|
HC CALPROTECTIN FECAL
|
Facility
|
OP
|
$241.37
|
|
|
Service Code
|
CPT 83993
|
| Hospital Charge Code |
30100638
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.27 |
| Max. Negotiated Rate |
$241.37 |
| Rate for Payer: Aetna Commercial |
$217.23
|
| Rate for Payer: Aetna Medicare |
$19.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.54
|
| Rate for Payer: ASR ASR |
$234.13
|
| Rate for Payer: BCBS Complete |
$10.78
|
| Rate for Payer: BCBS MAPPO |
$19.63
|
| Rate for Payer: BCBS Trust/PPO |
$199.01
|
| Rate for Payer: BCN Commercial |
$199.01
|
| Rate for Payer: BCN Medicare Advantage |
$19.63
|
| Rate for Payer: Cash Price |
$193.10
|
| Rate for Payer: Cash Price |
$193.10
|
| Rate for Payer: Cofinity Commercial |
$226.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$193.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.63
|
| Rate for Payer: Healthscope Commercial |
$234.13
|
| Rate for Payer: Healthscope Whirlpool |
$241.37
|
| Rate for Payer: Humana Choice PPO Medicare |
$19.63
|
| Rate for Payer: Mclaren Commercial |
$217.23
|
| Rate for Payer: Mclaren Medicaid |
$19.63
|
| Rate for Payer: Mclaren Medicare |
$19.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.61
|
| Rate for Payer: Meridian Medicaid |
$10.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$21.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$205.16
|
| Rate for Payer: Nomi Health Commercial |
$197.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$181.03
|
| Rate for Payer: PACE Medicare |
$18.65
|
| Rate for Payer: PACE SWMI |
$19.63
|
| Rate for Payer: PHP Commercial |
$21.59
|
| Rate for Payer: PHP Medicaid |
$10.52
|
| Rate for Payer: PHP Medicare Advantage |
$19.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$211.49
|
| Rate for Payer: Priority Health Medicare |
$19.63
|
| Rate for Payer: Priority Health Narrow Network |
$169.20
|
| Rate for Payer: Railroad Medicare Medicare |
$19.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$212.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$19.63
|
| Rate for Payer: UHC Exchange |
$30.43
|
| Rate for Payer: UHC Medicaid |
$10.27
|
| Rate for Payer: UHCCP DNSP |
$19.63
|
| Rate for Payer: UHCCP Medicaid |
$10.27
|
| Rate for Payer: VA VA |
$19.63
|
|
|
HC CALPROTECTIN, FECES
|
Facility
|
IP
|
$41.62
|
|
|
Service Code
|
CPT 83993
|
| Hospital Charge Code |
30100741
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.21 |
| Max. Negotiated Rate |
$41.62 |
| Rate for Payer: Aetna Commercial |
$37.46
|
| Rate for Payer: ASR ASR |
$40.37
|
| Rate for Payer: BCBS Trust/PPO |
$34.18
|
| Rate for Payer: BCN Commercial |
$34.18
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$39.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Healthscope Commercial |
$40.37
|
| Rate for Payer: Healthscope Whirlpool |
$41.62
|
| Rate for Payer: Mclaren Commercial |
$37.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$34.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$36.63
|
|
|
HC CALPROTECTIN, FECES
|
Facility
|
OP
|
$41.62
|
|
|
Service Code
|
CPT 83993
|
| Hospital Charge Code |
30100741
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.27 |
| Max. Negotiated Rate |
$41.62 |
| Rate for Payer: Aetna Commercial |
$37.46
|
| Rate for Payer: Aetna Medicare |
$19.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.54
|
| Rate for Payer: ASR ASR |
$40.37
|
| Rate for Payer: BCBS Complete |
$10.78
|
| Rate for Payer: BCBS MAPPO |
$19.63
|
| Rate for Payer: BCBS Trust/PPO |
$34.32
|
| Rate for Payer: BCN Commercial |
$34.32
|
| Rate for Payer: BCN Medicare Advantage |
$19.63
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$39.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.63
|
| Rate for Payer: Healthscope Commercial |
$40.37
|
| Rate for Payer: Healthscope Whirlpool |
$41.62
|
| Rate for Payer: Humana Choice PPO Medicare |
$19.63
|
| Rate for Payer: Mclaren Commercial |
$37.46
|
| Rate for Payer: Mclaren Medicaid |
$19.63
|
| Rate for Payer: Mclaren Medicare |
$19.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.61
|
| Rate for Payer: Meridian Medicaid |
$10.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$21.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$34.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.21
|
| Rate for Payer: PACE Medicare |
$18.65
|
| Rate for Payer: PACE SWMI |
$19.63
|
| Rate for Payer: PHP Commercial |
$21.59
|
| Rate for Payer: PHP Medicaid |
$10.52
|
| Rate for Payer: PHP Medicare Advantage |
$19.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$36.47
|
| Rate for Payer: Priority Health Medicare |
$19.63
|
| Rate for Payer: Priority Health Narrow Network |
$29.18
|
| Rate for Payer: Railroad Medicare Medicare |
$19.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$36.63
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$19.63
|
| Rate for Payer: UHC Exchange |
$30.43
|
| Rate for Payer: UHC Medicaid |
$10.27
|
| Rate for Payer: UHCCP DNSP |
$19.63
|
| Rate for Payer: UHCCP Medicaid |
$10.27
|
| Rate for Payer: VA VA |
$19.63
|
|
|
HC CALR, GENE MUTATION, EXON 9, REFLEX
|
Facility
|
OP
|
$686.70
|
|
|
Service Code
|
CPT 81219
|
| Hospital Charge Code |
30000108
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$63.61 |
| Max. Negotiated Rate |
$686.70 |
| Rate for Payer: Aetna Commercial |
$618.03
|
| Rate for Payer: Aetna Medicare |
$121.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$152.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$152.04
|
| Rate for Payer: ASR ASR |
$666.10
|
| Rate for Payer: BCBS Complete |
$66.80
|
| Rate for Payer: BCBS MAPPO |
$121.63
|
| Rate for Payer: BCBS Trust/PPO |
$566.18
|
| Rate for Payer: BCN Commercial |
$566.18
|
| Rate for Payer: BCN Medicare Advantage |
$121.63
|
| Rate for Payer: Cash Price |
$549.36
|
| Rate for Payer: Cash Price |
$549.36
|
| Rate for Payer: Cofinity Commercial |
$645.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$549.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$121.63
|
| Rate for Payer: Healthscope Commercial |
$666.10
|
| Rate for Payer: Healthscope Whirlpool |
$686.70
|
| Rate for Payer: Humana Choice PPO Medicare |
$121.63
|
| Rate for Payer: Mclaren Commercial |
$618.03
|
| Rate for Payer: Mclaren Medicaid |
$121.63
|
| Rate for Payer: Mclaren Medicare |
$121.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$127.71
|
| Rate for Payer: Meridian Medicaid |
$66.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$139.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$133.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$583.70
|
| Rate for Payer: Nomi Health Commercial |
$563.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$515.02
|
| Rate for Payer: PACE Medicare |
$115.55
|
| Rate for Payer: PACE SWMI |
$121.63
|
| Rate for Payer: PHP Commercial |
$133.79
|
| Rate for Payer: PHP Medicaid |
$65.19
|
| Rate for Payer: PHP Medicare Advantage |
$121.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$601.69
|
| Rate for Payer: Priority Health Medicare |
$121.63
|
| Rate for Payer: Priority Health Narrow Network |
$481.38
|
| Rate for Payer: Railroad Medicare Medicare |
$121.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$604.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$121.63
|
| Rate for Payer: UHC Exchange |
$188.53
|
| Rate for Payer: UHC Medicaid |
$63.61
|
| Rate for Payer: UHCCP DNSP |
$121.63
|
| Rate for Payer: UHCCP Medicaid |
$63.61
|
| Rate for Payer: VA VA |
$121.63
|
|
|
HC CALR, GENE MUTATION, EXON 9, REFLEX
|
Facility
|
IP
|
$686.70
|
|
|
Service Code
|
CPT 81219
|
| Hospital Charge Code |
30000108
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$515.02 |
| Max. Negotiated Rate |
$686.70 |
| Rate for Payer: Aetna Commercial |
$618.03
|
| Rate for Payer: ASR ASR |
$666.10
|
| Rate for Payer: BCBS Trust/PPO |
$563.92
|
| Rate for Payer: BCN Commercial |
$563.92
|
| Rate for Payer: Cash Price |
$549.36
|
| Rate for Payer: Cofinity Commercial |
$645.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$549.36
|
| Rate for Payer: Healthscope Commercial |
$666.10
|
| Rate for Payer: Healthscope Whirlpool |
$686.70
|
| Rate for Payer: Mclaren Commercial |
$618.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$583.70
|
| Rate for Payer: Nomi Health Commercial |
$563.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$515.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$604.30
|
|
|
HC CANALITH REPOSITIONING
|
Facility
|
OP
|
$134.24
|
|
|
Service Code
|
CPT 95992
|
| Hospital Charge Code |
42000008
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$49.67 |
| Max. Negotiated Rate |
$134.24 |
| Rate for Payer: Aetna Commercial |
$120.82
|
| Rate for Payer: Aetna Medicare |
$49.67
|
| Rate for Payer: ASR ASR |
$130.21
|
| Rate for Payer: BCBS Complete |
$53.70
|
| Rate for Payer: BCBS Trust/PPO |
$110.68
|
| Rate for Payer: BCN Commercial |
$110.68
|
| Rate for Payer: Cash Price |
$107.39
|
| Rate for Payer: Cash Price |
$107.39
|
| Rate for Payer: Cofinity Commercial |
$126.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.39
|
| Rate for Payer: Healthscope Commercial |
$130.21
|
| Rate for Payer: Healthscope Whirlpool |
$134.24
|
| Rate for Payer: Mclaren Commercial |
$120.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$107.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$114.10
|
| Rate for Payer: Nomi Health Commercial |
$110.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$100.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$92.00
|
| Rate for Payer: Priority Health Narrow Network |
$73.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$118.13
|
|
|
HC CANALITH REPOSITIONING
|
Facility
|
IP
|
$134.24
|
|
|
Service Code
|
CPT 95992
|
| Hospital Charge Code |
42000008
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$100.68 |
| Max. Negotiated Rate |
$134.24 |
| Rate for Payer: Aetna Commercial |
$120.82
|
| Rate for Payer: ASR ASR |
$130.21
|
| Rate for Payer: BCBS Trust/PPO |
$110.24
|
| Rate for Payer: BCN Commercial |
$110.24
|
| Rate for Payer: Cash Price |
$107.39
|
| Rate for Payer: Cofinity Commercial |
$126.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.39
|
| Rate for Payer: Healthscope Commercial |
$130.21
|
| Rate for Payer: Healthscope Whirlpool |
$134.24
|
| Rate for Payer: Mclaren Commercial |
$120.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$114.10
|
| Rate for Payer: Nomi Health Commercial |
$110.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$100.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$118.13
|
|
|
HC CANCER ANTIGEN 15-3
|
Facility
|
OP
|
$49.88
|
|
|
Service Code
|
CPT 86300
|
| Hospital Charge Code |
30200182
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.88 |
| Max. Negotiated Rate |
$102.91 |
| Rate for Payer: Aetna Commercial |
$44.89
|
| Rate for Payer: Aetna Medicare |
$20.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.01
|
| Rate for Payer: ASR ASR |
$48.38
|
| Rate for Payer: BCBS Complete |
$11.43
|
| Rate for Payer: BCBS MAPPO |
$20.81
|
| Rate for Payer: BCBS Trust/PPO |
$41.13
|
| Rate for Payer: BCN Commercial |
$41.13
|
| Rate for Payer: BCN Medicare Advantage |
$20.81
|
| Rate for Payer: Cash Price |
$39.90
|
| Rate for Payer: Cash Price |
$39.90
|
| Rate for Payer: Cofinity Commercial |
$46.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$48.38
|
| Rate for Payer: Healthscope Whirlpool |
$49.88
|
| Rate for Payer: Humana Choice PPO Medicare |
$20.81
|
| Rate for Payer: Mclaren Commercial |
$44.89
|
| Rate for Payer: Mclaren Medicaid |
$20.81
|
| Rate for Payer: Mclaren Medicare |
$20.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.85
|
| Rate for Payer: Meridian Medicaid |
$11.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$22.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.40
|
| Rate for Payer: Nomi Health Commercial |
$40.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.41
|
| Rate for Payer: PACE Medicare |
$19.77
|
| Rate for Payer: PACE SWMI |
$20.81
|
| Rate for Payer: PHP Commercial |
$22.89
|
| Rate for Payer: PHP Medicaid |
$11.15
|
| Rate for Payer: PHP Medicare Advantage |
$20.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$102.91
|
| Rate for Payer: Priority Health Medicare |
$20.81
|
| Rate for Payer: Priority Health Narrow Network |
$82.33
|
| Rate for Payer: Railroad Medicare Medicare |
$20.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$43.89
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$20.81
|
| Rate for Payer: UHC Exchange |
$32.26
|
| Rate for Payer: UHC Medicaid |
$10.88
|
| Rate for Payer: UHCCP DNSP |
$20.81
|
| Rate for Payer: UHCCP Medicaid |
$10.88
|
| Rate for Payer: VA VA |
$20.81
|
|
|
HC CANCER ANTIGEN 15-3
|
Facility
|
IP
|
$49.88
|
|
|
Service Code
|
CPT 86300
|
| Hospital Charge Code |
30200182
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$37.41 |
| Max. Negotiated Rate |
$49.88 |
| Rate for Payer: Aetna Commercial |
$44.89
|
| Rate for Payer: ASR ASR |
$48.38
|
| Rate for Payer: BCBS Trust/PPO |
$40.96
|
| Rate for Payer: BCN Commercial |
$40.96
|
| Rate for Payer: Cash Price |
$39.90
|
| Rate for Payer: Cofinity Commercial |
$46.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.90
|
| Rate for Payer: Healthscope Commercial |
$48.38
|
| Rate for Payer: Healthscope Whirlpool |
$49.88
|
| Rate for Payer: Mclaren Commercial |
$44.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.40
|
| Rate for Payer: Nomi Health Commercial |
$40.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$43.89
|
|
|
HC CANCER ANTIGEN 19-9
|
Facility
|
IP
|
$46.70
|
|
|
Service Code
|
CPT 86301
|
| Hospital Charge Code |
30200184
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$35.02 |
| Max. Negotiated Rate |
$46.70 |
| Rate for Payer: Aetna Commercial |
$42.03
|
| Rate for Payer: ASR ASR |
$45.30
|
| Rate for Payer: BCBS Trust/PPO |
$38.35
|
| Rate for Payer: BCN Commercial |
$38.35
|
| Rate for Payer: Cash Price |
$37.36
|
| Rate for Payer: Cofinity Commercial |
$43.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.36
|
| Rate for Payer: Healthscope Commercial |
$45.30
|
| Rate for Payer: Healthscope Whirlpool |
$46.70
|
| Rate for Payer: Mclaren Commercial |
$42.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.70
|
| Rate for Payer: Nomi Health Commercial |
$38.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$41.10
|
|
|
HC CANCER ANTIGEN 19-9
|
Facility
|
OP
|
$46.70
|
|
|
Service Code
|
CPT 86301
|
| Hospital Charge Code |
30200184
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.88 |
| Max. Negotiated Rate |
$71.42 |
| Rate for Payer: Aetna Commercial |
$42.03
|
| Rate for Payer: Aetna Medicare |
$20.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.01
|
| Rate for Payer: ASR ASR |
$45.30
|
| Rate for Payer: BCBS Complete |
$11.43
|
| Rate for Payer: BCBS MAPPO |
$20.81
|
| Rate for Payer: BCBS Trust/PPO |
$38.50
|
| Rate for Payer: BCN Commercial |
$38.50
|
| Rate for Payer: BCN Medicare Advantage |
$20.81
|
| Rate for Payer: Cash Price |
$37.36
|
| Rate for Payer: Cash Price |
$37.36
|
| Rate for Payer: Cofinity Commercial |
$43.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$45.30
|
| Rate for Payer: Healthscope Whirlpool |
$46.70
|
| Rate for Payer: Humana Choice PPO Medicare |
$20.81
|
| Rate for Payer: Mclaren Commercial |
$42.03
|
| Rate for Payer: Mclaren Medicaid |
$20.81
|
| Rate for Payer: Mclaren Medicare |
$20.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.85
|
| Rate for Payer: Meridian Medicaid |
$11.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$22.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.70
|
| Rate for Payer: Nomi Health Commercial |
$38.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.02
|
| Rate for Payer: PACE Medicare |
$19.77
|
| Rate for Payer: PACE SWMI |
$20.81
|
| Rate for Payer: PHP Commercial |
$22.89
|
| Rate for Payer: PHP Medicaid |
$11.15
|
| Rate for Payer: PHP Medicare Advantage |
$20.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$71.42
|
| Rate for Payer: Priority Health Medicare |
$20.81
|
| Rate for Payer: Priority Health Narrow Network |
$57.14
|
| Rate for Payer: Railroad Medicare Medicare |
$20.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$41.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$20.81
|
| Rate for Payer: UHC Exchange |
$32.26
|
| Rate for Payer: UHC Medicaid |
$10.88
|
| Rate for Payer: UHCCP DNSP |
$20.81
|
| Rate for Payer: UHCCP Medicaid |
$10.88
|
| Rate for Payer: VA VA |
$20.81
|
|
|
HC CANCER ANTIGEN 2729
|
Facility
|
OP
|
$42.02
|
|
|
Service Code
|
CPT 86300
|
| Hospital Charge Code |
30200183
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.88 |
| Max. Negotiated Rate |
$102.91 |
| Rate for Payer: Aetna Commercial |
$37.82
|
| Rate for Payer: Aetna Medicare |
$20.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.01
|
| Rate for Payer: ASR ASR |
$40.76
|
| Rate for Payer: BCBS Complete |
$11.43
|
| Rate for Payer: BCBS MAPPO |
$20.81
|
| Rate for Payer: BCBS Trust/PPO |
$34.65
|
| Rate for Payer: BCN Commercial |
$34.65
|
| Rate for Payer: BCN Medicare Advantage |
$20.81
|
| Rate for Payer: Cash Price |
$33.62
|
| Rate for Payer: Cash Price |
$33.62
|
| Rate for Payer: Cofinity Commercial |
$39.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$40.76
|
| Rate for Payer: Healthscope Whirlpool |
$42.02
|
| Rate for Payer: Humana Choice PPO Medicare |
$20.81
|
| Rate for Payer: Mclaren Commercial |
$37.82
|
| Rate for Payer: Mclaren Medicaid |
$20.81
|
| Rate for Payer: Mclaren Medicare |
$20.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.85
|
| Rate for Payer: Meridian Medicaid |
$11.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$22.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.72
|
| Rate for Payer: Nomi Health Commercial |
$34.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.52
|
| Rate for Payer: PACE Medicare |
$19.77
|
| Rate for Payer: PACE SWMI |
$20.81
|
| Rate for Payer: PHP Commercial |
$22.89
|
| Rate for Payer: PHP Medicaid |
$11.15
|
| Rate for Payer: PHP Medicare Advantage |
$20.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$102.91
|
| Rate for Payer: Priority Health Medicare |
$20.81
|
| Rate for Payer: Priority Health Narrow Network |
$82.33
|
| Rate for Payer: Railroad Medicare Medicare |
$20.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$36.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$20.81
|
| Rate for Payer: UHC Exchange |
$32.26
|
| Rate for Payer: UHC Medicaid |
$10.88
|
| Rate for Payer: UHCCP DNSP |
$20.81
|
| Rate for Payer: UHCCP Medicaid |
$10.88
|
| Rate for Payer: VA VA |
$20.81
|
|
|
HC CANCER ANTIGEN 2729
|
Facility
|
IP
|
$42.02
|
|
|
Service Code
|
CPT 86300
|
| Hospital Charge Code |
30200183
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$31.52 |
| Max. Negotiated Rate |
$42.02 |
| Rate for Payer: Aetna Commercial |
$37.82
|
| Rate for Payer: ASR ASR |
$40.76
|
| Rate for Payer: BCBS Trust/PPO |
$34.51
|
| Rate for Payer: BCN Commercial |
$34.51
|
| Rate for Payer: Cash Price |
$33.62
|
| Rate for Payer: Cofinity Commercial |
$39.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.62
|
| Rate for Payer: Healthscope Commercial |
$40.76
|
| Rate for Payer: Healthscope Whirlpool |
$42.02
|
| Rate for Payer: Mclaren Commercial |
$37.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.72
|
| Rate for Payer: Nomi Health Commercial |
$34.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$36.98
|
|
|
HC CANDIDA ALBICANS IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200077
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$25.90 |
| Rate for Payer: Aetna Commercial |
$23.31
|
| 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 |
$25.12
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$21.35
|
| Rate for Payer: BCN Commercial |
$21.35
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$24.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$25.12
|
| Rate for Payer: Healthscope Whirlpool |
$25.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$23.31
|
| Rate for Payer: Mclaren Medicaid |
$5.22
|
| 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 |
$2.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| 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 |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$22.69
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$18.16
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP DNSP |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC CANDIDA ALBICANS IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200077
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.43 |
| Max. Negotiated Rate |
$25.90 |
| Rate for Payer: Aetna Commercial |
$23.31
|
| Rate for Payer: ASR ASR |
$25.12
|
| Rate for Payer: BCBS Trust/PPO |
$21.27
|
| Rate for Payer: BCN Commercial |
$21.27
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$24.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$25.12
|
| Rate for Payer: Healthscope Whirlpool |
$25.90
|
| Rate for Payer: Mclaren Commercial |
$23.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.79
|
|
|
HC CANNABINOID URIN
|
Facility
|
OP
|
$111.25
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000125
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$32.50 |
| Max. Negotiated Rate |
$111.25 |
| Rate for Payer: Aetna Commercial |
$100.12
|
| Rate for Payer: Aetna Medicare |
$62.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.67
|
| Rate for Payer: ASR ASR |
$107.91
|
| Rate for Payer: BCBS Complete |
$34.13
|
| Rate for Payer: BCBS MAPPO |
$62.14
|
| Rate for Payer: BCBS Trust/PPO |
$91.73
|
| Rate for Payer: BCN Commercial |
$91.73
|
| Rate for Payer: BCN Medicare Advantage |
$62.14
|
| Rate for Payer: Cash Price |
$89.00
|
| Rate for Payer: Cash Price |
$89.00
|
| Rate for Payer: Cofinity Commercial |
$104.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.14
|
| Rate for Payer: Healthscope Commercial |
$107.91
|
| Rate for Payer: Healthscope Whirlpool |
$111.25
|
| Rate for Payer: Humana Choice PPO Medicare |
$62.14
|
| Rate for Payer: Mclaren Commercial |
$100.12
|
| Rate for Payer: Mclaren Medicaid |
$62.14
|
| Rate for Payer: Mclaren Medicare |
$62.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.25
|
| Rate for Payer: Meridian Medicaid |
$34.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$68.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.56
|
| Rate for Payer: Nomi Health Commercial |
$91.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$83.44
|
| Rate for Payer: PACE Medicare |
$59.03
|
| Rate for Payer: PACE SWMI |
$62.14
|
| Rate for Payer: PHP Commercial |
$68.35
|
| Rate for Payer: PHP Medicaid |
$33.31
|
| Rate for Payer: PHP Medicare Advantage |
$62.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$97.48
|
| Rate for Payer: Priority Health Medicare |
$62.14
|
| Rate for Payer: Priority Health Narrow Network |
$77.99
|
| Rate for Payer: Railroad Medicare Medicare |
$62.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$97.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$62.14
|
| Rate for Payer: UHC Exchange |
$96.32
|
| Rate for Payer: UHC Medicaid |
$32.50
|
| Rate for Payer: UHCCP DNSP |
$62.14
|
| Rate for Payer: UHCCP Medicaid |
$32.50
|
| Rate for Payer: VA VA |
$62.14
|
|
|
HC CANNABINOID URIN
|
Facility
|
IP
|
$111.25
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000125
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$83.44 |
| Max. Negotiated Rate |
$111.25 |
| Rate for Payer: Aetna Commercial |
$100.12
|
| Rate for Payer: ASR ASR |
$107.91
|
| Rate for Payer: BCBS Trust/PPO |
$91.36
|
| Rate for Payer: BCN Commercial |
$91.36
|
| Rate for Payer: Cash Price |
$89.00
|
| Rate for Payer: Cofinity Commercial |
$104.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.00
|
| Rate for Payer: Healthscope Commercial |
$107.91
|
| Rate for Payer: Healthscope Whirlpool |
$111.25
|
| Rate for Payer: Mclaren Commercial |
$100.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.56
|
| Rate for Payer: Nomi Health Commercial |
$91.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$83.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$97.90
|
|
|
HC CANN/INTRO FEM ART 17,19,21 FR
|
Facility
|
IP
|
$902.03
|
|
| Hospital Charge Code |
27000274
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$676.52 |
| Max. Negotiated Rate |
$902.03 |
| Rate for Payer: Aetna Commercial |
$811.83
|
| Rate for Payer: ASR ASR |
$874.97
|
| Rate for Payer: BCBS Trust/PPO |
$740.75
|
| Rate for Payer: BCN Commercial |
$740.75
|
| Rate for Payer: Cash Price |
$721.62
|
| Rate for Payer: Cofinity Commercial |
$847.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$721.62
|
| Rate for Payer: Healthscope Commercial |
$874.97
|
| Rate for Payer: Healthscope Whirlpool |
$902.03
|
| Rate for Payer: Mclaren Commercial |
$811.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$766.73
|
| Rate for Payer: Nomi Health Commercial |
$739.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$676.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$793.79
|
|
|
HC CANN/INTRO FEM ART 17,19,21 FR
|
Facility
|
OP
|
$902.03
|
|
| Hospital Charge Code |
27000274
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$333.75 |
| Max. Negotiated Rate |
$902.03 |
| Rate for Payer: Aetna Commercial |
$811.83
|
| Rate for Payer: Aetna Medicare |
$333.75
|
| Rate for Payer: ASR ASR |
$874.97
|
| Rate for Payer: BCBS Complete |
$360.81
|
| Rate for Payer: BCBS Trust/PPO |
$743.72
|
| Rate for Payer: BCN Commercial |
$743.72
|
| Rate for Payer: Cash Price |
$721.62
|
| Rate for Payer: Cofinity Commercial |
$847.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$721.62
|
| Rate for Payer: Healthscope Commercial |
$874.97
|
| Rate for Payer: Healthscope Whirlpool |
$902.03
|
| Rate for Payer: Mclaren Commercial |
$811.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$721.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$766.73
|
| Rate for Payer: Nomi Health Commercial |
$739.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$676.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$790.36
|
| Rate for Payer: Priority Health Narrow Network |
$632.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$793.79
|
|
|
HC CANN RT ANG BALLOON 4-6MM
|
Facility
|
OP
|
$309.00
|
|
| Hospital Charge Code |
27000446
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$114.33 |
| Max. Negotiated Rate |
$309.00 |
| Rate for Payer: Aetna Commercial |
$278.10
|
| Rate for Payer: Aetna Medicare |
$114.33
|
| Rate for Payer: ASR ASR |
$299.73
|
| Rate for Payer: BCBS Complete |
$123.60
|
| Rate for Payer: BCBS Trust/PPO |
$254.77
|
| Rate for Payer: BCN Commercial |
$254.77
|
| Rate for Payer: Cash Price |
$247.20
|
| Rate for Payer: Cofinity Commercial |
$290.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$247.20
|
| Rate for Payer: Healthscope Commercial |
$299.73
|
| Rate for Payer: Healthscope Whirlpool |
$309.00
|
| Rate for Payer: Mclaren Commercial |
$278.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$247.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$262.65
|
| Rate for Payer: Nomi Health Commercial |
$253.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$231.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$270.75
|
| Rate for Payer: Priority Health Narrow Network |
$216.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$271.92
|
|
|
HC CANN RT ANG BALLOON 4-6MM
|
Facility
|
IP
|
$309.00
|
|
| Hospital Charge Code |
27000446
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$231.75 |
| Max. Negotiated Rate |
$309.00 |
| Rate for Payer: Aetna Commercial |
$278.10
|
| Rate for Payer: ASR ASR |
$299.73
|
| Rate for Payer: BCBS Trust/PPO |
$253.75
|
| Rate for Payer: BCN Commercial |
$253.75
|
| Rate for Payer: Cash Price |
$247.20
|
| Rate for Payer: Cofinity Commercial |
$290.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$247.20
|
| Rate for Payer: Healthscope Commercial |
$299.73
|
| Rate for Payer: Healthscope Whirlpool |
$309.00
|
| Rate for Payer: Mclaren Commercial |
$278.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$262.65
|
| Rate for Payer: Nomi Health Commercial |
$253.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$231.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$271.92
|
|
|
HC CANNULA ARTERIAL 21, 24 FR
|
Facility
|
OP
|
$118.61
|
|
| Hospital Charge Code |
27000449
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$43.89 |
| Max. Negotiated Rate |
$118.61 |
| Rate for Payer: Aetna Commercial |
$106.75
|
| Rate for Payer: Aetna Medicare |
$43.89
|
| Rate for Payer: ASR ASR |
$115.05
|
| Rate for Payer: BCBS Complete |
$47.44
|
| Rate for Payer: BCBS Trust/PPO |
$97.79
|
| Rate for Payer: BCN Commercial |
$97.79
|
| Rate for Payer: Cash Price |
$94.89
|
| Rate for Payer: Cofinity Commercial |
$111.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.89
|
| Rate for Payer: Healthscope Commercial |
$115.05
|
| Rate for Payer: Healthscope Whirlpool |
$118.61
|
| Rate for Payer: Mclaren Commercial |
$106.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$94.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.82
|
| Rate for Payer: Nomi Health Commercial |
$97.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$88.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$103.93
|
| Rate for Payer: Priority Health Narrow Network |
$83.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$104.38
|
|
|
HC CANNULA ARTERIAL 21, 24 FR
|
Facility
|
IP
|
$118.61
|
|
| Hospital Charge Code |
27000449
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$88.96 |
| Max. Negotiated Rate |
$118.61 |
| Rate for Payer: Aetna Commercial |
$106.75
|
| Rate for Payer: ASR ASR |
$115.05
|
| Rate for Payer: BCBS Trust/PPO |
$97.40
|
| Rate for Payer: BCN Commercial |
$97.40
|
| Rate for Payer: Cash Price |
$94.89
|
| Rate for Payer: Cofinity Commercial |
$111.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.89
|
| Rate for Payer: Healthscope Commercial |
$115.05
|
| Rate for Payer: Healthscope Whirlpool |
$118.61
|
| Rate for Payer: Mclaren Commercial |
$106.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.82
|
| Rate for Payer: Nomi Health Commercial |
$97.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$88.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$104.38
|
|
|
HC CANNULA ARTERIOTOMY 2 MM
|
Facility
|
OP
|
$24.97
|
|
| Hospital Charge Code |
27000675
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$9.24 |
| Max. Negotiated Rate |
$24.97 |
| Rate for Payer: Aetna Commercial |
$22.47
|
| Rate for Payer: Aetna Medicare |
$9.24
|
| Rate for Payer: ASR ASR |
$24.22
|
| Rate for Payer: BCBS Complete |
$9.99
|
| Rate for Payer: BCBS Trust/PPO |
$20.59
|
| Rate for Payer: BCN Commercial |
$20.59
|
| Rate for Payer: Cash Price |
$19.98
|
| Rate for Payer: Cofinity Commercial |
$23.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.98
|
| Rate for Payer: Healthscope Commercial |
$24.22
|
| Rate for Payer: Healthscope Whirlpool |
$24.97
|
| Rate for Payer: Mclaren Commercial |
$22.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.22
|
| Rate for Payer: Nomi Health Commercial |
$20.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$21.88
|
| Rate for Payer: Priority Health Narrow Network |
$17.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.97
|
|
|
HC CANNULA ARTERIOTOMY 2 MM
|
Facility
|
IP
|
$24.97
|
|
| Hospital Charge Code |
27000675
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$18.73 |
| Max. Negotiated Rate |
$24.97 |
| Rate for Payer: Aetna Commercial |
$22.47
|
| Rate for Payer: ASR ASR |
$24.22
|
| Rate for Payer: BCBS Trust/PPO |
$20.51
|
| Rate for Payer: BCN Commercial |
$20.51
|
| Rate for Payer: Cash Price |
$19.98
|
| Rate for Payer: Cofinity Commercial |
$23.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.98
|
| Rate for Payer: Healthscope Commercial |
$24.22
|
| Rate for Payer: Healthscope Whirlpool |
$24.97
|
| Rate for Payer: Mclaren Commercial |
$22.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.22
|
| Rate for Payer: Nomi Health Commercial |
$20.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.97
|
|
