|
HC BIOPSY TRANSCATHETER
|
Facility
|
IP
|
$1,677.86
|
|
|
Service Code
|
CPT 37200
|
| Hospital Charge Code |
36100154
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,090.61 |
| Max. Negotiated Rate |
$1,677.86 |
| Rate for Payer: Aetna Commercial |
$1,510.07
|
| Rate for Payer: ASR ASR |
$1,627.52
|
| Rate for Payer: ASR Commercial |
$1,627.52
|
| Rate for Payer: BCBS Trust/PPO |
$1,367.29
|
| Rate for Payer: BCN Commercial |
$1,300.84
|
| Rate for Payer: Cash Price |
$1,342.29
|
| Rate for Payer: Cofinity Commercial |
$1,577.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,342.29
|
| Rate for Payer: Healthscope Commercial |
$1,677.86
|
| Rate for Payer: Healthscope Whirlpool |
$1,627.52
|
| Rate for Payer: Mclaren Commercial |
$1,510.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,426.18
|
| Rate for Payer: Nomi Health Commercial |
$1,375.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,090.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,476.52
|
|
|
HC BIOPSY TRANSCATHETER
|
Facility
|
OP
|
$1,677.86
|
|
|
Service Code
|
CPT 37200
|
| Hospital Charge Code |
36100154
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,090.61 |
| Max. Negotiated Rate |
$8,171.71 |
| Rate for Payer: Aetna Commercial |
$1,510.07
|
| Rate for Payer: Aetna Medicare |
$5,272.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,590.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,590.09
|
| Rate for Payer: ASR ASR |
$1,627.52
|
| Rate for Payer: ASR Commercial |
$1,627.52
|
| Rate for Payer: BCBS Complete |
$2,967.12
|
| Rate for Payer: BCBS MAPPO |
$5,272.07
|
| Rate for Payer: BCBS Trust/PPO |
$1,374.00
|
| Rate for Payer: BCN Commercial |
$1,300.84
|
| Rate for Payer: BCN Medicare Advantage |
$5,272.07
|
| Rate for Payer: Cash Price |
$1,342.29
|
| Rate for Payer: Cash Price |
$1,342.29
|
| Rate for Payer: Cofinity Commercial |
$1,577.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,342.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,272.07
|
| Rate for Payer: Healthscope Commercial |
$1,677.86
|
| Rate for Payer: Healthscope Whirlpool |
$1,627.52
|
| Rate for Payer: Humana Choice PPO Medicare |
$5,272.07
|
| Rate for Payer: Mclaren Commercial |
$1,510.07
|
| Rate for Payer: Mclaren Medicaid |
$2,825.83
|
| Rate for Payer: Mclaren Medicare |
$5,272.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,535.67
|
| Rate for Payer: Meridian Medicaid |
$2,967.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,062.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,426.18
|
| Rate for Payer: Nomi Health Commercial |
$1,375.85
|
| Rate for Payer: PACE Medicare |
$5,008.47
|
| Rate for Payer: PACE SWMI |
$5,272.07
|
| Rate for Payer: PHP Commercial |
$5,799.28
|
| Rate for Payer: PHP Medicaid |
$2,825.83
|
| Rate for Payer: PHP Medicare Advantage |
$5,272.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,825.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,090.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,470.14
|
| Rate for Payer: Priority Health Medicare |
$5,272.07
|
| Rate for Payer: Priority Health Narrow Network |
$1,176.18
|
| Rate for Payer: Railroad Medicare Medicare |
$5,272.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,476.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,272.07
|
| Rate for Payer: UHC Exchange |
$8,171.71
|
| Rate for Payer: UHC Medicare Advantage |
$5,272.07
|
| Rate for Payer: UHCCP DNSP |
$5,272.07
|
| Rate for Payer: UHCCP Medicaid |
$2,825.83
|
| Rate for Payer: VA VA |
$5,272.07
|
|
|
HC BIOPSY VESTIBULE MOUTH
|
Facility
|
IP
|
$1,377.00
|
|
|
Service Code
|
CPT 40808
|
| Hospital Charge Code |
76100460
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$895.05 |
| Max. Negotiated Rate |
$1,377.00 |
| Rate for Payer: Aetna Commercial |
$1,239.30
|
| Rate for Payer: ASR ASR |
$1,335.69
|
| Rate for Payer: ASR Commercial |
$1,335.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,122.12
|
| Rate for Payer: BCN Commercial |
$1,067.59
|
| Rate for Payer: Cash Price |
$1,101.60
|
| Rate for Payer: Cofinity Commercial |
$1,294.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,101.60
|
| Rate for Payer: Healthscope Commercial |
$1,377.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,335.69
|
| Rate for Payer: Mclaren Commercial |
$1,239.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,170.45
|
| Rate for Payer: Nomi Health Commercial |
$1,129.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$895.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,211.76
|
|
|
HC BIOPSY VESTIBULE MOUTH
|
Facility
|
OP
|
$1,377.00
|
|
|
Service Code
|
CPT 40808
|
| Hospital Charge Code |
76100460
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$266.21 |
| Max. Negotiated Rate |
$1,377.00 |
| Rate for Payer: Aetna Commercial |
$1,239.30
|
| Rate for Payer: Aetna Medicare |
$496.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$620.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$620.83
|
| Rate for Payer: ASR ASR |
$1,335.69
|
| Rate for Payer: ASR Commercial |
$1,335.69
|
| Rate for Payer: BCBS Complete |
$279.52
|
| Rate for Payer: BCBS MAPPO |
$496.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,127.63
|
| Rate for Payer: BCN Commercial |
$1,067.59
|
| Rate for Payer: BCN Medicare Advantage |
$496.66
|
| Rate for Payer: Cash Price |
$1,101.60
|
| Rate for Payer: Cash Price |
$1,101.60
|
| Rate for Payer: Cofinity Commercial |
$1,294.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,101.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$496.66
|
| Rate for Payer: Healthscope Commercial |
$1,377.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,335.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$496.66
|
| Rate for Payer: Mclaren Commercial |
$1,239.30
|
| Rate for Payer: Mclaren Medicaid |
$266.21
|
| Rate for Payer: Mclaren Medicare |
$496.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$521.49
|
| Rate for Payer: Meridian Medicaid |
$279.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$571.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,170.45
|
| Rate for Payer: Nomi Health Commercial |
$1,129.14
|
| Rate for Payer: PACE Medicare |
$471.83
|
| Rate for Payer: PACE SWMI |
$496.66
|
| Rate for Payer: PHP Commercial |
$546.33
|
| Rate for Payer: PHP Medicaid |
$266.21
|
| Rate for Payer: PHP Medicare Advantage |
$496.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$266.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$895.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,206.53
|
| Rate for Payer: Priority Health Medicare |
$496.66
|
| Rate for Payer: Priority Health Narrow Network |
$965.28
|
| Rate for Payer: Railroad Medicare Medicare |
$496.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,211.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$496.66
|
| Rate for Payer: UHC Exchange |
$769.82
|
| Rate for Payer: UHC Medicare Advantage |
$496.66
|
| Rate for Payer: UHCCP DNSP |
$496.66
|
| Rate for Payer: UHCCP Medicaid |
$266.21
|
| Rate for Payer: VA VA |
$496.66
|
|
|
HC BIOPSY VULVA PERINEUM ONE LESN
|
Facility
|
OP
|
$870.88
|
|
|
Service Code
|
CPT 56605
|
| Hospital Charge Code |
76100201
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$455.18 |
| Max. Negotiated Rate |
$1,316.29 |
| Rate for Payer: Aetna Commercial |
$783.79
|
| Rate for Payer: Aetna Medicare |
$849.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,061.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,061.53
|
| Rate for Payer: ASR ASR |
$844.75
|
| Rate for Payer: ASR Commercial |
$844.75
|
| Rate for Payer: BCBS Complete |
$477.94
|
| Rate for Payer: BCBS MAPPO |
$849.22
|
| Rate for Payer: BCBS Trust/PPO |
$713.16
|
| Rate for Payer: BCN Commercial |
$675.19
|
| Rate for Payer: BCN Medicare Advantage |
$849.22
|
| Rate for Payer: Cash Price |
$696.70
|
| Rate for Payer: Cash Price |
$696.70
|
| Rate for Payer: Cofinity Commercial |
$818.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$696.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$849.22
|
| Rate for Payer: Healthscope Commercial |
$870.88
|
| Rate for Payer: Healthscope Whirlpool |
$844.75
|
| Rate for Payer: Humana Choice PPO Medicare |
$849.22
|
| Rate for Payer: Mclaren Commercial |
$783.79
|
| Rate for Payer: Mclaren Medicaid |
$455.18
|
| Rate for Payer: Mclaren Medicare |
$849.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$891.68
|
| Rate for Payer: Meridian Medicaid |
$477.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$976.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$740.25
|
| Rate for Payer: Nomi Health Commercial |
$714.12
|
| Rate for Payer: PACE Medicare |
$806.76
|
| Rate for Payer: PACE SWMI |
$849.22
|
| Rate for Payer: PHP Commercial |
$934.14
|
| Rate for Payer: PHP Medicaid |
$455.18
|
| Rate for Payer: PHP Medicare Advantage |
$849.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$455.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$566.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$763.07
|
| Rate for Payer: Priority Health Medicare |
$849.22
|
| Rate for Payer: Priority Health Narrow Network |
$610.49
|
| Rate for Payer: Railroad Medicare Medicare |
$849.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$766.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$849.22
|
| Rate for Payer: UHC Exchange |
$1,316.29
|
| Rate for Payer: UHC Medicare Advantage |
$849.22
|
| Rate for Payer: UHCCP DNSP |
$849.22
|
| Rate for Payer: UHCCP Medicaid |
$455.18
|
| Rate for Payer: VA VA |
$849.22
|
|
|
HC BIOPSY VULVA PERINEUM ONE LESN
|
Facility
|
IP
|
$870.88
|
|
|
Service Code
|
CPT 56605
|
| Hospital Charge Code |
76100201
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$566.07 |
| Max. Negotiated Rate |
$870.88 |
| Rate for Payer: Aetna Commercial |
$783.79
|
| Rate for Payer: ASR ASR |
$844.75
|
| Rate for Payer: ASR Commercial |
$844.75
|
| Rate for Payer: BCBS Trust/PPO |
$709.68
|
| Rate for Payer: BCN Commercial |
$675.19
|
| Rate for Payer: Cash Price |
$696.70
|
| Rate for Payer: Cofinity Commercial |
$818.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$696.70
|
| Rate for Payer: Healthscope Commercial |
$870.88
|
| Rate for Payer: Healthscope Whirlpool |
$844.75
|
| Rate for Payer: Mclaren Commercial |
$783.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$740.25
|
| Rate for Payer: Nomi Health Commercial |
$714.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$566.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$766.37
|
|
|
HC BIOTINIDASE
|
Facility
|
OP
|
$68.34
|
|
|
Service Code
|
CPT 82261
|
| Hospital Charge Code |
30100119
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.04 |
| Max. Negotiated Rate |
$68.34 |
| Rate for Payer: Aetna Commercial |
$61.51
|
| Rate for Payer: Aetna Medicare |
$16.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.09
|
| Rate for Payer: ASR ASR |
$66.29
|
| Rate for Payer: ASR Commercial |
$66.29
|
| Rate for Payer: BCBS Complete |
$9.49
|
| Rate for Payer: BCBS MAPPO |
$16.87
|
| Rate for Payer: BCBS Trust/PPO |
$55.96
|
| Rate for Payer: BCN Commercial |
$52.98
|
| Rate for Payer: BCN Medicare Advantage |
$16.87
|
| Rate for Payer: Cash Price |
$54.67
|
| Rate for Payer: Cash Price |
$54.67
|
| Rate for Payer: Cofinity Commercial |
$64.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.87
|
| Rate for Payer: Healthscope Commercial |
$68.34
|
| Rate for Payer: Healthscope Whirlpool |
$66.29
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.87
|
| Rate for Payer: Mclaren Commercial |
$61.51
|
| Rate for Payer: Mclaren Medicaid |
$9.04
|
| Rate for Payer: Mclaren Medicare |
$16.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.71
|
| Rate for Payer: Meridian Medicaid |
$9.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.09
|
| Rate for Payer: Nomi Health Commercial |
$56.04
|
| Rate for Payer: PACE Medicare |
$16.03
|
| Rate for Payer: PACE SWMI |
$16.87
|
| Rate for Payer: PHP Commercial |
$18.56
|
| Rate for Payer: PHP Medicaid |
$9.04
|
| Rate for Payer: PHP Medicare Advantage |
$16.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$59.88
|
| Rate for Payer: Priority Health Medicare |
$16.87
|
| Rate for Payer: Priority Health Narrow Network |
$47.91
|
| Rate for Payer: Railroad Medicare Medicare |
$16.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$60.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.87
|
| Rate for Payer: UHC Exchange |
$26.15
|
| Rate for Payer: UHC Medicare Advantage |
$16.87
|
| Rate for Payer: UHCCP DNSP |
$16.87
|
| Rate for Payer: UHCCP Medicaid |
$9.04
|
| Rate for Payer: VA VA |
$16.87
|
|
|
HC BIOTINIDASE
|
Facility
|
IP
|
$68.34
|
|
|
Service Code
|
CPT 82261
|
| Hospital Charge Code |
30100119
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$44.42 |
| Max. Negotiated Rate |
$68.34 |
| Rate for Payer: Aetna Commercial |
$61.51
|
| Rate for Payer: ASR ASR |
$66.29
|
| Rate for Payer: ASR Commercial |
$66.29
|
| Rate for Payer: BCBS Trust/PPO |
$55.69
|
| Rate for Payer: BCN Commercial |
$52.98
|
| Rate for Payer: Cash Price |
$54.67
|
| Rate for Payer: Cofinity Commercial |
$64.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.67
|
| Rate for Payer: Healthscope Commercial |
$68.34
|
| Rate for Payer: Healthscope Whirlpool |
$66.29
|
| Rate for Payer: Mclaren Commercial |
$61.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.09
|
| Rate for Payer: Nomi Health Commercial |
$56.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$60.14
|
|
|
HC BIOTRONIK DUAL PACEMAKER
|
Facility
|
OP
|
$9,631.71
|
|
|
Service Code
|
HCPCS C1785
|
| Hospital Charge Code |
27500002
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$3,852.68 |
| Max. Negotiated Rate |
$9,631.71 |
| Rate for Payer: Aetna Commercial |
$8,668.54
|
| Rate for Payer: Aetna Medicare |
$4,815.85
|
| Rate for Payer: ASR ASR |
$9,342.76
|
| Rate for Payer: ASR Commercial |
$9,342.76
|
| Rate for Payer: BCBS Complete |
$3,852.68
|
| Rate for Payer: BCBS Trust/PPO |
$7,887.41
|
| Rate for Payer: BCN Commercial |
$7,467.46
|
| Rate for Payer: Cash Price |
$7,705.37
|
| Rate for Payer: Cofinity Commercial |
$9,053.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,705.37
|
| Rate for Payer: Healthscope Commercial |
$9,631.71
|
| Rate for Payer: Healthscope Whirlpool |
$9,342.76
|
| Rate for Payer: Mclaren Commercial |
$8,668.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,186.95
|
| Rate for Payer: Nomi Health Commercial |
$7,898.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,260.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,439.30
|
| Rate for Payer: Priority Health Narrow Network |
$6,751.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8,475.90
|
|
|
HC BIOTRONIK DUAL PACEMAKER
|
Facility
|
IP
|
$9,631.71
|
|
|
Service Code
|
HCPCS C1785
|
| Hospital Charge Code |
27500002
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$6,260.61 |
| Max. Negotiated Rate |
$9,631.71 |
| Rate for Payer: Aetna Commercial |
$8,668.54
|
| Rate for Payer: ASR ASR |
$9,342.76
|
| Rate for Payer: ASR Commercial |
$9,342.76
|
| Rate for Payer: BCBS Trust/PPO |
$7,848.88
|
| Rate for Payer: BCN Commercial |
$7,467.46
|
| Rate for Payer: Cash Price |
$7,705.37
|
| Rate for Payer: Cofinity Commercial |
$9,053.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,705.37
|
| Rate for Payer: Healthscope Commercial |
$9,631.71
|
| Rate for Payer: Healthscope Whirlpool |
$9,342.76
|
| Rate for Payer: Mclaren Commercial |
$8,668.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,186.95
|
| Rate for Payer: Nomi Health Commercial |
$7,898.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,260.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8,475.90
|
|
|
HC BIPAL BIOPSY FORCEPS
|
Facility
|
IP
|
$1,756.92
|
|
| Hospital Charge Code |
27200113
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,142.00 |
| Max. Negotiated Rate |
$1,756.92 |
| Rate for Payer: Aetna Commercial |
$1,581.23
|
| Rate for Payer: ASR ASR |
$1,704.21
|
| Rate for Payer: ASR Commercial |
$1,704.21
|
| Rate for Payer: BCBS Trust/PPO |
$1,431.71
|
| Rate for Payer: BCN Commercial |
$1,362.14
|
| Rate for Payer: Cash Price |
$1,405.54
|
| Rate for Payer: Cofinity Commercial |
$1,651.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,405.54
|
| Rate for Payer: Healthscope Commercial |
$1,756.92
|
| Rate for Payer: Healthscope Whirlpool |
$1,704.21
|
| Rate for Payer: Mclaren Commercial |
$1,581.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,493.38
|
| Rate for Payer: Nomi Health Commercial |
$1,440.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,142.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,546.09
|
|
|
HC BIPAL BIOPSY FORCEPS
|
Facility
|
OP
|
$1,756.92
|
|
| Hospital Charge Code |
27200113
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$702.77 |
| Max. Negotiated Rate |
$1,756.92 |
| Rate for Payer: Aetna Commercial |
$1,581.23
|
| Rate for Payer: Aetna Medicare |
$878.46
|
| Rate for Payer: ASR ASR |
$1,704.21
|
| Rate for Payer: ASR Commercial |
$1,704.21
|
| Rate for Payer: BCBS Complete |
$702.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,438.74
|
| Rate for Payer: BCN Commercial |
$1,362.14
|
| Rate for Payer: Cash Price |
$1,405.54
|
| Rate for Payer: Cofinity Commercial |
$1,651.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,405.54
|
| Rate for Payer: Healthscope Commercial |
$1,756.92
|
| Rate for Payer: Healthscope Whirlpool |
$1,704.21
|
| Rate for Payer: Mclaren Commercial |
$1,581.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,493.38
|
| Rate for Payer: Nomi Health Commercial |
$1,440.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,142.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,539.41
|
| Rate for Payer: Priority Health Narrow Network |
$1,231.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,546.09
|
|
|
HC BIPAP / CPAP PER DAY
|
Facility
|
IP
|
$875.11
|
|
|
Service Code
|
CPT 94660
|
| Hospital Charge Code |
41000008
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$568.82 |
| Max. Negotiated Rate |
$875.11 |
| Rate for Payer: Aetna Commercial |
$787.60
|
| Rate for Payer: ASR ASR |
$848.86
|
| Rate for Payer: ASR Commercial |
$848.86
|
| Rate for Payer: BCBS Trust/PPO |
$713.13
|
| Rate for Payer: BCN Commercial |
$678.47
|
| Rate for Payer: Cash Price |
$700.09
|
| Rate for Payer: Cofinity Commercial |
$822.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$700.09
|
| Rate for Payer: Healthscope Commercial |
$875.11
|
| Rate for Payer: Healthscope Whirlpool |
$848.86
|
| Rate for Payer: Mclaren Commercial |
$787.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$743.84
|
| Rate for Payer: Nomi Health Commercial |
$717.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$568.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$770.10
|
|
|
HC BIPAP / CPAP PER DAY
|
Facility
|
OP
|
$875.11
|
|
|
Service Code
|
CPT 94660
|
| Hospital Charge Code |
41000008
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$106.32 |
| Max. Negotiated Rate |
$875.11 |
| Rate for Payer: Aetna Commercial |
$787.60
|
| Rate for Payer: Aetna Medicare |
$198.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$247.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$247.95
|
| Rate for Payer: ASR ASR |
$848.86
|
| Rate for Payer: ASR Commercial |
$848.86
|
| Rate for Payer: BCBS Complete |
$111.64
|
| Rate for Payer: BCBS MAPPO |
$198.36
|
| Rate for Payer: BCBS Trust/PPO |
$716.63
|
| Rate for Payer: BCN Commercial |
$678.47
|
| Rate for Payer: BCN Medicare Advantage |
$198.36
|
| Rate for Payer: Cash Price |
$700.09
|
| Rate for Payer: Cash Price |
$700.09
|
| Rate for Payer: Cofinity Commercial |
$822.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$700.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$198.36
|
| Rate for Payer: Healthscope Commercial |
$875.11
|
| Rate for Payer: Healthscope Whirlpool |
$848.86
|
| Rate for Payer: Humana Choice PPO Medicare |
$198.36
|
| Rate for Payer: Mclaren Commercial |
$787.60
|
| Rate for Payer: Mclaren Medicaid |
$106.32
|
| Rate for Payer: Mclaren Medicare |
$198.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$208.28
|
| Rate for Payer: Meridian Medicaid |
$111.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$228.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$743.84
|
| Rate for Payer: Nomi Health Commercial |
$717.59
|
| Rate for Payer: PACE Medicare |
$188.44
|
| Rate for Payer: PACE SWMI |
$198.36
|
| Rate for Payer: PHP Commercial |
$218.20
|
| Rate for Payer: PHP Medicaid |
$106.32
|
| Rate for Payer: PHP Medicare Advantage |
$198.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$106.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$568.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$766.77
|
| Rate for Payer: Priority Health Medicare |
$198.36
|
| Rate for Payer: Priority Health Narrow Network |
$613.45
|
| Rate for Payer: Railroad Medicare Medicare |
$198.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$770.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$198.36
|
| Rate for Payer: UHC Exchange |
$307.46
|
| Rate for Payer: UHC Medicare Advantage |
$198.36
|
| Rate for Payer: UHCCP DNSP |
$198.36
|
| Rate for Payer: UHCCP Medicaid |
$106.32
|
| Rate for Payer: VA VA |
$198.36
|
|
|
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 |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| 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 BIRCH IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200029
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$25.39 |
| Rate for Payer: Aetna Commercial |
$22.85
|
| Rate for Payer: ASR ASR |
$24.63
|
| Rate for Payer: ASR Commercial |
$24.63
|
| Rate for Payer: BCBS Trust/PPO |
$20.69
|
| Rate for Payer: BCN Commercial |
$19.68
|
| 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: Healthscope Commercial |
$25.39
|
| Rate for Payer: Healthscope Whirlpool |
$24.63
|
| Rate for Payer: Mclaren Commercial |
$22.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.34
|
|
|
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 |
$1,019.35
|
| 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 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 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 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 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
|
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 |
$251.87
|
| 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 |
$251.87
|
| 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 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 |
$251.87
|
| Rate for Payer: Aetna Medicare |
$139.93
|
| 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 |
$251.87
|
| 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 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
|
|
