|
HC CARDIAC REH OP PH 2 WO MONITOR
|
Facility
|
OP
|
$201.87
|
|
|
Service Code
|
CPT 93797
|
| Hospital Charge Code |
94300007
|
|
Hospital Revenue Code
|
943
|
| Min. Negotiated Rate |
$67.17 |
| Max. Negotiated Rate |
$201.87 |
| Rate for Payer: Aetna Commercial |
$181.68
|
| Rate for Payer: Aetna Medicare |
$128.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$160.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$160.55
|
| Rate for Payer: ASR ASR |
$195.81
|
| Rate for Payer: BCBS Complete |
$70.54
|
| Rate for Payer: BCBS MAPPO |
$128.44
|
| Rate for Payer: BCBS Trust/PPO |
$166.44
|
| Rate for Payer: BCN Commercial |
$166.44
|
| Rate for Payer: BCN Medicare Advantage |
$128.44
|
| Rate for Payer: Cash Price |
$161.50
|
| Rate for Payer: Cash Price |
$161.50
|
| Rate for Payer: Cofinity Commercial |
$189.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$161.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.44
|
| Rate for Payer: Healthscope Commercial |
$195.81
|
| Rate for Payer: Healthscope Whirlpool |
$201.87
|
| Rate for Payer: Humana Choice PPO Medicare |
$128.44
|
| Rate for Payer: Mclaren Commercial |
$181.68
|
| Rate for Payer: Mclaren Medicaid |
$128.44
|
| Rate for Payer: Mclaren Medicare |
$128.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$134.86
|
| Rate for Payer: Meridian Medicaid |
$70.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$147.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$141.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$171.59
|
| Rate for Payer: Nomi Health Commercial |
$165.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$151.40
|
| Rate for Payer: PACE Medicare |
$122.02
|
| Rate for Payer: PACE SWMI |
$128.44
|
| Rate for Payer: PHP Commercial |
$141.28
|
| Rate for Payer: PHP Medicaid |
$68.84
|
| Rate for Payer: PHP Medicare Advantage |
$128.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$192.48
|
| Rate for Payer: Priority Health Medicare |
$128.44
|
| Rate for Payer: Priority Health Narrow Network |
$153.98
|
| Rate for Payer: Railroad Medicare Medicare |
$128.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$177.65
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$128.44
|
| Rate for Payer: UHC Exchange |
$199.08
|
| Rate for Payer: UHC Medicaid |
$67.17
|
| Rate for Payer: UHCCP DNSP |
$128.44
|
| Rate for Payer: UHCCP Medicaid |
$67.17
|
| Rate for Payer: VA VA |
$128.44
|
|
|
HC CARDIOLIPIN AB IGA
|
Facility
|
IP
|
$52.19
|
|
|
Service Code
|
CPT 86147
|
| Hospital Charge Code |
30200146
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$39.14 |
| Max. Negotiated Rate |
$52.19 |
| Rate for Payer: Aetna Commercial |
$46.97
|
| Rate for Payer: ASR ASR |
$50.62
|
| Rate for Payer: BCBS Trust/PPO |
$42.86
|
| Rate for Payer: BCN Commercial |
$42.86
|
| Rate for Payer: Cash Price |
$41.75
|
| Rate for Payer: Cofinity Commercial |
$49.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.75
|
| Rate for Payer: Healthscope Commercial |
$50.62
|
| Rate for Payer: Healthscope Whirlpool |
$52.19
|
| Rate for Payer: Mclaren Commercial |
$46.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.36
|
| Rate for Payer: Nomi Health Commercial |
$42.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.93
|
|
|
HC CARDIOLIPIN AB IGA
|
Facility
|
OP
|
$52.19
|
|
|
Service Code
|
CPT 86147
|
| Hospital Charge Code |
30200146
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.31 |
| Max. Negotiated Rate |
$153.74 |
| Rate for Payer: Aetna Commercial |
$46.97
|
| Rate for Payer: Aetna Medicare |
$25.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.81
|
| Rate for Payer: ASR ASR |
$50.62
|
| Rate for Payer: BCBS Complete |
$13.98
|
| Rate for Payer: BCBS MAPPO |
$25.45
|
| Rate for Payer: BCBS Trust/PPO |
$43.03
|
| Rate for Payer: BCN Commercial |
$43.03
|
| Rate for Payer: BCN Medicare Advantage |
$25.45
|
| Rate for Payer: Cash Price |
$41.75
|
| Rate for Payer: Cash Price |
$41.75
|
| Rate for Payer: Cofinity Commercial |
$49.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.45
|
| Rate for Payer: Healthscope Commercial |
$50.62
|
| Rate for Payer: Healthscope Whirlpool |
$52.19
|
| Rate for Payer: Humana Choice PPO Medicare |
$25.45
|
| Rate for Payer: Mclaren Commercial |
$46.97
|
| Rate for Payer: Mclaren Medicaid |
$25.45
|
| Rate for Payer: Mclaren Medicare |
$25.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.72
|
| Rate for Payer: Meridian Medicaid |
$13.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$28.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.36
|
| Rate for Payer: Nomi Health Commercial |
$42.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.14
|
| Rate for Payer: PACE Medicare |
$24.18
|
| Rate for Payer: PACE SWMI |
$25.45
|
| Rate for Payer: PHP Commercial |
$28.00
|
| Rate for Payer: PHP Medicaid |
$13.64
|
| Rate for Payer: PHP Medicare Advantage |
$25.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$153.74
|
| Rate for Payer: Priority Health Medicare |
$25.45
|
| Rate for Payer: Priority Health Narrow Network |
$122.99
|
| Rate for Payer: Railroad Medicare Medicare |
$25.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$25.45
|
| Rate for Payer: UHC Exchange |
$39.45
|
| Rate for Payer: UHC Medicaid |
$13.31
|
| Rate for Payer: UHCCP DNSP |
$25.45
|
| Rate for Payer: UHCCP Medicaid |
$13.31
|
| Rate for Payer: VA VA |
$25.45
|
|
|
HC CARDIOLIPIN AB IGG
|
Facility
|
OP
|
$52.19
|
|
|
Service Code
|
CPT 86147
|
| Hospital Charge Code |
30200144
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.31 |
| Max. Negotiated Rate |
$153.74 |
| Rate for Payer: Aetna Commercial |
$46.97
|
| Rate for Payer: Aetna Medicare |
$25.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.81
|
| Rate for Payer: ASR ASR |
$50.62
|
| Rate for Payer: BCBS Complete |
$13.98
|
| Rate for Payer: BCBS MAPPO |
$25.45
|
| Rate for Payer: BCBS Trust/PPO |
$43.03
|
| Rate for Payer: BCN Commercial |
$43.03
|
| Rate for Payer: BCN Medicare Advantage |
$25.45
|
| Rate for Payer: Cash Price |
$41.75
|
| Rate for Payer: Cash Price |
$41.75
|
| Rate for Payer: Cofinity Commercial |
$49.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.45
|
| Rate for Payer: Healthscope Commercial |
$50.62
|
| Rate for Payer: Healthscope Whirlpool |
$52.19
|
| Rate for Payer: Humana Choice PPO Medicare |
$25.45
|
| Rate for Payer: Mclaren Commercial |
$46.97
|
| Rate for Payer: Mclaren Medicaid |
$25.45
|
| Rate for Payer: Mclaren Medicare |
$25.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.72
|
| Rate for Payer: Meridian Medicaid |
$13.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$28.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.36
|
| Rate for Payer: Nomi Health Commercial |
$42.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.14
|
| Rate for Payer: PACE Medicare |
$24.18
|
| Rate for Payer: PACE SWMI |
$25.45
|
| Rate for Payer: PHP Commercial |
$28.00
|
| Rate for Payer: PHP Medicaid |
$13.64
|
| Rate for Payer: PHP Medicare Advantage |
$25.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$153.74
|
| Rate for Payer: Priority Health Medicare |
$25.45
|
| Rate for Payer: Priority Health Narrow Network |
$122.99
|
| Rate for Payer: Railroad Medicare Medicare |
$25.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$25.45
|
| Rate for Payer: UHC Exchange |
$39.45
|
| Rate for Payer: UHC Medicaid |
$13.31
|
| Rate for Payer: UHCCP DNSP |
$25.45
|
| Rate for Payer: UHCCP Medicaid |
$13.31
|
| Rate for Payer: VA VA |
$25.45
|
|
|
HC CARDIOLIPIN AB IGG
|
Facility
|
IP
|
$52.19
|
|
|
Service Code
|
CPT 86147
|
| Hospital Charge Code |
30200144
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$39.14 |
| Max. Negotiated Rate |
$52.19 |
| Rate for Payer: Aetna Commercial |
$46.97
|
| Rate for Payer: ASR ASR |
$50.62
|
| Rate for Payer: BCBS Trust/PPO |
$42.86
|
| Rate for Payer: BCN Commercial |
$42.86
|
| Rate for Payer: Cash Price |
$41.75
|
| Rate for Payer: Cofinity Commercial |
$49.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.75
|
| Rate for Payer: Healthscope Commercial |
$50.62
|
| Rate for Payer: Healthscope Whirlpool |
$52.19
|
| Rate for Payer: Mclaren Commercial |
$46.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.36
|
| Rate for Payer: Nomi Health Commercial |
$42.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.93
|
|
|
HC CARDIOLIPIN AB IGM
|
Facility
|
OP
|
$52.19
|
|
|
Service Code
|
CPT 86147
|
| Hospital Charge Code |
30200145
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.31 |
| Max. Negotiated Rate |
$153.74 |
| Rate for Payer: Aetna Commercial |
$46.97
|
| Rate for Payer: Aetna Medicare |
$25.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.81
|
| Rate for Payer: ASR ASR |
$50.62
|
| Rate for Payer: BCBS Complete |
$13.98
|
| Rate for Payer: BCBS MAPPO |
$25.45
|
| Rate for Payer: BCBS Trust/PPO |
$43.03
|
| Rate for Payer: BCN Commercial |
$43.03
|
| Rate for Payer: BCN Medicare Advantage |
$25.45
|
| Rate for Payer: Cash Price |
$41.75
|
| Rate for Payer: Cash Price |
$41.75
|
| Rate for Payer: Cofinity Commercial |
$49.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.45
|
| Rate for Payer: Healthscope Commercial |
$50.62
|
| Rate for Payer: Healthscope Whirlpool |
$52.19
|
| Rate for Payer: Humana Choice PPO Medicare |
$25.45
|
| Rate for Payer: Mclaren Commercial |
$46.97
|
| Rate for Payer: Mclaren Medicaid |
$25.45
|
| Rate for Payer: Mclaren Medicare |
$25.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.72
|
| Rate for Payer: Meridian Medicaid |
$13.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$28.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.36
|
| Rate for Payer: Nomi Health Commercial |
$42.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.14
|
| Rate for Payer: PACE Medicare |
$24.18
|
| Rate for Payer: PACE SWMI |
$25.45
|
| Rate for Payer: PHP Commercial |
$28.00
|
| Rate for Payer: PHP Medicaid |
$13.64
|
| Rate for Payer: PHP Medicare Advantage |
$25.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$153.74
|
| Rate for Payer: Priority Health Medicare |
$25.45
|
| Rate for Payer: Priority Health Narrow Network |
$122.99
|
| Rate for Payer: Railroad Medicare Medicare |
$25.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$25.45
|
| Rate for Payer: UHC Exchange |
$39.45
|
| Rate for Payer: UHC Medicaid |
$13.31
|
| Rate for Payer: UHCCP DNSP |
$25.45
|
| Rate for Payer: UHCCP Medicaid |
$13.31
|
| Rate for Payer: VA VA |
$25.45
|
|
|
HC CARDIOLIPIN AB IGM
|
Facility
|
IP
|
$52.19
|
|
|
Service Code
|
CPT 86147
|
| Hospital Charge Code |
30200145
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$39.14 |
| Max. Negotiated Rate |
$52.19 |
| Rate for Payer: Aetna Commercial |
$46.97
|
| Rate for Payer: ASR ASR |
$50.62
|
| Rate for Payer: BCBS Trust/PPO |
$42.86
|
| Rate for Payer: BCN Commercial |
$42.86
|
| Rate for Payer: Cash Price |
$41.75
|
| Rate for Payer: Cofinity Commercial |
$49.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.75
|
| Rate for Payer: Healthscope Commercial |
$50.62
|
| Rate for Payer: Healthscope Whirlpool |
$52.19
|
| Rate for Payer: Mclaren Commercial |
$46.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.36
|
| Rate for Payer: Nomi Health Commercial |
$42.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.93
|
|
|
HC CARDIOLITE/MIRALUMA STUDY
|
Facility
|
OP
|
$525.85
|
|
|
Service Code
|
HCPCS A9500
|
| Hospital Charge Code |
34300001
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$194.56 |
| Max. Negotiated Rate |
$525.85 |
| Rate for Payer: Aetna Commercial |
$473.26
|
| Rate for Payer: Aetna Medicare |
$194.56
|
| Rate for Payer: ASR ASR |
$510.07
|
| Rate for Payer: BCBS Complete |
$210.34
|
| Rate for Payer: BCBS Trust/PPO |
$433.56
|
| Rate for Payer: BCN Commercial |
$433.56
|
| Rate for Payer: Cash Price |
$420.68
|
| Rate for Payer: Cash Price |
$420.68
|
| Rate for Payer: Cofinity Commercial |
$494.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$420.68
|
| Rate for Payer: Healthscope Commercial |
$510.07
|
| Rate for Payer: Healthscope Whirlpool |
$525.85
|
| Rate for Payer: Mclaren Commercial |
$473.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$420.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$446.97
|
| Rate for Payer: Nomi Health Commercial |
$431.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$394.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$304.46
|
| Rate for Payer: Priority Health Narrow Network |
$243.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$462.75
|
|
|
HC CARDIOLITE/MIRALUMA STUDY
|
Facility
|
IP
|
$525.85
|
|
|
Service Code
|
HCPCS A9500
|
| Hospital Charge Code |
34300001
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$394.39 |
| Max. Negotiated Rate |
$525.85 |
| Rate for Payer: Aetna Commercial |
$473.26
|
| Rate for Payer: ASR ASR |
$510.07
|
| Rate for Payer: BCBS Trust/PPO |
$431.83
|
| Rate for Payer: BCN Commercial |
$431.83
|
| Rate for Payer: Cash Price |
$420.68
|
| Rate for Payer: Cofinity Commercial |
$494.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$420.68
|
| Rate for Payer: Healthscope Commercial |
$510.07
|
| Rate for Payer: Healthscope Whirlpool |
$525.85
|
| Rate for Payer: Mclaren Commercial |
$473.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$446.97
|
| Rate for Payer: Nomi Health Commercial |
$431.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$394.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$462.75
|
|
|
HC CARDIOPULMONARY EX TEST
|
Facility
|
IP
|
$1,145.14
|
|
|
Service Code
|
CPT 94621
|
| Hospital Charge Code |
46000007
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$858.86 |
| Max. Negotiated Rate |
$1,145.14 |
| Rate for Payer: Aetna Commercial |
$1,030.63
|
| Rate for Payer: ASR ASR |
$1,110.79
|
| Rate for Payer: BCBS Trust/PPO |
$940.39
|
| Rate for Payer: BCN Commercial |
$940.39
|
| Rate for Payer: Cash Price |
$916.11
|
| Rate for Payer: Cofinity Commercial |
$1,076.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$916.11
|
| Rate for Payer: Healthscope Commercial |
$1,110.79
|
| Rate for Payer: Healthscope Whirlpool |
$1,145.14
|
| Rate for Payer: Mclaren Commercial |
$1,030.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$973.37
|
| Rate for Payer: Nomi Health Commercial |
$939.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$858.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,007.72
|
|
|
HC CARDIOPULMONARY EX TEST
|
Facility
|
OP
|
$1,145.14
|
|
|
Service Code
|
CPT 94621
|
| Hospital Charge Code |
46000007
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$194.46 |
| Max. Negotiated Rate |
$1,145.14 |
| Rate for Payer: Aetna Commercial |
$1,030.63
|
| Rate for Payer: Aetna Medicare |
$371.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$464.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$464.77
|
| Rate for Payer: ASR ASR |
$1,110.79
|
| Rate for Payer: BCBS Complete |
$204.20
|
| Rate for Payer: BCBS MAPPO |
$371.82
|
| Rate for Payer: BCBS Trust/PPO |
$944.17
|
| Rate for Payer: BCN Commercial |
$944.17
|
| Rate for Payer: BCN Medicare Advantage |
$371.82
|
| Rate for Payer: Cash Price |
$916.11
|
| Rate for Payer: Cash Price |
$916.11
|
| Rate for Payer: Cofinity Commercial |
$1,076.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$916.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$371.82
|
| Rate for Payer: Healthscope Commercial |
$1,110.79
|
| Rate for Payer: Healthscope Whirlpool |
$1,145.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$371.82
|
| Rate for Payer: Mclaren Commercial |
$1,030.63
|
| Rate for Payer: Mclaren Medicaid |
$371.82
|
| Rate for Payer: Mclaren Medicare |
$371.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$390.41
|
| Rate for Payer: Meridian Medicaid |
$204.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$427.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$409.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$973.37
|
| Rate for Payer: Nomi Health Commercial |
$939.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$858.86
|
| Rate for Payer: PACE Medicare |
$353.23
|
| Rate for Payer: PACE SWMI |
$371.82
|
| Rate for Payer: PHP Commercial |
$409.00
|
| Rate for Payer: PHP Medicaid |
$199.30
|
| Rate for Payer: PHP Medicare Advantage |
$371.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$194.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$502.37
|
| Rate for Payer: Priority Health Medicare |
$371.82
|
| Rate for Payer: Priority Health Narrow Network |
$401.90
|
| Rate for Payer: Railroad Medicare Medicare |
$371.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,007.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$371.82
|
| Rate for Payer: UHC Exchange |
$576.32
|
| Rate for Payer: UHC Medicaid |
$194.46
|
| Rate for Payer: UHCCP DNSP |
$371.82
|
| Rate for Payer: UHCCP Medicaid |
$194.46
|
| Rate for Payer: VA VA |
$371.82
|
|
|
HC CARDIOVERSION
|
Facility
|
IP
|
$1,232.88
|
|
|
Service Code
|
CPT 92960
|
| Hospital Charge Code |
48000002
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$924.66 |
| Max. Negotiated Rate |
$1,232.88 |
| Rate for Payer: Aetna Commercial |
$1,109.59
|
| Rate for Payer: ASR ASR |
$1,195.89
|
| Rate for Payer: BCBS Trust/PPO |
$1,012.44
|
| Rate for Payer: BCN Commercial |
$1,012.44
|
| Rate for Payer: Cash Price |
$986.30
|
| Rate for Payer: Cofinity Commercial |
$1,158.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$986.30
|
| Rate for Payer: Healthscope Commercial |
$1,195.89
|
| Rate for Payer: Healthscope Whirlpool |
$1,232.88
|
| Rate for Payer: Mclaren Commercial |
$1,109.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,047.95
|
| Rate for Payer: Nomi Health Commercial |
$1,010.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$924.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,084.93
|
|
|
HC CARDIOVERSION
|
Facility
|
OP
|
$1,232.88
|
|
|
Service Code
|
CPT 92960
|
| Hospital Charge Code |
48000002
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$344.43 |
| Max. Negotiated Rate |
$1,232.88 |
| Rate for Payer: Aetna Commercial |
$1,109.59
|
| Rate for Payer: Aetna Medicare |
$658.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$823.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$823.21
|
| Rate for Payer: ASR ASR |
$1,195.89
|
| Rate for Payer: BCBS Complete |
$361.69
|
| Rate for Payer: BCBS MAPPO |
$658.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,016.51
|
| Rate for Payer: BCN Commercial |
$1,016.51
|
| Rate for Payer: BCN Medicare Advantage |
$658.57
|
| Rate for Payer: Cash Price |
$986.30
|
| Rate for Payer: Cash Price |
$986.30
|
| Rate for Payer: Cofinity Commercial |
$1,158.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$986.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$658.57
|
| Rate for Payer: Healthscope Commercial |
$1,195.89
|
| Rate for Payer: Healthscope Whirlpool |
$1,232.88
|
| Rate for Payer: Humana Choice PPO Medicare |
$658.57
|
| Rate for Payer: Mclaren Commercial |
$1,109.59
|
| Rate for Payer: Mclaren Medicaid |
$658.57
|
| Rate for Payer: Mclaren Medicare |
$658.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$691.50
|
| Rate for Payer: Meridian Medicaid |
$361.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$757.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$724.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,047.95
|
| Rate for Payer: Nomi Health Commercial |
$1,010.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$924.66
|
| Rate for Payer: PACE Medicare |
$625.64
|
| Rate for Payer: PACE SWMI |
$658.57
|
| Rate for Payer: PHP Commercial |
$724.43
|
| Rate for Payer: PHP Medicaid |
$352.99
|
| Rate for Payer: PHP Medicare Advantage |
$658.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$344.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$900.66
|
| Rate for Payer: Priority Health Medicare |
$658.57
|
| Rate for Payer: Priority Health Narrow Network |
$720.53
|
| Rate for Payer: Railroad Medicare Medicare |
$658.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,084.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$658.57
|
| Rate for Payer: UHC Exchange |
$1,020.78
|
| Rate for Payer: UHC Medicaid |
$344.43
|
| Rate for Payer: UHCCP DNSP |
$658.57
|
| Rate for Payer: UHCCP Medicaid |
$344.43
|
| Rate for Payer: VA VA |
$658.57
|
|
|
HC CARDIOVERSION EXT
|
Facility
|
IP
|
$1,018.16
|
|
| Hospital Charge Code |
45000034
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$763.62 |
| Max. Negotiated Rate |
$1,018.16 |
| Rate for Payer: Aetna Commercial |
$916.34
|
| Rate for Payer: ASR ASR |
$987.62
|
| Rate for Payer: BCBS Trust/PPO |
$836.11
|
| Rate for Payer: BCN Commercial |
$836.11
|
| Rate for Payer: Cash Price |
$814.53
|
| Rate for Payer: Cofinity Commercial |
$957.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$814.53
|
| Rate for Payer: Healthscope Commercial |
$987.62
|
| Rate for Payer: Healthscope Whirlpool |
$1,018.16
|
| Rate for Payer: Mclaren Commercial |
$916.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$865.44
|
| Rate for Payer: Nomi Health Commercial |
$834.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$763.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$895.98
|
|
|
HC CARDIOVERSION EXT
|
Facility
|
OP
|
$1,018.16
|
|
| Hospital Charge Code |
45000034
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$376.72 |
| Max. Negotiated Rate |
$1,018.16 |
| Rate for Payer: Aetna Commercial |
$916.34
|
| Rate for Payer: Aetna Medicare |
$376.72
|
| Rate for Payer: ASR ASR |
$987.62
|
| Rate for Payer: BCBS Complete |
$407.26
|
| Rate for Payer: BCBS Trust/PPO |
$839.47
|
| Rate for Payer: BCN Commercial |
$839.47
|
| Rate for Payer: Cash Price |
$814.53
|
| Rate for Payer: Cofinity Commercial |
$957.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$814.53
|
| Rate for Payer: Healthscope Commercial |
$987.62
|
| Rate for Payer: Healthscope Whirlpool |
$1,018.16
|
| Rate for Payer: Mclaren Commercial |
$916.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$814.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$865.44
|
| Rate for Payer: Nomi Health Commercial |
$834.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$763.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$892.11
|
| Rate for Payer: Priority Health Narrow Network |
$713.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$895.98
|
|
|
HC CAREGIVER HEALTH RISK ASSMT
|
Facility
|
IP
|
$54.12
|
|
|
Service Code
|
CPT 96161
|
| Hospital Charge Code |
51000095
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$40.59 |
| Max. Negotiated Rate |
$54.12 |
| Rate for Payer: Aetna Commercial |
$48.71
|
| Rate for Payer: ASR ASR |
$52.50
|
| Rate for Payer: BCBS Trust/PPO |
$44.44
|
| Rate for Payer: BCN Commercial |
$44.44
|
| Rate for Payer: Cash Price |
$43.30
|
| Rate for Payer: Cofinity Commercial |
$50.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.30
|
| Rate for Payer: Healthscope Commercial |
$52.50
|
| Rate for Payer: Healthscope Whirlpool |
$54.12
|
| Rate for Payer: Mclaren Commercial |
$48.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.00
|
| Rate for Payer: Nomi Health Commercial |
$44.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$47.63
|
|
|
HC CAREGIVER HEALTH RISK ASSMT
|
Facility
|
OP
|
$54.12
|
|
|
Service Code
|
CPT 96161
|
| Hospital Charge Code |
51000095
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$19.52 |
| Max. Negotiated Rate |
$57.86 |
| Rate for Payer: Aetna Commercial |
$48.71
|
| Rate for Payer: Aetna Medicare |
$37.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$46.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$46.66
|
| Rate for Payer: ASR ASR |
$52.50
|
| Rate for Payer: BCBS Complete |
$20.50
|
| Rate for Payer: BCBS MAPPO |
$37.33
|
| Rate for Payer: BCBS Trust/PPO |
$44.62
|
| Rate for Payer: BCN Commercial |
$44.62
|
| Rate for Payer: BCN Medicare Advantage |
$37.33
|
| Rate for Payer: Cash Price |
$43.30
|
| Rate for Payer: Cash Price |
$43.30
|
| Rate for Payer: Cofinity Commercial |
$50.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.33
|
| Rate for Payer: Healthscope Commercial |
$52.50
|
| Rate for Payer: Healthscope Whirlpool |
$54.12
|
| Rate for Payer: Humana Choice PPO Medicare |
$37.33
|
| Rate for Payer: Mclaren Commercial |
$48.71
|
| Rate for Payer: Mclaren Medicaid |
$37.33
|
| Rate for Payer: Mclaren Medicare |
$37.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.20
|
| Rate for Payer: Meridian Medicaid |
$20.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$41.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.00
|
| Rate for Payer: Nomi Health Commercial |
$44.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.59
|
| Rate for Payer: PACE Medicare |
$35.46
|
| Rate for Payer: PACE SWMI |
$37.33
|
| Rate for Payer: PHP Commercial |
$41.06
|
| Rate for Payer: PHP Medicaid |
$20.01
|
| Rate for Payer: PHP Medicare Advantage |
$37.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$47.42
|
| Rate for Payer: Priority Health Medicare |
$37.33
|
| Rate for Payer: Priority Health Narrow Network |
$37.94
|
| Rate for Payer: Railroad Medicare Medicare |
$37.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$47.63
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$37.33
|
| Rate for Payer: UHC Exchange |
$57.86
|
| Rate for Payer: UHC Medicaid |
$19.52
|
| Rate for Payer: UHCCP DNSP |
$37.33
|
| Rate for Payer: UHCCP Medicaid |
$19.52
|
| Rate for Payer: VA VA |
$37.33
|
|
|
HC CARE MGMT SERVICES BEHAVIORAL HLTH COND 20 MINS
|
Facility
|
OP
|
$83.83
|
|
|
Service Code
|
CPT 99484
|
| Hospital Charge Code |
51000107
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$19.52 |
| Max. Negotiated Rate |
$83.83 |
| Rate for Payer: Aetna Commercial |
$75.45
|
| Rate for Payer: Aetna Medicare |
$37.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$46.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$46.66
|
| Rate for Payer: ASR ASR |
$81.32
|
| Rate for Payer: BCBS Complete |
$20.50
|
| Rate for Payer: BCBS MAPPO |
$37.33
|
| Rate for Payer: BCBS Trust/PPO |
$69.12
|
| Rate for Payer: BCN Commercial |
$69.12
|
| Rate for Payer: BCN Medicare Advantage |
$37.33
|
| Rate for Payer: Cash Price |
$67.06
|
| Rate for Payer: Cash Price |
$67.06
|
| Rate for Payer: Cofinity Commercial |
$78.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.33
|
| Rate for Payer: Healthscope Commercial |
$81.32
|
| Rate for Payer: Healthscope Whirlpool |
$83.83
|
| Rate for Payer: Humana Choice PPO Medicare |
$37.33
|
| Rate for Payer: Mclaren Commercial |
$75.45
|
| Rate for Payer: Mclaren Medicaid |
$37.33
|
| Rate for Payer: Mclaren Medicare |
$37.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.20
|
| Rate for Payer: Meridian Medicaid |
$20.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$41.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.26
|
| Rate for Payer: Nomi Health Commercial |
$68.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$62.87
|
| Rate for Payer: PACE Medicare |
$35.46
|
| Rate for Payer: PACE SWMI |
$37.33
|
| Rate for Payer: PHP Commercial |
$41.06
|
| Rate for Payer: PHP Medicaid |
$20.01
|
| Rate for Payer: PHP Medicare Advantage |
$37.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$38.39
|
| Rate for Payer: Priority Health Medicare |
$37.33
|
| Rate for Payer: Priority Health Narrow Network |
$30.71
|
| Rate for Payer: Railroad Medicare Medicare |
$37.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$73.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$37.33
|
| Rate for Payer: UHC Exchange |
$57.86
|
| Rate for Payer: UHC Medicaid |
$19.52
|
| Rate for Payer: UHCCP DNSP |
$37.33
|
| Rate for Payer: UHCCP Medicaid |
$19.52
|
| Rate for Payer: VA VA |
$37.33
|
|
|
HC CARE MGMT SERVICES BEHAVIORAL HLTH COND 20 MINS
|
Facility
|
IP
|
$83.83
|
|
|
Service Code
|
CPT 99484
|
| Hospital Charge Code |
51000107
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$62.87 |
| Max. Negotiated Rate |
$83.83 |
| Rate for Payer: Aetna Commercial |
$75.45
|
| Rate for Payer: ASR ASR |
$81.32
|
| Rate for Payer: BCBS Trust/PPO |
$68.84
|
| Rate for Payer: BCN Commercial |
$68.84
|
| Rate for Payer: Cash Price |
$67.06
|
| Rate for Payer: Cofinity Commercial |
$78.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.06
|
| Rate for Payer: Healthscope Commercial |
$81.32
|
| Rate for Payer: Healthscope Whirlpool |
$83.83
|
| Rate for Payer: Mclaren Commercial |
$75.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.26
|
| Rate for Payer: Nomi Health Commercial |
$68.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$62.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$73.77
|
|
|
HC CARNITINE
|
Facility
|
OP
|
$60.34
|
|
|
Service Code
|
CPT 82379
|
| Hospital Charge Code |
30100136
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.82 |
| Max. Negotiated Rate |
$250.58 |
| Rate for Payer: Aetna Commercial |
$54.31
|
| Rate for Payer: Aetna Medicare |
$16.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.09
|
| Rate for Payer: ASR ASR |
$58.53
|
| Rate for Payer: BCBS Complete |
$9.27
|
| Rate for Payer: BCBS MAPPO |
$16.87
|
| Rate for Payer: BCBS Trust/PPO |
$49.75
|
| Rate for Payer: BCN Commercial |
$49.75
|
| Rate for Payer: BCN Medicare Advantage |
$16.87
|
| Rate for Payer: Cash Price |
$48.27
|
| Rate for Payer: Cash Price |
$48.27
|
| Rate for Payer: Cofinity Commercial |
$56.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.87
|
| Rate for Payer: Healthscope Commercial |
$58.53
|
| Rate for Payer: Healthscope Whirlpool |
$60.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.87
|
| Rate for Payer: Mclaren Commercial |
$54.31
|
| Rate for Payer: Mclaren Medicaid |
$16.87
|
| Rate for Payer: Mclaren Medicare |
$16.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.71
|
| Rate for Payer: Meridian Medicaid |
$9.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51.29
|
| Rate for Payer: Nomi Health Commercial |
$49.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$45.26
|
| Rate for Payer: PACE Medicare |
$16.03
|
| Rate for Payer: PACE SWMI |
$16.87
|
| Rate for Payer: PHP Commercial |
$18.56
|
| Rate for Payer: PHP Medicaid |
$9.04
|
| Rate for Payer: PHP Medicare Advantage |
$16.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$250.58
|
| Rate for Payer: Priority Health Medicare |
$16.87
|
| Rate for Payer: Priority Health Narrow Network |
$200.47
|
| Rate for Payer: Railroad Medicare Medicare |
$16.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$53.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$16.87
|
| Rate for Payer: UHC Exchange |
$26.15
|
| Rate for Payer: UHC Medicaid |
$8.82
|
| Rate for Payer: UHCCP DNSP |
$16.87
|
| Rate for Payer: UHCCP Medicaid |
$8.82
|
| Rate for Payer: VA VA |
$16.87
|
|
|
HC CARNITINE
|
Facility
|
IP
|
$60.34
|
|
|
Service Code
|
CPT 82379
|
| Hospital Charge Code |
30100136
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$45.26 |
| Max. Negotiated Rate |
$60.34 |
| Rate for Payer: Aetna Commercial |
$54.31
|
| Rate for Payer: ASR ASR |
$58.53
|
| Rate for Payer: BCBS Trust/PPO |
$49.55
|
| Rate for Payer: BCN Commercial |
$49.55
|
| Rate for Payer: Cash Price |
$48.27
|
| Rate for Payer: Cofinity Commercial |
$56.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.27
|
| Rate for Payer: Healthscope Commercial |
$58.53
|
| Rate for Payer: Healthscope Whirlpool |
$60.34
|
| Rate for Payer: Mclaren Commercial |
$54.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51.29
|
| Rate for Payer: Nomi Health Commercial |
$49.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$45.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$53.10
|
|
|
HC CAR OBSERVATION PER HOUR
|
Facility
|
OP
|
$160.00
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200010
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$54.44 |
| Max. Negotiated Rate |
$1,608.00 |
| Rate for Payer: Aetna Commercial |
$144.00
|
| Rate for Payer: Aetna Medicare |
$59.20
|
| Rate for Payer: ASR ASR |
$155.20
|
| Rate for Payer: BCBS Complete |
$64.00
|
| Rate for Payer: BCBS Trust/PPO |
$131.92
|
| Rate for Payer: BCN Commercial |
$131.92
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cofinity Commercial |
$150.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.00
|
| Rate for Payer: Healthscope Commercial |
$155.20
|
| Rate for Payer: Healthscope Whirlpool |
$160.00
|
| Rate for Payer: Mclaren Commercial |
$144.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$128.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.00
|
| Rate for Payer: Nomi Health Commercial |
$131.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$120.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$68.05
|
| Rate for Payer: Priority Health Narrow Network |
$54.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$140.80
|
| Rate for Payer: UHC Medicaid |
$1,608.00
|
|
|
HC CAR OBSERVATION PER HOUR
|
Facility
|
IP
|
$160.00
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200010
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$120.00 |
| Max. Negotiated Rate |
$160.00 |
| Rate for Payer: Aetna Commercial |
$144.00
|
| Rate for Payer: ASR ASR |
$155.20
|
| Rate for Payer: BCBS Trust/PPO |
$131.39
|
| Rate for Payer: BCN Commercial |
$131.39
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cofinity Commercial |
$150.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.00
|
| Rate for Payer: Healthscope Commercial |
$155.20
|
| Rate for Payer: Healthscope Whirlpool |
$160.00
|
| Rate for Payer: Mclaren Commercial |
$144.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.00
|
| Rate for Payer: Nomi Health Commercial |
$131.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$120.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$140.80
|
|
|
HC CAROTENE
|
Facility
|
OP
|
$153.98
|
|
|
Service Code
|
CPT 82380
|
| Hospital Charge Code |
30100137
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.82 |
| Max. Negotiated Rate |
$153.98 |
| Rate for Payer: Aetna Commercial |
$138.58
|
| Rate for Payer: Aetna Medicare |
$9.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.53
|
| Rate for Payer: ASR ASR |
$149.36
|
| Rate for Payer: BCBS Complete |
$5.06
|
| Rate for Payer: BCBS MAPPO |
$9.22
|
| Rate for Payer: BCBS Trust/PPO |
$126.96
|
| Rate for Payer: BCN Commercial |
$126.96
|
| Rate for Payer: BCN Medicare Advantage |
$9.22
|
| Rate for Payer: Cash Price |
$123.18
|
| Rate for Payer: Cash Price |
$123.18
|
| Rate for Payer: Cofinity Commercial |
$144.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.22
|
| Rate for Payer: Healthscope Commercial |
$149.36
|
| Rate for Payer: Healthscope Whirlpool |
$153.98
|
| Rate for Payer: Humana Choice PPO Medicare |
$9.22
|
| Rate for Payer: Mclaren Commercial |
$138.58
|
| Rate for Payer: Mclaren Medicaid |
$9.22
|
| Rate for Payer: Mclaren Medicare |
$9.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.68
|
| Rate for Payer: Meridian Medicaid |
$5.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.88
|
| Rate for Payer: Nomi Health Commercial |
$126.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$115.48
|
| Rate for Payer: PACE Medicare |
$8.76
|
| Rate for Payer: PACE SWMI |
$9.22
|
| Rate for Payer: PHP Commercial |
$10.14
|
| Rate for Payer: PHP Medicaid |
$4.94
|
| Rate for Payer: PHP Medicare Advantage |
$9.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$64.17
|
| Rate for Payer: Priority Health Medicare |
$9.22
|
| Rate for Payer: Priority Health Narrow Network |
$51.33
|
| Rate for Payer: Railroad Medicare Medicare |
$9.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$135.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$9.22
|
| Rate for Payer: UHC Exchange |
$14.29
|
| Rate for Payer: UHC Medicaid |
$4.82
|
| Rate for Payer: UHCCP DNSP |
$9.22
|
| Rate for Payer: UHCCP Medicaid |
$4.82
|
| Rate for Payer: VA VA |
$9.22
|
|
|
HC CAROTENE
|
Facility
|
IP
|
$153.98
|
|
|
Service Code
|
CPT 82380
|
| Hospital Charge Code |
30100137
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$115.48 |
| Max. Negotiated Rate |
$153.98 |
| Rate for Payer: Aetna Commercial |
$138.58
|
| Rate for Payer: ASR ASR |
$149.36
|
| Rate for Payer: BCBS Trust/PPO |
$126.45
|
| Rate for Payer: BCN Commercial |
$126.45
|
| Rate for Payer: Cash Price |
$123.18
|
| Rate for Payer: Cofinity Commercial |
$144.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.18
|
| Rate for Payer: Healthscope Commercial |
$149.36
|
| Rate for Payer: Healthscope Whirlpool |
$153.98
|
| Rate for Payer: Mclaren Commercial |
$138.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.88
|
| Rate for Payer: Nomi Health Commercial |
$126.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$115.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$135.50
|
|
