|
HC CARE MGMT SERVICES BEHAVIORAL HLTH COND 20 MINS
|
Facility
|
IP
|
$82.19
|
|
|
Service Code
|
CPT 99484
|
| Hospital Charge Code |
51000107
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$53.42 |
| Max. Negotiated Rate |
$82.19 |
| Rate for Payer: Aetna Commercial |
$73.97
|
| Rate for Payer: ASR ASR |
$79.72
|
| Rate for Payer: ASR Commercial |
$79.72
|
| Rate for Payer: BCBS Trust/PPO |
$66.98
|
| Rate for Payer: BCN Commercial |
$63.72
|
| Rate for Payer: Cash Price |
$65.75
|
| Rate for Payer: Cofinity Commercial |
$77.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$65.75
|
| Rate for Payer: Healthscope Commercial |
$82.19
|
| Rate for Payer: Healthscope Whirlpool |
$79.72
|
| Rate for Payer: Mclaren Commercial |
$73.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$69.86
|
| Rate for Payer: Nomi Health Commercial |
$67.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$72.33
|
|
|
HC CARNITINE
|
Facility
|
OP
|
$59.16
|
|
|
Service Code
|
CPT 82379
|
| Hospital Charge Code |
30100136
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.04 |
| Max. Negotiated Rate |
$227.29 |
| Rate for Payer: Aetna Commercial |
$53.24
|
| 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 |
$57.39
|
| Rate for Payer: ASR Commercial |
$57.39
|
| Rate for Payer: BCBS Complete |
$9.49
|
| Rate for Payer: BCBS MAPPO |
$16.87
|
| Rate for Payer: BCBS Trust/PPO |
$48.45
|
| Rate for Payer: BCN Commercial |
$45.87
|
| Rate for Payer: BCN Medicare Advantage |
$16.87
|
| Rate for Payer: Cash Price |
$47.33
|
| Rate for Payer: Cash Price |
$47.33
|
| Rate for Payer: Cofinity Commercial |
$55.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.87
|
| Rate for Payer: Healthscope Commercial |
$59.16
|
| Rate for Payer: Healthscope Whirlpool |
$57.39
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.87
|
| Rate for Payer: Mclaren Commercial |
$53.24
|
| 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 |
$50.29
|
| Rate for Payer: Nomi Health Commercial |
$48.51
|
| 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 |
$38.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$227.29
|
| Rate for Payer: Priority Health Medicare |
$16.87
|
| Rate for Payer: Priority Health Narrow Network |
$181.83
|
| Rate for Payer: Railroad Medicare Medicare |
$16.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$52.06
|
| 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 CARNITINE
|
Facility
|
IP
|
$59.16
|
|
|
Service Code
|
CPT 82379
|
| Hospital Charge Code |
30100136
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$38.45 |
| Max. Negotiated Rate |
$59.16 |
| Rate for Payer: Aetna Commercial |
$53.24
|
| Rate for Payer: ASR ASR |
$57.39
|
| Rate for Payer: ASR Commercial |
$57.39
|
| Rate for Payer: BCBS Trust/PPO |
$48.21
|
| Rate for Payer: BCN Commercial |
$45.87
|
| Rate for Payer: Cash Price |
$47.33
|
| Rate for Payer: Cofinity Commercial |
$55.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.33
|
| Rate for Payer: Healthscope Commercial |
$59.16
|
| Rate for Payer: Healthscope Whirlpool |
$57.39
|
| Rate for Payer: Mclaren Commercial |
$53.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.29
|
| Rate for Payer: Nomi Health Commercial |
$48.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$52.06
|
|
|
HC CAR OBSERVATION PER HOUR
|
Facility
|
OP
|
$145.08
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200010
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$49.38 |
| Max. Negotiated Rate |
$145.08 |
| Rate for Payer: Aetna Commercial |
$130.57
|
| Rate for Payer: Aetna Medicare |
$72.54
|
| Rate for Payer: ASR ASR |
$140.73
|
| Rate for Payer: ASR Commercial |
$140.73
|
| Rate for Payer: BCBS Complete |
$58.03
|
| Rate for Payer: BCBS Trust/PPO |
$118.81
|
| Rate for Payer: BCN Commercial |
$112.48
|
| Rate for Payer: Cash Price |
$116.06
|
| Rate for Payer: Cash Price |
$116.06
|
| Rate for Payer: Cofinity Commercial |
$136.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.06
|
| Rate for Payer: Healthscope Commercial |
$145.08
|
| Rate for Payer: Healthscope Whirlpool |
$140.73
|
| Rate for Payer: Mclaren Commercial |
$130.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.32
|
| Rate for Payer: Nomi Health Commercial |
$118.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$61.72
|
| Rate for Payer: Priority Health Narrow Network |
$49.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$127.67
|
|
|
HC CAR OBSERVATION PER HOUR
|
Facility
|
IP
|
$145.08
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200010
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$94.30 |
| Max. Negotiated Rate |
$145.08 |
| Rate for Payer: Aetna Commercial |
$130.57
|
| Rate for Payer: ASR ASR |
$140.73
|
| Rate for Payer: ASR Commercial |
$140.73
|
| Rate for Payer: BCBS Trust/PPO |
$118.23
|
| Rate for Payer: BCN Commercial |
$112.48
|
| Rate for Payer: Cash Price |
$116.06
|
| Rate for Payer: Cofinity Commercial |
$136.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.06
|
| Rate for Payer: Healthscope Commercial |
$145.08
|
| Rate for Payer: Healthscope Whirlpool |
$140.73
|
| Rate for Payer: Mclaren Commercial |
$130.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.32
|
| Rate for Payer: Nomi Health Commercial |
$118.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$127.67
|
|
|
HC CAROTENE
|
Facility
|
OP
|
$150.96
|
|
|
Service Code
|
CPT 82380
|
| Hospital Charge Code |
30100137
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.94 |
| Max. Negotiated Rate |
$150.96 |
| Rate for Payer: Aetna Commercial |
$135.86
|
| Rate for Payer: Aetna Medicare |
$9.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.52
|
| Rate for Payer: ASR ASR |
$146.43
|
| Rate for Payer: ASR Commercial |
$146.43
|
| Rate for Payer: BCBS Complete |
$5.19
|
| Rate for Payer: BCBS MAPPO |
$9.22
|
| Rate for Payer: BCBS Trust/PPO |
$123.62
|
| Rate for Payer: BCN Commercial |
$117.04
|
| Rate for Payer: BCN Medicare Advantage |
$9.22
|
| Rate for Payer: Cash Price |
$120.77
|
| Rate for Payer: Cash Price |
$120.77
|
| Rate for Payer: Cofinity Commercial |
$141.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.22
|
| Rate for Payer: Healthscope Commercial |
$150.96
|
| Rate for Payer: Healthscope Whirlpool |
$146.43
|
| Rate for Payer: Humana Choice PPO Medicare |
$9.22
|
| Rate for Payer: Mclaren Commercial |
$135.86
|
| Rate for Payer: Mclaren Medicaid |
$4.94
|
| Rate for Payer: Mclaren Medicare |
$9.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.68
|
| Rate for Payer: Meridian Medicaid |
$5.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$128.32
|
| Rate for Payer: Nomi Health Commercial |
$123.79
|
| Rate for Payer: PACE Medicare |
$8.76
|
| Rate for Payer: PACE SWMI |
$9.22
|
| Rate for Payer: PHP Commercial |
$10.14
|
| Rate for Payer: PHP Medicaid |
$4.94
|
| Rate for Payer: PHP Medicare Advantage |
$9.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$58.20
|
| Rate for Payer: Priority Health Medicare |
$9.22
|
| Rate for Payer: Priority Health Narrow Network |
$46.56
|
| Rate for Payer: Railroad Medicare Medicare |
$9.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$132.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.22
|
| Rate for Payer: UHC Exchange |
$14.29
|
| Rate for Payer: UHC Medicare Advantage |
$9.22
|
| Rate for Payer: UHCCP DNSP |
$9.22
|
| Rate for Payer: UHCCP Medicaid |
$4.94
|
| Rate for Payer: VA VA |
$9.22
|
|
|
HC CAROTENE
|
Facility
|
IP
|
$150.96
|
|
|
Service Code
|
CPT 82380
|
| Hospital Charge Code |
30100137
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$98.12 |
| Max. Negotiated Rate |
$150.96 |
| Rate for Payer: Aetna Commercial |
$135.86
|
| Rate for Payer: ASR ASR |
$146.43
|
| Rate for Payer: ASR Commercial |
$146.43
|
| Rate for Payer: BCBS Trust/PPO |
$123.02
|
| Rate for Payer: BCN Commercial |
$117.04
|
| Rate for Payer: Cash Price |
$120.77
|
| Rate for Payer: Cofinity Commercial |
$141.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.77
|
| Rate for Payer: Healthscope Commercial |
$150.96
|
| Rate for Payer: Healthscope Whirlpool |
$146.43
|
| Rate for Payer: Mclaren Commercial |
$135.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$128.32
|
| Rate for Payer: Nomi Health Commercial |
$123.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$132.84
|
|
|
HC CAROTID/VERTEBRAL LIMITED
|
Facility
|
IP
|
$726.53
|
|
|
Service Code
|
CPT 93882
|
| Hospital Charge Code |
40200054
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$472.24 |
| Max. Negotiated Rate |
$726.53 |
| Rate for Payer: Aetna Commercial |
$653.88
|
| Rate for Payer: ASR ASR |
$704.73
|
| Rate for Payer: ASR Commercial |
$704.73
|
| Rate for Payer: BCBS Trust/PPO |
$592.05
|
| Rate for Payer: BCN Commercial |
$563.28
|
| Rate for Payer: Cash Price |
$581.22
|
| Rate for Payer: Cofinity Commercial |
$682.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$581.22
|
| Rate for Payer: Healthscope Commercial |
$726.53
|
| Rate for Payer: Healthscope Whirlpool |
$704.73
|
| Rate for Payer: Mclaren Commercial |
$653.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$617.55
|
| Rate for Payer: Nomi Health Commercial |
$595.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$472.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$639.35
|
|
|
HC CAROTID/VERTEBRAL LIMITED
|
Facility
|
OP
|
$726.53
|
|
|
Service Code
|
CPT 93882
|
| Hospital Charge Code |
40200054
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$55.85 |
| Max. Negotiated Rate |
$726.53 |
| Rate for Payer: Aetna Commercial |
$653.88
|
| Rate for Payer: Aetna Medicare |
$104.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.24
|
| Rate for Payer: ASR ASR |
$704.73
|
| Rate for Payer: ASR Commercial |
$704.73
|
| Rate for Payer: BCBS Complete |
$58.64
|
| Rate for Payer: BCBS MAPPO |
$104.19
|
| Rate for Payer: BCBS Trust/PPO |
$594.96
|
| Rate for Payer: BCN Commercial |
$563.28
|
| Rate for Payer: BCN Medicare Advantage |
$104.19
|
| Rate for Payer: Cash Price |
$581.22
|
| Rate for Payer: Cash Price |
$581.22
|
| Rate for Payer: Cofinity Commercial |
$682.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$581.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.19
|
| Rate for Payer: Healthscope Commercial |
$726.53
|
| Rate for Payer: Healthscope Whirlpool |
$704.73
|
| Rate for Payer: Humana Choice PPO Medicare |
$104.19
|
| Rate for Payer: Mclaren Commercial |
$653.88
|
| Rate for Payer: Mclaren Medicaid |
$55.85
|
| Rate for Payer: Mclaren Medicare |
$104.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.40
|
| Rate for Payer: Meridian Medicaid |
$58.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$617.55
|
| Rate for Payer: Nomi Health Commercial |
$595.75
|
| Rate for Payer: PACE Medicare |
$98.98
|
| Rate for Payer: PACE SWMI |
$104.19
|
| Rate for Payer: PHP Commercial |
$114.61
|
| Rate for Payer: PHP Medicaid |
$55.85
|
| Rate for Payer: PHP Medicare Advantage |
$104.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$472.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$340.38
|
| Rate for Payer: Priority Health Medicare |
$104.19
|
| Rate for Payer: Priority Health Narrow Network |
$272.30
|
| Rate for Payer: Railroad Medicare Medicare |
$104.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$639.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$104.19
|
| Rate for Payer: UHC Exchange |
$161.49
|
| Rate for Payer: UHC Medicare Advantage |
$104.19
|
| Rate for Payer: UHCCP DNSP |
$104.19
|
| Rate for Payer: UHCCP Medicaid |
$55.85
|
| Rate for Payer: VA VA |
$104.19
|
|
|
HC CAROTID/VERTEBRAL ULTRASOUND
|
Facility
|
IP
|
$1,382.09
|
|
|
Service Code
|
CPT 93880
|
| Hospital Charge Code |
92100001
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$898.36 |
| Max. Negotiated Rate |
$1,382.09 |
| Rate for Payer: Aetna Commercial |
$1,243.88
|
| Rate for Payer: ASR ASR |
$1,340.63
|
| Rate for Payer: ASR Commercial |
$1,340.63
|
| Rate for Payer: BCBS Trust/PPO |
$1,126.27
|
| Rate for Payer: BCN Commercial |
$1,071.53
|
| Rate for Payer: Cash Price |
$1,105.67
|
| Rate for Payer: Cofinity Commercial |
$1,299.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,105.67
|
| Rate for Payer: Healthscope Commercial |
$1,382.09
|
| Rate for Payer: Healthscope Whirlpool |
$1,340.63
|
| Rate for Payer: Mclaren Commercial |
$1,243.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,174.78
|
| Rate for Payer: Nomi Health Commercial |
$1,133.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$898.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,216.24
|
|
|
HC CAROTID/VERTEBRAL ULTRASOUND
|
Facility
|
OP
|
$1,382.09
|
|
|
Service Code
|
CPT 93880
|
| Hospital Charge Code |
92100001
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$126.94 |
| Max. Negotiated Rate |
$1,382.09 |
| Rate for Payer: Aetna Commercial |
$1,243.88
|
| Rate for Payer: Aetna Medicare |
$236.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$296.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$296.04
|
| Rate for Payer: ASR ASR |
$1,340.63
|
| Rate for Payer: ASR Commercial |
$1,340.63
|
| Rate for Payer: BCBS Complete |
$133.29
|
| Rate for Payer: BCBS MAPPO |
$236.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,131.79
|
| Rate for Payer: BCN Commercial |
$1,071.53
|
| Rate for Payer: BCN Medicare Advantage |
$236.83
|
| Rate for Payer: Cash Price |
$1,105.67
|
| Rate for Payer: Cash Price |
$1,105.67
|
| Rate for Payer: Cofinity Commercial |
$1,299.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,105.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.83
|
| Rate for Payer: Healthscope Commercial |
$1,382.09
|
| Rate for Payer: Healthscope Whirlpool |
$1,340.63
|
| Rate for Payer: Humana Choice PPO Medicare |
$236.83
|
| Rate for Payer: Mclaren Commercial |
$1,243.88
|
| Rate for Payer: Mclaren Medicaid |
$126.94
|
| Rate for Payer: Mclaren Medicare |
$236.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$248.67
|
| Rate for Payer: Meridian Medicaid |
$133.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$272.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,174.78
|
| Rate for Payer: Nomi Health Commercial |
$1,133.31
|
| Rate for Payer: PACE Medicare |
$224.99
|
| Rate for Payer: PACE SWMI |
$236.83
|
| Rate for Payer: PHP Commercial |
$260.51
|
| Rate for Payer: PHP Medicaid |
$126.94
|
| Rate for Payer: PHP Medicare Advantage |
$236.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$898.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$617.63
|
| Rate for Payer: Priority Health Medicare |
$236.83
|
| Rate for Payer: Priority Health Narrow Network |
$494.10
|
| Rate for Payer: Railroad Medicare Medicare |
$236.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,216.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$236.83
|
| Rate for Payer: UHC Exchange |
$367.09
|
| Rate for Payer: UHC Medicare Advantage |
$236.83
|
| Rate for Payer: UHCCP DNSP |
$236.83
|
| Rate for Payer: UHCCP Medicaid |
$126.94
|
| Rate for Payer: VA VA |
$236.83
|
|
|
HC CASHEW IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200030
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$25.39 |
| Rate for Payer: Aetna Commercial |
$22.85
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: ASR ASR |
$24.63
|
| Rate for Payer: ASR Commercial |
$24.63
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$20.79
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$23.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$25.39
|
| Rate for Payer: Healthscope Whirlpool |
$24.63
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$22.85
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$5.74
|
| Rate for Payer: PHP Medicaid |
$2.80
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.25
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$17.80
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP DNSP |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.80
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC CASHEW IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200030
|
|
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 CASSETTES QUEST
|
Facility
|
OP
|
$76.50
|
|
| Hospital Charge Code |
27000458
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$30.60 |
| Max. Negotiated Rate |
$76.50 |
| Rate for Payer: Aetna Commercial |
$68.85
|
| Rate for Payer: Aetna Medicare |
$38.25
|
| Rate for Payer: ASR ASR |
$74.20
|
| Rate for Payer: ASR Commercial |
$74.20
|
| Rate for Payer: BCBS Complete |
$30.60
|
| Rate for Payer: BCBS Trust/PPO |
$62.65
|
| Rate for Payer: BCN Commercial |
$59.31
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$71.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Healthscope Commercial |
$76.50
|
| Rate for Payer: Healthscope Whirlpool |
$74.20
|
| Rate for Payer: Mclaren Commercial |
$68.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.02
|
| Rate for Payer: Nomi Health Commercial |
$62.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$67.03
|
| Rate for Payer: Priority Health Narrow Network |
$53.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$67.32
|
|
|
HC CASSETTES QUEST
|
Facility
|
IP
|
$76.50
|
|
| Hospital Charge Code |
27000458
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$49.72 |
| Max. Negotiated Rate |
$76.50 |
| Rate for Payer: Aetna Commercial |
$68.85
|
| Rate for Payer: ASR ASR |
$74.20
|
| Rate for Payer: ASR Commercial |
$74.20
|
| Rate for Payer: BCBS Trust/PPO |
$62.34
|
| Rate for Payer: BCN Commercial |
$59.31
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$71.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Healthscope Commercial |
$76.50
|
| Rate for Payer: Healthscope Whirlpool |
$74.20
|
| Rate for Payer: Mclaren Commercial |
$68.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.02
|
| Rate for Payer: Nomi Health Commercial |
$62.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$67.32
|
|
|
HC CAST CLUB FOOT
|
Facility
|
IP
|
$422.52
|
|
|
Service Code
|
CPT 29450
|
| Hospital Charge Code |
70000011
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$274.64 |
| Max. Negotiated Rate |
$422.52 |
| Rate for Payer: Aetna Commercial |
$380.27
|
| Rate for Payer: ASR ASR |
$409.84
|
| Rate for Payer: ASR Commercial |
$409.84
|
| Rate for Payer: BCBS Trust/PPO |
$344.31
|
| Rate for Payer: BCN Commercial |
$327.58
|
| Rate for Payer: Cash Price |
$338.02
|
| Rate for Payer: Cofinity Commercial |
$397.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$338.02
|
| Rate for Payer: Healthscope Commercial |
$422.52
|
| Rate for Payer: Healthscope Whirlpool |
$409.84
|
| Rate for Payer: Mclaren Commercial |
$380.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$359.14
|
| Rate for Payer: Nomi Health Commercial |
$346.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$274.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$371.82
|
|
|
HC CAST CLUB FOOT
|
Facility
|
OP
|
$422.52
|
|
|
Service Code
|
CPT 29450
|
| Hospital Charge Code |
70000011
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$82.87 |
| Max. Negotiated Rate |
$422.52 |
| Rate for Payer: Aetna Commercial |
$380.27
|
| Rate for Payer: Aetna Medicare |
$154.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$193.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$193.25
|
| Rate for Payer: ASR ASR |
$409.84
|
| Rate for Payer: ASR Commercial |
$409.84
|
| Rate for Payer: BCBS Complete |
$87.01
|
| Rate for Payer: BCBS MAPPO |
$154.60
|
| Rate for Payer: BCBS Trust/PPO |
$346.00
|
| Rate for Payer: BCN Commercial |
$327.58
|
| Rate for Payer: BCN Medicare Advantage |
$154.60
|
| Rate for Payer: Cash Price |
$338.02
|
| Rate for Payer: Cash Price |
$338.02
|
| Rate for Payer: Cofinity Commercial |
$397.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$338.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$154.60
|
| Rate for Payer: Healthscope Commercial |
$422.52
|
| Rate for Payer: Healthscope Whirlpool |
$409.84
|
| Rate for Payer: Humana Choice PPO Medicare |
$154.60
|
| Rate for Payer: Mclaren Commercial |
$380.27
|
| Rate for Payer: Mclaren Medicaid |
$82.87
|
| Rate for Payer: Mclaren Medicare |
$154.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$162.33
|
| Rate for Payer: Meridian Medicaid |
$87.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$177.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$359.14
|
| Rate for Payer: Nomi Health Commercial |
$346.47
|
| Rate for Payer: PACE Medicare |
$146.87
|
| Rate for Payer: PACE SWMI |
$154.60
|
| Rate for Payer: PHP Commercial |
$170.06
|
| Rate for Payer: PHP Medicaid |
$82.87
|
| Rate for Payer: PHP Medicare Advantage |
$154.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$274.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$370.21
|
| Rate for Payer: Priority Health Medicare |
$154.60
|
| Rate for Payer: Priority Health Narrow Network |
$296.19
|
| Rate for Payer: Railroad Medicare Medicare |
$154.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$371.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$154.60
|
| Rate for Payer: UHC Exchange |
$239.63
|
| Rate for Payer: UHC Medicare Advantage |
$154.60
|
| Rate for Payer: UHCCP DNSP |
$154.60
|
| Rate for Payer: UHCCP Medicaid |
$82.87
|
| Rate for Payer: VA VA |
$154.60
|
|
|
HC CAST COLOR ROLL
|
Facility
|
IP
|
$61.55
|
|
| Hospital Charge Code |
27000040
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$40.01 |
| Max. Negotiated Rate |
$61.55 |
| Rate for Payer: Aetna Commercial |
$55.40
|
| Rate for Payer: ASR ASR |
$59.70
|
| Rate for Payer: ASR Commercial |
$59.70
|
| Rate for Payer: BCBS Trust/PPO |
$50.16
|
| Rate for Payer: BCN Commercial |
$47.72
|
| Rate for Payer: Cash Price |
$49.24
|
| Rate for Payer: Cofinity Commercial |
$57.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.24
|
| Rate for Payer: Healthscope Commercial |
$61.55
|
| Rate for Payer: Healthscope Whirlpool |
$59.70
|
| Rate for Payer: Mclaren Commercial |
$55.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.32
|
| Rate for Payer: Nomi Health Commercial |
$50.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$54.16
|
|
|
HC CAST COLOR ROLL
|
Facility
|
OP
|
$61.55
|
|
| Hospital Charge Code |
27000040
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$24.62 |
| Max. Negotiated Rate |
$61.55 |
| Rate for Payer: Aetna Commercial |
$55.40
|
| Rate for Payer: Aetna Medicare |
$30.78
|
| Rate for Payer: ASR ASR |
$59.70
|
| Rate for Payer: ASR Commercial |
$59.70
|
| Rate for Payer: BCBS Complete |
$24.62
|
| Rate for Payer: BCBS Trust/PPO |
$50.40
|
| Rate for Payer: BCN Commercial |
$47.72
|
| Rate for Payer: Cash Price |
$49.24
|
| Rate for Payer: Cofinity Commercial |
$57.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.24
|
| Rate for Payer: Healthscope Commercial |
$61.55
|
| Rate for Payer: Healthscope Whirlpool |
$59.70
|
| Rate for Payer: Mclaren Commercial |
$55.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.32
|
| Rate for Payer: Nomi Health Commercial |
$50.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.01
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.93
|
| Rate for Payer: Priority Health Narrow Network |
$43.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$54.16
|
|
|
HC CAST CYLINDER
|
Facility
|
IP
|
$408.07
|
|
|
Service Code
|
CPT 29365
|
| Hospital Charge Code |
70000006
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$265.25 |
| Max. Negotiated Rate |
$408.07 |
| Rate for Payer: Aetna Commercial |
$367.26
|
| Rate for Payer: ASR ASR |
$395.83
|
| Rate for Payer: ASR Commercial |
$395.83
|
| Rate for Payer: BCBS Trust/PPO |
$332.54
|
| Rate for Payer: BCN Commercial |
$316.38
|
| Rate for Payer: Cash Price |
$326.46
|
| Rate for Payer: Cofinity Commercial |
$383.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$326.46
|
| Rate for Payer: Healthscope Commercial |
$408.07
|
| Rate for Payer: Healthscope Whirlpool |
$395.83
|
| Rate for Payer: Mclaren Commercial |
$367.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$346.86
|
| Rate for Payer: Nomi Health Commercial |
$334.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$359.10
|
|
|
HC CAST CYLINDER
|
Facility
|
OP
|
$408.07
|
|
|
Service Code
|
CPT 29365
|
| Hospital Charge Code |
70000006
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$139.47 |
| Max. Negotiated Rate |
$408.07 |
| Rate for Payer: Aetna Commercial |
$367.26
|
| Rate for Payer: Aetna Medicare |
$260.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$325.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$325.26
|
| Rate for Payer: ASR ASR |
$395.83
|
| Rate for Payer: ASR Commercial |
$395.83
|
| Rate for Payer: BCBS Complete |
$146.45
|
| Rate for Payer: BCBS MAPPO |
$260.21
|
| Rate for Payer: BCBS Trust/PPO |
$334.17
|
| Rate for Payer: BCN Commercial |
$316.38
|
| Rate for Payer: BCN Medicare Advantage |
$260.21
|
| Rate for Payer: Cash Price |
$326.46
|
| Rate for Payer: Cash Price |
$326.46
|
| Rate for Payer: Cofinity Commercial |
$383.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$326.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$260.21
|
| Rate for Payer: Healthscope Commercial |
$408.07
|
| Rate for Payer: Healthscope Whirlpool |
$395.83
|
| Rate for Payer: Humana Choice PPO Medicare |
$260.21
|
| Rate for Payer: Mclaren Commercial |
$367.26
|
| Rate for Payer: Mclaren Medicaid |
$139.47
|
| Rate for Payer: Mclaren Medicare |
$260.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$273.22
|
| Rate for Payer: Meridian Medicaid |
$146.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$299.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$346.86
|
| Rate for Payer: Nomi Health Commercial |
$334.62
|
| Rate for Payer: PACE Medicare |
$247.20
|
| Rate for Payer: PACE SWMI |
$260.21
|
| Rate for Payer: PHP Commercial |
$286.23
|
| Rate for Payer: PHP Medicaid |
$139.47
|
| Rate for Payer: PHP Medicare Advantage |
$260.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$139.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$357.55
|
| Rate for Payer: Priority Health Medicare |
$260.21
|
| Rate for Payer: Priority Health Narrow Network |
$286.06
|
| Rate for Payer: Railroad Medicare Medicare |
$260.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$359.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$260.21
|
| Rate for Payer: UHC Exchange |
$403.33
|
| Rate for Payer: UHC Medicare Advantage |
$260.21
|
| Rate for Payer: UHCCP DNSP |
$260.21
|
| Rate for Payer: UHCCP Medicaid |
$139.47
|
| Rate for Payer: VA VA |
$260.21
|
|
|
HC CAST FINGER (CONTRACTURE)
|
Facility
|
OP
|
$210.09
|
|
|
Service Code
|
CPT 29086
|
| Hospital Charge Code |
43000021
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$82.87 |
| Max. Negotiated Rate |
$239.63 |
| Rate for Payer: Aetna Commercial |
$189.08
|
| Rate for Payer: Aetna Medicare |
$154.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$193.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$193.25
|
| Rate for Payer: ASR ASR |
$203.79
|
| Rate for Payer: ASR Commercial |
$203.79
|
| Rate for Payer: BCBS Complete |
$87.01
|
| Rate for Payer: BCBS MAPPO |
$154.60
|
| Rate for Payer: BCBS Trust/PPO |
$172.04
|
| Rate for Payer: BCN Commercial |
$162.88
|
| Rate for Payer: BCN Medicare Advantage |
$154.60
|
| Rate for Payer: Cash Price |
$168.07
|
| Rate for Payer: Cash Price |
$168.07
|
| Rate for Payer: Cofinity Commercial |
$197.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$168.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$154.60
|
| Rate for Payer: Healthscope Commercial |
$210.09
|
| Rate for Payer: Healthscope Whirlpool |
$203.79
|
| Rate for Payer: Humana Choice PPO Medicare |
$154.60
|
| Rate for Payer: Mclaren Commercial |
$189.08
|
| Rate for Payer: Mclaren Medicaid |
$82.87
|
| Rate for Payer: Mclaren Medicare |
$154.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$162.33
|
| Rate for Payer: Meridian Medicaid |
$87.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$177.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$178.58
|
| Rate for Payer: Nomi Health Commercial |
$172.27
|
| Rate for Payer: PACE Medicare |
$146.87
|
| Rate for Payer: PACE SWMI |
$154.60
|
| Rate for Payer: PHP Commercial |
$170.06
|
| Rate for Payer: PHP Medicaid |
$82.87
|
| Rate for Payer: PHP Medicare Advantage |
$154.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$136.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$184.08
|
| Rate for Payer: Priority Health Medicare |
$154.60
|
| Rate for Payer: Priority Health Narrow Network |
$147.27
|
| Rate for Payer: Railroad Medicare Medicare |
$154.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$184.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$154.60
|
| Rate for Payer: UHC Exchange |
$239.63
|
| Rate for Payer: UHC Medicare Advantage |
$154.60
|
| Rate for Payer: UHCCP DNSP |
$154.60
|
| Rate for Payer: UHCCP Medicaid |
$82.87
|
| Rate for Payer: VA VA |
$154.60
|
|
|
HC CAST FINGER (CONTRACTURE)
|
Facility
|
IP
|
$210.09
|
|
|
Service Code
|
CPT 29086
|
| Hospital Charge Code |
43000021
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$136.56 |
| Max. Negotiated Rate |
$210.09 |
| Rate for Payer: Aetna Commercial |
$189.08
|
| Rate for Payer: ASR ASR |
$203.79
|
| Rate for Payer: ASR Commercial |
$203.79
|
| Rate for Payer: BCBS Trust/PPO |
$171.20
|
| Rate for Payer: BCN Commercial |
$162.88
|
| Rate for Payer: Cash Price |
$168.07
|
| Rate for Payer: Cofinity Commercial |
$197.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$168.07
|
| Rate for Payer: Healthscope Commercial |
$210.09
|
| Rate for Payer: Healthscope Whirlpool |
$203.79
|
| Rate for Payer: Mclaren Commercial |
$189.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$178.58
|
| Rate for Payer: Nomi Health Commercial |
$172.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$136.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$184.88
|
|
|
HC CAST GAUNTLET
|
Facility
|
IP
|
$238.14
|
|
|
Service Code
|
CPT 29085
|
| Hospital Charge Code |
42100002
|
|
Hospital Revenue Code
|
421
|
| Min. Negotiated Rate |
$154.79 |
| Max. Negotiated Rate |
$238.14 |
| Rate for Payer: Aetna Commercial |
$214.33
|
| Rate for Payer: ASR ASR |
$231.00
|
| Rate for Payer: ASR Commercial |
$231.00
|
| Rate for Payer: BCBS Trust/PPO |
$194.06
|
| Rate for Payer: BCN Commercial |
$184.63
|
| Rate for Payer: Cash Price |
$190.51
|
| Rate for Payer: Cofinity Commercial |
$223.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$190.51
|
| Rate for Payer: Healthscope Commercial |
$238.14
|
| Rate for Payer: Healthscope Whirlpool |
$231.00
|
| Rate for Payer: Mclaren Commercial |
$214.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$202.42
|
| Rate for Payer: Nomi Health Commercial |
$195.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$154.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$209.56
|
|
|
HC CAST GAUNTLET
|
Facility
|
OP
|
$238.14
|
|
|
Service Code
|
CPT 29085
|
| Hospital Charge Code |
42100002
|
|
Hospital Revenue Code
|
421
|
| Min. Negotiated Rate |
$82.87 |
| Max. Negotiated Rate |
$239.63 |
| Rate for Payer: Aetna Commercial |
$214.33
|
| Rate for Payer: Aetna Medicare |
$154.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$193.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$193.25
|
| Rate for Payer: ASR ASR |
$231.00
|
| Rate for Payer: ASR Commercial |
$231.00
|
| Rate for Payer: BCBS Complete |
$87.01
|
| Rate for Payer: BCBS MAPPO |
$154.60
|
| Rate for Payer: BCBS Trust/PPO |
$195.01
|
| Rate for Payer: BCN Commercial |
$184.63
|
| Rate for Payer: BCN Medicare Advantage |
$154.60
|
| Rate for Payer: Cash Price |
$190.51
|
| Rate for Payer: Cash Price |
$190.51
|
| Rate for Payer: Cofinity Commercial |
$223.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$190.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$154.60
|
| Rate for Payer: Healthscope Commercial |
$238.14
|
| Rate for Payer: Healthscope Whirlpool |
$231.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$154.60
|
| Rate for Payer: Mclaren Commercial |
$214.33
|
| Rate for Payer: Mclaren Medicaid |
$82.87
|
| Rate for Payer: Mclaren Medicare |
$154.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$162.33
|
| Rate for Payer: Meridian Medicaid |
$87.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$177.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$202.42
|
| Rate for Payer: Nomi Health Commercial |
$195.27
|
| Rate for Payer: PACE Medicare |
$146.87
|
| Rate for Payer: PACE SWMI |
$154.60
|
| Rate for Payer: PHP Commercial |
$170.06
|
| Rate for Payer: PHP Medicaid |
$82.87
|
| Rate for Payer: PHP Medicare Advantage |
$154.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$154.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$171.81
|
| Rate for Payer: Priority Health Medicare |
$154.60
|
| Rate for Payer: Priority Health Narrow Network |
$137.45
|
| Rate for Payer: Railroad Medicare Medicare |
$154.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$209.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$154.60
|
| Rate for Payer: UHC Exchange |
$239.63
|
| Rate for Payer: UHC Medicare Advantage |
$154.60
|
| Rate for Payer: UHCCP DNSP |
$154.60
|
| Rate for Payer: UHCCP Medicaid |
$82.87
|
| Rate for Payer: VA VA |
$154.60
|
|
