|
HC EEG W/O VID 12-26 HRS INTMT MNTR
|
Facility
|
IP
|
$2,754.67
|
|
|
Service Code
|
CPT 95709
|
| Hospital Charge Code |
74000030
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$1,928.27 |
| Max. Negotiated Rate |
$2,754.67 |
| Rate for Payer: Aetna Commercial |
$2,479.20
|
| Rate for Payer: ASR ASR |
$2,672.03
|
| Rate for Payer: BCBS Trust/PPO |
$2,135.70
|
| Rate for Payer: BCN Commercial |
$2,135.70
|
| Rate for Payer: Cash Price |
$2,203.74
|
| Rate for Payer: Cofinity Commercial |
$2,589.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,203.74
|
| Rate for Payer: Healthscope Commercial |
$2,754.67
|
| Rate for Payer: Healthscope Whirlpool |
$2,672.03
|
| Rate for Payer: Mclaren Commercial |
$2,479.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,341.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,928.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,424.11
|
|
|
HC EEG W/O VID 12-26 HRS INTMT MNTR
|
Facility
|
OP
|
$2,754.67
|
|
|
Service Code
|
CPT 95709
|
| Hospital Charge Code |
74000030
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$260.60 |
| Max. Negotiated Rate |
$2,754.67 |
| Rate for Payer: Aetna Commercial |
$2,479.20
|
| Rate for Payer: Aetna Medicare |
$476.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$595.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$595.52
|
| Rate for Payer: ASR ASR |
$2,672.03
|
| Rate for Payer: BCBS Complete |
$273.66
|
| Rate for Payer: BCBS MAPPO |
$476.42
|
| Rate for Payer: BCBS Trust/PPO |
$2,135.70
|
| Rate for Payer: BCN Commercial |
$2,135.70
|
| Rate for Payer: BCN Medicare Advantage |
$476.42
|
| Rate for Payer: Cash Price |
$2,203.74
|
| Rate for Payer: Cash Price |
$2,203.74
|
| Rate for Payer: Cofinity Commercial |
$2,589.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,203.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$476.42
|
| Rate for Payer: Healthscope Commercial |
$2,754.67
|
| Rate for Payer: Healthscope Whirlpool |
$2,672.03
|
| Rate for Payer: Humana Choice PPO Medicare |
$476.42
|
| Rate for Payer: Mclaren Commercial |
$2,479.20
|
| Rate for Payer: Mclaren Medicaid |
$260.60
|
| Rate for Payer: Mclaren Medicare |
$476.42
|
| Rate for Payer: Meridian Medicaid |
$273.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$500.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$547.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,341.47
|
| Rate for Payer: PACE Medicare |
$452.60
|
| Rate for Payer: PACE SWMI |
$476.42
|
| Rate for Payer: PHP Commercial |
$524.06
|
| Rate for Payer: PHP Medicaid |
$260.60
|
| Rate for Payer: PHP Medicare Advantage |
$476.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$260.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,928.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$519.54
|
| Rate for Payer: Priority Health Medicare |
$476.42
|
| Rate for Payer: Priority Health Narrow Network |
$415.63
|
| Rate for Payer: Railroad Medicare Medicare |
$476.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,424.11
|
| Rate for Payer: UHC Medicare Advantage |
$490.71
|
| Rate for Payer: VA VA |
$476.42
|
|
|
HC EEG W/O VID 2-12 HRS CONT MNTR
|
Facility
|
OP
|
$1,614.20
|
|
|
Service Code
|
CPT 95707
|
| Hospital Charge Code |
74000029
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$152.61 |
| Max. Negotiated Rate |
$1,614.20 |
| Rate for Payer: Aetna Commercial |
$1,452.78
|
| Rate for Payer: Aetna Medicare |
$279.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$348.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$348.75
|
| Rate for Payer: ASR ASR |
$1,565.77
|
| Rate for Payer: BCBS Complete |
$160.26
|
| Rate for Payer: BCBS MAPPO |
$279.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,251.49
|
| Rate for Payer: BCN Commercial |
$1,251.49
|
| Rate for Payer: BCN Medicare Advantage |
$279.00
|
| Rate for Payer: Cash Price |
$1,291.36
|
| Rate for Payer: Cash Price |
$1,291.36
|
| Rate for Payer: Cofinity Commercial |
$1,517.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,291.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$279.00
|
| Rate for Payer: Healthscope Commercial |
$1,614.20
|
| Rate for Payer: Healthscope Whirlpool |
$1,565.77
|
| Rate for Payer: Humana Choice PPO Medicare |
$279.00
|
| Rate for Payer: Mclaren Commercial |
$1,452.78
|
| Rate for Payer: Mclaren Medicaid |
$152.61
|
| Rate for Payer: Mclaren Medicare |
$279.00
|
| Rate for Payer: Meridian Medicaid |
$160.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$292.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$320.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,372.07
|
| Rate for Payer: PACE Medicare |
$265.05
|
| Rate for Payer: PACE SWMI |
$279.00
|
| Rate for Payer: PHP Commercial |
$306.90
|
| Rate for Payer: PHP Medicaid |
$152.61
|
| Rate for Payer: PHP Medicare Advantage |
$279.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$152.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,129.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$270.78
|
| Rate for Payer: Priority Health Medicare |
$279.00
|
| Rate for Payer: Priority Health Narrow Network |
$216.62
|
| Rate for Payer: Railroad Medicare Medicare |
$279.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,420.50
|
| Rate for Payer: UHC Medicare Advantage |
$287.37
|
| Rate for Payer: VA VA |
$279.00
|
|
|
HC EEG W/O VID 2-12 HRS CONT MNTR
|
Facility
|
IP
|
$1,614.20
|
|
|
Service Code
|
CPT 95707
|
| Hospital Charge Code |
74000029
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$1,129.94 |
| Max. Negotiated Rate |
$1,614.20 |
| Rate for Payer: Aetna Commercial |
$1,452.78
|
| Rate for Payer: ASR ASR |
$1,565.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,251.49
|
| Rate for Payer: BCN Commercial |
$1,251.49
|
| Rate for Payer: Cash Price |
$1,291.36
|
| Rate for Payer: Cofinity Commercial |
$1,517.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,291.36
|
| Rate for Payer: Healthscope Commercial |
$1,614.20
|
| Rate for Payer: Healthscope Whirlpool |
$1,565.77
|
| Rate for Payer: Mclaren Commercial |
$1,452.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,372.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,129.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,420.50
|
|
|
HC EEG W/O VID 2-12 HRS INTMT MNTR
|
Facility
|
OP
|
$1,614.01
|
|
|
Service Code
|
CPT 95706
|
| Hospital Charge Code |
74000028
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$152.61 |
| Max. Negotiated Rate |
$1,614.01 |
| Rate for Payer: Aetna Commercial |
$1,452.61
|
| Rate for Payer: Aetna Medicare |
$279.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$348.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$348.75
|
| Rate for Payer: ASR ASR |
$1,565.59
|
| Rate for Payer: BCBS Complete |
$160.26
|
| Rate for Payer: BCBS MAPPO |
$279.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,251.34
|
| Rate for Payer: BCN Commercial |
$1,251.34
|
| Rate for Payer: BCN Medicare Advantage |
$279.00
|
| Rate for Payer: Cash Price |
$1,291.21
|
| Rate for Payer: Cash Price |
$1,291.21
|
| Rate for Payer: Cofinity Commercial |
$1,517.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,291.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$279.00
|
| Rate for Payer: Healthscope Commercial |
$1,614.01
|
| Rate for Payer: Healthscope Whirlpool |
$1,565.59
|
| Rate for Payer: Humana Choice PPO Medicare |
$279.00
|
| Rate for Payer: Mclaren Commercial |
$1,452.61
|
| Rate for Payer: Mclaren Medicaid |
$152.61
|
| Rate for Payer: Mclaren Medicare |
$279.00
|
| Rate for Payer: Meridian Medicaid |
$160.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$292.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$320.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,371.91
|
| Rate for Payer: PACE Medicare |
$265.05
|
| Rate for Payer: PACE SWMI |
$279.00
|
| Rate for Payer: PHP Commercial |
$306.90
|
| Rate for Payer: PHP Medicaid |
$152.61
|
| Rate for Payer: PHP Medicare Advantage |
$279.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$152.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,129.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$270.78
|
| Rate for Payer: Priority Health Medicare |
$279.00
|
| Rate for Payer: Priority Health Narrow Network |
$216.62
|
| Rate for Payer: Railroad Medicare Medicare |
$279.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,420.33
|
| Rate for Payer: UHC Medicare Advantage |
$287.37
|
| Rate for Payer: VA VA |
$279.00
|
|
|
HC EEG W/O VID 2-12 HRS INTMT MNTR
|
Facility
|
IP
|
$1,614.01
|
|
|
Service Code
|
CPT 95706
|
| Hospital Charge Code |
74000028
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$1,129.81 |
| Max. Negotiated Rate |
$1,614.01 |
| Rate for Payer: Aetna Commercial |
$1,452.61
|
| Rate for Payer: ASR ASR |
$1,565.59
|
| Rate for Payer: BCBS Trust/PPO |
$1,251.34
|
| Rate for Payer: BCN Commercial |
$1,251.34
|
| Rate for Payer: Cash Price |
$1,291.21
|
| Rate for Payer: Cofinity Commercial |
$1,517.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,291.21
|
| Rate for Payer: Healthscope Commercial |
$1,614.01
|
| Rate for Payer: Healthscope Whirlpool |
$1,565.59
|
| Rate for Payer: Mclaren Commercial |
$1,452.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,371.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,129.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,420.33
|
|
|
HC EEG W/O VID 2-12 HR UNMNTR
|
Facility
|
OP
|
$1,001.24
|
|
|
Service Code
|
CPT 95705
|
| Hospital Charge Code |
74000020
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$152.61 |
| Max. Negotiated Rate |
$1,001.24 |
| Rate for Payer: Aetna Commercial |
$901.12
|
| Rate for Payer: Aetna Medicare |
$279.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$348.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$348.75
|
| Rate for Payer: ASR ASR |
$971.20
|
| Rate for Payer: BCBS Complete |
$160.26
|
| Rate for Payer: BCBS MAPPO |
$279.00
|
| Rate for Payer: BCBS Trust/PPO |
$776.26
|
| Rate for Payer: BCN Commercial |
$776.26
|
| Rate for Payer: BCN Medicare Advantage |
$279.00
|
| Rate for Payer: Cash Price |
$800.99
|
| Rate for Payer: Cash Price |
$800.99
|
| Rate for Payer: Cofinity Commercial |
$941.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$800.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$279.00
|
| Rate for Payer: Healthscope Commercial |
$1,001.24
|
| Rate for Payer: Healthscope Whirlpool |
$971.20
|
| Rate for Payer: Humana Choice PPO Medicare |
$279.00
|
| Rate for Payer: Mclaren Commercial |
$901.12
|
| Rate for Payer: Mclaren Medicaid |
$152.61
|
| Rate for Payer: Mclaren Medicare |
$279.00
|
| Rate for Payer: Meridian Medicaid |
$160.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$292.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$320.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$851.05
|
| Rate for Payer: PACE Medicare |
$265.05
|
| Rate for Payer: PACE SWMI |
$279.00
|
| Rate for Payer: PHP Commercial |
$306.90
|
| Rate for Payer: PHP Medicaid |
$152.61
|
| Rate for Payer: PHP Medicare Advantage |
$279.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$152.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$700.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$270.78
|
| Rate for Payer: Priority Health Medicare |
$279.00
|
| Rate for Payer: Priority Health Narrow Network |
$216.62
|
| Rate for Payer: Railroad Medicare Medicare |
$279.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$881.09
|
| Rate for Payer: UHC Medicare Advantage |
$287.37
|
| Rate for Payer: VA VA |
$279.00
|
|
|
HC EEG W/O VID 2-12 HR UNMNTR
|
Facility
|
IP
|
$1,001.24
|
|
|
Service Code
|
CPT 95705
|
| Hospital Charge Code |
74000020
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$700.87 |
| Max. Negotiated Rate |
$1,001.24 |
| Rate for Payer: Aetna Commercial |
$901.12
|
| Rate for Payer: ASR ASR |
$971.20
|
| Rate for Payer: BCBS Trust/PPO |
$776.26
|
| Rate for Payer: BCN Commercial |
$776.26
|
| Rate for Payer: Cash Price |
$800.99
|
| Rate for Payer: Cofinity Commercial |
$941.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$800.99
|
| Rate for Payer: Healthscope Commercial |
$1,001.24
|
| Rate for Payer: Healthscope Whirlpool |
$971.20
|
| Rate for Payer: Mclaren Commercial |
$901.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$851.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$700.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$881.09
|
|
|
HC EEG W/O VID EA 12-26 HR UNMNTR
|
Facility
|
OP
|
$1,921.04
|
|
|
Service Code
|
CPT 95708
|
| Hospital Charge Code |
74000021
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$260.60 |
| Max. Negotiated Rate |
$1,921.04 |
| Rate for Payer: Aetna Commercial |
$1,728.94
|
| Rate for Payer: Aetna Medicare |
$476.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$595.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$595.52
|
| Rate for Payer: ASR ASR |
$1,863.41
|
| Rate for Payer: BCBS Complete |
$273.66
|
| Rate for Payer: BCBS MAPPO |
$476.42
|
| Rate for Payer: BCBS Trust/PPO |
$1,489.38
|
| Rate for Payer: BCN Commercial |
$1,489.38
|
| Rate for Payer: BCN Medicare Advantage |
$476.42
|
| Rate for Payer: Cash Price |
$1,536.83
|
| Rate for Payer: Cash Price |
$1,536.83
|
| Rate for Payer: Cofinity Commercial |
$1,805.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,536.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$476.42
|
| Rate for Payer: Healthscope Commercial |
$1,921.04
|
| Rate for Payer: Healthscope Whirlpool |
$1,863.41
|
| Rate for Payer: Humana Choice PPO Medicare |
$476.42
|
| Rate for Payer: Mclaren Commercial |
$1,728.94
|
| Rate for Payer: Mclaren Medicaid |
$260.60
|
| Rate for Payer: Mclaren Medicare |
$476.42
|
| Rate for Payer: Meridian Medicaid |
$273.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$500.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$547.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,632.88
|
| Rate for Payer: PACE Medicare |
$452.60
|
| Rate for Payer: PACE SWMI |
$476.42
|
| Rate for Payer: PHP Commercial |
$524.06
|
| Rate for Payer: PHP Medicaid |
$260.60
|
| Rate for Payer: PHP Medicare Advantage |
$476.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$260.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,344.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$519.54
|
| Rate for Payer: Priority Health Medicare |
$476.42
|
| Rate for Payer: Priority Health Narrow Network |
$415.63
|
| Rate for Payer: Railroad Medicare Medicare |
$476.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,690.52
|
| Rate for Payer: UHC Medicare Advantage |
$490.71
|
| Rate for Payer: VA VA |
$476.42
|
|
|
HC EEG W/O VID EA 12-26 HR UNMNTR
|
Facility
|
IP
|
$1,921.04
|
|
|
Service Code
|
CPT 95708
|
| Hospital Charge Code |
74000021
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$1,344.73 |
| Max. Negotiated Rate |
$1,921.04 |
| Rate for Payer: Aetna Commercial |
$1,728.94
|
| Rate for Payer: ASR ASR |
$1,863.41
|
| Rate for Payer: BCBS Trust/PPO |
$1,489.38
|
| Rate for Payer: BCN Commercial |
$1,489.38
|
| Rate for Payer: Cash Price |
$1,536.83
|
| Rate for Payer: Cofinity Commercial |
$1,805.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,536.83
|
| Rate for Payer: Healthscope Commercial |
$1,921.04
|
| Rate for Payer: Healthscope Whirlpool |
$1,863.41
|
| Rate for Payer: Mclaren Commercial |
$1,728.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,632.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,344.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,690.52
|
|
|
HC EGD W EUS EXAM ESOPH ONLY
|
Facility
|
OP
|
$2,796.13
|
|
| Hospital Charge Code |
36000035
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,118.45 |
| Max. Negotiated Rate |
$2,796.13 |
| Rate for Payer: Aetna Commercial |
$2,516.52
|
| Rate for Payer: ASR ASR |
$2,712.25
|
| Rate for Payer: BCBS Complete |
$1,118.45
|
| Rate for Payer: BCBS Trust/PPO |
$2,167.84
|
| Rate for Payer: BCN Commercial |
$2,167.84
|
| Rate for Payer: Cash Price |
$2,236.90
|
| Rate for Payer: Cofinity Commercial |
$2,628.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,236.90
|
| Rate for Payer: Healthscope Commercial |
$2,796.13
|
| Rate for Payer: Healthscope Whirlpool |
$2,712.25
|
| Rate for Payer: Mclaren Commercial |
$2,516.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,376.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,957.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,544.48
|
| Rate for Payer: Priority Health Narrow Network |
$1,985.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,460.59
|
|
|
HC EGD W EUS EXAM ESOPH ONLY
|
Facility
|
IP
|
$2,796.13
|
|
| Hospital Charge Code |
36000035
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,957.29 |
| Max. Negotiated Rate |
$2,796.13 |
| Rate for Payer: Aetna Commercial |
$2,516.52
|
| Rate for Payer: ASR ASR |
$2,712.25
|
| Rate for Payer: BCBS Trust/PPO |
$2,167.84
|
| Rate for Payer: BCN Commercial |
$2,167.84
|
| Rate for Payer: Cash Price |
$2,236.90
|
| Rate for Payer: Cofinity Commercial |
$2,628.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,236.90
|
| Rate for Payer: Healthscope Commercial |
$2,796.13
|
| Rate for Payer: Healthscope Whirlpool |
$2,712.25
|
| Rate for Payer: Mclaren Commercial |
$2,516.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,376.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,957.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,460.59
|
|
|
HC EGD W EUS EXAM ESOPH,STOM,DUO,
|
Facility
|
OP
|
$2,920.68
|
|
| Hospital Charge Code |
36000036
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,168.27 |
| Max. Negotiated Rate |
$2,920.68 |
| Rate for Payer: Aetna Commercial |
$2,628.61
|
| Rate for Payer: ASR ASR |
$2,833.06
|
| Rate for Payer: BCBS Complete |
$1,168.27
|
| Rate for Payer: BCBS Trust/PPO |
$2,264.40
|
| Rate for Payer: BCN Commercial |
$2,264.40
|
| Rate for Payer: Cash Price |
$2,336.54
|
| Rate for Payer: Cofinity Commercial |
$2,745.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,336.54
|
| Rate for Payer: Healthscope Commercial |
$2,920.68
|
| Rate for Payer: Healthscope Whirlpool |
$2,833.06
|
| Rate for Payer: Mclaren Commercial |
$2,628.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,482.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,044.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,657.82
|
| Rate for Payer: Priority Health Narrow Network |
$2,073.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,570.20
|
|
|
HC EGD W EUS EXAM ESOPH,STOM,DUO,
|
Facility
|
IP
|
$2,920.68
|
|
| Hospital Charge Code |
36000036
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,044.48 |
| Max. Negotiated Rate |
$2,920.68 |
| Rate for Payer: Aetna Commercial |
$2,628.61
|
| Rate for Payer: ASR ASR |
$2,833.06
|
| Rate for Payer: BCBS Trust/PPO |
$2,264.40
|
| Rate for Payer: BCN Commercial |
$2,264.40
|
| Rate for Payer: Cash Price |
$2,336.54
|
| Rate for Payer: Cofinity Commercial |
$2,745.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,336.54
|
| Rate for Payer: Healthscope Commercial |
$2,920.68
|
| Rate for Payer: Healthscope Whirlpool |
$2,833.06
|
| Rate for Payer: Mclaren Commercial |
$2,628.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,482.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,044.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,570.20
|
|
|
HC EGG WHITE IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200041
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$17.42 |
| Max. Negotiated Rate |
$24.89 |
| Rate for Payer: Aetna Commercial |
$22.40
|
| Rate for Payer: ASR ASR |
$24.14
|
| Rate for Payer: BCBS Trust/PPO |
$19.30
|
| Rate for Payer: BCN Commercial |
$19.30
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$23.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$24.89
|
| Rate for Payer: Healthscope Whirlpool |
$24.14
|
| Rate for Payer: Mclaren Commercial |
$22.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.90
|
|
|
HC EGG WHITE IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200041
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.86 |
| Max. Negotiated Rate |
$24.89 |
| Rate for Payer: Aetna Commercial |
$22.40
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: ASR ASR |
$24.14
|
| Rate for Payer: BCBS Complete |
$3.00
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.30
|
| Rate for Payer: BCN Commercial |
$19.30
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$23.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$24.89
|
| Rate for Payer: Healthscope Whirlpool |
$24.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$22.40
|
| Rate for Payer: Mclaren Medicaid |
$2.86
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Medicaid |
$3.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| 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 |
$2.86
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.65
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$17.67
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.90
|
| Rate for Payer: UHC Medicare Advantage |
$5.38
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC EGG YOLK, IGE
|
Facility
|
OP
|
$30.60
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200482
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.86 |
| Max. Negotiated Rate |
$30.60 |
| Rate for Payer: Aetna Commercial |
$27.54
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: ASR ASR |
$29.68
|
| Rate for Payer: BCBS Complete |
$3.00
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$23.72
|
| Rate for Payer: BCN Commercial |
$23.72
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$28.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$30.60
|
| Rate for Payer: Healthscope Whirlpool |
$29.68
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$27.54
|
| Rate for Payer: Mclaren Medicaid |
$2.86
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Medicaid |
$3.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.01
|
| 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 |
$2.86
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$27.85
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$21.73
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.93
|
| Rate for Payer: UHC Medicare Advantage |
$5.38
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC EGG YOLK, IGE
|
Facility
|
IP
|
$30.60
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200482
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$21.42 |
| Max. Negotiated Rate |
$30.60 |
| Rate for Payer: Aetna Commercial |
$27.54
|
| Rate for Payer: ASR ASR |
$29.68
|
| Rate for Payer: BCBS Trust/PPO |
$23.72
|
| Rate for Payer: BCN Commercial |
$23.72
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$28.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.48
|
| Rate for Payer: Healthscope Commercial |
$30.60
|
| Rate for Payer: Healthscope Whirlpool |
$29.68
|
| Rate for Payer: Mclaren Commercial |
$27.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.93
|
|
|
HC EKG RHYTHM STRIP
|
Facility
|
OP
|
$72.41
|
|
|
Service Code
|
CPT 93041
|
| Hospital Charge Code |
73000002
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$29.74 |
| Max. Negotiated Rate |
$72.41 |
| Rate for Payer: Aetna Commercial |
$65.17
|
| Rate for Payer: Aetna Medicare |
$54.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$67.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$67.96
|
| Rate for Payer: ASR ASR |
$70.24
|
| Rate for Payer: BCBS Complete |
$31.23
|
| Rate for Payer: BCBS MAPPO |
$54.37
|
| Rate for Payer: BCBS Trust/PPO |
$56.14
|
| Rate for Payer: BCN Commercial |
$56.14
|
| Rate for Payer: BCN Medicare Advantage |
$54.37
|
| Rate for Payer: Cash Price |
$57.93
|
| Rate for Payer: Cash Price |
$57.93
|
| Rate for Payer: Cofinity Commercial |
$68.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.37
|
| Rate for Payer: Healthscope Commercial |
$72.41
|
| Rate for Payer: Healthscope Whirlpool |
$70.24
|
| Rate for Payer: Humana Choice PPO Medicare |
$54.37
|
| Rate for Payer: Mclaren Commercial |
$65.17
|
| Rate for Payer: Mclaren Medicaid |
$29.74
|
| Rate for Payer: Mclaren Medicare |
$54.37
|
| Rate for Payer: Meridian Medicaid |
$31.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$57.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$62.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$61.55
|
| Rate for Payer: PACE Medicare |
$51.65
|
| Rate for Payer: PACE SWMI |
$54.37
|
| Rate for Payer: PHP Commercial |
$59.81
|
| Rate for Payer: PHP Medicaid |
$29.74
|
| Rate for Payer: PHP Medicare Advantage |
$54.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$37.96
|
| Rate for Payer: Priority Health Medicare |
$54.37
|
| Rate for Payer: Priority Health Narrow Network |
$30.37
|
| Rate for Payer: Railroad Medicare Medicare |
$54.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$63.72
|
| Rate for Payer: UHC Medicare Advantage |
$56.00
|
| Rate for Payer: VA VA |
$54.37
|
|
|
HC EKG RHYTHM STRIP
|
Facility
|
IP
|
$72.41
|
|
|
Service Code
|
CPT 93041
|
| Hospital Charge Code |
73000002
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$50.69 |
| Max. Negotiated Rate |
$72.41 |
| Rate for Payer: Aetna Commercial |
$65.17
|
| Rate for Payer: ASR ASR |
$70.24
|
| Rate for Payer: BCBS Trust/PPO |
$56.14
|
| Rate for Payer: BCN Commercial |
$56.14
|
| Rate for Payer: Cash Price |
$57.93
|
| Rate for Payer: Cofinity Commercial |
$68.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.93
|
| Rate for Payer: Healthscope Commercial |
$72.41
|
| Rate for Payer: Healthscope Whirlpool |
$70.24
|
| Rate for Payer: Mclaren Commercial |
$65.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$61.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$63.72
|
|
|
HC EKG TRACING FOR INITIAL PREV
|
Facility
|
IP
|
$35.68
|
|
|
Service Code
|
HCPCS G0404
|
| Hospital Charge Code |
73000004
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$24.98 |
| Max. Negotiated Rate |
$35.68 |
| Rate for Payer: Aetna Commercial |
$32.11
|
| Rate for Payer: ASR ASR |
$34.61
|
| Rate for Payer: BCBS Trust/PPO |
$27.66
|
| Rate for Payer: BCN Commercial |
$27.66
|
| Rate for Payer: Cash Price |
$28.54
|
| Rate for Payer: Cofinity Commercial |
$33.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.54
|
| Rate for Payer: Healthscope Commercial |
$35.68
|
| Rate for Payer: Healthscope Whirlpool |
$34.61
|
| Rate for Payer: Mclaren Commercial |
$32.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$30.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$31.40
|
|
|
HC EKG TRACING FOR INITIAL PREV
|
Facility
|
OP
|
$35.68
|
|
|
Service Code
|
HCPCS G0404
|
| Hospital Charge Code |
73000004
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$14.48 |
| Max. Negotiated Rate |
$35.68 |
| Rate for Payer: Aetna Commercial |
$32.11
|
| Rate for Payer: Aetna Medicare |
$26.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.09
|
| Rate for Payer: ASR ASR |
$34.61
|
| Rate for Payer: BCBS Complete |
$15.20
|
| Rate for Payer: BCBS MAPPO |
$26.47
|
| Rate for Payer: BCBS Trust/PPO |
$27.66
|
| Rate for Payer: BCN Commercial |
$27.66
|
| Rate for Payer: BCN Medicare Advantage |
$26.47
|
| Rate for Payer: Cash Price |
$28.54
|
| Rate for Payer: Cash Price |
$28.54
|
| Rate for Payer: Cofinity Commercial |
$33.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.47
|
| Rate for Payer: Healthscope Commercial |
$35.68
|
| Rate for Payer: Healthscope Whirlpool |
$34.61
|
| Rate for Payer: Humana Choice PPO Medicare |
$26.47
|
| Rate for Payer: Mclaren Commercial |
$32.11
|
| Rate for Payer: Mclaren Medicaid |
$14.48
|
| Rate for Payer: Mclaren Medicare |
$26.47
|
| Rate for Payer: Meridian Medicaid |
$15.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$27.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$30.33
|
| Rate for Payer: PACE Medicare |
$25.15
|
| Rate for Payer: PACE SWMI |
$26.47
|
| Rate for Payer: PHP Commercial |
$29.12
|
| Rate for Payer: PHP Medicaid |
$14.48
|
| Rate for Payer: PHP Medicare Advantage |
$26.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$32.47
|
| Rate for Payer: Priority Health Medicare |
$26.47
|
| Rate for Payer: Priority Health Narrow Network |
$25.33
|
| Rate for Payer: Railroad Medicare Medicare |
$26.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$31.40
|
| Rate for Payer: UHC Medicare Advantage |
$27.26
|
| Rate for Payer: VA VA |
$26.47
|
|
|
HC EKO INFUSION SYSTEM
|
Facility
|
IP
|
$7,545.17
|
|
| Hospital Charge Code |
27200279
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5,281.62 |
| Max. Negotiated Rate |
$7,545.17 |
| Rate for Payer: Aetna Commercial |
$6,790.65
|
| Rate for Payer: ASR ASR |
$7,318.81
|
| Rate for Payer: BCBS Trust/PPO |
$5,849.77
|
| Rate for Payer: BCN Commercial |
$5,849.77
|
| Rate for Payer: Cash Price |
$6,036.14
|
| Rate for Payer: Cofinity Commercial |
$7,092.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,036.14
|
| Rate for Payer: Healthscope Commercial |
$7,545.17
|
| Rate for Payer: Healthscope Whirlpool |
$7,318.81
|
| Rate for Payer: Mclaren Commercial |
$6,790.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,413.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,281.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,639.75
|
|
|
HC EKO INFUSION SYSTEM
|
Facility
|
OP
|
$7,545.17
|
|
| Hospital Charge Code |
27200279
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,018.07 |
| Max. Negotiated Rate |
$7,545.17 |
| Rate for Payer: Aetna Commercial |
$6,790.65
|
| Rate for Payer: ASR ASR |
$7,318.81
|
| Rate for Payer: BCBS Complete |
$3,018.07
|
| Rate for Payer: BCBS Trust/PPO |
$5,849.77
|
| Rate for Payer: BCN Commercial |
$5,849.77
|
| Rate for Payer: Cash Price |
$6,036.14
|
| Rate for Payer: Cofinity Commercial |
$7,092.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,036.14
|
| Rate for Payer: Healthscope Commercial |
$7,545.17
|
| Rate for Payer: Healthscope Whirlpool |
$7,318.81
|
| Rate for Payer: Mclaren Commercial |
$6,790.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,413.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,281.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,866.10
|
| Rate for Payer: Priority Health Narrow Network |
$5,357.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,639.75
|
|
|
HC ELEC ALYS IMPLT NPGT CPLX SP/PN PRGM
|
Facility
|
OP
|
$190.74
|
|
|
Service Code
|
CPT 95972
|
| Hospital Charge Code |
92000029
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$47.06 |
| Max. Negotiated Rate |
$190.74 |
| Rate for Payer: Aetna Commercial |
$171.67
|
| Rate for Payer: Aetna Medicare |
$86.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.55
|
| Rate for Payer: ASR ASR |
$185.02
|
| Rate for Payer: BCBS Complete |
$49.42
|
| Rate for Payer: BCBS MAPPO |
$86.04
|
| Rate for Payer: BCBS Trust/PPO |
$147.88
|
| Rate for Payer: BCN Commercial |
$147.88
|
| Rate for Payer: BCN Medicare Advantage |
$86.04
|
| Rate for Payer: Cash Price |
$152.59
|
| Rate for Payer: Cash Price |
$152.59
|
| Rate for Payer: Cofinity Commercial |
$179.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$152.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.04
|
| Rate for Payer: Healthscope Commercial |
$190.74
|
| Rate for Payer: Healthscope Whirlpool |
$185.02
|
| Rate for Payer: Humana Choice PPO Medicare |
$86.04
|
| Rate for Payer: Mclaren Commercial |
$171.67
|
| Rate for Payer: Mclaren Medicaid |
$47.06
|
| Rate for Payer: Mclaren Medicare |
$86.04
|
| Rate for Payer: Meridian Medicaid |
$49.42
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$90.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$162.13
|
| Rate for Payer: PACE Medicare |
$81.74
|
| Rate for Payer: PACE SWMI |
$86.04
|
| Rate for Payer: PHP Commercial |
$94.64
|
| Rate for Payer: PHP Medicaid |
$47.06
|
| Rate for Payer: PHP Medicare Advantage |
$86.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$47.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$173.57
|
| Rate for Payer: Priority Health Medicare |
$86.04
|
| Rate for Payer: Priority Health Narrow Network |
$135.43
|
| Rate for Payer: Railroad Medicare Medicare |
$86.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$167.85
|
| Rate for Payer: UHC Medicare Advantage |
$88.62
|
| Rate for Payer: VA VA |
$86.04
|
|
