|
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 |
$26.41
|
| 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 |
$26.41
|
| 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 |
$11,470.81 |
| Rate for Payer: Aetna Commercial |
$3,619.24
|
| Rate for Payer: Aetna Medicare |
$7,400.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,250.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,250.65
|
| Rate for Payer: ASR ASR |
$3,900.74
|
| Rate for Payer: ASR Commercial |
$3,900.74
|
| Rate for Payer: BCBS Complete |
$4,165.01
|
| Rate for Payer: BCBS MAPPO |
$7,400.52
|
| Rate for Payer: BCBS Trust/PPO |
$3,293.11
|
| Rate for Payer: BCN Commercial |
$3,117.78
|
| Rate for Payer: BCN Medicare Advantage |
$7,400.52
|
| 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 |
$7,400.52
|
| Rate for Payer: Healthscope Commercial |
$4,021.38
|
| Rate for Payer: Healthscope Whirlpool |
$3,900.74
|
| Rate for Payer: Humana Choice PPO Medicare |
$7,400.52
|
| Rate for Payer: Mclaren Commercial |
$3,619.24
|
| Rate for Payer: Mclaren Medicaid |
$3,966.68
|
| Rate for Payer: Mclaren Medicare |
$7,400.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,770.55
|
| Rate for Payer: Meridian Medicaid |
$4,165.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,510.60
|
| 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 |
$7,030.49
|
| Rate for Payer: PACE SWMI |
$7,400.52
|
| Rate for Payer: PHP Commercial |
$8,140.57
|
| Rate for Payer: PHP Medicaid |
$3,966.68
|
| Rate for Payer: PHP Medicare Advantage |
$7,400.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,966.68
|
| 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 |
$7,400.52
|
| Rate for Payer: Priority Health Narrow Network |
$2,818.99
|
| Rate for Payer: Railroad Medicare Medicare |
$7,400.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,538.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,400.52
|
| Rate for Payer: UHC Exchange |
$11,470.81
|
| Rate for Payer: UHC Medicare Advantage |
$7,400.52
|
| Rate for Payer: UHCCP DNSP |
$7,400.52
|
| Rate for Payer: UHCCP Medicaid |
$3,966.68
|
| Rate for Payer: VA VA |
$7,400.52
|
|
|
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 BUPIVACAINE 0.5 MG
|
Facility
|
OP
|
$1.51
|
|
|
Service Code
|
HCPCS J0665
|
| Hospital Charge Code |
25000016
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.60 |
| 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: 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 |
$1.32
|
| Rate for Payer: Priority Health Narrow Network |
$1.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1.33
|
|
|
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 & 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 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 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 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 |
$622.49
|
| 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 |
$622.49
|
| 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 LARGE
|
Facility
|
OP
|
$691.65
|
|
|
Service Code
|
CPT 16030
|
| Hospital Charge Code |
36100007
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$208.85 |
| Max. Negotiated Rate |
$691.65 |
| Rate for Payer: Aetna Commercial |
$622.49
|
| Rate for Payer: Aetna Medicare |
$389.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$487.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$487.06
|
| Rate for Payer: ASR ASR |
$670.90
|
| Rate for Payer: ASR Commercial |
$670.90
|
| Rate for Payer: BCBS Complete |
$219.30
|
| Rate for Payer: BCBS MAPPO |
$389.65
|
| Rate for Payer: BCBS Trust/PPO |
$566.39
|
| Rate for Payer: BCN Commercial |
$536.24
|
| Rate for Payer: BCN Medicare Advantage |
$389.65
|
| 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 |
$389.65
|
| Rate for Payer: Healthscope Commercial |
$691.65
|
| Rate for Payer: Healthscope Whirlpool |
$670.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$389.65
|
| Rate for Payer: Mclaren Commercial |
$622.49
|
| Rate for Payer: Mclaren Medicaid |
$208.85
|
| Rate for Payer: Mclaren Medicare |
$389.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$409.13
|
| Rate for Payer: Meridian Medicaid |
$219.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$448.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$587.90
|
| Rate for Payer: Nomi Health Commercial |
$567.15
|
| Rate for Payer: PACE Medicare |
$370.17
|
| Rate for Payer: PACE SWMI |
$389.65
|
| Rate for Payer: PHP Commercial |
$428.62
|
| Rate for Payer: PHP Medicaid |
$208.85
|
| Rate for Payer: PHP Medicare Advantage |
$389.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$449.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$606.02
|
| Rate for Payer: Priority Health Medicare |
$389.65
|
| Rate for Payer: Priority Health Narrow Network |
$484.85
|
| Rate for Payer: Railroad Medicare Medicare |
$389.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$608.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$389.65
|
| Rate for Payer: UHC Exchange |
$603.96
|
| Rate for Payer: UHC Medicare Advantage |
$389.65
|
| Rate for Payer: UHCCP DNSP |
$389.65
|
| Rate for Payer: UHCCP Medicaid |
$208.85
|
| Rate for Payer: VA VA |
$389.65
|
|
|
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 |
$103.87 |
| Max. Negotiated Rate |
$531.94 |
| Rate for Payer: Aetna Commercial |
$478.75
|
| Rate for Payer: Aetna Medicare |
$193.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$242.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$242.24
|
| Rate for Payer: ASR ASR |
$515.98
|
| Rate for Payer: ASR Commercial |
$515.98
|
| Rate for Payer: BCBS Complete |
$109.07
|
| Rate for Payer: BCBS MAPPO |
$193.79
|
| Rate for Payer: BCBS Trust/PPO |
$435.61
|
| Rate for Payer: BCN Commercial |
$412.41
|
| Rate for Payer: BCN Medicare Advantage |
$193.79
|
| 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 |
$193.79
|
| Rate for Payer: Healthscope Commercial |
$531.94
|
| Rate for Payer: Healthscope Whirlpool |
$515.98
|
| Rate for Payer: Humana Choice PPO Medicare |
$193.79
|
| Rate for Payer: Mclaren Commercial |
$478.75
|
| Rate for Payer: Mclaren Medicaid |
$103.87
|
| Rate for Payer: Mclaren Medicare |
$193.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$203.48
|
| Rate for Payer: Meridian Medicaid |
$109.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$222.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$452.15
|
| Rate for Payer: Nomi Health Commercial |
$436.19
|
| Rate for Payer: PACE Medicare |
$184.10
|
| Rate for Payer: PACE SWMI |
$193.79
|
| Rate for Payer: PHP Commercial |
$213.17
|
| Rate for Payer: PHP Medicaid |
$103.87
|
| Rate for Payer: PHP Medicare Advantage |
$193.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$345.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$466.09
|
| Rate for Payer: Priority Health Medicare |
$193.79
|
| Rate for Payer: Priority Health Narrow Network |
$372.89
|
| Rate for Payer: Railroad Medicare Medicare |
$193.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$468.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$193.79
|
| Rate for Payer: UHC Exchange |
$300.37
|
| Rate for Payer: UHC Medicare Advantage |
$193.79
|
| Rate for Payer: UHCCP DNSP |
$193.79
|
| Rate for Payer: UHCCP Medicaid |
$103.87
|
| Rate for Payer: VA VA |
$193.79
|
|
|
HC BURN CARE SMALL
|
Facility
|
OP
|
$365.20
|
|
|
Service Code
|
CPT 16020
|
| Hospital Charge Code |
36100005
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$103.87 |
| Max. Negotiated Rate |
$365.20 |
| Rate for Payer: Aetna Commercial |
$328.68
|
| Rate for Payer: Aetna Medicare |
$193.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$242.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$242.24
|
| Rate for Payer: ASR ASR |
$354.24
|
| Rate for Payer: ASR Commercial |
$354.24
|
| Rate for Payer: BCBS Complete |
$109.07
|
| Rate for Payer: BCBS MAPPO |
$193.79
|
| Rate for Payer: BCBS Trust/PPO |
$299.06
|
| Rate for Payer: BCN Commercial |
$283.14
|
| Rate for Payer: BCN Medicare Advantage |
$193.79
|
| 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 |
$193.79
|
| Rate for Payer: Healthscope Commercial |
$365.20
|
| Rate for Payer: Healthscope Whirlpool |
$354.24
|
| Rate for Payer: Humana Choice PPO Medicare |
$193.79
|
| Rate for Payer: Mclaren Commercial |
$328.68
|
| Rate for Payer: Mclaren Medicaid |
$103.87
|
| Rate for Payer: Mclaren Medicare |
$193.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$203.48
|
| Rate for Payer: Meridian Medicaid |
$109.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$222.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$310.42
|
| Rate for Payer: Nomi Health Commercial |
$299.46
|
| Rate for Payer: PACE Medicare |
$184.10
|
| Rate for Payer: PACE SWMI |
$193.79
|
| Rate for Payer: PHP Commercial |
$213.17
|
| Rate for Payer: PHP Medicaid |
$103.87
|
| Rate for Payer: PHP Medicare Advantage |
$193.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$237.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$319.99
|
| Rate for Payer: Priority Health Medicare |
$193.79
|
| Rate for Payer: Priority Health Narrow Network |
$256.01
|
| Rate for Payer: Railroad Medicare Medicare |
$193.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$321.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$193.79
|
| Rate for Payer: UHC Exchange |
$300.37
|
| Rate for Payer: UHC Medicare Advantage |
$193.79
|
| Rate for Payer: UHCCP DNSP |
$193.79
|
| Rate for Payer: UHCCP Medicaid |
$103.87
|
| Rate for Payer: VA VA |
$193.79
|
|
|
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
|
|
|
HC BURN R&B
|
Facility
|
IP
|
$7,438.86
|
|
| Hospital Charge Code |
20700001
|
|
Hospital Revenue Code
|
207
|
| Min. Negotiated Rate |
$4,835.26 |
| Max. Negotiated Rate |
$7,438.86 |
| Rate for Payer: Aetna Commercial |
$6,694.97
|
| Rate for Payer: ASR ASR |
$7,215.69
|
| Rate for Payer: ASR Commercial |
$7,215.69
|
| Rate for Payer: BCBS Trust/PPO |
$6,061.93
|
| Rate for Payer: BCN Commercial |
$5,767.35
|
| Rate for Payer: Cash Price |
$5,951.09
|
| Rate for Payer: Cofinity Commercial |
$6,992.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,951.09
|
| Rate for Payer: Healthscope Commercial |
$7,438.86
|
| Rate for Payer: Healthscope Whirlpool |
$7,215.69
|
| Rate for Payer: Mclaren Commercial |
$6,694.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,323.03
|
| Rate for Payer: Nomi Health Commercial |
$6,099.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,835.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,546.20
|
|
|
HC BX VULVA PERINEUM ADDL LESION
|
Facility
|
IP
|
$223.87
|
|
|
Service Code
|
CPT 56606
|
| Hospital Charge Code |
76100202
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$145.52 |
| Max. Negotiated Rate |
$223.87 |
| Rate for Payer: Aetna Commercial |
$201.48
|
| Rate for Payer: ASR ASR |
$217.15
|
| Rate for Payer: ASR Commercial |
$217.15
|
| Rate for Payer: BCBS Trust/PPO |
$182.43
|
| Rate for Payer: BCN Commercial |
$173.57
|
| Rate for Payer: Cash Price |
$179.10
|
| Rate for Payer: Cofinity Commercial |
$210.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$179.10
|
| Rate for Payer: Healthscope Commercial |
$223.87
|
| Rate for Payer: Healthscope Whirlpool |
$217.15
|
| Rate for Payer: Mclaren Commercial |
$201.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$190.29
|
| Rate for Payer: Nomi Health Commercial |
$183.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$145.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$197.01
|
|
|
HC BX VULVA PERINEUM ADDL LESION
|
Facility
|
OP
|
$223.87
|
|
|
Service Code
|
CPT 56606
|
| Hospital Charge Code |
76100202
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$89.55 |
| Max. Negotiated Rate |
$223.87 |
| Rate for Payer: Aetna Commercial |
$201.48
|
| Rate for Payer: Aetna Medicare |
$111.94
|
| Rate for Payer: ASR ASR |
$217.15
|
| Rate for Payer: ASR Commercial |
$217.15
|
| Rate for Payer: BCBS Complete |
$89.55
|
| Rate for Payer: BCBS Trust/PPO |
$183.33
|
| Rate for Payer: BCN Commercial |
$173.57
|
| Rate for Payer: Cash Price |
$179.10
|
| Rate for Payer: Cofinity Commercial |
$210.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$179.10
|
| Rate for Payer: Healthscope Commercial |
$223.87
|
| Rate for Payer: Healthscope Whirlpool |
$217.15
|
| Rate for Payer: Mclaren Commercial |
$201.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$190.29
|
| Rate for Payer: Nomi Health Commercial |
$183.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$145.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$196.15
|
| Rate for Payer: Priority Health Narrow Network |
$156.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$197.01
|
|
|
HC C1 ESTERASE INHIBITOR FUNCTION
|
Facility
|
OP
|
$75.95
|
|
|
Service Code
|
CPT 86161
|
| Hospital Charge Code |
30200153
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.43 |
| Max. Negotiated Rate |
$75.95 |
| Rate for Payer: Aetna Commercial |
$68.36
|
| Rate for Payer: Aetna Medicare |
$12.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.00
|
| Rate for Payer: ASR ASR |
$73.67
|
| Rate for Payer: ASR Commercial |
$73.67
|
| Rate for Payer: BCBS Complete |
$6.75
|
| Rate for Payer: BCBS MAPPO |
$12.00
|
| Rate for Payer: BCBS Trust/PPO |
$62.20
|
| Rate for Payer: BCN Commercial |
$58.88
|
| Rate for Payer: BCN Medicare Advantage |
$12.00
|
| Rate for Payer: Cash Price |
$60.76
|
| Rate for Payer: Cash Price |
$60.76
|
| Rate for Payer: Cofinity Commercial |
$71.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.00
|
| Rate for Payer: Healthscope Commercial |
$75.95
|
| Rate for Payer: Healthscope Whirlpool |
$73.67
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.00
|
| Rate for Payer: Mclaren Commercial |
$68.36
|
| Rate for Payer: Mclaren Medicaid |
$6.43
|
| Rate for Payer: Mclaren Medicare |
$12.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.60
|
| Rate for Payer: Meridian Medicaid |
$6.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.56
|
| Rate for Payer: Nomi Health Commercial |
$62.28
|
| Rate for Payer: PACE Medicare |
$11.40
|
| Rate for Payer: PACE SWMI |
$12.00
|
| Rate for Payer: PHP Commercial |
$13.20
|
| Rate for Payer: PHP Medicaid |
$6.43
|
| Rate for Payer: PHP Medicare Advantage |
$12.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.37
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$66.55
|
| Rate for Payer: Priority Health Medicare |
$12.00
|
| Rate for Payer: Priority Health Narrow Network |
$53.24
|
| Rate for Payer: Railroad Medicare Medicare |
$12.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$66.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.00
|
| Rate for Payer: UHC Exchange |
$18.60
|
| Rate for Payer: UHC Medicare Advantage |
$12.00
|
| Rate for Payer: UHCCP DNSP |
$12.00
|
| Rate for Payer: UHCCP Medicaid |
$6.43
|
| Rate for Payer: VA VA |
$12.00
|
|
|
HC C1 ESTERASE INHIBITOR FUNCTION
|
Facility
|
IP
|
$75.95
|
|
|
Service Code
|
CPT 86161
|
| Hospital Charge Code |
30200153
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$49.37 |
| Max. Negotiated Rate |
$75.95 |
| Rate for Payer: Aetna Commercial |
$68.36
|
| Rate for Payer: ASR ASR |
$73.67
|
| Rate for Payer: ASR Commercial |
$73.67
|
| Rate for Payer: BCBS Trust/PPO |
$61.89
|
| Rate for Payer: BCN Commercial |
$58.88
|
| Rate for Payer: Cash Price |
$60.76
|
| Rate for Payer: Cofinity Commercial |
$71.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.76
|
| Rate for Payer: Healthscope Commercial |
$75.95
|
| Rate for Payer: Healthscope Whirlpool |
$73.67
|
| Rate for Payer: Mclaren Commercial |
$68.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.56
|
| Rate for Payer: Nomi Health Commercial |
$62.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$66.84
|
|
|
HC C1 ESTERASE INHIBITOR QUANTITATIVE
|
Facility
|
IP
|
$74.51
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100257
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$48.43 |
| Max. Negotiated Rate |
$74.51 |
| Rate for Payer: Aetna Commercial |
$67.06
|
| Rate for Payer: ASR ASR |
$72.27
|
| Rate for Payer: ASR Commercial |
$72.27
|
| Rate for Payer: BCBS Trust/PPO |
$60.72
|
| Rate for Payer: BCN Commercial |
$57.77
|
| Rate for Payer: Cash Price |
$59.61
|
| Rate for Payer: Cofinity Commercial |
$70.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.61
|
| Rate for Payer: Healthscope Commercial |
$74.51
|
| Rate for Payer: Healthscope Whirlpool |
$72.27
|
| Rate for Payer: Mclaren Commercial |
$67.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.33
|
| Rate for Payer: Nomi Health Commercial |
$61.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$65.57
|
|
|
HC C1 ESTERASE INHIBITOR QUANTITATIVE
|
Facility
|
OP
|
$74.51
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100257
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.26 |
| Max. Negotiated Rate |
$74.51 |
| Rate for Payer: Aetna Commercial |
$67.06
|
| Rate for Payer: Aetna Medicare |
$17.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.59
|
| Rate for Payer: ASR ASR |
$72.27
|
| Rate for Payer: ASR Commercial |
$72.27
|
| Rate for Payer: BCBS Complete |
$9.72
|
| Rate for Payer: BCBS MAPPO |
$17.27
|
| Rate for Payer: BCBS Trust/PPO |
$61.02
|
| Rate for Payer: BCN Commercial |
$57.77
|
| Rate for Payer: BCN Medicare Advantage |
$17.27
|
| Rate for Payer: Cash Price |
$59.61
|
| Rate for Payer: Cash Price |
$59.61
|
| Rate for Payer: Cofinity Commercial |
$70.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.27
|
| Rate for Payer: Healthscope Commercial |
$74.51
|
| Rate for Payer: Healthscope Whirlpool |
$72.27
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.27
|
| Rate for Payer: Mclaren Commercial |
$67.06
|
| Rate for Payer: Mclaren Medicaid |
$9.26
|
| Rate for Payer: Mclaren Medicare |
$17.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.13
|
| Rate for Payer: Meridian Medicaid |
$9.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.33
|
| Rate for Payer: Nomi Health Commercial |
$61.10
|
| Rate for Payer: PACE Medicare |
$16.41
|
| Rate for Payer: PACE SWMI |
$17.27
|
| Rate for Payer: PHP Commercial |
$19.00
|
| Rate for Payer: PHP Medicaid |
$9.26
|
| Rate for Payer: PHP Medicare Advantage |
$17.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$65.29
|
| Rate for Payer: Priority Health Medicare |
$17.27
|
| Rate for Payer: Priority Health Narrow Network |
$52.23
|
| Rate for Payer: Railroad Medicare Medicare |
$17.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$65.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.27
|
| Rate for Payer: UHC Exchange |
$26.77
|
| Rate for Payer: UHC Medicare Advantage |
$17.27
|
| Rate for Payer: UHCCP DNSP |
$17.27
|
| Rate for Payer: UHCCP Medicaid |
$9.26
|
| Rate for Payer: VA VA |
$17.27
|
|
|
HC C1Q BINDING
|
Facility
|
OP
|
$113.22
|
|
|
Service Code
|
CPT 86332
|
| Hospital Charge Code |
30200193
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.06 |
| Max. Negotiated Rate |
$113.22 |
| Rate for Payer: Aetna Commercial |
$101.90
|
| Rate for Payer: Aetna Medicare |
$24.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.46
|
| Rate for Payer: ASR ASR |
$109.82
|
| Rate for Payer: ASR Commercial |
$109.82
|
| Rate for Payer: BCBS Complete |
$13.72
|
| Rate for Payer: BCBS MAPPO |
$24.37
|
| Rate for Payer: BCBS Trust/PPO |
$92.72
|
| Rate for Payer: BCN Commercial |
$87.78
|
| Rate for Payer: BCN Medicare Advantage |
$24.37
|
| Rate for Payer: Cash Price |
$90.58
|
| Rate for Payer: Cash Price |
$90.58
|
| Rate for Payer: Cofinity Commercial |
$106.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$90.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.37
|
| Rate for Payer: Healthscope Commercial |
$113.22
|
| Rate for Payer: Healthscope Whirlpool |
$109.82
|
| Rate for Payer: Humana Choice PPO Medicare |
$24.37
|
| Rate for Payer: Mclaren Commercial |
$101.90
|
| Rate for Payer: Mclaren Medicaid |
$13.06
|
| Rate for Payer: Mclaren Medicare |
$24.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.59
|
| Rate for Payer: Meridian Medicaid |
$13.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$96.24
|
| Rate for Payer: Nomi Health Commercial |
$92.84
|
| Rate for Payer: PACE Medicare |
$23.15
|
| Rate for Payer: PACE SWMI |
$24.37
|
| Rate for Payer: PHP Commercial |
$26.81
|
| Rate for Payer: PHP Medicaid |
$13.06
|
| Rate for Payer: PHP Medicare Advantage |
$24.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$73.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$99.20
|
| Rate for Payer: Priority Health Medicare |
$24.37
|
| Rate for Payer: Priority Health Narrow Network |
$79.37
|
| Rate for Payer: Railroad Medicare Medicare |
$24.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$99.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.37
|
| Rate for Payer: UHC Exchange |
$37.77
|
| Rate for Payer: UHC Medicare Advantage |
$24.37
|
| Rate for Payer: UHCCP DNSP |
$24.37
|
| Rate for Payer: UHCCP Medicaid |
$13.06
|
| Rate for Payer: VA VA |
$24.37
|
|
|
HC C1Q BINDING
|
Facility
|
IP
|
$113.22
|
|
|
Service Code
|
CPT 86332
|
| Hospital Charge Code |
30200193
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$73.59 |
| Max. Negotiated Rate |
$113.22 |
| Rate for Payer: Aetna Commercial |
$101.90
|
| Rate for Payer: ASR ASR |
$109.82
|
| Rate for Payer: ASR Commercial |
$109.82
|
| Rate for Payer: BCBS Trust/PPO |
$92.26
|
| Rate for Payer: BCN Commercial |
$87.78
|
| Rate for Payer: Cash Price |
$90.58
|
| Rate for Payer: Cofinity Commercial |
$106.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$90.58
|
| Rate for Payer: Healthscope Commercial |
$113.22
|
| Rate for Payer: Healthscope Whirlpool |
$109.82
|
| Rate for Payer: Mclaren Commercial |
$101.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$96.24
|
| Rate for Payer: Nomi Health Commercial |
$92.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$73.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$99.63
|
|
|
HC C1Q COMPL COMPONENT, S
|
Facility
|
OP
|
$68.67
|
|
|
Service Code
|
CPT 86160
|
| Hospital Charge Code |
30200409
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.43 |
| Max. Negotiated Rate |
$68.67 |
| Rate for Payer: Aetna Commercial |
$61.80
|
| Rate for Payer: Aetna Medicare |
$12.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.00
|
| Rate for Payer: ASR ASR |
$66.61
|
| Rate for Payer: ASR Commercial |
$66.61
|
| Rate for Payer: BCBS Complete |
$6.75
|
| Rate for Payer: BCBS MAPPO |
$12.00
|
| Rate for Payer: BCBS Trust/PPO |
$56.23
|
| Rate for Payer: BCN Commercial |
$53.24
|
| Rate for Payer: BCN Medicare Advantage |
$12.00
|
| Rate for Payer: Cash Price |
$54.94
|
| Rate for Payer: Cash Price |
$54.94
|
| Rate for Payer: Cofinity Commercial |
$64.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.00
|
| Rate for Payer: Healthscope Commercial |
$68.67
|
| Rate for Payer: Healthscope Whirlpool |
$66.61
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.00
|
| Rate for Payer: Mclaren Commercial |
$61.80
|
| Rate for Payer: Mclaren Medicaid |
$6.43
|
| Rate for Payer: Mclaren Medicare |
$12.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.60
|
| Rate for Payer: Meridian Medicaid |
$6.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.37
|
| Rate for Payer: Nomi Health Commercial |
$56.31
|
| Rate for Payer: PACE Medicare |
$11.40
|
| Rate for Payer: PACE SWMI |
$12.00
|
| Rate for Payer: PHP Commercial |
$13.20
|
| Rate for Payer: PHP Medicaid |
$6.43
|
| Rate for Payer: PHP Medicare Advantage |
$12.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$60.17
|
| Rate for Payer: Priority Health Medicare |
$12.00
|
| Rate for Payer: Priority Health Narrow Network |
$48.14
|
| Rate for Payer: Railroad Medicare Medicare |
$12.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$60.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.00
|
| Rate for Payer: UHC Exchange |
$18.60
|
| Rate for Payer: UHC Medicare Advantage |
$12.00
|
| Rate for Payer: UHCCP DNSP |
$12.00
|
| Rate for Payer: UHCCP Medicaid |
$6.43
|
| Rate for Payer: VA VA |
$12.00
|
|
