|
HC BRONCHOSCOPY W EBUS EXAM
|
Facility
|
IP
|
$3,178.02
|
|
| Hospital Charge Code |
36000015
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,065.71 |
| Max. Negotiated Rate |
$3,178.02 |
| Rate for Payer: Aetna Commercial |
$2,860.22
|
| Rate for Payer: ASR ASR |
$3,082.68
|
| Rate for Payer: ASR Commercial |
$3,082.68
|
| Rate for Payer: BCBS Trust/PPO |
$2,589.77
|
| Rate for Payer: BCN Commercial |
$2,463.92
|
| Rate for Payer: Cash Price |
$2,542.42
|
| Rate for Payer: Cofinity Commercial |
$2,987.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,542.42
|
| Rate for Payer: Healthscope Commercial |
$3,178.02
|
| Rate for Payer: Healthscope Whirlpool |
$3,082.68
|
| Rate for Payer: Mclaren Commercial |
$2,860.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,701.32
|
| Rate for Payer: Nomi Health Commercial |
$2,605.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,065.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,796.66
|
|
|
HC BRONCHOSPASM PROVOCATION (METHACHOLINE CHALLENGE)
|
Facility
|
OP
|
$708.68
|
|
|
Service Code
|
CPT 94070
|
| Hospital Charge Code |
46000003
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$163.53 |
| Max. Negotiated Rate |
$708.68 |
| Rate for Payer: Aetna Commercial |
$637.81
|
| Rate for Payer: Aetna Medicare |
$305.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$381.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$381.38
|
| Rate for Payer: ASR ASR |
$687.42
|
| Rate for Payer: ASR Commercial |
$687.42
|
| Rate for Payer: BCBS Complete |
$171.71
|
| Rate for Payer: BCBS MAPPO |
$305.10
|
| Rate for Payer: BCBS Trust/PPO |
$580.34
|
| Rate for Payer: BCN Commercial |
$549.44
|
| Rate for Payer: BCN Medicare Advantage |
$305.10
|
| Rate for Payer: Cash Price |
$566.94
|
| Rate for Payer: Cash Price |
$566.94
|
| Rate for Payer: Cofinity Commercial |
$666.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$566.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.10
|
| Rate for Payer: Healthscope Commercial |
$708.68
|
| Rate for Payer: Healthscope Whirlpool |
$687.42
|
| Rate for Payer: Humana Choice PPO Medicare |
$305.10
|
| Rate for Payer: Mclaren Commercial |
$637.81
|
| Rate for Payer: Mclaren Medicaid |
$163.53
|
| Rate for Payer: Mclaren Medicare |
$305.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$320.36
|
| Rate for Payer: Meridian Medicaid |
$171.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$350.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$602.38
|
| Rate for Payer: Nomi Health Commercial |
$581.12
|
| Rate for Payer: PACE Medicare |
$289.84
|
| Rate for Payer: PACE SWMI |
$305.10
|
| Rate for Payer: PHP Commercial |
$335.61
|
| Rate for Payer: PHP Medicaid |
$163.53
|
| Rate for Payer: PHP Medicare Advantage |
$305.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$163.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$460.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$620.95
|
| Rate for Payer: Priority Health Medicare |
$305.10
|
| Rate for Payer: Priority Health Narrow Network |
$496.78
|
| Rate for Payer: Railroad Medicare Medicare |
$305.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$623.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$305.10
|
| Rate for Payer: UHC Exchange |
$472.90
|
| Rate for Payer: UHC Medicare Advantage |
$305.10
|
| Rate for Payer: UHCCP DNSP |
$305.10
|
| Rate for Payer: UHCCP Medicaid |
$163.53
|
| Rate for Payer: VA VA |
$305.10
|
|
|
HC BRONCHOSPASM PROVOCATION (METHACHOLINE CHALLENGE)
|
Facility
|
IP
|
$708.68
|
|
|
Service Code
|
CPT 94070
|
| Hospital Charge Code |
46000003
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$460.64 |
| Max. Negotiated Rate |
$708.68 |
| Rate for Payer: Aetna Commercial |
$637.81
|
| Rate for Payer: ASR ASR |
$687.42
|
| Rate for Payer: ASR Commercial |
$687.42
|
| Rate for Payer: BCBS Trust/PPO |
$577.50
|
| Rate for Payer: BCN Commercial |
$549.44
|
| Rate for Payer: Cash Price |
$566.94
|
| Rate for Payer: Cofinity Commercial |
$666.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$566.94
|
| Rate for Payer: Healthscope Commercial |
$708.68
|
| Rate for Payer: Healthscope Whirlpool |
$687.42
|
| Rate for Payer: Mclaren Commercial |
$637.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$602.38
|
| Rate for Payer: Nomi Health Commercial |
$581.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$460.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$623.64
|
|
|
HC BRUCELLA ANTIBODY
|
Facility
|
IP
|
$73.44
|
|
|
Service Code
|
CPT 86622
|
| Hospital Charge Code |
30200236
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$47.74 |
| Max. Negotiated Rate |
$73.44 |
| Rate for Payer: Aetna Commercial |
$66.10
|
| Rate for Payer: ASR ASR |
$71.24
|
| Rate for Payer: ASR Commercial |
$71.24
|
| Rate for Payer: BCBS Trust/PPO |
$59.85
|
| Rate for Payer: BCN Commercial |
$56.94
|
| Rate for Payer: Cash Price |
$58.75
|
| Rate for Payer: Cofinity Commercial |
$69.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.75
|
| Rate for Payer: Healthscope Commercial |
$73.44
|
| Rate for Payer: Healthscope Whirlpool |
$71.24
|
| Rate for Payer: Mclaren Commercial |
$66.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.42
|
| Rate for Payer: Nomi Health Commercial |
$60.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$64.63
|
|
|
HC BRUCELLA ANTIBODY
|
Facility
|
OP
|
$73.44
|
|
|
Service Code
|
CPT 86622
|
| Hospital Charge Code |
30200236
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.79 |
| Max. Negotiated Rate |
$166.89 |
| Rate for Payer: Aetna Commercial |
$66.10
|
| Rate for Payer: Aetna Medicare |
$8.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.16
|
| Rate for Payer: ASR ASR |
$71.24
|
| Rate for Payer: ASR Commercial |
$71.24
|
| Rate for Payer: BCBS Complete |
$5.03
|
| Rate for Payer: BCBS MAPPO |
$8.93
|
| Rate for Payer: BCBS Trust/PPO |
$60.14
|
| Rate for Payer: BCN Commercial |
$56.94
|
| Rate for Payer: BCN Medicare Advantage |
$8.93
|
| Rate for Payer: Cash Price |
$58.75
|
| Rate for Payer: Cash Price |
$58.75
|
| Rate for Payer: Cofinity Commercial |
$69.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.93
|
| Rate for Payer: Healthscope Commercial |
$73.44
|
| Rate for Payer: Healthscope Whirlpool |
$71.24
|
| Rate for Payer: Humana Choice PPO Medicare |
$8.93
|
| Rate for Payer: Mclaren Commercial |
$66.10
|
| Rate for Payer: Mclaren Medicaid |
$4.79
|
| Rate for Payer: Mclaren Medicare |
$8.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.38
|
| Rate for Payer: Meridian Medicaid |
$5.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.42
|
| Rate for Payer: Nomi Health Commercial |
$60.22
|
| Rate for Payer: PACE Medicare |
$8.48
|
| Rate for Payer: PACE SWMI |
$8.93
|
| Rate for Payer: PHP Commercial |
$9.82
|
| Rate for Payer: PHP Medicaid |
$4.79
|
| Rate for Payer: PHP Medicare Advantage |
$8.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$166.89
|
| Rate for Payer: Priority Health Medicare |
$8.93
|
| Rate for Payer: Priority Health Narrow Network |
$133.51
|
| Rate for Payer: Railroad Medicare Medicare |
$8.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$64.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.93
|
| Rate for Payer: UHC Exchange |
$13.84
|
| Rate for Payer: UHC Medicare Advantage |
$8.93
|
| Rate for Payer: UHCCP DNSP |
$8.93
|
| Rate for Payer: UHCCP Medicaid |
$4.79
|
| Rate for Payer: VA VA |
$8.93
|
|
|
HC BRUCELLA ANTIBODY CMPT
|
Facility
|
IP
|
$73.44
|
|
|
Service Code
|
CPT 86622
|
| Hospital Charge Code |
30200238
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$47.74 |
| Max. Negotiated Rate |
$73.44 |
| Rate for Payer: Aetna Commercial |
$66.10
|
| Rate for Payer: ASR ASR |
$71.24
|
| Rate for Payer: ASR Commercial |
$71.24
|
| Rate for Payer: BCBS Trust/PPO |
$59.85
|
| Rate for Payer: BCN Commercial |
$56.94
|
| Rate for Payer: Cash Price |
$58.75
|
| Rate for Payer: Cofinity Commercial |
$69.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.75
|
| Rate for Payer: Healthscope Commercial |
$73.44
|
| Rate for Payer: Healthscope Whirlpool |
$71.24
|
| Rate for Payer: Mclaren Commercial |
$66.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.42
|
| Rate for Payer: Nomi Health Commercial |
$60.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$64.63
|
|
|
HC BRUCELLA ANTIBODY CMPT
|
Facility
|
OP
|
$73.44
|
|
|
Service Code
|
CPT 86622
|
| Hospital Charge Code |
30200238
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.79 |
| Max. Negotiated Rate |
$166.89 |
| Rate for Payer: Aetna Commercial |
$66.10
|
| Rate for Payer: Aetna Medicare |
$8.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.16
|
| Rate for Payer: ASR ASR |
$71.24
|
| Rate for Payer: ASR Commercial |
$71.24
|
| Rate for Payer: BCBS Complete |
$5.03
|
| Rate for Payer: BCBS MAPPO |
$8.93
|
| Rate for Payer: BCBS Trust/PPO |
$60.14
|
| Rate for Payer: BCN Commercial |
$56.94
|
| Rate for Payer: BCN Medicare Advantage |
$8.93
|
| Rate for Payer: Cash Price |
$58.75
|
| Rate for Payer: Cash Price |
$58.75
|
| Rate for Payer: Cofinity Commercial |
$69.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.93
|
| Rate for Payer: Healthscope Commercial |
$73.44
|
| Rate for Payer: Healthscope Whirlpool |
$71.24
|
| Rate for Payer: Humana Choice PPO Medicare |
$8.93
|
| Rate for Payer: Mclaren Commercial |
$66.10
|
| Rate for Payer: Mclaren Medicaid |
$4.79
|
| Rate for Payer: Mclaren Medicare |
$8.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.38
|
| Rate for Payer: Meridian Medicaid |
$5.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.42
|
| Rate for Payer: Nomi Health Commercial |
$60.22
|
| Rate for Payer: PACE Medicare |
$8.48
|
| Rate for Payer: PACE SWMI |
$8.93
|
| Rate for Payer: PHP Commercial |
$9.82
|
| Rate for Payer: PHP Medicaid |
$4.79
|
| Rate for Payer: PHP Medicare Advantage |
$8.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$166.89
|
| Rate for Payer: Priority Health Medicare |
$8.93
|
| Rate for Payer: Priority Health Narrow Network |
$133.51
|
| Rate for Payer: Railroad Medicare Medicare |
$8.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$64.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.93
|
| Rate for Payer: UHC Exchange |
$13.84
|
| Rate for Payer: UHC Medicare Advantage |
$8.93
|
| Rate for Payer: UHCCP DNSP |
$8.93
|
| Rate for Payer: UHCCP Medicaid |
$4.79
|
| Rate for Payer: VA VA |
$8.93
|
|
|
HC BRUCELLA ANTIBODY CONFIRMATION
|
Facility
|
OP
|
$53.04
|
|
|
Service Code
|
CPT 86622
|
| Hospital Charge Code |
30200237
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.79 |
| Max. Negotiated Rate |
$166.89 |
| Rate for Payer: Aetna Commercial |
$47.74
|
| Rate for Payer: Aetna Medicare |
$8.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.16
|
| Rate for Payer: ASR ASR |
$51.45
|
| Rate for Payer: ASR Commercial |
$51.45
|
| Rate for Payer: BCBS Complete |
$5.03
|
| Rate for Payer: BCBS MAPPO |
$8.93
|
| Rate for Payer: BCBS Trust/PPO |
$43.43
|
| Rate for Payer: BCN Commercial |
$41.12
|
| Rate for Payer: BCN Medicare Advantage |
$8.93
|
| Rate for Payer: Cash Price |
$42.43
|
| Rate for Payer: Cash Price |
$42.43
|
| Rate for Payer: Cofinity Commercial |
$49.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.93
|
| Rate for Payer: Healthscope Commercial |
$53.04
|
| Rate for Payer: Healthscope Whirlpool |
$51.45
|
| Rate for Payer: Humana Choice PPO Medicare |
$8.93
|
| Rate for Payer: Mclaren Commercial |
$47.74
|
| Rate for Payer: Mclaren Medicaid |
$4.79
|
| Rate for Payer: Mclaren Medicare |
$8.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.38
|
| Rate for Payer: Meridian Medicaid |
$5.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.08
|
| Rate for Payer: Nomi Health Commercial |
$43.49
|
| Rate for Payer: PACE Medicare |
$8.48
|
| Rate for Payer: PACE SWMI |
$8.93
|
| Rate for Payer: PHP Commercial |
$9.82
|
| Rate for Payer: PHP Medicaid |
$4.79
|
| Rate for Payer: PHP Medicare Advantage |
$8.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$166.89
|
| Rate for Payer: Priority Health Medicare |
$8.93
|
| Rate for Payer: Priority Health Narrow Network |
$133.51
|
| Rate for Payer: Railroad Medicare Medicare |
$8.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.93
|
| Rate for Payer: UHC Exchange |
$13.84
|
| Rate for Payer: UHC Medicare Advantage |
$8.93
|
| Rate for Payer: UHCCP DNSP |
$8.93
|
| Rate for Payer: UHCCP Medicaid |
$4.79
|
| Rate for Payer: VA VA |
$8.93
|
|
|
HC BRUCELLA ANTIBODY CONFIRMATION
|
Facility
|
IP
|
$53.04
|
|
|
Service Code
|
CPT 86622
|
| Hospital Charge Code |
30200237
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$34.48 |
| Max. Negotiated Rate |
$53.04 |
| Rate for Payer: Aetna Commercial |
$47.74
|
| Rate for Payer: ASR ASR |
$51.45
|
| Rate for Payer: ASR Commercial |
$51.45
|
| Rate for Payer: BCBS Trust/PPO |
$43.22
|
| Rate for Payer: BCN Commercial |
$41.12
|
| Rate for Payer: Cash Price |
$42.43
|
| Rate for Payer: Cofinity Commercial |
$49.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.43
|
| Rate for Payer: Healthscope Commercial |
$53.04
|
| Rate for Payer: Healthscope Whirlpool |
$51.45
|
| Rate for Payer: Mclaren Commercial |
$47.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.08
|
| Rate for Payer: Nomi Health Commercial |
$43.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.68
|
|
|
HC BUDESONIDE INHALATION SOLUTION
|
Facility
|
OP
|
$29.35
|
|
| Hospital Charge Code |
63700005
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$11.74 |
| Max. Negotiated Rate |
$29.35 |
| Rate for Payer: Aetna Commercial |
$26.42
|
| Rate for Payer: Aetna Medicare |
$14.68
|
| Rate for Payer: ASR ASR |
$28.47
|
| Rate for Payer: ASR Commercial |
$28.47
|
| Rate for Payer: BCBS Complete |
$11.74
|
| Rate for Payer: BCBS Trust/PPO |
$24.03
|
| Rate for Payer: BCN Commercial |
$22.76
|
| Rate for Payer: Cash Price |
$23.48
|
| Rate for Payer: Cofinity Commercial |
$27.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.48
|
| Rate for Payer: Healthscope Commercial |
$29.35
|
| Rate for Payer: Healthscope Whirlpool |
$28.47
|
| Rate for Payer: Mclaren Commercial |
$26.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.95
|
| Rate for Payer: Nomi Health Commercial |
$24.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25.72
|
| Rate for Payer: Priority Health Narrow Network |
$20.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.83
|
|
|
HC BUDESONIDE INHALATION SOLUTION
|
Facility
|
IP
|
$29.35
|
|
| Hospital Charge Code |
63700005
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$19.08 |
| Max. Negotiated Rate |
$29.35 |
| Rate for Payer: Aetna Commercial |
$26.42
|
| Rate for Payer: ASR ASR |
$28.47
|
| Rate for Payer: ASR Commercial |
$28.47
|
| Rate for Payer: BCBS Trust/PPO |
$23.92
|
| Rate for Payer: BCN Commercial |
$22.76
|
| Rate for Payer: Cash Price |
$23.48
|
| Rate for Payer: Cofinity Commercial |
$27.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.48
|
| Rate for Payer: Healthscope Commercial |
$29.35
|
| Rate for Payer: Healthscope Whirlpool |
$28.47
|
| Rate for Payer: Mclaren Commercial |
$26.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.95
|
| Rate for Payer: Nomi Health Commercial |
$24.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.83
|
|
|
HC BUNDLE OF HIS RECORDING
|
Facility
|
IP
|
$4,021.38
|
|
|
Service Code
|
CPT 93600
|
| Hospital Charge Code |
48100029
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,613.90 |
| Max. Negotiated Rate |
$4,021.38 |
| Rate for Payer: Aetna Commercial |
$3,619.24
|
| Rate for Payer: ASR ASR |
$3,900.74
|
| Rate for Payer: ASR Commercial |
$3,900.74
|
| Rate for Payer: BCBS Trust/PPO |
$3,277.02
|
| Rate for Payer: BCN Commercial |
$3,117.78
|
| Rate for Payer: Cash Price |
$3,217.10
|
| Rate for Payer: Cofinity Commercial |
$3,780.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,217.10
|
| Rate for Payer: Healthscope Commercial |
$4,021.38
|
| Rate for Payer: Healthscope Whirlpool |
$3,900.74
|
| Rate for Payer: Mclaren Commercial |
$3,619.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,418.17
|
| Rate for Payer: Nomi Health Commercial |
$3,297.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,613.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,538.81
|
|
|
HC BUNDLE OF HIS RECORDING
|
Facility
|
OP
|
$4,021.38
|
|
|
Service Code
|
CPT 93600
|
| Hospital Charge Code |
48100029
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,613.90 |
| Max. Negotiated Rate |
$11,523.74 |
| Rate for Payer: Aetna Commercial |
$3,619.24
|
| Rate for Payer: Aetna Medicare |
$7,434.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,293.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,293.34
|
| Rate for Payer: ASR ASR |
$3,900.74
|
| Rate for Payer: ASR Commercial |
$3,900.74
|
| Rate for Payer: BCBS Complete |
$4,184.23
|
| Rate for Payer: BCBS MAPPO |
$7,434.67
|
| Rate for Payer: BCBS Trust/PPO |
$3,293.11
|
| Rate for Payer: BCN Commercial |
$3,117.78
|
| Rate for Payer: BCN Medicare Advantage |
$7,434.67
|
| Rate for Payer: Cash Price |
$3,217.10
|
| Rate for Payer: Cash Price |
$3,217.10
|
| Rate for Payer: Cofinity Commercial |
$3,780.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,217.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,434.67
|
| Rate for Payer: Healthscope Commercial |
$4,021.38
|
| Rate for Payer: Healthscope Whirlpool |
$3,900.74
|
| Rate for Payer: Humana Choice PPO Medicare |
$7,434.67
|
| Rate for Payer: Mclaren Commercial |
$3,619.24
|
| Rate for Payer: Mclaren Medicaid |
$3,984.98
|
| Rate for Payer: Mclaren Medicare |
$7,434.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,806.40
|
| Rate for Payer: Meridian Medicaid |
$4,184.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,549.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,418.17
|
| Rate for Payer: Nomi Health Commercial |
$3,297.53
|
| Rate for Payer: PACE Medicare |
$7,062.94
|
| Rate for Payer: PACE SWMI |
$7,434.67
|
| Rate for Payer: PHP Commercial |
$8,178.14
|
| Rate for Payer: PHP Medicaid |
$3,984.98
|
| Rate for Payer: PHP Medicare Advantage |
$7,434.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,984.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,613.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,523.53
|
| Rate for Payer: Priority Health Medicare |
$7,434.67
|
| Rate for Payer: Priority Health Narrow Network |
$2,818.99
|
| Rate for Payer: Railroad Medicare Medicare |
$7,434.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,538.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,434.67
|
| Rate for Payer: UHC Exchange |
$11,523.74
|
| Rate for Payer: UHC Medicare Advantage |
$7,434.67
|
| Rate for Payer: UHCCP DNSP |
$7,434.67
|
| Rate for Payer: UHCCP Medicaid |
$3,984.98
|
| Rate for Payer: VA VA |
$7,434.67
|
|
|
HC BUPIVACAINE 0.5 MG
|
Facility
|
OP
|
$1.51
|
|
|
Service Code
|
HCPCS J0665
|
| Hospital Charge Code |
25000016
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$1.51 |
| Rate for Payer: Aetna Commercial |
$1.36
|
| Rate for Payer: Aetna Medicare |
$0.76
|
| Rate for Payer: ASR ASR |
$1.46
|
| Rate for Payer: ASR Commercial |
$1.46
|
| Rate for Payer: BCBS Complete |
$0.60
|
| Rate for Payer: BCBS Trust/PPO |
$1.24
|
| Rate for Payer: BCN Commercial |
$1.17
|
| Rate for Payer: Cash Price |
$1.21
|
| Rate for Payer: Cash Price |
$1.21
|
| Rate for Payer: Cofinity Commercial |
$1.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.21
|
| Rate for Payer: Healthscope Commercial |
$1.51
|
| Rate for Payer: Healthscope Whirlpool |
$1.46
|
| Rate for Payer: Mclaren Commercial |
$1.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.28
|
| Rate for Payer: Nomi Health Commercial |
$1.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$0.01
|
| Rate for Payer: Priority Health Narrow Network |
$0.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1.33
|
|
|
HC BUPIVACAINE 0.5 MG
|
Facility
|
IP
|
$1.51
|
|
|
Service Code
|
HCPCS J0665
|
| Hospital Charge Code |
25000016
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.98 |
| Max. Negotiated Rate |
$1.51 |
| Rate for Payer: Aetna Commercial |
$1.36
|
| Rate for Payer: ASR ASR |
$1.46
|
| Rate for Payer: ASR Commercial |
$1.46
|
| Rate for Payer: BCBS Trust/PPO |
$1.23
|
| Rate for Payer: BCN Commercial |
$1.17
|
| Rate for Payer: Cash Price |
$1.21
|
| Rate for Payer: Cofinity Commercial |
$1.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.21
|
| Rate for Payer: Healthscope Commercial |
$1.51
|
| Rate for Payer: Healthscope Whirlpool |
$1.46
|
| Rate for Payer: Mclaren Commercial |
$1.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.28
|
| Rate for Payer: Nomi Health Commercial |
$1.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1.33
|
|
|
HC BUPRENORPHINE & MET QUANT, UR
|
Facility
|
IP
|
$177.48
|
|
|
Service Code
|
CPT 80348
|
| Hospital Charge Code |
30100598
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$115.36 |
| Max. Negotiated Rate |
$177.48 |
| Rate for Payer: Aetna Commercial |
$159.73
|
| Rate for Payer: ASR ASR |
$172.16
|
| Rate for Payer: ASR Commercial |
$172.16
|
| Rate for Payer: BCBS Trust/PPO |
$144.63
|
| Rate for Payer: BCN Commercial |
$137.60
|
| Rate for Payer: Cash Price |
$141.98
|
| Rate for Payer: Cofinity Commercial |
$166.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$141.98
|
| Rate for Payer: Healthscope Commercial |
$177.48
|
| Rate for Payer: Healthscope Whirlpool |
$172.16
|
| Rate for Payer: Mclaren Commercial |
$159.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$150.86
|
| Rate for Payer: Nomi Health Commercial |
$145.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$115.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$156.18
|
|
|
HC BUPRENORPHINE & MET QUANT, UR
|
Facility
|
OP
|
$177.48
|
|
|
Service Code
|
CPT 80348
|
| Hospital Charge Code |
30100598
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$70.99 |
| Max. Negotiated Rate |
$177.48 |
| Rate for Payer: Aetna Commercial |
$159.73
|
| Rate for Payer: Aetna Medicare |
$88.74
|
| Rate for Payer: ASR ASR |
$172.16
|
| Rate for Payer: ASR Commercial |
$172.16
|
| Rate for Payer: BCBS Complete |
$70.99
|
| Rate for Payer: BCBS Trust/PPO |
$145.34
|
| Rate for Payer: BCN Commercial |
$137.60
|
| Rate for Payer: Cash Price |
$141.98
|
| Rate for Payer: Cofinity Commercial |
$166.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$141.98
|
| Rate for Payer: Healthscope Commercial |
$177.48
|
| Rate for Payer: Healthscope Whirlpool |
$172.16
|
| Rate for Payer: Mclaren Commercial |
$159.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$150.86
|
| Rate for Payer: Nomi Health Commercial |
$145.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$115.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$155.51
|
| Rate for Payer: Priority Health Narrow Network |
$124.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$156.18
|
|
|
HC BUPRENORPHINE SCRN URN
|
Facility
|
IP
|
$41.62
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30000116
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$27.05 |
| Max. Negotiated Rate |
$41.62 |
| Rate for Payer: Aetna Commercial |
$37.46
|
| Rate for Payer: ASR ASR |
$40.37
|
| Rate for Payer: ASR Commercial |
$40.37
|
| Rate for Payer: BCBS Trust/PPO |
$33.92
|
| Rate for Payer: BCN Commercial |
$32.27
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$39.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Healthscope Commercial |
$41.62
|
| Rate for Payer: Healthscope Whirlpool |
$40.37
|
| Rate for Payer: Mclaren Commercial |
$37.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$34.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$36.63
|
|
|
HC BUPRENORPHINE SCRN URN
|
Facility
|
OP
|
$41.62
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30000116
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.75 |
| Max. Negotiated Rate |
$41.62 |
| Rate for Payer: Aetna Commercial |
$37.46
|
| Rate for Payer: Aetna Medicare |
$12.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.75
|
| Rate for Payer: ASR ASR |
$40.37
|
| Rate for Payer: ASR Commercial |
$40.37
|
| Rate for Payer: BCBS Complete |
$7.09
|
| Rate for Payer: BCBS MAPPO |
$12.60
|
| Rate for Payer: BCBS Trust/PPO |
$34.08
|
| Rate for Payer: BCN Commercial |
$32.27
|
| Rate for Payer: BCN Medicare Advantage |
$12.60
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$39.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.60
|
| Rate for Payer: Healthscope Commercial |
$41.62
|
| Rate for Payer: Healthscope Whirlpool |
$40.37
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.60
|
| Rate for Payer: Mclaren Commercial |
$37.46
|
| Rate for Payer: Mclaren Medicaid |
$6.75
|
| Rate for Payer: Mclaren Medicare |
$12.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.23
|
| Rate for Payer: Meridian Medicaid |
$7.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$34.13
|
| Rate for Payer: PACE Medicare |
$11.97
|
| Rate for Payer: PACE SWMI |
$12.60
|
| Rate for Payer: PHP Commercial |
$13.86
|
| Rate for Payer: PHP Medicaid |
$6.75
|
| Rate for Payer: PHP Medicare Advantage |
$12.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$36.47
|
| Rate for Payer: Priority Health Medicare |
$12.60
|
| Rate for Payer: Priority Health Narrow Network |
$29.18
|
| Rate for Payer: Railroad Medicare Medicare |
$12.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$36.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.60
|
| Rate for Payer: UHC Exchange |
$19.53
|
| Rate for Payer: UHC Medicare Advantage |
$12.60
|
| Rate for Payer: UHCCP DNSP |
$12.60
|
| Rate for Payer: UHCCP Medicaid |
$6.75
|
| Rate for Payer: VA VA |
$12.60
|
|
|
HC BURN CARE LARGE
|
Facility
|
OP
|
$691.65
|
|
|
Service Code
|
CPT 16030
|
| Hospital Charge Code |
36100007
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$180.95 |
| Max. Negotiated Rate |
$691.65 |
| Rate for Payer: Aetna Commercial |
$622.48
|
| Rate for Payer: Aetna Medicare |
$391.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$489.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$489.31
|
| Rate for Payer: ASR ASR |
$670.90
|
| Rate for Payer: ASR Commercial |
$670.90
|
| Rate for Payer: BCBS Complete |
$220.31
|
| Rate for Payer: BCBS MAPPO |
$391.45
|
| Rate for Payer: BCBS Trust/PPO |
$566.39
|
| Rate for Payer: BCN Commercial |
$536.24
|
| Rate for Payer: BCN Medicare Advantage |
$391.45
|
| Rate for Payer: Cash Price |
$553.32
|
| Rate for Payer: Cash Price |
$553.32
|
| Rate for Payer: Cofinity Commercial |
$650.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$553.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$391.45
|
| Rate for Payer: Healthscope Commercial |
$691.65
|
| Rate for Payer: Healthscope Whirlpool |
$670.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$391.45
|
| Rate for Payer: Mclaren Commercial |
$622.48
|
| Rate for Payer: Mclaren Medicaid |
$209.82
|
| Rate for Payer: Mclaren Medicare |
$391.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$411.02
|
| Rate for Payer: Meridian Medicaid |
$220.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$450.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$587.90
|
| Rate for Payer: Nomi Health Commercial |
$567.15
|
| Rate for Payer: PACE Medicare |
$371.88
|
| Rate for Payer: PACE SWMI |
$391.45
|
| Rate for Payer: PHP Commercial |
$430.60
|
| Rate for Payer: PHP Medicaid |
$209.82
|
| Rate for Payer: PHP Medicare Advantage |
$391.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$209.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$449.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$226.19
|
| Rate for Payer: Priority Health Medicare |
$391.45
|
| Rate for Payer: Priority Health Narrow Network |
$180.95
|
| Rate for Payer: Railroad Medicare Medicare |
$391.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$608.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$391.45
|
| Rate for Payer: UHC Exchange |
$606.75
|
| Rate for Payer: UHC Medicare Advantage |
$391.45
|
| Rate for Payer: UHCCP DNSP |
$391.45
|
| Rate for Payer: UHCCP Medicaid |
$209.82
|
| Rate for Payer: VA VA |
$391.45
|
|
|
HC BURN CARE LARGE
|
Facility
|
IP
|
$691.65
|
|
|
Service Code
|
CPT 16030
|
| Hospital Charge Code |
36100007
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$449.57 |
| Max. Negotiated Rate |
$691.65 |
| Rate for Payer: Aetna Commercial |
$622.48
|
| Rate for Payer: ASR ASR |
$670.90
|
| Rate for Payer: ASR Commercial |
$670.90
|
| Rate for Payer: BCBS Trust/PPO |
$563.63
|
| Rate for Payer: BCN Commercial |
$536.24
|
| Rate for Payer: Cash Price |
$553.32
|
| Rate for Payer: Cofinity Commercial |
$650.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$553.32
|
| Rate for Payer: Healthscope Commercial |
$691.65
|
| Rate for Payer: Healthscope Whirlpool |
$670.90
|
| Rate for Payer: Mclaren Commercial |
$622.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$587.90
|
| Rate for Payer: Nomi Health Commercial |
$567.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$449.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$608.65
|
|
|
HC BURN CARE MEDIUM
|
Facility
|
IP
|
$531.94
|
|
|
Service Code
|
CPT 16025
|
| Hospital Charge Code |
36100006
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$345.76 |
| Max. Negotiated Rate |
$531.94 |
| Rate for Payer: Aetna Commercial |
$478.75
|
| Rate for Payer: ASR ASR |
$515.98
|
| Rate for Payer: ASR Commercial |
$515.98
|
| Rate for Payer: BCBS Trust/PPO |
$433.48
|
| Rate for Payer: BCN Commercial |
$412.41
|
| Rate for Payer: Cash Price |
$425.55
|
| Rate for Payer: Cofinity Commercial |
$500.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$425.55
|
| Rate for Payer: Healthscope Commercial |
$531.94
|
| Rate for Payer: Healthscope Whirlpool |
$515.98
|
| Rate for Payer: Mclaren Commercial |
$478.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$452.15
|
| Rate for Payer: Nomi Health Commercial |
$436.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$345.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$468.11
|
|
|
HC BURN CARE MEDIUM
|
Facility
|
OP
|
$531.94
|
|
|
Service Code
|
CPT 16025
|
| Hospital Charge Code |
36100006
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$104.35 |
| Max. Negotiated Rate |
$531.94 |
| Rate for Payer: Aetna Commercial |
$478.75
|
| Rate for Payer: Aetna Medicare |
$194.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$243.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$243.35
|
| Rate for Payer: ASR ASR |
$515.98
|
| Rate for Payer: ASR Commercial |
$515.98
|
| Rate for Payer: BCBS Complete |
$109.57
|
| Rate for Payer: BCBS MAPPO |
$194.68
|
| Rate for Payer: BCBS Trust/PPO |
$435.61
|
| Rate for Payer: BCN Commercial |
$412.41
|
| Rate for Payer: BCN Medicare Advantage |
$194.68
|
| Rate for Payer: Cash Price |
$425.55
|
| Rate for Payer: Cash Price |
$425.55
|
| Rate for Payer: Cofinity Commercial |
$500.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$425.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$194.68
|
| Rate for Payer: Healthscope Commercial |
$531.94
|
| Rate for Payer: Healthscope Whirlpool |
$515.98
|
| Rate for Payer: Humana Choice PPO Medicare |
$194.68
|
| Rate for Payer: Mclaren Commercial |
$478.75
|
| Rate for Payer: Mclaren Medicaid |
$104.35
|
| Rate for Payer: Mclaren Medicare |
$194.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$204.41
|
| Rate for Payer: Meridian Medicaid |
$109.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$223.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$452.15
|
| Rate for Payer: Nomi Health Commercial |
$436.19
|
| Rate for Payer: PACE Medicare |
$184.95
|
| Rate for Payer: PACE SWMI |
$194.68
|
| Rate for Payer: PHP Commercial |
$214.15
|
| Rate for Payer: PHP Medicaid |
$104.35
|
| Rate for Payer: PHP Medicare Advantage |
$194.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$345.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$226.19
|
| Rate for Payer: Priority Health Medicare |
$194.68
|
| Rate for Payer: Priority Health Narrow Network |
$180.95
|
| Rate for Payer: Railroad Medicare Medicare |
$194.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$468.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$194.68
|
| Rate for Payer: UHC Exchange |
$301.75
|
| Rate for Payer: UHC Medicare Advantage |
$194.68
|
| Rate for Payer: UHCCP DNSP |
$194.68
|
| Rate for Payer: UHCCP Medicaid |
$104.35
|
| Rate for Payer: VA VA |
$194.68
|
|
|
HC BURN CARE SMALL
|
Facility
|
OP
|
$365.20
|
|
|
Service Code
|
CPT 16020
|
| Hospital Charge Code |
36100005
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$104.35 |
| Max. Negotiated Rate |
$365.20 |
| Rate for Payer: Aetna Commercial |
$328.68
|
| Rate for Payer: Aetna Medicare |
$194.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$243.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$243.35
|
| Rate for Payer: ASR ASR |
$354.24
|
| Rate for Payer: ASR Commercial |
$354.24
|
| Rate for Payer: BCBS Complete |
$109.57
|
| Rate for Payer: BCBS MAPPO |
$194.68
|
| Rate for Payer: BCBS Trust/PPO |
$299.06
|
| Rate for Payer: BCN Commercial |
$283.14
|
| Rate for Payer: BCN Medicare Advantage |
$194.68
|
| Rate for Payer: Cash Price |
$292.16
|
| Rate for Payer: Cash Price |
$292.16
|
| Rate for Payer: Cofinity Commercial |
$343.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$292.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$194.68
|
| Rate for Payer: Healthscope Commercial |
$365.20
|
| Rate for Payer: Healthscope Whirlpool |
$354.24
|
| Rate for Payer: Humana Choice PPO Medicare |
$194.68
|
| Rate for Payer: Mclaren Commercial |
$328.68
|
| Rate for Payer: Mclaren Medicaid |
$104.35
|
| Rate for Payer: Mclaren Medicare |
$194.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$204.41
|
| Rate for Payer: Meridian Medicaid |
$109.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$223.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$310.42
|
| Rate for Payer: Nomi Health Commercial |
$299.46
|
| Rate for Payer: PACE Medicare |
$184.95
|
| Rate for Payer: PACE SWMI |
$194.68
|
| Rate for Payer: PHP Commercial |
$214.15
|
| Rate for Payer: PHP Medicaid |
$104.35
|
| Rate for Payer: PHP Medicare Advantage |
$194.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$237.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$226.19
|
| Rate for Payer: Priority Health Medicare |
$194.68
|
| Rate for Payer: Priority Health Narrow Network |
$180.95
|
| Rate for Payer: Railroad Medicare Medicare |
$194.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$321.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$194.68
|
| Rate for Payer: UHC Exchange |
$301.75
|
| Rate for Payer: UHC Medicare Advantage |
$194.68
|
| Rate for Payer: UHCCP DNSP |
$194.68
|
| Rate for Payer: UHCCP Medicaid |
$104.35
|
| Rate for Payer: VA VA |
$194.68
|
|
|
HC BURN CARE SMALL
|
Facility
|
IP
|
$365.20
|
|
|
Service Code
|
CPT 16020
|
| Hospital Charge Code |
36100005
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$237.38 |
| Max. Negotiated Rate |
$365.20 |
| Rate for Payer: Aetna Commercial |
$328.68
|
| Rate for Payer: ASR ASR |
$354.24
|
| Rate for Payer: ASR Commercial |
$354.24
|
| Rate for Payer: BCBS Trust/PPO |
$297.60
|
| Rate for Payer: BCN Commercial |
$283.14
|
| Rate for Payer: Cash Price |
$292.16
|
| Rate for Payer: Cofinity Commercial |
$343.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$292.16
|
| Rate for Payer: Healthscope Commercial |
$365.20
|
| Rate for Payer: Healthscope Whirlpool |
$354.24
|
| Rate for Payer: Mclaren Commercial |
$328.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$310.42
|
| Rate for Payer: Nomi Health Commercial |
$299.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$237.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$321.38
|
|
