|
HC EMG CRANIAL CERV THOR LUMB PARASPINE NDL EXAM W NCS UNI
|
Facility
|
IP
|
$600.05
|
|
|
Service Code
|
CPT 95887
|
| Hospital Charge Code |
92200024
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$420.04 |
| Max. Negotiated Rate |
$600.05 |
| Rate for Payer: Aetna Commercial |
$540.04
|
| Rate for Payer: ASR ASR |
$582.05
|
| Rate for Payer: BCBS Trust/PPO |
$465.22
|
| Rate for Payer: BCN Commercial |
$465.22
|
| Rate for Payer: Cash Price |
$480.04
|
| Rate for Payer: Cofinity Commercial |
$564.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$480.04
|
| Rate for Payer: Healthscope Commercial |
$600.05
|
| Rate for Payer: Healthscope Whirlpool |
$582.05
|
| Rate for Payer: Mclaren Commercial |
$540.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$510.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$420.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$528.04
|
|
|
HC EMG NDL GUIDANCE NERVE DEST WITH CHEMODENERVATION
|
Facility
|
IP
|
$183.71
|
|
|
Service Code
|
CPT 95874
|
| Hospital Charge Code |
92200034
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$128.60 |
| Max. Negotiated Rate |
$183.71 |
| Rate for Payer: Aetna Commercial |
$165.34
|
| Rate for Payer: ASR ASR |
$178.20
|
| Rate for Payer: BCBS Trust/PPO |
$142.43
|
| Rate for Payer: BCN Commercial |
$142.43
|
| Rate for Payer: Cash Price |
$146.97
|
| Rate for Payer: Cofinity Commercial |
$172.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$146.97
|
| Rate for Payer: Healthscope Commercial |
$183.71
|
| Rate for Payer: Healthscope Whirlpool |
$178.20
|
| Rate for Payer: Mclaren Commercial |
$165.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$156.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$128.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$161.66
|
|
|
HC EMG NDL GUIDANCE NERVE DEST WITH CHEMODENERVATION
|
Facility
|
OP
|
$183.71
|
|
|
Service Code
|
CPT 95874
|
| Hospital Charge Code |
92200034
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$73.48 |
| Max. Negotiated Rate |
$183.71 |
| Rate for Payer: Aetna Commercial |
$165.34
|
| Rate for Payer: ASR ASR |
$178.20
|
| Rate for Payer: BCBS Complete |
$73.48
|
| Rate for Payer: BCBS Trust/PPO |
$142.43
|
| Rate for Payer: BCN Commercial |
$142.43
|
| Rate for Payer: Cash Price |
$146.97
|
| Rate for Payer: Cofinity Commercial |
$172.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$146.97
|
| Rate for Payer: Healthscope Commercial |
$183.71
|
| Rate for Payer: Healthscope Whirlpool |
$178.20
|
| Rate for Payer: Mclaren Commercial |
$165.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$156.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$128.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$167.18
|
| Rate for Payer: Priority Health Narrow Network |
$130.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$161.66
|
|
|
HC EMG NEEDLE EXAM-1 EXT.
|
Facility
|
IP
|
$585.47
|
|
|
Service Code
|
CPT 95860
|
| Hospital Charge Code |
92200001
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$409.83 |
| Max. Negotiated Rate |
$585.47 |
| Rate for Payer: Aetna Commercial |
$526.92
|
| Rate for Payer: ASR ASR |
$567.91
|
| Rate for Payer: BCBS Trust/PPO |
$453.91
|
| Rate for Payer: BCN Commercial |
$453.91
|
| Rate for Payer: Cash Price |
$468.38
|
| Rate for Payer: Cofinity Commercial |
$550.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$468.38
|
| Rate for Payer: Healthscope Commercial |
$585.47
|
| Rate for Payer: Healthscope Whirlpool |
$567.91
|
| Rate for Payer: Mclaren Commercial |
$526.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$497.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$409.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$515.21
|
|
|
HC EMG NEEDLE EXAM-1 EXT.
|
Facility
|
OP
|
$585.47
|
|
|
Service Code
|
CPT 95860
|
| Hospital Charge Code |
92200001
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$62.11 |
| Max. Negotiated Rate |
$585.47 |
| Rate for Payer: Aetna Commercial |
$526.92
|
| Rate for Payer: Aetna Medicare |
$113.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$141.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$141.94
|
| Rate for Payer: ASR ASR |
$567.91
|
| Rate for Payer: BCBS Complete |
$65.22
|
| Rate for Payer: BCBS MAPPO |
$113.55
|
| Rate for Payer: BCBS Trust/PPO |
$453.91
|
| Rate for Payer: BCN Commercial |
$453.91
|
| Rate for Payer: BCN Medicare Advantage |
$113.55
|
| Rate for Payer: Cash Price |
$468.38
|
| Rate for Payer: Cash Price |
$468.38
|
| Rate for Payer: Cofinity Commercial |
$550.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$468.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$113.55
|
| Rate for Payer: Healthscope Commercial |
$585.47
|
| Rate for Payer: Healthscope Whirlpool |
$567.91
|
| Rate for Payer: Humana Choice PPO Medicare |
$113.55
|
| Rate for Payer: Mclaren Commercial |
$526.92
|
| Rate for Payer: Mclaren Medicaid |
$62.11
|
| Rate for Payer: Mclaren Medicare |
$113.55
|
| Rate for Payer: Meridian Medicaid |
$65.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$119.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$130.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$497.65
|
| Rate for Payer: PACE Medicare |
$107.87
|
| Rate for Payer: PACE SWMI |
$113.55
|
| Rate for Payer: PHP Commercial |
$124.90
|
| Rate for Payer: PHP Medicaid |
$62.11
|
| Rate for Payer: PHP Medicare Advantage |
$113.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$409.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$532.78
|
| Rate for Payer: Priority Health Medicare |
$113.55
|
| Rate for Payer: Priority Health Narrow Network |
$415.68
|
| Rate for Payer: Railroad Medicare Medicare |
$113.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$515.21
|
| Rate for Payer: UHC Medicare Advantage |
$116.96
|
| Rate for Payer: VA VA |
$113.55
|
|
|
HC EMG NEEDLE EXAM 2 EXT
|
Facility
|
OP
|
$690.78
|
|
|
Service Code
|
CPT 95861
|
| Hospital Charge Code |
92200002
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$62.11 |
| Max. Negotiated Rate |
$690.78 |
| Rate for Payer: Aetna Commercial |
$621.70
|
| Rate for Payer: Aetna Medicare |
$113.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$141.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$141.94
|
| Rate for Payer: ASR ASR |
$670.06
|
| Rate for Payer: BCBS Complete |
$65.22
|
| Rate for Payer: BCBS MAPPO |
$113.55
|
| Rate for Payer: BCBS Trust/PPO |
$535.56
|
| Rate for Payer: BCN Commercial |
$535.56
|
| Rate for Payer: BCN Medicare Advantage |
$113.55
|
| Rate for Payer: Cash Price |
$552.62
|
| Rate for Payer: Cash Price |
$552.62
|
| Rate for Payer: Cofinity Commercial |
$649.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$552.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$113.55
|
| Rate for Payer: Healthscope Commercial |
$690.78
|
| Rate for Payer: Healthscope Whirlpool |
$670.06
|
| Rate for Payer: Humana Choice PPO Medicare |
$113.55
|
| Rate for Payer: Mclaren Commercial |
$621.70
|
| Rate for Payer: Mclaren Medicaid |
$62.11
|
| Rate for Payer: Mclaren Medicare |
$113.55
|
| Rate for Payer: Meridian Medicaid |
$65.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$119.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$130.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$587.16
|
| Rate for Payer: PACE Medicare |
$107.87
|
| Rate for Payer: PACE SWMI |
$113.55
|
| Rate for Payer: PHP Commercial |
$124.90
|
| Rate for Payer: PHP Medicaid |
$62.11
|
| Rate for Payer: PHP Medicare Advantage |
$113.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$483.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$628.61
|
| Rate for Payer: Priority Health Medicare |
$113.55
|
| Rate for Payer: Priority Health Narrow Network |
$490.45
|
| Rate for Payer: Railroad Medicare Medicare |
$113.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$607.89
|
| Rate for Payer: UHC Medicare Advantage |
$116.96
|
| Rate for Payer: VA VA |
$113.55
|
|
|
HC EMG NEEDLE EXAM 2 EXT
|
Facility
|
IP
|
$690.78
|
|
|
Service Code
|
CPT 95861
|
| Hospital Charge Code |
92200002
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$483.55 |
| Max. Negotiated Rate |
$690.78 |
| Rate for Payer: Aetna Commercial |
$621.70
|
| Rate for Payer: ASR ASR |
$670.06
|
| Rate for Payer: BCBS Trust/PPO |
$535.56
|
| Rate for Payer: BCN Commercial |
$535.56
|
| Rate for Payer: Cash Price |
$552.62
|
| Rate for Payer: Cofinity Commercial |
$649.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$552.62
|
| Rate for Payer: Healthscope Commercial |
$690.78
|
| Rate for Payer: Healthscope Whirlpool |
$670.06
|
| Rate for Payer: Mclaren Commercial |
$621.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$587.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$483.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$607.89
|
|
|
HC EMG NEEDLE EXAM 3 EXT
|
Facility
|
IP
|
$638.36
|
|
|
Service Code
|
CPT 95863
|
| Hospital Charge Code |
92200003
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$446.85 |
| Max. Negotiated Rate |
$638.36 |
| Rate for Payer: Aetna Commercial |
$574.52
|
| Rate for Payer: ASR ASR |
$619.21
|
| Rate for Payer: BCBS Trust/PPO |
$494.92
|
| Rate for Payer: BCN Commercial |
$494.92
|
| Rate for Payer: Cash Price |
$510.69
|
| Rate for Payer: Cofinity Commercial |
$600.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$510.69
|
| Rate for Payer: Healthscope Commercial |
$638.36
|
| Rate for Payer: Healthscope Whirlpool |
$619.21
|
| Rate for Payer: Mclaren Commercial |
$574.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$542.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$446.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$561.76
|
|
|
HC EMG NEEDLE EXAM 3 EXT
|
Facility
|
OP
|
$638.36
|
|
|
Service Code
|
CPT 95863
|
| Hospital Charge Code |
92200003
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$75.95 |
| Max. Negotiated Rate |
$638.36 |
| Rate for Payer: Aetna Commercial |
$574.52
|
| Rate for Payer: Aetna Medicare |
$138.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$173.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$173.56
|
| Rate for Payer: ASR ASR |
$619.21
|
| Rate for Payer: BCBS Complete |
$79.76
|
| Rate for Payer: BCBS MAPPO |
$138.85
|
| Rate for Payer: BCBS Trust/PPO |
$494.92
|
| Rate for Payer: BCN Commercial |
$494.92
|
| Rate for Payer: BCN Medicare Advantage |
$138.85
|
| Rate for Payer: Cash Price |
$510.69
|
| Rate for Payer: Cash Price |
$510.69
|
| Rate for Payer: Cofinity Commercial |
$600.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$510.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.85
|
| Rate for Payer: Healthscope Commercial |
$638.36
|
| Rate for Payer: Healthscope Whirlpool |
$619.21
|
| Rate for Payer: Humana Choice PPO Medicare |
$138.85
|
| Rate for Payer: Mclaren Commercial |
$574.52
|
| Rate for Payer: Mclaren Medicaid |
$75.95
|
| Rate for Payer: Mclaren Medicare |
$138.85
|
| Rate for Payer: Meridian Medicaid |
$79.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$145.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$159.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$542.61
|
| Rate for Payer: PACE Medicare |
$131.91
|
| Rate for Payer: PACE SWMI |
$138.85
|
| Rate for Payer: PHP Commercial |
$152.74
|
| Rate for Payer: PHP Medicaid |
$75.95
|
| Rate for Payer: PHP Medicare Advantage |
$138.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$446.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$580.91
|
| Rate for Payer: Priority Health Medicare |
$138.85
|
| Rate for Payer: Priority Health Narrow Network |
$453.24
|
| Rate for Payer: Railroad Medicare Medicare |
$138.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$561.76
|
| Rate for Payer: UHC Medicare Advantage |
$143.02
|
| Rate for Payer: VA VA |
$138.85
|
|
|
HC EMG NEEDLE EXAM 4 EXT
|
Facility
|
IP
|
$800.53
|
|
|
Service Code
|
CPT 95864
|
| Hospital Charge Code |
92200004
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$560.37 |
| Max. Negotiated Rate |
$800.53 |
| Rate for Payer: Aetna Commercial |
$720.48
|
| Rate for Payer: ASR ASR |
$776.51
|
| Rate for Payer: BCBS Trust/PPO |
$620.65
|
| Rate for Payer: BCN Commercial |
$620.65
|
| Rate for Payer: Cash Price |
$640.42
|
| Rate for Payer: Cofinity Commercial |
$752.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$640.42
|
| Rate for Payer: Healthscope Commercial |
$800.53
|
| Rate for Payer: Healthscope Whirlpool |
$776.51
|
| Rate for Payer: Mclaren Commercial |
$720.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$680.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$560.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$704.47
|
|
|
HC EMG NEEDLE EXAM 4 EXT
|
Facility
|
OP
|
$800.53
|
|
|
Service Code
|
CPT 95864
|
| Hospital Charge Code |
92200004
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$75.95 |
| Max. Negotiated Rate |
$800.53 |
| Rate for Payer: Aetna Commercial |
$720.48
|
| Rate for Payer: Aetna Medicare |
$138.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$173.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$173.56
|
| Rate for Payer: ASR ASR |
$776.51
|
| Rate for Payer: BCBS Complete |
$79.76
|
| Rate for Payer: BCBS MAPPO |
$138.85
|
| Rate for Payer: BCBS Trust/PPO |
$620.65
|
| Rate for Payer: BCN Commercial |
$620.65
|
| Rate for Payer: BCN Medicare Advantage |
$138.85
|
| Rate for Payer: Cash Price |
$640.42
|
| Rate for Payer: Cash Price |
$640.42
|
| Rate for Payer: Cofinity Commercial |
$752.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$640.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.85
|
| Rate for Payer: Healthscope Commercial |
$800.53
|
| Rate for Payer: Healthscope Whirlpool |
$776.51
|
| Rate for Payer: Humana Choice PPO Medicare |
$138.85
|
| Rate for Payer: Mclaren Commercial |
$720.48
|
| Rate for Payer: Mclaren Medicaid |
$75.95
|
| Rate for Payer: Mclaren Medicare |
$138.85
|
| Rate for Payer: Meridian Medicaid |
$79.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$145.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$159.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$680.45
|
| Rate for Payer: PACE Medicare |
$131.91
|
| Rate for Payer: PACE SWMI |
$138.85
|
| Rate for Payer: PHP Commercial |
$152.74
|
| Rate for Payer: PHP Medicaid |
$75.95
|
| Rate for Payer: PHP Medicare Advantage |
$138.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$560.37
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$728.48
|
| Rate for Payer: Priority Health Medicare |
$138.85
|
| Rate for Payer: Priority Health Narrow Network |
$568.38
|
| Rate for Payer: Railroad Medicare Medicare |
$138.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$704.47
|
| Rate for Payer: UHC Medicare Advantage |
$143.02
|
| Rate for Payer: VA VA |
$138.85
|
|
|
HC EMG NEEDLE EXAM CRANIAL BILAT NCS
|
Facility
|
IP
|
$800.53
|
|
|
Service Code
|
CPT 95868
|
| Hospital Charge Code |
92200007
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$560.37 |
| Max. Negotiated Rate |
$800.53 |
| Rate for Payer: Aetna Commercial |
$720.48
|
| Rate for Payer: ASR ASR |
$776.51
|
| Rate for Payer: BCBS Trust/PPO |
$620.65
|
| Rate for Payer: BCN Commercial |
$620.65
|
| Rate for Payer: Cash Price |
$640.42
|
| Rate for Payer: Cofinity Commercial |
$752.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$640.42
|
| Rate for Payer: Healthscope Commercial |
$800.53
|
| Rate for Payer: Healthscope Whirlpool |
$776.51
|
| Rate for Payer: Mclaren Commercial |
$720.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$680.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$560.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$704.47
|
|
|
HC EMG NEEDLE EXAM CRANIAL BILAT NCS
|
Facility
|
OP
|
$800.53
|
|
|
Service Code
|
CPT 95868
|
| Hospital Charge Code |
92200007
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$152.61 |
| Max. Negotiated Rate |
$800.53 |
| Rate for Payer: Aetna Commercial |
$720.48
|
| 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 |
$776.51
|
| Rate for Payer: BCBS Complete |
$160.26
|
| Rate for Payer: BCBS MAPPO |
$279.00
|
| Rate for Payer: BCBS Trust/PPO |
$620.65
|
| Rate for Payer: BCN Commercial |
$620.65
|
| Rate for Payer: BCN Medicare Advantage |
$279.00
|
| Rate for Payer: Cash Price |
$640.42
|
| Rate for Payer: Cash Price |
$640.42
|
| Rate for Payer: Cofinity Commercial |
$752.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$640.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$279.00
|
| Rate for Payer: Healthscope Commercial |
$800.53
|
| Rate for Payer: Healthscope Whirlpool |
$776.51
|
| Rate for Payer: Humana Choice PPO Medicare |
$279.00
|
| Rate for Payer: Mclaren Commercial |
$720.48
|
| 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 |
$680.45
|
| 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 |
$560.37
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$728.48
|
| Rate for Payer: Priority Health Medicare |
$279.00
|
| Rate for Payer: Priority Health Narrow Network |
$568.38
|
| Rate for Payer: Railroad Medicare Medicare |
$279.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$704.47
|
| Rate for Payer: UHC Medicare Advantage |
$287.37
|
| Rate for Payer: VA VA |
$279.00
|
|
|
HC EMG NEEDLE EXAM CRANIAL UNILAT WO NCS
|
Facility
|
OP
|
$720.52
|
|
|
Service Code
|
CPT 95867
|
| Hospital Charge Code |
92200006
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$152.61 |
| Max. Negotiated Rate |
$720.52 |
| Rate for Payer: Aetna Commercial |
$648.47
|
| 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 |
$698.90
|
| Rate for Payer: BCBS Complete |
$160.26
|
| Rate for Payer: BCBS MAPPO |
$279.00
|
| Rate for Payer: BCBS Trust/PPO |
$558.62
|
| Rate for Payer: BCN Commercial |
$558.62
|
| Rate for Payer: BCN Medicare Advantage |
$279.00
|
| Rate for Payer: Cash Price |
$576.42
|
| Rate for Payer: Cash Price |
$576.42
|
| Rate for Payer: Cofinity Commercial |
$677.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$576.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$279.00
|
| Rate for Payer: Healthscope Commercial |
$720.52
|
| Rate for Payer: Healthscope Whirlpool |
$698.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$279.00
|
| Rate for Payer: Mclaren Commercial |
$648.47
|
| 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 |
$612.44
|
| 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 |
$504.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$655.67
|
| Rate for Payer: Priority Health Medicare |
$279.00
|
| Rate for Payer: Priority Health Narrow Network |
$511.57
|
| Rate for Payer: Railroad Medicare Medicare |
$279.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$634.06
|
| Rate for Payer: UHC Medicare Advantage |
$287.37
|
| Rate for Payer: VA VA |
$279.00
|
|
|
HC EMG NEEDLE EXAM CRANIAL UNILAT WO NCS
|
Facility
|
IP
|
$720.52
|
|
|
Service Code
|
CPT 95867
|
| Hospital Charge Code |
92200006
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$504.36 |
| Max. Negotiated Rate |
$720.52 |
| Rate for Payer: Aetna Commercial |
$648.47
|
| Rate for Payer: ASR ASR |
$698.90
|
| Rate for Payer: BCBS Trust/PPO |
$558.62
|
| Rate for Payer: BCN Commercial |
$558.62
|
| Rate for Payer: Cash Price |
$576.42
|
| Rate for Payer: Cofinity Commercial |
$677.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$576.42
|
| Rate for Payer: Healthscope Commercial |
$720.52
|
| Rate for Payer: Healthscope Whirlpool |
$698.90
|
| Rate for Payer: Mclaren Commercial |
$648.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$612.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$504.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$634.06
|
|
|
HC EMG NEEDLE EXAM WITH NCS LIMITED
|
Facility
|
IP
|
$367.63
|
|
|
Service Code
|
CPT 95885
|
| Hospital Charge Code |
92200022
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$257.34 |
| Max. Negotiated Rate |
$367.63 |
| Rate for Payer: Aetna Commercial |
$330.87
|
| Rate for Payer: ASR ASR |
$356.60
|
| Rate for Payer: BCBS Trust/PPO |
$285.02
|
| Rate for Payer: BCN Commercial |
$285.02
|
| Rate for Payer: Cash Price |
$294.10
|
| Rate for Payer: Cofinity Commercial |
$345.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$294.10
|
| Rate for Payer: Healthscope Commercial |
$367.63
|
| Rate for Payer: Healthscope Whirlpool |
$356.60
|
| Rate for Payer: Mclaren Commercial |
$330.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$312.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$257.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$323.51
|
|
|
HC EMG NEEDLE EXAM WITH NCS LIMITED
|
Facility
|
OP
|
$367.63
|
|
|
Service Code
|
CPT 95885
|
| Hospital Charge Code |
92200022
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$147.05 |
| Max. Negotiated Rate |
$367.63 |
| Rate for Payer: Aetna Commercial |
$330.87
|
| Rate for Payer: ASR ASR |
$356.60
|
| Rate for Payer: BCBS Complete |
$147.05
|
| Rate for Payer: BCBS Trust/PPO |
$285.02
|
| Rate for Payer: BCN Commercial |
$285.02
|
| Rate for Payer: Cash Price |
$294.10
|
| Rate for Payer: Cofinity Commercial |
$345.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$294.10
|
| Rate for Payer: Healthscope Commercial |
$367.63
|
| Rate for Payer: Healthscope Whirlpool |
$356.60
|
| Rate for Payer: Mclaren Commercial |
$330.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$312.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$257.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$334.54
|
| Rate for Payer: Priority Health Narrow Network |
$261.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$323.51
|
|
|
HC EMG NEEDLE EXAM WITH NCV COMPLETE
|
Facility
|
IP
|
$445.19
|
|
|
Service Code
|
CPT 95886
|
| Hospital Charge Code |
92200023
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$311.63 |
| Max. Negotiated Rate |
$445.19 |
| Rate for Payer: Aetna Commercial |
$400.67
|
| Rate for Payer: ASR ASR |
$431.83
|
| Rate for Payer: BCBS Trust/PPO |
$345.16
|
| Rate for Payer: BCN Commercial |
$345.16
|
| Rate for Payer: Cash Price |
$356.15
|
| Rate for Payer: Cofinity Commercial |
$418.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$356.15
|
| Rate for Payer: Healthscope Commercial |
$445.19
|
| Rate for Payer: Healthscope Whirlpool |
$431.83
|
| Rate for Payer: Mclaren Commercial |
$400.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$378.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$311.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$391.77
|
|
|
HC EMG NEEDLE EXAM WITH NCV COMPLETE
|
Facility
|
OP
|
$445.19
|
|
|
Service Code
|
CPT 95886
|
| Hospital Charge Code |
92200023
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$178.08 |
| Max. Negotiated Rate |
$445.19 |
| Rate for Payer: Aetna Commercial |
$400.67
|
| Rate for Payer: ASR ASR |
$431.83
|
| Rate for Payer: BCBS Complete |
$178.08
|
| Rate for Payer: BCBS Trust/PPO |
$345.16
|
| Rate for Payer: BCN Commercial |
$345.16
|
| Rate for Payer: Cash Price |
$356.15
|
| Rate for Payer: Cofinity Commercial |
$418.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$356.15
|
| Rate for Payer: Healthscope Commercial |
$445.19
|
| Rate for Payer: Healthscope Whirlpool |
$431.83
|
| Rate for Payer: Mclaren Commercial |
$400.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$378.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$311.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$405.12
|
| Rate for Payer: Priority Health Narrow Network |
$316.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$391.77
|
|
|
HC EMG NEEDLE FROM LARYNX
|
Facility
|
IP
|
$390.33
|
|
|
Service Code
|
CPT 95865
|
| Hospital Charge Code |
92200005
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$273.23 |
| Max. Negotiated Rate |
$390.33 |
| Rate for Payer: Aetna Commercial |
$351.30
|
| Rate for Payer: ASR ASR |
$378.62
|
| Rate for Payer: BCBS Trust/PPO |
$302.62
|
| Rate for Payer: BCN Commercial |
$302.62
|
| Rate for Payer: Cash Price |
$312.26
|
| Rate for Payer: Cofinity Commercial |
$366.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$312.26
|
| Rate for Payer: Healthscope Commercial |
$390.33
|
| Rate for Payer: Healthscope Whirlpool |
$378.62
|
| Rate for Payer: Mclaren Commercial |
$351.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$331.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$273.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$343.49
|
|
|
HC EMG NEEDLE FROM LARYNX
|
Facility
|
OP
|
$390.33
|
|
|
Service Code
|
CPT 95865
|
| Hospital Charge Code |
92200005
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$62.11 |
| Max. Negotiated Rate |
$390.33 |
| Rate for Payer: Aetna Commercial |
$351.30
|
| Rate for Payer: Aetna Medicare |
$113.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$141.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$141.94
|
| Rate for Payer: ASR ASR |
$378.62
|
| Rate for Payer: BCBS Complete |
$65.22
|
| Rate for Payer: BCBS MAPPO |
$113.55
|
| Rate for Payer: BCBS Trust/PPO |
$302.62
|
| Rate for Payer: BCN Commercial |
$302.62
|
| Rate for Payer: BCN Medicare Advantage |
$113.55
|
| Rate for Payer: Cash Price |
$312.26
|
| Rate for Payer: Cash Price |
$312.26
|
| Rate for Payer: Cofinity Commercial |
$366.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$312.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$113.55
|
| Rate for Payer: Healthscope Commercial |
$390.33
|
| Rate for Payer: Healthscope Whirlpool |
$378.62
|
| Rate for Payer: Humana Choice PPO Medicare |
$113.55
|
| Rate for Payer: Mclaren Commercial |
$351.30
|
| Rate for Payer: Mclaren Medicaid |
$62.11
|
| Rate for Payer: Mclaren Medicare |
$113.55
|
| Rate for Payer: Meridian Medicaid |
$65.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$119.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$130.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$331.78
|
| Rate for Payer: PACE Medicare |
$107.87
|
| Rate for Payer: PACE SWMI |
$113.55
|
| Rate for Payer: PHP Commercial |
$124.90
|
| Rate for Payer: PHP Medicaid |
$62.11
|
| Rate for Payer: PHP Medicare Advantage |
$113.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$273.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$355.20
|
| Rate for Payer: Priority Health Medicare |
$113.55
|
| Rate for Payer: Priority Health Narrow Network |
$277.13
|
| Rate for Payer: Railroad Medicare Medicare |
$113.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$343.49
|
| Rate for Payer: UHC Medicare Advantage |
$116.96
|
| Rate for Payer: VA VA |
$113.55
|
|
|
HC EMG REPETITIVE STIMULATION
|
Facility
|
IP
|
$430.40
|
|
|
Service Code
|
CPT 95937
|
| Hospital Charge Code |
92200021
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$301.28 |
| Max. Negotiated Rate |
$430.40 |
| Rate for Payer: Aetna Commercial |
$387.36
|
| Rate for Payer: ASR ASR |
$417.49
|
| Rate for Payer: BCBS Trust/PPO |
$333.69
|
| Rate for Payer: BCN Commercial |
$333.69
|
| Rate for Payer: Cash Price |
$344.32
|
| Rate for Payer: Cofinity Commercial |
$404.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$344.32
|
| Rate for Payer: Healthscope Commercial |
$430.40
|
| Rate for Payer: Healthscope Whirlpool |
$417.49
|
| Rate for Payer: Mclaren Commercial |
$387.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$365.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$301.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$378.75
|
|
|
HC EMG REPETITIVE STIMULATION
|
Facility
|
OP
|
$430.40
|
|
|
Service Code
|
CPT 95937
|
| Hospital Charge Code |
92200021
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$75.95 |
| Max. Negotiated Rate |
$430.40 |
| Rate for Payer: Aetna Commercial |
$387.36
|
| Rate for Payer: Aetna Medicare |
$138.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$173.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$173.56
|
| Rate for Payer: ASR ASR |
$417.49
|
| Rate for Payer: BCBS Complete |
$79.76
|
| Rate for Payer: BCBS MAPPO |
$138.85
|
| Rate for Payer: BCBS Trust/PPO |
$333.69
|
| Rate for Payer: BCN Commercial |
$333.69
|
| Rate for Payer: BCN Medicare Advantage |
$138.85
|
| Rate for Payer: Cash Price |
$344.32
|
| Rate for Payer: Cash Price |
$344.32
|
| Rate for Payer: Cofinity Commercial |
$404.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$344.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.85
|
| Rate for Payer: Healthscope Commercial |
$430.40
|
| Rate for Payer: Healthscope Whirlpool |
$417.49
|
| Rate for Payer: Humana Choice PPO Medicare |
$138.85
|
| Rate for Payer: Mclaren Commercial |
$387.36
|
| Rate for Payer: Mclaren Medicaid |
$75.95
|
| Rate for Payer: Mclaren Medicare |
$138.85
|
| Rate for Payer: Meridian Medicaid |
$79.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$145.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$159.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$365.84
|
| Rate for Payer: PACE Medicare |
$131.91
|
| Rate for Payer: PACE SWMI |
$138.85
|
| Rate for Payer: PHP Commercial |
$152.74
|
| Rate for Payer: PHP Medicaid |
$75.95
|
| Rate for Payer: PHP Medicare Advantage |
$138.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$301.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$391.66
|
| Rate for Payer: Priority Health Medicare |
$138.85
|
| Rate for Payer: Priority Health Narrow Network |
$305.58
|
| Rate for Payer: Railroad Medicare Medicare |
$138.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$378.75
|
| Rate for Payer: UHC Medicare Advantage |
$143.02
|
| Rate for Payer: VA VA |
$138.85
|
|
|
HC EMG SINGLE FIBER
|
Facility
|
OP
|
$450.54
|
|
|
Service Code
|
CPT 95872
|
| Hospital Charge Code |
92200010
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$75.95 |
| Max. Negotiated Rate |
$450.54 |
| Rate for Payer: Aetna Commercial |
$405.49
|
| Rate for Payer: Aetna Medicare |
$138.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$173.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$173.56
|
| Rate for Payer: ASR ASR |
$437.02
|
| Rate for Payer: BCBS Complete |
$79.76
|
| Rate for Payer: BCBS MAPPO |
$138.85
|
| Rate for Payer: BCBS Trust/PPO |
$349.30
|
| Rate for Payer: BCN Commercial |
$349.30
|
| Rate for Payer: BCN Medicare Advantage |
$138.85
|
| Rate for Payer: Cash Price |
$360.43
|
| Rate for Payer: Cash Price |
$360.43
|
| Rate for Payer: Cofinity Commercial |
$423.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$360.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.85
|
| Rate for Payer: Healthscope Commercial |
$450.54
|
| Rate for Payer: Healthscope Whirlpool |
$437.02
|
| Rate for Payer: Humana Choice PPO Medicare |
$138.85
|
| Rate for Payer: Mclaren Commercial |
$405.49
|
| Rate for Payer: Mclaren Medicaid |
$75.95
|
| Rate for Payer: Mclaren Medicare |
$138.85
|
| Rate for Payer: Meridian Medicaid |
$79.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$145.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$159.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$382.96
|
| Rate for Payer: PACE Medicare |
$131.91
|
| Rate for Payer: PACE SWMI |
$138.85
|
| Rate for Payer: PHP Commercial |
$152.74
|
| Rate for Payer: PHP Medicaid |
$75.95
|
| Rate for Payer: PHP Medicare Advantage |
$138.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$315.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$409.99
|
| Rate for Payer: Priority Health Medicare |
$138.85
|
| Rate for Payer: Priority Health Narrow Network |
$319.88
|
| Rate for Payer: Railroad Medicare Medicare |
$138.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$396.48
|
| Rate for Payer: UHC Medicare Advantage |
$143.02
|
| Rate for Payer: VA VA |
$138.85
|
|
|
HC EMG SINGLE FIBER
|
Facility
|
IP
|
$450.54
|
|
|
Service Code
|
CPT 95872
|
| Hospital Charge Code |
92200010
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$315.38 |
| Max. Negotiated Rate |
$450.54 |
| Rate for Payer: Aetna Commercial |
$405.49
|
| Rate for Payer: ASR ASR |
$437.02
|
| Rate for Payer: BCBS Trust/PPO |
$349.30
|
| Rate for Payer: BCN Commercial |
$349.30
|
| Rate for Payer: Cash Price |
$360.43
|
| Rate for Payer: Cofinity Commercial |
$423.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$360.43
|
| Rate for Payer: Healthscope Commercial |
$450.54
|
| Rate for Payer: Healthscope Whirlpool |
$437.02
|
| Rate for Payer: Mclaren Commercial |
$405.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$382.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$315.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$396.48
|
|
