|
HC BIRCH IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200029
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$25.39 |
| Rate for Payer: Aetna Commercial |
$22.85
|
| 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 |
$24.63
|
| Rate for Payer: ASR Commercial |
$24.63
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$20.79
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$23.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$25.39
|
| Rate for Payer: Healthscope Whirlpool |
$24.63
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$22.85
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$5.74
|
| Rate for Payer: PHP Medicaid |
$2.80
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.25
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$17.80
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP DNSP |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.80
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC BIVENTRICULAR DELIVERY SYSTEM
|
Facility
|
IP
|
$2,038.69
|
|
| Hospital Charge Code |
27200114
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,325.15 |
| Max. Negotiated Rate |
$2,038.69 |
| Rate for Payer: Aetna Commercial |
$1,834.82
|
| Rate for Payer: ASR ASR |
$1,977.53
|
| Rate for Payer: ASR Commercial |
$1,977.53
|
| Rate for Payer: BCBS Trust/PPO |
$1,661.33
|
| Rate for Payer: BCN Commercial |
$1,580.60
|
| Rate for Payer: Cash Price |
$1,630.95
|
| Rate for Payer: Cofinity Commercial |
$1,916.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,630.95
|
| Rate for Payer: Healthscope Commercial |
$2,038.69
|
| Rate for Payer: Healthscope Whirlpool |
$1,977.53
|
| Rate for Payer: Mclaren Commercial |
$1,834.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,732.89
|
| Rate for Payer: Nomi Health Commercial |
$1,671.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,325.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,794.05
|
|
|
HC BIVENTRICULAR DELIVERY SYSTEM
|
Facility
|
OP
|
$2,038.69
|
|
| Hospital Charge Code |
27200114
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$815.48 |
| Max. Negotiated Rate |
$2,038.69 |
| Rate for Payer: Aetna Commercial |
$1,834.82
|
| Rate for Payer: Aetna Medicare |
$1,019.34
|
| Rate for Payer: ASR ASR |
$1,977.53
|
| Rate for Payer: ASR Commercial |
$1,977.53
|
| Rate for Payer: BCBS Complete |
$815.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,669.48
|
| Rate for Payer: BCN Commercial |
$1,580.60
|
| Rate for Payer: Cash Price |
$1,630.95
|
| Rate for Payer: Cofinity Commercial |
$1,916.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,630.95
|
| Rate for Payer: Healthscope Commercial |
$2,038.69
|
| Rate for Payer: Healthscope Whirlpool |
$1,977.53
|
| Rate for Payer: Mclaren Commercial |
$1,834.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,732.89
|
| Rate for Payer: Nomi Health Commercial |
$1,671.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,325.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,786.30
|
| Rate for Payer: Priority Health Narrow Network |
$1,429.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,794.05
|
|
|
HC BI V PACEMAKER
|
Facility
|
OP
|
$27,936.42
|
|
|
Service Code
|
HCPCS C2621
|
| Hospital Charge Code |
27500001
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$11,174.57 |
| Max. Negotiated Rate |
$27,936.42 |
| Rate for Payer: Aetna Commercial |
$25,142.78
|
| Rate for Payer: Aetna Medicare |
$13,968.21
|
| Rate for Payer: ASR ASR |
$27,098.33
|
| Rate for Payer: ASR Commercial |
$27,098.33
|
| Rate for Payer: BCBS Complete |
$11,174.57
|
| Rate for Payer: BCBS Trust/PPO |
$22,877.13
|
| Rate for Payer: BCN Commercial |
$21,659.11
|
| Rate for Payer: Cash Price |
$22,349.14
|
| Rate for Payer: Cofinity Commercial |
$26,260.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22,349.14
|
| Rate for Payer: Healthscope Commercial |
$27,936.42
|
| Rate for Payer: Healthscope Whirlpool |
$27,098.33
|
| Rate for Payer: Mclaren Commercial |
$25,142.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23,745.96
|
| Rate for Payer: Nomi Health Commercial |
$22,907.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18,158.67
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24,477.89
|
| Rate for Payer: Priority Health Narrow Network |
$19,583.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$24,584.05
|
|
|
HC BI V PACEMAKER
|
Facility
|
IP
|
$27,936.42
|
|
|
Service Code
|
HCPCS C2621
|
| Hospital Charge Code |
27500001
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$18,158.67 |
| Max. Negotiated Rate |
$27,936.42 |
| Rate for Payer: Aetna Commercial |
$25,142.78
|
| Rate for Payer: ASR ASR |
$27,098.33
|
| Rate for Payer: ASR Commercial |
$27,098.33
|
| Rate for Payer: BCBS Trust/PPO |
$22,765.39
|
| Rate for Payer: BCN Commercial |
$21,659.11
|
| Rate for Payer: Cash Price |
$22,349.14
|
| Rate for Payer: Cofinity Commercial |
$26,260.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22,349.14
|
| Rate for Payer: Healthscope Commercial |
$27,936.42
|
| Rate for Payer: Healthscope Whirlpool |
$27,098.33
|
| Rate for Payer: Mclaren Commercial |
$25,142.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23,745.96
|
| Rate for Payer: Nomi Health Commercial |
$22,907.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18,158.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$24,584.05
|
|
|
HC BK VIRUS PCR, QUANT
|
Facility
|
IP
|
$113.40
|
|
|
Service Code
|
CPT 87799
|
| Hospital Charge Code |
30600289
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$73.71 |
| Max. Negotiated Rate |
$113.40 |
| Rate for Payer: Aetna Commercial |
$102.06
|
| Rate for Payer: ASR ASR |
$110.00
|
| Rate for Payer: ASR Commercial |
$110.00
|
| Rate for Payer: BCBS Trust/PPO |
$92.41
|
| Rate for Payer: BCN Commercial |
$87.92
|
| Rate for Payer: Cash Price |
$90.72
|
| Rate for Payer: Cofinity Commercial |
$106.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$90.72
|
| Rate for Payer: Healthscope Commercial |
$113.40
|
| Rate for Payer: Healthscope Whirlpool |
$110.00
|
| Rate for Payer: Mclaren Commercial |
$102.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$96.39
|
| Rate for Payer: Nomi Health Commercial |
$92.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$73.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$99.79
|
|
|
HC BK VIRUS PCR, QUANT
|
Facility
|
OP
|
$113.40
|
|
|
Service Code
|
CPT 87799
|
| Hospital Charge Code |
30600289
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$22.96 |
| Max. Negotiated Rate |
$113.40 |
| Rate for Payer: Aetna Commercial |
$102.06
|
| Rate for Payer: Aetna Medicare |
$42.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$53.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$53.55
|
| Rate for Payer: ASR ASR |
$110.00
|
| Rate for Payer: ASR Commercial |
$110.00
|
| Rate for Payer: BCBS Complete |
$24.11
|
| Rate for Payer: BCBS MAPPO |
$42.84
|
| Rate for Payer: BCBS Trust/PPO |
$92.86
|
| Rate for Payer: BCN Commercial |
$87.92
|
| Rate for Payer: BCN Medicare Advantage |
$42.84
|
| Rate for Payer: Cash Price |
$90.72
|
| Rate for Payer: Cash Price |
$90.72
|
| Rate for Payer: Cofinity Commercial |
$106.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$90.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.84
|
| Rate for Payer: Healthscope Commercial |
$113.40
|
| Rate for Payer: Healthscope Whirlpool |
$110.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$42.84
|
| Rate for Payer: Mclaren Commercial |
$102.06
|
| Rate for Payer: Mclaren Medicaid |
$22.96
|
| Rate for Payer: Mclaren Medicare |
$42.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.98
|
| Rate for Payer: Meridian Medicaid |
$24.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$49.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$96.39
|
| Rate for Payer: Nomi Health Commercial |
$92.99
|
| Rate for Payer: PACE Medicare |
$40.70
|
| Rate for Payer: PACE SWMI |
$42.84
|
| Rate for Payer: PHP Commercial |
$47.12
|
| Rate for Payer: PHP Medicaid |
$22.96
|
| Rate for Payer: PHP Medicare Advantage |
$42.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$73.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$99.36
|
| Rate for Payer: Priority Health Medicare |
$42.84
|
| Rate for Payer: Priority Health Narrow Network |
$79.49
|
| Rate for Payer: Railroad Medicare Medicare |
$42.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$99.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.84
|
| Rate for Payer: UHC Exchange |
$66.40
|
| Rate for Payer: UHC Medicare Advantage |
$42.84
|
| Rate for Payer: UHCCP DNSP |
$42.84
|
| Rate for Payer: UHCCP Medicaid |
$22.96
|
| Rate for Payer: VA VA |
$42.84
|
|
|
HC BLADDER IRRIGATION
|
Facility
|
OP
|
$279.85
|
|
| Hospital Charge Code |
45000032
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$111.94 |
| Max. Negotiated Rate |
$279.85 |
| Rate for Payer: Aetna Commercial |
$251.86
|
| Rate for Payer: Aetna Medicare |
$139.92
|
| Rate for Payer: ASR ASR |
$271.45
|
| Rate for Payer: ASR Commercial |
$271.45
|
| Rate for Payer: BCBS Complete |
$111.94
|
| Rate for Payer: BCBS Trust/PPO |
$229.17
|
| Rate for Payer: BCN Commercial |
$216.97
|
| Rate for Payer: Cash Price |
$223.88
|
| Rate for Payer: Cofinity Commercial |
$263.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$223.88
|
| Rate for Payer: Healthscope Commercial |
$279.85
|
| Rate for Payer: Healthscope Whirlpool |
$271.45
|
| Rate for Payer: Mclaren Commercial |
$251.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$237.87
|
| Rate for Payer: Nomi Health Commercial |
$229.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$181.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$245.20
|
| Rate for Payer: Priority Health Narrow Network |
$196.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$246.27
|
|
|
HC BLADDER IRRIGATION
|
Facility
|
IP
|
$279.85
|
|
| Hospital Charge Code |
45000032
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$181.90 |
| Max. Negotiated Rate |
$279.85 |
| Rate for Payer: Aetna Commercial |
$251.86
|
| Rate for Payer: ASR ASR |
$271.45
|
| Rate for Payer: ASR Commercial |
$271.45
|
| Rate for Payer: BCBS Trust/PPO |
$228.05
|
| Rate for Payer: BCN Commercial |
$216.97
|
| Rate for Payer: Cash Price |
$223.88
|
| Rate for Payer: Cofinity Commercial |
$263.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$223.88
|
| Rate for Payer: Healthscope Commercial |
$279.85
|
| Rate for Payer: Healthscope Whirlpool |
$271.45
|
| Rate for Payer: Mclaren Commercial |
$251.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$237.87
|
| Rate for Payer: Nomi Health Commercial |
$229.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$181.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$246.27
|
|
|
HC BLADDER SCAN
|
Facility
|
OP
|
$153.14
|
|
|
Service Code
|
CPT 51798
|
| Hospital Charge Code |
45000006
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$153.14 |
| Rate for Payer: Aetna Commercial |
$137.83
|
| Rate for Payer: Aetna Medicare |
$58.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$72.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$72.75
|
| Rate for Payer: ASR ASR |
$148.55
|
| Rate for Payer: ASR Commercial |
$148.55
|
| Rate for Payer: BCBS Complete |
$32.75
|
| Rate for Payer: BCBS MAPPO |
$58.20
|
| Rate for Payer: BCBS Trust/PPO |
$125.41
|
| Rate for Payer: BCN Commercial |
$118.73
|
| Rate for Payer: BCN Medicare Advantage |
$58.20
|
| Rate for Payer: Cash Price |
$122.51
|
| Rate for Payer: Cash Price |
$122.51
|
| Rate for Payer: Cofinity Commercial |
$143.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$122.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.20
|
| Rate for Payer: Healthscope Commercial |
$153.14
|
| Rate for Payer: Healthscope Whirlpool |
$148.55
|
| Rate for Payer: Humana Choice PPO Medicare |
$58.20
|
| Rate for Payer: Mclaren Commercial |
$137.83
|
| Rate for Payer: Mclaren Medicaid |
$31.20
|
| Rate for Payer: Mclaren Medicare |
$58.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.11
|
| Rate for Payer: Meridian Medicaid |
$32.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$66.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.17
|
| Rate for Payer: Nomi Health Commercial |
$125.57
|
| Rate for Payer: PACE Medicare |
$55.29
|
| Rate for Payer: PACE SWMI |
$58.20
|
| Rate for Payer: PHP Commercial |
$64.02
|
| Rate for Payer: PHP Medicaid |
$31.20
|
| Rate for Payer: PHP Medicare Advantage |
$58.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$99.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$134.18
|
| Rate for Payer: Priority Health Medicare |
$58.20
|
| Rate for Payer: Priority Health Narrow Network |
$107.35
|
| Rate for Payer: Railroad Medicare Medicare |
$58.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$134.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$58.20
|
| Rate for Payer: UHC Exchange |
$90.21
|
| Rate for Payer: UHC Medicare Advantage |
$58.20
|
| Rate for Payer: UHCCP DNSP |
$58.20
|
| Rate for Payer: UHCCP Medicaid |
$31.20
|
| Rate for Payer: VA VA |
$58.20
|
|
|
HC BLADDER SCAN
|
Facility
|
IP
|
$153.14
|
|
|
Service Code
|
CPT 51798
|
| Hospital Charge Code |
45000006
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$99.54 |
| Max. Negotiated Rate |
$153.14 |
| Rate for Payer: Aetna Commercial |
$137.83
|
| Rate for Payer: ASR ASR |
$148.55
|
| Rate for Payer: ASR Commercial |
$148.55
|
| Rate for Payer: BCBS Trust/PPO |
$124.79
|
| Rate for Payer: BCN Commercial |
$118.73
|
| Rate for Payer: Cash Price |
$122.51
|
| Rate for Payer: Cofinity Commercial |
$143.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$122.51
|
| Rate for Payer: Healthscope Commercial |
$153.14
|
| Rate for Payer: Healthscope Whirlpool |
$148.55
|
| Rate for Payer: Mclaren Commercial |
$137.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.17
|
| Rate for Payer: Nomi Health Commercial |
$125.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$99.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$134.76
|
|
|
HC BLASTOMYCES ABS BY COMP FIX
|
Facility
|
IP
|
$76.50
|
|
|
Service Code
|
CPT 86612
|
| Hospital Charge Code |
30200230
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$49.72 |
| Max. Negotiated Rate |
$76.50 |
| Rate for Payer: Aetna Commercial |
$68.85
|
| Rate for Payer: ASR ASR |
$74.20
|
| Rate for Payer: ASR Commercial |
$74.20
|
| Rate for Payer: BCBS Trust/PPO |
$62.34
|
| Rate for Payer: BCN Commercial |
$59.31
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$71.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Healthscope Commercial |
$76.50
|
| Rate for Payer: Healthscope Whirlpool |
$74.20
|
| Rate for Payer: Mclaren Commercial |
$68.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.02
|
| Rate for Payer: Nomi Health Commercial |
$62.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$67.32
|
|
|
HC BLASTOMYCES ABS BY COMP FIX
|
Facility
|
OP
|
$76.50
|
|
|
Service Code
|
CPT 86612
|
| Hospital Charge Code |
30200230
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.91 |
| Max. Negotiated Rate |
$76.50 |
| Rate for Payer: Aetna Commercial |
$68.85
|
| Rate for Payer: Aetna Medicare |
$12.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.12
|
| Rate for Payer: ASR ASR |
$74.20
|
| Rate for Payer: ASR Commercial |
$74.20
|
| Rate for Payer: BCBS Complete |
$7.26
|
| Rate for Payer: BCBS MAPPO |
$12.90
|
| Rate for Payer: BCBS Trust/PPO |
$62.65
|
| Rate for Payer: BCN Commercial |
$59.31
|
| Rate for Payer: BCN Medicare Advantage |
$12.90
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$71.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.90
|
| Rate for Payer: Healthscope Commercial |
$76.50
|
| Rate for Payer: Healthscope Whirlpool |
$74.20
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.90
|
| Rate for Payer: Mclaren Commercial |
$68.85
|
| Rate for Payer: Mclaren Medicaid |
$6.91
|
| Rate for Payer: Mclaren Medicare |
$12.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.54
|
| Rate for Payer: Meridian Medicaid |
$7.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.02
|
| Rate for Payer: Nomi Health Commercial |
$62.73
|
| Rate for Payer: PACE Medicare |
$12.26
|
| Rate for Payer: PACE SWMI |
$12.90
|
| Rate for Payer: PHP Commercial |
$14.19
|
| Rate for Payer: PHP Medicaid |
$6.91
|
| Rate for Payer: PHP Medicare Advantage |
$12.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$67.03
|
| Rate for Payer: Priority Health Medicare |
$12.90
|
| Rate for Payer: Priority Health Narrow Network |
$53.63
|
| Rate for Payer: Railroad Medicare Medicare |
$12.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$67.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.90
|
| Rate for Payer: UHC Exchange |
$20.00
|
| Rate for Payer: UHC Medicare Advantage |
$12.90
|
| Rate for Payer: UHCCP DNSP |
$12.90
|
| Rate for Payer: UHCCP Medicaid |
$6.91
|
| Rate for Payer: VA VA |
$12.90
|
|
|
HC BLD DRAW CENTRAL/PERIPH VENOUS CATH
|
Facility
|
OP
|
$124.52
|
|
|
Service Code
|
CPT 36592
|
| Hospital Charge Code |
76100004
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$67.69 |
| Max. Negotiated Rate |
$195.75 |
| Rate for Payer: Aetna Commercial |
$112.07
|
| Rate for Payer: Aetna Medicare |
$126.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.86
|
| Rate for Payer: ASR ASR |
$120.78
|
| Rate for Payer: ASR Commercial |
$120.78
|
| Rate for Payer: BCBS Complete |
$71.08
|
| Rate for Payer: BCBS MAPPO |
$126.29
|
| Rate for Payer: BCBS Trust/PPO |
$101.97
|
| Rate for Payer: BCN Commercial |
$96.54
|
| Rate for Payer: BCN Medicare Advantage |
$126.29
|
| Rate for Payer: Cash Price |
$99.62
|
| Rate for Payer: Cash Price |
$99.62
|
| Rate for Payer: Cofinity Commercial |
$117.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.29
|
| Rate for Payer: Healthscope Commercial |
$124.52
|
| Rate for Payer: Healthscope Whirlpool |
$120.78
|
| Rate for Payer: Humana Choice PPO Medicare |
$126.29
|
| Rate for Payer: Mclaren Commercial |
$112.07
|
| Rate for Payer: Mclaren Medicaid |
$67.69
|
| Rate for Payer: Mclaren Medicare |
$126.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.60
|
| Rate for Payer: Meridian Medicaid |
$71.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$145.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$105.84
|
| Rate for Payer: Nomi Health Commercial |
$102.11
|
| Rate for Payer: PACE Medicare |
$119.98
|
| Rate for Payer: PACE SWMI |
$126.29
|
| Rate for Payer: PHP Commercial |
$138.92
|
| Rate for Payer: PHP Medicaid |
$67.69
|
| Rate for Payer: PHP Medicare Advantage |
$126.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$95.53
|
| Rate for Payer: Priority Health Medicare |
$126.29
|
| Rate for Payer: Priority Health Narrow Network |
$76.42
|
| Rate for Payer: Railroad Medicare Medicare |
$126.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$109.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$126.29
|
| Rate for Payer: UHC Exchange |
$195.75
|
| Rate for Payer: UHC Medicare Advantage |
$126.29
|
| Rate for Payer: UHCCP DNSP |
$126.29
|
| Rate for Payer: UHCCP Medicaid |
$67.69
|
| Rate for Payer: VA VA |
$126.29
|
|
|
HC BLD DRAW CENTRAL/PERIPH VENOUS CATH
|
Facility
|
IP
|
$124.52
|
|
|
Service Code
|
CPT 36592
|
| Hospital Charge Code |
76100004
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$80.94 |
| Max. Negotiated Rate |
$124.52 |
| Rate for Payer: Aetna Commercial |
$112.07
|
| Rate for Payer: ASR ASR |
$120.78
|
| Rate for Payer: ASR Commercial |
$120.78
|
| Rate for Payer: BCBS Trust/PPO |
$101.47
|
| Rate for Payer: BCN Commercial |
$96.54
|
| Rate for Payer: Cash Price |
$99.62
|
| Rate for Payer: Cofinity Commercial |
$117.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.62
|
| Rate for Payer: Healthscope Commercial |
$124.52
|
| Rate for Payer: Healthscope Whirlpool |
$120.78
|
| Rate for Payer: Mclaren Commercial |
$112.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$105.84
|
| Rate for Payer: Nomi Health Commercial |
$102.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$109.58
|
|
|
HC BLEEDING TIME
|
Facility
|
IP
|
$76.91
|
|
|
Service Code
|
CPT 85002
|
| Hospital Charge Code |
30500001
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$49.99 |
| Max. Negotiated Rate |
$76.91 |
| Rate for Payer: Aetna Commercial |
$69.22
|
| Rate for Payer: ASR ASR |
$74.60
|
| Rate for Payer: ASR Commercial |
$74.60
|
| Rate for Payer: BCBS Trust/PPO |
$62.67
|
| Rate for Payer: BCN Commercial |
$59.63
|
| Rate for Payer: Cash Price |
$61.53
|
| Rate for Payer: Cofinity Commercial |
$72.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.53
|
| Rate for Payer: Healthscope Commercial |
$76.91
|
| Rate for Payer: Healthscope Whirlpool |
$74.60
|
| Rate for Payer: Mclaren Commercial |
$69.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.37
|
| Rate for Payer: Nomi Health Commercial |
$63.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$67.68
|
|
|
HC BLEEDING TIME
|
Facility
|
OP
|
$76.91
|
|
|
Service Code
|
CPT 85002
|
| Hospital Charge Code |
30500001
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.58 |
| Max. Negotiated Rate |
$76.91 |
| Rate for Payer: Aetna Commercial |
$69.22
|
| Rate for Payer: Aetna Medicare |
$4.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.02
|
| Rate for Payer: ASR ASR |
$74.60
|
| Rate for Payer: ASR Commercial |
$74.60
|
| Rate for Payer: BCBS Complete |
$2.71
|
| Rate for Payer: BCBS MAPPO |
$4.82
|
| Rate for Payer: BCBS Trust/PPO |
$62.98
|
| Rate for Payer: BCN Commercial |
$59.63
|
| Rate for Payer: BCN Medicare Advantage |
$4.82
|
| Rate for Payer: Cash Price |
$61.53
|
| Rate for Payer: Cash Price |
$61.53
|
| Rate for Payer: Cofinity Commercial |
$72.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.82
|
| Rate for Payer: Healthscope Commercial |
$76.91
|
| Rate for Payer: Healthscope Whirlpool |
$74.60
|
| Rate for Payer: Humana Choice PPO Medicare |
$4.82
|
| Rate for Payer: Mclaren Commercial |
$69.22
|
| Rate for Payer: Mclaren Medicaid |
$2.58
|
| Rate for Payer: Mclaren Medicare |
$4.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.06
|
| Rate for Payer: Meridian Medicaid |
$2.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.37
|
| Rate for Payer: Nomi Health Commercial |
$63.07
|
| Rate for Payer: PACE Medicare |
$4.58
|
| Rate for Payer: PACE SWMI |
$4.82
|
| Rate for Payer: PHP Commercial |
$5.30
|
| Rate for Payer: PHP Medicaid |
$2.58
|
| Rate for Payer: PHP Medicare Advantage |
$4.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45.01
|
| Rate for Payer: Priority Health Medicare |
$4.82
|
| Rate for Payer: Priority Health Narrow Network |
$36.01
|
| Rate for Payer: Railroad Medicare Medicare |
$4.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$67.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.82
|
| Rate for Payer: UHC Exchange |
$7.47
|
| Rate for Payer: UHC Medicare Advantage |
$4.82
|
| Rate for Payer: UHCCP DNSP |
$4.82
|
| Rate for Payer: UHCCP Medicaid |
$2.58
|
| Rate for Payer: VA VA |
$4.82
|
|
|
HC BLOOD CULTURE
|
Facility
|
OP
|
$97.70
|
|
|
Service Code
|
CPT 87040
|
| Hospital Charge Code |
30600072
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.53 |
| Max. Negotiated Rate |
$130.12 |
| Rate for Payer: Aetna Commercial |
$87.93
|
| Rate for Payer: Aetna Medicare |
$10.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.90
|
| Rate for Payer: ASR ASR |
$94.77
|
| Rate for Payer: ASR Commercial |
$94.77
|
| Rate for Payer: BCBS Complete |
$5.81
|
| Rate for Payer: BCBS MAPPO |
$10.32
|
| Rate for Payer: BCBS Trust/PPO |
$80.01
|
| Rate for Payer: BCN Commercial |
$75.75
|
| Rate for Payer: BCN Medicare Advantage |
$10.32
|
| Rate for Payer: Cash Price |
$78.16
|
| Rate for Payer: Cash Price |
$78.16
|
| Rate for Payer: Cofinity Commercial |
$91.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.32
|
| Rate for Payer: Healthscope Commercial |
$97.70
|
| Rate for Payer: Healthscope Whirlpool |
$94.77
|
| Rate for Payer: Humana Choice PPO Medicare |
$10.32
|
| Rate for Payer: Mclaren Commercial |
$87.93
|
| Rate for Payer: Mclaren Medicaid |
$5.53
|
| Rate for Payer: Mclaren Medicare |
$10.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.84
|
| Rate for Payer: Meridian Medicaid |
$5.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.04
|
| Rate for Payer: Nomi Health Commercial |
$80.11
|
| Rate for Payer: PACE Medicare |
$9.80
|
| Rate for Payer: PACE SWMI |
$10.32
|
| Rate for Payer: PHP Commercial |
$11.35
|
| Rate for Payer: PHP Medicaid |
$5.53
|
| Rate for Payer: PHP Medicare Advantage |
$10.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$130.12
|
| Rate for Payer: Priority Health Medicare |
$10.32
|
| Rate for Payer: Priority Health Narrow Network |
$104.10
|
| Rate for Payer: Railroad Medicare Medicare |
$10.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$85.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.32
|
| Rate for Payer: UHC Exchange |
$16.00
|
| Rate for Payer: UHC Medicare Advantage |
$10.32
|
| Rate for Payer: UHCCP DNSP |
$10.32
|
| Rate for Payer: UHCCP Medicaid |
$5.53
|
| Rate for Payer: VA VA |
$10.32
|
|
|
HC BLOOD CULTURE
|
Facility
|
IP
|
$97.70
|
|
|
Service Code
|
CPT 87040
|
| Hospital Charge Code |
30600072
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$63.50 |
| Max. Negotiated Rate |
$97.70 |
| Rate for Payer: Aetna Commercial |
$87.93
|
| Rate for Payer: ASR ASR |
$94.77
|
| Rate for Payer: ASR Commercial |
$94.77
|
| Rate for Payer: BCBS Trust/PPO |
$79.62
|
| Rate for Payer: BCN Commercial |
$75.75
|
| Rate for Payer: Cash Price |
$78.16
|
| Rate for Payer: Cofinity Commercial |
$91.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.16
|
| Rate for Payer: Healthscope Commercial |
$97.70
|
| Rate for Payer: Healthscope Whirlpool |
$94.77
|
| Rate for Payer: Mclaren Commercial |
$87.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.04
|
| Rate for Payer: Nomi Health Commercial |
$80.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$85.98
|
|
|
HC BLOOD DRAW IMPLANTED DEVICE
|
Facility
|
IP
|
$167.77
|
|
|
Service Code
|
CPT 36591
|
| Hospital Charge Code |
76100003
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$109.05 |
| Max. Negotiated Rate |
$167.77 |
| Rate for Payer: Aetna Commercial |
$150.99
|
| Rate for Payer: ASR ASR |
$162.74
|
| Rate for Payer: ASR Commercial |
$162.74
|
| Rate for Payer: BCBS Trust/PPO |
$136.72
|
| Rate for Payer: BCN Commercial |
$130.07
|
| Rate for Payer: Cash Price |
$134.22
|
| Rate for Payer: Cofinity Commercial |
$157.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$134.22
|
| Rate for Payer: Healthscope Commercial |
$167.77
|
| Rate for Payer: Healthscope Whirlpool |
$162.74
|
| Rate for Payer: Mclaren Commercial |
$150.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$142.60
|
| Rate for Payer: Nomi Health Commercial |
$137.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$147.64
|
|
|
HC BLOOD DRAW IMPLANTED DEVICE
|
Facility
|
OP
|
$167.77
|
|
|
Service Code
|
CPT 36591
|
| Hospital Charge Code |
76100003
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$67.69 |
| Max. Negotiated Rate |
$195.75 |
| Rate for Payer: Aetna Commercial |
$150.99
|
| Rate for Payer: Aetna Medicare |
$126.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.86
|
| Rate for Payer: ASR ASR |
$162.74
|
| Rate for Payer: ASR Commercial |
$162.74
|
| Rate for Payer: BCBS Complete |
$71.08
|
| Rate for Payer: BCBS MAPPO |
$126.29
|
| Rate for Payer: BCBS Trust/PPO |
$137.39
|
| Rate for Payer: BCN Commercial |
$130.07
|
| Rate for Payer: BCN Medicare Advantage |
$126.29
|
| Rate for Payer: Cash Price |
$134.22
|
| Rate for Payer: Cash Price |
$134.22
|
| Rate for Payer: Cofinity Commercial |
$157.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$134.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.29
|
| Rate for Payer: Healthscope Commercial |
$167.77
|
| Rate for Payer: Healthscope Whirlpool |
$162.74
|
| Rate for Payer: Humana Choice PPO Medicare |
$126.29
|
| Rate for Payer: Mclaren Commercial |
$150.99
|
| Rate for Payer: Mclaren Medicaid |
$67.69
|
| Rate for Payer: Mclaren Medicare |
$126.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.60
|
| Rate for Payer: Meridian Medicaid |
$71.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$145.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$142.60
|
| Rate for Payer: Nomi Health Commercial |
$137.57
|
| Rate for Payer: PACE Medicare |
$119.98
|
| Rate for Payer: PACE SWMI |
$126.29
|
| Rate for Payer: PHP Commercial |
$138.92
|
| Rate for Payer: PHP Medicaid |
$67.69
|
| Rate for Payer: PHP Medicare Advantage |
$126.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$95.53
|
| Rate for Payer: Priority Health Medicare |
$126.29
|
| Rate for Payer: Priority Health Narrow Network |
$76.42
|
| Rate for Payer: Railroad Medicare Medicare |
$126.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$147.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$126.29
|
| Rate for Payer: UHC Exchange |
$195.75
|
| Rate for Payer: UHC Medicare Advantage |
$126.29
|
| Rate for Payer: UHCCP DNSP |
$126.29
|
| Rate for Payer: UHCCP Medicaid |
$67.69
|
| Rate for Payer: VA VA |
$126.29
|
|
|
HC BLOOD GAS PKG, CALC O2 SAT
|
Facility
|
IP
|
$176.97
|
|
|
Service Code
|
CPT 82803
|
| Hospital Charge Code |
30100216
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$115.03 |
| Max. Negotiated Rate |
$176.97 |
| Rate for Payer: Aetna Commercial |
$159.27
|
| Rate for Payer: ASR ASR |
$171.66
|
| Rate for Payer: ASR Commercial |
$171.66
|
| Rate for Payer: BCBS Trust/PPO |
$144.21
|
| Rate for Payer: BCN Commercial |
$137.20
|
| Rate for Payer: Cash Price |
$141.58
|
| Rate for Payer: Cofinity Commercial |
$166.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$141.58
|
| Rate for Payer: Healthscope Commercial |
$176.97
|
| Rate for Payer: Healthscope Whirlpool |
$171.66
|
| Rate for Payer: Mclaren Commercial |
$159.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$150.42
|
| Rate for Payer: Nomi Health Commercial |
$145.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$115.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$155.73
|
|
|
HC BLOOD GAS PKG, CALC O2 SAT
|
Facility
|
OP
|
$176.97
|
|
|
Service Code
|
CPT 82803
|
| Hospital Charge Code |
30100216
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.97 |
| Max. Negotiated Rate |
$176.97 |
| Rate for Payer: Aetna Commercial |
$159.27
|
| Rate for Payer: Aetna Medicare |
$26.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.59
|
| Rate for Payer: ASR ASR |
$171.66
|
| Rate for Payer: ASR Commercial |
$171.66
|
| Rate for Payer: BCBS Complete |
$14.67
|
| Rate for Payer: BCBS MAPPO |
$26.07
|
| Rate for Payer: BCBS Trust/PPO |
$144.92
|
| Rate for Payer: BCN Commercial |
$137.20
|
| Rate for Payer: BCN Medicare Advantage |
$26.07
|
| Rate for Payer: Cash Price |
$141.58
|
| Rate for Payer: Cash Price |
$141.58
|
| Rate for Payer: Cofinity Commercial |
$166.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$141.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.07
|
| Rate for Payer: Healthscope Commercial |
$176.97
|
| Rate for Payer: Healthscope Whirlpool |
$171.66
|
| Rate for Payer: Humana Choice PPO Medicare |
$26.07
|
| Rate for Payer: Mclaren Commercial |
$159.27
|
| Rate for Payer: Mclaren Medicaid |
$13.97
|
| Rate for Payer: Mclaren Medicare |
$26.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.37
|
| Rate for Payer: Meridian Medicaid |
$14.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$150.42
|
| Rate for Payer: Nomi Health Commercial |
$145.12
|
| Rate for Payer: PACE Medicare |
$24.77
|
| Rate for Payer: PACE SWMI |
$26.07
|
| Rate for Payer: PHP Commercial |
$28.68
|
| Rate for Payer: PHP Medicaid |
$13.97
|
| Rate for Payer: PHP Medicare Advantage |
$26.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$115.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$163.06
|
| Rate for Payer: Priority Health Medicare |
$26.07
|
| Rate for Payer: Priority Health Narrow Network |
$130.45
|
| Rate for Payer: Railroad Medicare Medicare |
$26.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$155.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.07
|
| Rate for Payer: UHC Exchange |
$40.41
|
| Rate for Payer: UHC Medicare Advantage |
$26.07
|
| Rate for Payer: UHCCP DNSP |
$26.07
|
| Rate for Payer: UHCCP Medicaid |
$13.97
|
| Rate for Payer: VA VA |
$26.07
|
|
|
HC BLOOD GAS PKG & DIRECT O2 SAT
|
Facility
|
IP
|
$188.00
|
|
|
Service Code
|
CPT 82805
|
| Hospital Charge Code |
30100218
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$122.20 |
| Max. Negotiated Rate |
$188.00 |
| Rate for Payer: Aetna Commercial |
$169.20
|
| Rate for Payer: ASR ASR |
$182.36
|
| Rate for Payer: ASR Commercial |
$182.36
|
| Rate for Payer: BCBS Trust/PPO |
$153.20
|
| Rate for Payer: BCN Commercial |
$145.76
|
| Rate for Payer: Cash Price |
$150.40
|
| Rate for Payer: Cofinity Commercial |
$176.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$150.40
|
| Rate for Payer: Healthscope Commercial |
$188.00
|
| Rate for Payer: Healthscope Whirlpool |
$182.36
|
| Rate for Payer: Mclaren Commercial |
$169.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$159.80
|
| Rate for Payer: Nomi Health Commercial |
$154.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$122.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$165.44
|
|
|
HC BLOOD GAS PKG & DIRECT O2 SAT
|
Facility
|
OP
|
$188.00
|
|
|
Service Code
|
CPT 82805
|
| Hospital Charge Code |
30100218
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$42.22 |
| Max. Negotiated Rate |
$188.00 |
| Rate for Payer: Aetna Commercial |
$169.20
|
| Rate for Payer: Aetna Medicare |
$78.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$98.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$98.46
|
| Rate for Payer: ASR ASR |
$182.36
|
| Rate for Payer: ASR Commercial |
$182.36
|
| Rate for Payer: BCBS Complete |
$44.33
|
| Rate for Payer: BCBS MAPPO |
$78.77
|
| Rate for Payer: BCBS Trust/PPO |
$153.95
|
| Rate for Payer: BCN Commercial |
$145.76
|
| Rate for Payer: BCN Medicare Advantage |
$78.77
|
| Rate for Payer: Cash Price |
$150.40
|
| Rate for Payer: Cash Price |
$150.40
|
| Rate for Payer: Cofinity Commercial |
$176.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$150.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$78.77
|
| Rate for Payer: Healthscope Commercial |
$188.00
|
| Rate for Payer: Healthscope Whirlpool |
$182.36
|
| Rate for Payer: Humana Choice PPO Medicare |
$78.77
|
| Rate for Payer: Mclaren Commercial |
$169.20
|
| Rate for Payer: Mclaren Medicaid |
$42.22
|
| Rate for Payer: Mclaren Medicare |
$78.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$82.71
|
| Rate for Payer: Meridian Medicaid |
$44.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$90.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$159.80
|
| Rate for Payer: Nomi Health Commercial |
$154.16
|
| Rate for Payer: PACE Medicare |
$74.83
|
| Rate for Payer: PACE SWMI |
$78.77
|
| Rate for Payer: PHP Commercial |
$86.65
|
| Rate for Payer: PHP Medicaid |
$42.22
|
| Rate for Payer: PHP Medicare Advantage |
$78.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$122.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$164.73
|
| Rate for Payer: Priority Health Medicare |
$78.77
|
| Rate for Payer: Priority Health Narrow Network |
$131.79
|
| Rate for Payer: Railroad Medicare Medicare |
$78.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$165.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$78.77
|
| Rate for Payer: UHC Exchange |
$122.09
|
| Rate for Payer: UHC Medicare Advantage |
$78.77
|
| Rate for Payer: UHCCP DNSP |
$78.77
|
| Rate for Payer: UHCCP Medicaid |
$42.22
|
| Rate for Payer: VA VA |
$78.77
|
|
