC ATHERECTOMY RENAL ARTERY
|
Facility
|
OP
|
$12,970.49
|
|
|
Service Code
|
CPT 0234T
|
| Hospital Charge Code |
36100304
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,955.64 |
| Max. Negotiated Rate |
$17,222.45 |
| Rate for Payer: Aetna Commercial |
$11,673.44
|
| Rate for Payer: Aetna Medicare |
$11,111.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,889.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,889.08
|
| Rate for Payer: ASR ASR |
$12,581.38
|
| Rate for Payer: ASR Commercial |
$12,581.38
|
| Rate for Payer: BCBS Complete |
$6,253.42
|
| Rate for Payer: BCBS MAPPO |
$11,111.26
|
| Rate for Payer: BCBS Trust/PPO |
$10,621.53
|
| Rate for Payer: BCN Commercial |
$10,056.02
|
| Rate for Payer: BCN Medicare Advantage |
$11,111.26
|
| Rate for Payer: Cash Price |
$10,376.39
|
| Rate for Payer: Cash Price |
$10,376.39
|
| Rate for Payer: Cofinity Commercial |
$12,192.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,376.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,111.26
|
| Rate for Payer: Healthscope Commercial |
$12,970.49
|
| Rate for Payer: Healthscope Whirlpool |
$12,581.38
|
| Rate for Payer: Humana Choice PPO Medicare |
$11,111.26
|
| Rate for Payer: Mclaren Commercial |
$11,673.44
|
| Rate for Payer: Mclaren Medicaid |
$5,955.64
|
| Rate for Payer: Mclaren Medicare |
$11,111.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,666.82
|
| Rate for Payer: Meridian Medicaid |
$6,253.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,777.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,024.92
|
| Rate for Payer: Nomi Health Commercial |
$10,635.80
|
| Rate for Payer: PACE Medicare |
$10,555.70
|
| Rate for Payer: PACE SWMI |
$11,111.26
|
| Rate for Payer: PHP Commercial |
$12,222.39
|
| Rate for Payer: PHP Medicaid |
$5,955.64
|
| Rate for Payer: PHP Medicare Advantage |
$11,111.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,955.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,430.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11,364.74
|
| Rate for Payer: Priority Health Medicare |
$11,111.26
|
| Rate for Payer: Priority Health Narrow Network |
$9,092.31
|
| Rate for Payer: Railroad Medicare Medicare |
$11,111.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11,414.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,111.26
|
| Rate for Payer: UHC Exchange |
$17,222.45
|
| Rate for Payer: UHC Medicare Advantage |
$11,111.26
|
| Rate for Payer: UHCCP DNSP |
$11,111.26
|
| Rate for Payer: UHCCP Medicaid |
$5,955.64
|
| Rate for Payer: VA VA |
$11,111.26
|
|
|
HC ATHERECT VISCERAL EACH VESS
|
Facility
|
IP
|
$12,970.49
|
|
|
Service Code
|
CPT 0235T
|
| Hospital Charge Code |
36100303
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,430.82 |
| Max. Negotiated Rate |
$12,970.49 |
| Rate for Payer: Aetna Commercial |
$11,673.44
|
| Rate for Payer: ASR ASR |
$12,581.38
|
| Rate for Payer: ASR Commercial |
$12,581.38
|
| Rate for Payer: BCBS Trust/PPO |
$10,569.65
|
| Rate for Payer: BCN Commercial |
$10,056.02
|
| Rate for Payer: Cash Price |
$10,376.39
|
| Rate for Payer: Cofinity Commercial |
$12,192.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,376.39
|
| Rate for Payer: Healthscope Commercial |
$12,970.49
|
| Rate for Payer: Healthscope Whirlpool |
$12,581.38
|
| Rate for Payer: Mclaren Commercial |
$11,673.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,024.92
|
| Rate for Payer: Nomi Health Commercial |
$10,635.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,430.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11,414.03
|
|
|
HC ATHERECT VISCERAL EACH VESS
|
Facility
|
OP
|
$12,970.49
|
|
|
Service Code
|
CPT 0235T
|
| Hospital Charge Code |
36100303
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,188.20 |
| Max. Negotiated Rate |
$12,970.49 |
| Rate for Payer: Aetna Commercial |
$11,673.44
|
| Rate for Payer: Aetna Medicare |
$6,485.24
|
| Rate for Payer: ASR ASR |
$12,581.38
|
| Rate for Payer: ASR Commercial |
$12,581.38
|
| Rate for Payer: BCBS Complete |
$5,188.20
|
| Rate for Payer: BCBS Trust/PPO |
$10,621.53
|
| Rate for Payer: BCN Commercial |
$10,056.02
|
| Rate for Payer: Cash Price |
$10,376.39
|
| Rate for Payer: Cofinity Commercial |
$12,192.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,376.39
|
| Rate for Payer: Healthscope Commercial |
$12,970.49
|
| Rate for Payer: Healthscope Whirlpool |
$12,581.38
|
| Rate for Payer: Mclaren Commercial |
$11,673.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,024.92
|
| Rate for Payer: Nomi Health Commercial |
$10,635.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,430.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11,364.74
|
| Rate for Payer: Priority Health Narrow Network |
$9,092.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11,414.03
|
|
|
HC ATS NON OPEN HEART
|
Facility
|
IP
|
$2,250.45
|
|
| Hospital Charge Code |
27000088
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,462.79 |
| Max. Negotiated Rate |
$2,250.45 |
| Rate for Payer: Aetna Commercial |
$2,025.40
|
| Rate for Payer: ASR ASR |
$2,182.94
|
| Rate for Payer: ASR Commercial |
$2,182.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,833.89
|
| Rate for Payer: BCN Commercial |
$1,744.77
|
| Rate for Payer: Cash Price |
$1,800.36
|
| Rate for Payer: Cofinity Commercial |
$2,115.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,800.36
|
| Rate for Payer: Healthscope Commercial |
$2,250.45
|
| Rate for Payer: Healthscope Whirlpool |
$2,182.94
|
| Rate for Payer: Mclaren Commercial |
$2,025.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,912.88
|
| Rate for Payer: Nomi Health Commercial |
$1,845.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,462.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,980.40
|
|
|
HC ATS NON OPEN HEART
|
Facility
|
OP
|
$2,250.45
|
|
| Hospital Charge Code |
27000088
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$900.18 |
| Max. Negotiated Rate |
$2,250.45 |
| Rate for Payer: Aetna Commercial |
$2,025.40
|
| Rate for Payer: Aetna Medicare |
$1,125.22
|
| Rate for Payer: ASR ASR |
$2,182.94
|
| Rate for Payer: ASR Commercial |
$2,182.94
|
| Rate for Payer: BCBS Complete |
$900.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,842.89
|
| Rate for Payer: BCN Commercial |
$1,744.77
|
| Rate for Payer: Cash Price |
$1,800.36
|
| Rate for Payer: Cofinity Commercial |
$2,115.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,800.36
|
| Rate for Payer: Healthscope Commercial |
$2,250.45
|
| Rate for Payer: Healthscope Whirlpool |
$2,182.94
|
| Rate for Payer: Mclaren Commercial |
$2,025.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,912.88
|
| Rate for Payer: Nomi Health Commercial |
$1,845.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,462.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,971.84
|
| Rate for Payer: Priority Health Narrow Network |
$1,577.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,980.40
|
|
|
HC ATS STAND BY HR
|
Facility
|
OP
|
$1,537.13
|
|
| Hospital Charge Code |
27000089
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$614.85 |
| Max. Negotiated Rate |
$1,537.13 |
| Rate for Payer: Aetna Commercial |
$1,383.42
|
| Rate for Payer: Aetna Medicare |
$768.56
|
| Rate for Payer: ASR ASR |
$1,491.02
|
| Rate for Payer: ASR Commercial |
$1,491.02
|
| Rate for Payer: BCBS Complete |
$614.85
|
| Rate for Payer: BCBS Trust/PPO |
$1,258.76
|
| Rate for Payer: BCN Commercial |
$1,191.74
|
| Rate for Payer: Cash Price |
$1,229.70
|
| Rate for Payer: Cofinity Commercial |
$1,444.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,229.70
|
| Rate for Payer: Healthscope Commercial |
$1,537.13
|
| Rate for Payer: Healthscope Whirlpool |
$1,491.02
|
| Rate for Payer: Mclaren Commercial |
$1,383.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,306.56
|
| Rate for Payer: Nomi Health Commercial |
$1,260.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$999.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,346.83
|
| Rate for Payer: Priority Health Narrow Network |
$1,077.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,352.67
|
|
|
HC ATS STAND BY HR
|
Facility
|
IP
|
$1,537.13
|
|
| Hospital Charge Code |
27000089
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$999.13 |
| Max. Negotiated Rate |
$1,537.13 |
| Rate for Payer: Aetna Commercial |
$1,383.42
|
| Rate for Payer: ASR ASR |
$1,491.02
|
| Rate for Payer: ASR Commercial |
$1,491.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,252.61
|
| Rate for Payer: BCN Commercial |
$1,191.74
|
| Rate for Payer: Cash Price |
$1,229.70
|
| Rate for Payer: Cofinity Commercial |
$1,444.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,229.70
|
| Rate for Payer: Healthscope Commercial |
$1,537.13
|
| Rate for Payer: Healthscope Whirlpool |
$1,491.02
|
| Rate for Payer: Mclaren Commercial |
$1,383.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,306.56
|
| Rate for Payer: Nomi Health Commercial |
$1,260.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$999.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,352.67
|
|
|
HC ATYPICAL PNEUMO EVAL C PNEUM
|
Facility
|
OP
|
$15.61
|
|
|
Service Code
|
CPT 86631
|
| Hospital Charge Code |
30200240
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.34 |
| Max. Negotiated Rate |
$18.32 |
| Rate for Payer: Aetna Commercial |
$14.05
|
| Rate for Payer: Aetna Medicare |
$11.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.78
|
| Rate for Payer: ASR ASR |
$15.14
|
| Rate for Payer: ASR Commercial |
$15.14
|
| Rate for Payer: BCBS Complete |
$6.65
|
| Rate for Payer: BCBS MAPPO |
$11.82
|
| Rate for Payer: BCBS Trust/PPO |
$12.78
|
| Rate for Payer: BCN Commercial |
$12.10
|
| Rate for Payer: BCN Medicare Advantage |
$11.82
|
| Rate for Payer: Cash Price |
$12.49
|
| Rate for Payer: Cash Price |
$12.49
|
| Rate for Payer: Cofinity Commercial |
$14.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.82
|
| Rate for Payer: Healthscope Commercial |
$15.61
|
| Rate for Payer: Healthscope Whirlpool |
$15.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$11.82
|
| Rate for Payer: Mclaren Commercial |
$14.05
|
| Rate for Payer: Mclaren Medicaid |
$6.34
|
| Rate for Payer: Mclaren Medicare |
$11.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.41
|
| Rate for Payer: Meridian Medicaid |
$6.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.27
|
| Rate for Payer: Nomi Health Commercial |
$12.80
|
| Rate for Payer: PACE Medicare |
$11.23
|
| Rate for Payer: PACE SWMI |
$11.82
|
| Rate for Payer: PHP Commercial |
$13.00
|
| Rate for Payer: PHP Medicaid |
$6.34
|
| Rate for Payer: PHP Medicare Advantage |
$11.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.68
|
| Rate for Payer: Priority Health Medicare |
$11.82
|
| Rate for Payer: Priority Health Narrow Network |
$10.94
|
| Rate for Payer: Railroad Medicare Medicare |
$11.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$13.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.82
|
| Rate for Payer: UHC Exchange |
$18.32
|
| Rate for Payer: UHC Medicare Advantage |
$11.82
|
| Rate for Payer: UHCCP DNSP |
$11.82
|
| Rate for Payer: UHCCP Medicaid |
$6.34
|
| Rate for Payer: VA VA |
$11.82
|
|
|
HC ATYPICAL PNEUMO EVAL C PNEUM
|
Facility
|
IP
|
$15.61
|
|
|
Service Code
|
CPT 86631
|
| Hospital Charge Code |
30200240
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.15 |
| Max. Negotiated Rate |
$15.61 |
| Rate for Payer: Aetna Commercial |
$14.05
|
| Rate for Payer: ASR ASR |
$15.14
|
| Rate for Payer: ASR Commercial |
$15.14
|
| Rate for Payer: BCBS Trust/PPO |
$12.72
|
| Rate for Payer: BCN Commercial |
$12.10
|
| Rate for Payer: Cash Price |
$12.49
|
| Rate for Payer: Cofinity Commercial |
$14.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.49
|
| Rate for Payer: Healthscope Commercial |
$15.61
|
| Rate for Payer: Healthscope Whirlpool |
$15.14
|
| Rate for Payer: Mclaren Commercial |
$14.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.27
|
| Rate for Payer: Nomi Health Commercial |
$12.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$13.74
|
|
|
HC ATYPICAL PNEUMO EVAL C PNEUM IGM
|
Facility
|
OP
|
$15.61
|
|
|
Service Code
|
CPT 86632
|
| Hospital Charge Code |
30200243
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.80 |
| Max. Negotiated Rate |
$19.65 |
| Rate for Payer: Aetna Commercial |
$14.05
|
| Rate for Payer: Aetna Medicare |
$12.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.85
|
| Rate for Payer: ASR ASR |
$15.14
|
| Rate for Payer: ASR Commercial |
$15.14
|
| Rate for Payer: BCBS Complete |
$7.14
|
| Rate for Payer: BCBS MAPPO |
$12.68
|
| Rate for Payer: BCBS Trust/PPO |
$12.78
|
| Rate for Payer: BCN Commercial |
$12.10
|
| Rate for Payer: BCN Medicare Advantage |
$12.68
|
| Rate for Payer: Cash Price |
$12.49
|
| Rate for Payer: Cash Price |
$12.49
|
| Rate for Payer: Cofinity Commercial |
$14.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.68
|
| Rate for Payer: Healthscope Commercial |
$15.61
|
| Rate for Payer: Healthscope Whirlpool |
$15.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.68
|
| Rate for Payer: Mclaren Commercial |
$14.05
|
| Rate for Payer: Mclaren Medicaid |
$6.80
|
| Rate for Payer: Mclaren Medicare |
$12.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.31
|
| Rate for Payer: Meridian Medicaid |
$7.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.27
|
| Rate for Payer: Nomi Health Commercial |
$12.80
|
| Rate for Payer: PACE Medicare |
$12.05
|
| Rate for Payer: PACE SWMI |
$12.68
|
| Rate for Payer: PHP Commercial |
$13.95
|
| Rate for Payer: PHP Medicaid |
$6.80
|
| Rate for Payer: PHP Medicare Advantage |
$12.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.68
|
| Rate for Payer: Priority Health Medicare |
$12.68
|
| Rate for Payer: Priority Health Narrow Network |
$10.94
|
| Rate for Payer: Railroad Medicare Medicare |
$12.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$13.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.68
|
| Rate for Payer: UHC Exchange |
$19.65
|
| Rate for Payer: UHC Medicare Advantage |
$12.68
|
| Rate for Payer: UHCCP DNSP |
$12.68
|
| Rate for Payer: UHCCP Medicaid |
$6.80
|
| Rate for Payer: VA VA |
$12.68
|
|
|
HC ATYPICAL PNEUMO EVAL C PNEUM IGM
|
Facility
|
IP
|
$15.61
|
|
|
Service Code
|
CPT 86632
|
| Hospital Charge Code |
30200243
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.15 |
| Max. Negotiated Rate |
$15.61 |
| Rate for Payer: Aetna Commercial |
$14.05
|
| Rate for Payer: ASR ASR |
$15.14
|
| Rate for Payer: ASR Commercial |
$15.14
|
| Rate for Payer: BCBS Trust/PPO |
$12.72
|
| Rate for Payer: BCN Commercial |
$12.10
|
| Rate for Payer: Cash Price |
$12.49
|
| Rate for Payer: Cofinity Commercial |
$14.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.49
|
| Rate for Payer: Healthscope Commercial |
$15.61
|
| Rate for Payer: Healthscope Whirlpool |
$15.14
|
| Rate for Payer: Mclaren Commercial |
$14.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.27
|
| Rate for Payer: Nomi Health Commercial |
$12.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$13.74
|
|
|
HC ATYPICAL PNEUMO EVAL L PNEUM
|
Facility
|
IP
|
$21.85
|
|
|
Service Code
|
CPT 86713
|
| Hospital Charge Code |
30200302
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.20 |
| Max. Negotiated Rate |
$21.85 |
| Rate for Payer: Aetna Commercial |
$19.66
|
| Rate for Payer: ASR ASR |
$21.19
|
| Rate for Payer: ASR Commercial |
$21.19
|
| Rate for Payer: BCBS Trust/PPO |
$17.81
|
| Rate for Payer: BCN Commercial |
$16.94
|
| Rate for Payer: Cash Price |
$17.48
|
| Rate for Payer: Cofinity Commercial |
$20.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.48
|
| Rate for Payer: Healthscope Commercial |
$21.85
|
| Rate for Payer: Healthscope Whirlpool |
$21.19
|
| Rate for Payer: Mclaren Commercial |
$19.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.57
|
| Rate for Payer: Nomi Health Commercial |
$17.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19.23
|
|
|
HC ATYPICAL PNEUMO EVAL L PNEUM
|
Facility
|
OP
|
$21.85
|
|
|
Service Code
|
CPT 86713
|
| Hospital Charge Code |
30200302
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.20 |
| Max. Negotiated Rate |
$83.45 |
| Rate for Payer: Aetna Commercial |
$19.66
|
| Rate for Payer: Aetna Medicare |
$15.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.12
|
| Rate for Payer: ASR ASR |
$21.19
|
| Rate for Payer: ASR Commercial |
$21.19
|
| Rate for Payer: BCBS Complete |
$8.61
|
| Rate for Payer: BCBS MAPPO |
$15.30
|
| Rate for Payer: BCBS Trust/PPO |
$17.89
|
| Rate for Payer: BCN Commercial |
$16.94
|
| Rate for Payer: BCN Medicare Advantage |
$15.30
|
| Rate for Payer: Cash Price |
$17.48
|
| Rate for Payer: Cash Price |
$17.48
|
| Rate for Payer: Cofinity Commercial |
$20.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.30
|
| Rate for Payer: Healthscope Commercial |
$21.85
|
| Rate for Payer: Healthscope Whirlpool |
$21.19
|
| Rate for Payer: Humana Choice PPO Medicare |
$15.30
|
| Rate for Payer: Mclaren Commercial |
$19.66
|
| Rate for Payer: Mclaren Medicaid |
$8.20
|
| Rate for Payer: Mclaren Medicare |
$15.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.06
|
| Rate for Payer: Meridian Medicaid |
$8.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.57
|
| Rate for Payer: Nomi Health Commercial |
$17.92
|
| Rate for Payer: PACE Medicare |
$14.54
|
| Rate for Payer: PACE SWMI |
$15.30
|
| Rate for Payer: PHP Commercial |
$16.83
|
| Rate for Payer: PHP Medicaid |
$8.20
|
| Rate for Payer: PHP Medicare Advantage |
$15.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$83.45
|
| Rate for Payer: Priority Health Medicare |
$15.30
|
| Rate for Payer: Priority Health Narrow Network |
$66.76
|
| Rate for Payer: Railroad Medicare Medicare |
$15.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.30
|
| Rate for Payer: UHC Exchange |
$23.72
|
| Rate for Payer: UHC Medicare Advantage |
$15.30
|
| Rate for Payer: UHCCP DNSP |
$15.30
|
| Rate for Payer: UHCCP Medicaid |
$8.20
|
| Rate for Payer: VA VA |
$15.30
|
|
|
HC ATYPICAL PNEUMO EVAL M PNEUM
|
Facility
|
OP
|
$14.57
|
|
|
Service Code
|
CPT 86738
|
| Hospital Charge Code |
30200308
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.10 |
| Max. Negotiated Rate |
$59.85 |
| Rate for Payer: Aetna Commercial |
$13.11
|
| Rate for Payer: Aetna Medicare |
$13.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.55
|
| Rate for Payer: ASR ASR |
$14.13
|
| Rate for Payer: ASR Commercial |
$14.13
|
| Rate for Payer: BCBS Complete |
$7.45
|
| Rate for Payer: BCBS MAPPO |
$13.24
|
| Rate for Payer: BCBS Trust/PPO |
$11.93
|
| Rate for Payer: BCN Commercial |
$11.30
|
| Rate for Payer: BCN Medicare Advantage |
$13.24
|
| Rate for Payer: Cash Price |
$11.66
|
| Rate for Payer: Cash Price |
$11.66
|
| Rate for Payer: Cofinity Commercial |
$13.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.24
|
| Rate for Payer: Healthscope Commercial |
$14.57
|
| Rate for Payer: Healthscope Whirlpool |
$14.13
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.24
|
| Rate for Payer: Mclaren Commercial |
$13.11
|
| Rate for Payer: Mclaren Medicaid |
$7.10
|
| Rate for Payer: Mclaren Medicare |
$13.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.90
|
| Rate for Payer: Meridian Medicaid |
$7.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.38
|
| Rate for Payer: Nomi Health Commercial |
$11.95
|
| Rate for Payer: PACE Medicare |
$12.58
|
| Rate for Payer: PACE SWMI |
$13.24
|
| Rate for Payer: PHP Commercial |
$14.56
|
| Rate for Payer: PHP Medicaid |
$7.10
|
| Rate for Payer: PHP Medicare Advantage |
$13.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$59.85
|
| Rate for Payer: Priority Health Medicare |
$13.24
|
| Rate for Payer: Priority Health Narrow Network |
$47.88
|
| Rate for Payer: Railroad Medicare Medicare |
$13.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.24
|
| Rate for Payer: UHC Exchange |
$20.52
|
| Rate for Payer: UHC Medicare Advantage |
$13.24
|
| Rate for Payer: UHCCP DNSP |
$13.24
|
| Rate for Payer: UHCCP Medicaid |
$7.10
|
| Rate for Payer: VA VA |
$13.24
|
|
|
HC ATYPICAL PNEUMO EVAL M PNEUM
|
Facility
|
IP
|
$14.57
|
|
|
Service Code
|
CPT 86738
|
| Hospital Charge Code |
30200308
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.47 |
| Max. Negotiated Rate |
$14.57 |
| Rate for Payer: Aetna Commercial |
$13.11
|
| Rate for Payer: ASR ASR |
$14.13
|
| Rate for Payer: ASR Commercial |
$14.13
|
| Rate for Payer: BCBS Trust/PPO |
$11.87
|
| Rate for Payer: BCN Commercial |
$11.30
|
| Rate for Payer: Cash Price |
$11.66
|
| Rate for Payer: Cofinity Commercial |
$13.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.66
|
| Rate for Payer: Healthscope Commercial |
$14.57
|
| Rate for Payer: Healthscope Whirlpool |
$14.13
|
| Rate for Payer: Mclaren Commercial |
$13.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.38
|
| Rate for Payer: Nomi Health Commercial |
$11.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12.82
|
|
|
HC ATYPICAL PNEUMO EVALUATION
|
Facility
|
OP
|
$15.61
|
|
|
Service Code
|
CPT 86631
|
| Hospital Charge Code |
30200241
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.34 |
| Max. Negotiated Rate |
$18.32 |
| Rate for Payer: Aetna Commercial |
$14.05
|
| Rate for Payer: Aetna Medicare |
$11.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.78
|
| Rate for Payer: ASR ASR |
$15.14
|
| Rate for Payer: ASR Commercial |
$15.14
|
| Rate for Payer: BCBS Complete |
$6.65
|
| Rate for Payer: BCBS MAPPO |
$11.82
|
| Rate for Payer: BCBS Trust/PPO |
$12.78
|
| Rate for Payer: BCN Commercial |
$12.10
|
| Rate for Payer: BCN Medicare Advantage |
$11.82
|
| Rate for Payer: Cash Price |
$12.49
|
| Rate for Payer: Cash Price |
$12.49
|
| Rate for Payer: Cofinity Commercial |
$14.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.82
|
| Rate for Payer: Healthscope Commercial |
$15.61
|
| Rate for Payer: Healthscope Whirlpool |
$15.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$11.82
|
| Rate for Payer: Mclaren Commercial |
$14.05
|
| Rate for Payer: Mclaren Medicaid |
$6.34
|
| Rate for Payer: Mclaren Medicare |
$11.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.41
|
| Rate for Payer: Meridian Medicaid |
$6.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.27
|
| Rate for Payer: Nomi Health Commercial |
$12.80
|
| Rate for Payer: PACE Medicare |
$11.23
|
| Rate for Payer: PACE SWMI |
$11.82
|
| Rate for Payer: PHP Commercial |
$13.00
|
| Rate for Payer: PHP Medicaid |
$6.34
|
| Rate for Payer: PHP Medicare Advantage |
$11.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.68
|
| Rate for Payer: Priority Health Medicare |
$11.82
|
| Rate for Payer: Priority Health Narrow Network |
$10.94
|
| Rate for Payer: Railroad Medicare Medicare |
$11.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$13.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.82
|
| Rate for Payer: UHC Exchange |
$18.32
|
| Rate for Payer: UHC Medicare Advantage |
$11.82
|
| Rate for Payer: UHCCP DNSP |
$11.82
|
| Rate for Payer: UHCCP Medicaid |
$6.34
|
| Rate for Payer: VA VA |
$11.82
|
|
|
HC ATYPICAL PNEUMO EVALUATION
|
Facility
|
IP
|
$15.61
|
|
|
Service Code
|
CPT 86631
|
| Hospital Charge Code |
30200241
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.15 |
| Max. Negotiated Rate |
$15.61 |
| Rate for Payer: Aetna Commercial |
$14.05
|
| Rate for Payer: ASR ASR |
$15.14
|
| Rate for Payer: ASR Commercial |
$15.14
|
| Rate for Payer: BCBS Trust/PPO |
$12.72
|
| Rate for Payer: BCN Commercial |
$12.10
|
| Rate for Payer: Cash Price |
$12.49
|
| Rate for Payer: Cofinity Commercial |
$14.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.49
|
| Rate for Payer: Healthscope Commercial |
$15.61
|
| Rate for Payer: Healthscope Whirlpool |
$15.14
|
| Rate for Payer: Mclaren Commercial |
$14.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.27
|
| Rate for Payer: Nomi Health Commercial |
$12.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$13.74
|
|
|
HC AUDIOMETRY AIR AND BONE
|
Facility
|
IP
|
$212.17
|
|
|
Service Code
|
CPT 92553
|
| Hospital Charge Code |
47100010
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$137.91 |
| Max. Negotiated Rate |
$212.17 |
| Rate for Payer: Aetna Commercial |
$190.95
|
| Rate for Payer: ASR ASR |
$205.80
|
| Rate for Payer: ASR Commercial |
$205.80
|
| Rate for Payer: BCBS Trust/PPO |
$172.90
|
| Rate for Payer: BCN Commercial |
$164.50
|
| Rate for Payer: Cash Price |
$169.74
|
| Rate for Payer: Cofinity Commercial |
$199.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$169.74
|
| Rate for Payer: Healthscope Commercial |
$212.17
|
| Rate for Payer: Healthscope Whirlpool |
$205.80
|
| Rate for Payer: Mclaren Commercial |
$190.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$180.34
|
| Rate for Payer: Nomi Health Commercial |
$173.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$137.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$186.71
|
|
|
HC AUDIOMETRY AIR AND BONE
|
Facility
|
OP
|
$212.17
|
|
|
Service Code
|
CPT 92553
|
| Hospital Charge Code |
47100010
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$82.17 |
| Max. Negotiated Rate |
$237.62 |
| Rate for Payer: Aetna Commercial |
$190.95
|
| Rate for Payer: Aetna Medicare |
$153.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$191.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$191.62
|
| Rate for Payer: ASR ASR |
$205.80
|
| Rate for Payer: ASR Commercial |
$205.80
|
| Rate for Payer: BCBS Complete |
$86.28
|
| Rate for Payer: BCBS MAPPO |
$153.30
|
| Rate for Payer: BCBS Trust/PPO |
$173.75
|
| Rate for Payer: BCN Commercial |
$164.50
|
| Rate for Payer: BCN Medicare Advantage |
$153.30
|
| Rate for Payer: Cash Price |
$169.74
|
| Rate for Payer: Cash Price |
$169.74
|
| Rate for Payer: Cofinity Commercial |
$199.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$169.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.30
|
| Rate for Payer: Healthscope Commercial |
$212.17
|
| Rate for Payer: Healthscope Whirlpool |
$205.80
|
| Rate for Payer: Humana Choice PPO Medicare |
$153.30
|
| Rate for Payer: Mclaren Commercial |
$190.95
|
| Rate for Payer: Mclaren Medicaid |
$82.17
|
| Rate for Payer: Mclaren Medicare |
$153.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.96
|
| Rate for Payer: Meridian Medicaid |
$86.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$176.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$180.34
|
| Rate for Payer: Nomi Health Commercial |
$173.98
|
| Rate for Payer: PACE Medicare |
$145.64
|
| Rate for Payer: PACE SWMI |
$153.30
|
| Rate for Payer: PHP Commercial |
$168.63
|
| Rate for Payer: PHP Medicaid |
$82.17
|
| Rate for Payer: PHP Medicare Advantage |
$153.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$137.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$185.90
|
| Rate for Payer: Priority Health Medicare |
$153.30
|
| Rate for Payer: Priority Health Narrow Network |
$148.73
|
| Rate for Payer: Railroad Medicare Medicare |
$153.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$186.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.30
|
| Rate for Payer: UHC Exchange |
$237.62
|
| Rate for Payer: UHC Medicare Advantage |
$153.30
|
| Rate for Payer: UHCCP DNSP |
$153.30
|
| Rate for Payer: UHCCP Medicaid |
$82.17
|
| Rate for Payer: VA VA |
$153.30
|
|
