|
HC CONNECTIVE TISSUE CASCADE ANA & CCP
|
Facility
|
IP
|
$32.47
|
|
|
Service Code
|
CPT 86200
|
| Hospital Charge Code |
30200156
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$24.35 |
| Max. Negotiated Rate |
$32.47 |
| Rate for Payer: Aetna Commercial |
$29.22
|
| Rate for Payer: ASR ASR |
$31.50
|
| Rate for Payer: BCBS Trust/PPO |
$26.66
|
| Rate for Payer: BCN Commercial |
$26.66
|
| Rate for Payer: Cash Price |
$25.98
|
| Rate for Payer: Cofinity Commercial |
$30.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.98
|
| Rate for Payer: Healthscope Commercial |
$31.50
|
| Rate for Payer: Healthscope Whirlpool |
$32.47
|
| Rate for Payer: Mclaren Commercial |
$29.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.60
|
| Rate for Payer: Nomi Health Commercial |
$26.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.57
|
|
|
HC CONNECTIVE TISSUE CASCADE ANA & CCP
|
Facility
|
OP
|
$32.47
|
|
|
Service Code
|
CPT 86200
|
| Hospital Charge Code |
30200156
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.77 |
| Max. Negotiated Rate |
$163.42 |
| Rate for Payer: Aetna Commercial |
$29.22
|
| Rate for Payer: Aetna Medicare |
$12.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.19
|
| Rate for Payer: ASR ASR |
$31.50
|
| Rate for Payer: BCBS Complete |
$7.11
|
| Rate for Payer: BCBS MAPPO |
$12.95
|
| Rate for Payer: BCBS Trust/PPO |
$26.77
|
| Rate for Payer: BCN Commercial |
$26.77
|
| Rate for Payer: BCN Medicare Advantage |
$12.95
|
| Rate for Payer: Cash Price |
$25.98
|
| Rate for Payer: Cash Price |
$25.98
|
| Rate for Payer: Cofinity Commercial |
$30.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.95
|
| Rate for Payer: Healthscope Commercial |
$31.50
|
| Rate for Payer: Healthscope Whirlpool |
$32.47
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.95
|
| Rate for Payer: Mclaren Commercial |
$29.22
|
| Rate for Payer: Mclaren Medicaid |
$12.95
|
| Rate for Payer: Mclaren Medicare |
$12.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.60
|
| Rate for Payer: Meridian Medicaid |
$7.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.60
|
| Rate for Payer: Nomi Health Commercial |
$26.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.35
|
| Rate for Payer: PACE Medicare |
$12.30
|
| Rate for Payer: PACE SWMI |
$12.95
|
| Rate for Payer: PHP Commercial |
$14.24
|
| Rate for Payer: PHP Medicaid |
$6.94
|
| Rate for Payer: PHP Medicare Advantage |
$12.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$163.42
|
| Rate for Payer: Priority Health Medicare |
$12.95
|
| Rate for Payer: Priority Health Narrow Network |
$130.74
|
| Rate for Payer: Railroad Medicare Medicare |
$12.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.95
|
| Rate for Payer: UHC Exchange |
$20.07
|
| Rate for Payer: UHC Medicaid |
$6.77
|
| Rate for Payer: UHCCP DNSP |
$12.95
|
| Rate for Payer: UHCCP Medicaid |
$6.77
|
| Rate for Payer: VA VA |
$12.95
|
|
|
HC CONNECTOR 3/8 W/ LL
|
Facility
|
IP
|
$5.47
|
|
| Hospital Charge Code |
27000448
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.10 |
| Max. Negotiated Rate |
$5.47 |
| Rate for Payer: Aetna Commercial |
$4.92
|
| Rate for Payer: ASR ASR |
$5.31
|
| Rate for Payer: BCBS Trust/PPO |
$4.49
|
| Rate for Payer: BCN Commercial |
$4.49
|
| Rate for Payer: Cash Price |
$4.38
|
| Rate for Payer: Cofinity Commercial |
$5.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.38
|
| Rate for Payer: Healthscope Commercial |
$5.31
|
| Rate for Payer: Healthscope Whirlpool |
$5.47
|
| Rate for Payer: Mclaren Commercial |
$4.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.65
|
| Rate for Payer: Nomi Health Commercial |
$4.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4.81
|
|
|
HC CONNECTOR 3/8 W/ LL
|
Facility
|
OP
|
$5.47
|
|
| Hospital Charge Code |
27000448
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.02 |
| Max. Negotiated Rate |
$5.47 |
| Rate for Payer: Aetna Commercial |
$4.92
|
| Rate for Payer: Aetna Medicare |
$2.02
|
| Rate for Payer: ASR ASR |
$5.31
|
| Rate for Payer: BCBS Complete |
$2.19
|
| Rate for Payer: BCBS Trust/PPO |
$4.51
|
| Rate for Payer: BCN Commercial |
$4.51
|
| Rate for Payer: Cash Price |
$4.38
|
| Rate for Payer: Cofinity Commercial |
$5.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.38
|
| Rate for Payer: Healthscope Commercial |
$5.31
|
| Rate for Payer: Healthscope Whirlpool |
$5.47
|
| Rate for Payer: Mclaren Commercial |
$4.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.65
|
| Rate for Payer: Nomi Health Commercial |
$4.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4.79
|
| Rate for Payer: Priority Health Narrow Network |
$3.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4.81
|
|
|
HC CONNECTOR REDUCER
|
Facility
|
IP
|
$5.47
|
|
| Hospital Charge Code |
27000651
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.10 |
| Max. Negotiated Rate |
$5.47 |
| Rate for Payer: Aetna Commercial |
$4.92
|
| Rate for Payer: ASR ASR |
$5.31
|
| Rate for Payer: BCBS Trust/PPO |
$4.49
|
| Rate for Payer: BCN Commercial |
$4.49
|
| Rate for Payer: Cash Price |
$4.38
|
| Rate for Payer: Cofinity Commercial |
$5.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.38
|
| Rate for Payer: Healthscope Commercial |
$5.31
|
| Rate for Payer: Healthscope Whirlpool |
$5.47
|
| Rate for Payer: Mclaren Commercial |
$4.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.65
|
| Rate for Payer: Nomi Health Commercial |
$4.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4.81
|
|
|
HC CONNECTOR REDUCER
|
Facility
|
OP
|
$5.47
|
|
| Hospital Charge Code |
27000651
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.02 |
| Max. Negotiated Rate |
$5.47 |
| Rate for Payer: Aetna Commercial |
$4.92
|
| Rate for Payer: Aetna Medicare |
$2.02
|
| Rate for Payer: ASR ASR |
$5.31
|
| Rate for Payer: BCBS Complete |
$2.19
|
| Rate for Payer: BCBS Trust/PPO |
$4.51
|
| Rate for Payer: BCN Commercial |
$4.51
|
| Rate for Payer: Cash Price |
$4.38
|
| Rate for Payer: Cofinity Commercial |
$5.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.38
|
| Rate for Payer: Healthscope Commercial |
$5.31
|
| Rate for Payer: Healthscope Whirlpool |
$5.47
|
| Rate for Payer: Mclaren Commercial |
$4.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.65
|
| Rate for Payer: Nomi Health Commercial |
$4.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4.79
|
| Rate for Payer: Priority Health Narrow Network |
$3.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4.81
|
|
|
HC CONNECTOR ST 1/2 X 1/2
|
Facility
|
IP
|
$7.80
|
|
| Hospital Charge Code |
27000047
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$5.85 |
| Max. Negotiated Rate |
$7.80 |
| Rate for Payer: Aetna Commercial |
$7.02
|
| Rate for Payer: ASR ASR |
$7.57
|
| Rate for Payer: BCBS Trust/PPO |
$6.41
|
| Rate for Payer: BCN Commercial |
$6.41
|
| Rate for Payer: Cash Price |
$6.24
|
| Rate for Payer: Cofinity Commercial |
$7.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.24
|
| Rate for Payer: Healthscope Commercial |
$7.57
|
| Rate for Payer: Healthscope Whirlpool |
$7.80
|
| Rate for Payer: Mclaren Commercial |
$7.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.63
|
| Rate for Payer: Nomi Health Commercial |
$6.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6.86
|
|
|
HC CONNECTOR ST 1/2 X 1/2
|
Facility
|
OP
|
$7.80
|
|
| Hospital Charge Code |
27000047
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.89 |
| Max. Negotiated Rate |
$7.80 |
| Rate for Payer: Aetna Commercial |
$7.02
|
| Rate for Payer: Aetna Medicare |
$2.89
|
| Rate for Payer: ASR ASR |
$7.57
|
| Rate for Payer: BCBS Complete |
$3.12
|
| Rate for Payer: BCBS Trust/PPO |
$6.43
|
| Rate for Payer: BCN Commercial |
$6.43
|
| Rate for Payer: Cash Price |
$6.24
|
| Rate for Payer: Cofinity Commercial |
$7.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.24
|
| Rate for Payer: Healthscope Commercial |
$7.57
|
| Rate for Payer: Healthscope Whirlpool |
$7.80
|
| Rate for Payer: Mclaren Commercial |
$7.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.63
|
| Rate for Payer: Nomi Health Commercial |
$6.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$6.83
|
| Rate for Payer: Priority Health Narrow Network |
$5.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6.86
|
|
|
HC CONNECTOR ST 3/8 OR 1/4
|
Facility
|
IP
|
$5.47
|
|
| Hospital Charge Code |
27000685
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.10 |
| Max. Negotiated Rate |
$5.47 |
| Rate for Payer: Aetna Commercial |
$4.92
|
| Rate for Payer: ASR ASR |
$5.31
|
| Rate for Payer: BCBS Trust/PPO |
$4.49
|
| Rate for Payer: BCN Commercial |
$4.49
|
| Rate for Payer: Cash Price |
$4.38
|
| Rate for Payer: Cofinity Commercial |
$5.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.38
|
| Rate for Payer: Healthscope Commercial |
$5.31
|
| Rate for Payer: Healthscope Whirlpool |
$5.47
|
| Rate for Payer: Mclaren Commercial |
$4.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.65
|
| Rate for Payer: Nomi Health Commercial |
$4.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4.81
|
|
|
HC CONNECTOR ST 3/8 OR 1/4
|
Facility
|
OP
|
$5.47
|
|
| Hospital Charge Code |
27000685
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.02 |
| Max. Negotiated Rate |
$5.47 |
| Rate for Payer: Aetna Commercial |
$4.92
|
| Rate for Payer: Aetna Medicare |
$2.02
|
| Rate for Payer: ASR ASR |
$5.31
|
| Rate for Payer: BCBS Complete |
$2.19
|
| Rate for Payer: BCBS Trust/PPO |
$4.51
|
| Rate for Payer: BCN Commercial |
$4.51
|
| Rate for Payer: Cash Price |
$4.38
|
| Rate for Payer: Cofinity Commercial |
$5.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.38
|
| Rate for Payer: Healthscope Commercial |
$5.31
|
| Rate for Payer: Healthscope Whirlpool |
$5.47
|
| Rate for Payer: Mclaren Commercial |
$4.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.65
|
| Rate for Payer: Nomi Health Commercial |
$4.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4.79
|
| Rate for Payer: Priority Health Narrow Network |
$3.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4.81
|
|
|
HC CONNECTOR V
|
Facility
|
OP
|
$7.80
|
|
| Hospital Charge Code |
27000678
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.89 |
| Max. Negotiated Rate |
$7.80 |
| Rate for Payer: Aetna Commercial |
$7.02
|
| Rate for Payer: Aetna Medicare |
$2.89
|
| Rate for Payer: ASR ASR |
$7.57
|
| Rate for Payer: BCBS Complete |
$3.12
|
| Rate for Payer: BCBS Trust/PPO |
$6.43
|
| Rate for Payer: BCN Commercial |
$6.43
|
| Rate for Payer: Cash Price |
$6.24
|
| Rate for Payer: Cofinity Commercial |
$7.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.24
|
| Rate for Payer: Healthscope Commercial |
$7.57
|
| Rate for Payer: Healthscope Whirlpool |
$7.80
|
| Rate for Payer: Mclaren Commercial |
$7.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.63
|
| Rate for Payer: Nomi Health Commercial |
$6.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$6.83
|
| Rate for Payer: Priority Health Narrow Network |
$5.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6.86
|
|
|
HC CONNECTOR V
|
Facility
|
IP
|
$7.80
|
|
| Hospital Charge Code |
27000678
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$5.85 |
| Max. Negotiated Rate |
$7.80 |
| Rate for Payer: Aetna Commercial |
$7.02
|
| Rate for Payer: ASR ASR |
$7.57
|
| Rate for Payer: BCBS Trust/PPO |
$6.41
|
| Rate for Payer: BCN Commercial |
$6.41
|
| Rate for Payer: Cash Price |
$6.24
|
| Rate for Payer: Cofinity Commercial |
$7.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.24
|
| Rate for Payer: Healthscope Commercial |
$7.57
|
| Rate for Payer: Healthscope Whirlpool |
$7.80
|
| Rate for Payer: Mclaren Commercial |
$7.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.63
|
| Rate for Payer: Nomi Health Commercial |
$6.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6.86
|
|
|
HC CONNECTOR Y
|
Facility
|
IP
|
$5.47
|
|
| Hospital Charge Code |
27000048
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.10 |
| Max. Negotiated Rate |
$5.47 |
| Rate for Payer: Aetna Commercial |
$4.92
|
| Rate for Payer: ASR ASR |
$5.31
|
| Rate for Payer: BCBS Trust/PPO |
$4.49
|
| Rate for Payer: BCN Commercial |
$4.49
|
| Rate for Payer: Cash Price |
$4.38
|
| Rate for Payer: Cofinity Commercial |
$5.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.38
|
| Rate for Payer: Healthscope Commercial |
$5.31
|
| Rate for Payer: Healthscope Whirlpool |
$5.47
|
| Rate for Payer: Mclaren Commercial |
$4.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.65
|
| Rate for Payer: Nomi Health Commercial |
$4.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4.81
|
|
|
HC CONNECTOR Y
|
Facility
|
OP
|
$5.47
|
|
| Hospital Charge Code |
27000048
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.02 |
| Max. Negotiated Rate |
$5.47 |
| Rate for Payer: Aetna Commercial |
$4.92
|
| Rate for Payer: Aetna Medicare |
$2.02
|
| Rate for Payer: ASR ASR |
$5.31
|
| Rate for Payer: BCBS Complete |
$2.19
|
| Rate for Payer: BCBS Trust/PPO |
$4.51
|
| Rate for Payer: BCN Commercial |
$4.51
|
| Rate for Payer: Cash Price |
$4.38
|
| Rate for Payer: Cofinity Commercial |
$5.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.38
|
| Rate for Payer: Healthscope Commercial |
$5.31
|
| Rate for Payer: Healthscope Whirlpool |
$5.47
|
| Rate for Payer: Mclaren Commercial |
$4.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.65
|
| Rate for Payer: Nomi Health Commercial |
$4.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4.79
|
| Rate for Payer: Priority Health Narrow Network |
$3.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4.81
|
|
|
HC CONSULT NUTRITIONAL
|
Facility
|
IP
|
$35.66
|
|
| Hospital Charge Code |
94200010
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$26.75 |
| Max. Negotiated Rate |
$35.66 |
| Rate for Payer: Aetna Commercial |
$32.09
|
| Rate for Payer: ASR ASR |
$34.59
|
| Rate for Payer: BCBS Trust/PPO |
$29.28
|
| Rate for Payer: BCN Commercial |
$29.28
|
| Rate for Payer: Cash Price |
$28.53
|
| Rate for Payer: Cofinity Commercial |
$33.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.53
|
| Rate for Payer: Healthscope Commercial |
$34.59
|
| Rate for Payer: Healthscope Whirlpool |
$35.66
|
| Rate for Payer: Mclaren Commercial |
$32.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.31
|
| Rate for Payer: Nomi Health Commercial |
$29.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$31.38
|
|
|
HC CONSULT NUTRITIONAL
|
Facility
|
OP
|
$35.66
|
|
| Hospital Charge Code |
94200010
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$13.19 |
| Max. Negotiated Rate |
$35.66 |
| Rate for Payer: Aetna Commercial |
$32.09
|
| Rate for Payer: Aetna Medicare |
$13.19
|
| Rate for Payer: ASR ASR |
$34.59
|
| Rate for Payer: BCBS Complete |
$14.26
|
| Rate for Payer: BCBS Trust/PPO |
$29.40
|
| Rate for Payer: BCN Commercial |
$29.40
|
| Rate for Payer: Cash Price |
$28.53
|
| Rate for Payer: Cofinity Commercial |
$33.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.53
|
| Rate for Payer: Healthscope Commercial |
$34.59
|
| Rate for Payer: Healthscope Whirlpool |
$35.66
|
| Rate for Payer: Mclaren Commercial |
$32.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.31
|
| Rate for Payer: Nomi Health Commercial |
$29.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$31.25
|
| Rate for Payer: Priority Health Narrow Network |
$25.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$31.38
|
|
|
HC CONT GLUCOSE MONITOR OFFICE EQUIP
|
Facility
|
IP
|
$1,004.28
|
|
|
Service Code
|
CPT 95250
|
| Hospital Charge Code |
94200001
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$753.21 |
| Max. Negotiated Rate |
$1,004.28 |
| Rate for Payer: Aetna Commercial |
$903.85
|
| Rate for Payer: ASR ASR |
$974.15
|
| Rate for Payer: BCBS Trust/PPO |
$824.71
|
| Rate for Payer: BCN Commercial |
$824.71
|
| Rate for Payer: Cash Price |
$803.42
|
| Rate for Payer: Cofinity Commercial |
$944.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$803.42
|
| Rate for Payer: Healthscope Commercial |
$974.15
|
| Rate for Payer: Healthscope Whirlpool |
$1,004.28
|
| Rate for Payer: Mclaren Commercial |
$903.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$853.64
|
| Rate for Payer: Nomi Health Commercial |
$823.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$753.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$883.77
|
|
|
HC CONT GLUCOSE MONITOR OFFICE EQUIP
|
Facility
|
OP
|
$1,004.28
|
|
|
Service Code
|
CPT 95250
|
| Hospital Charge Code |
94200001
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$69.38 |
| Max. Negotiated Rate |
$1,004.28 |
| Rate for Payer: Aetna Commercial |
$903.85
|
| Rate for Payer: Aetna Medicare |
$132.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$165.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$165.82
|
| Rate for Payer: ASR ASR |
$974.15
|
| Rate for Payer: BCBS Complete |
$72.86
|
| Rate for Payer: BCBS MAPPO |
$132.66
|
| Rate for Payer: BCBS Trust/PPO |
$828.03
|
| Rate for Payer: BCN Commercial |
$828.03
|
| Rate for Payer: BCN Medicare Advantage |
$132.66
|
| Rate for Payer: Cash Price |
$803.42
|
| Rate for Payer: Cash Price |
$803.42
|
| Rate for Payer: Cofinity Commercial |
$944.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$803.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.66
|
| Rate for Payer: Healthscope Commercial |
$974.15
|
| Rate for Payer: Healthscope Whirlpool |
$1,004.28
|
| Rate for Payer: Humana Choice PPO Medicare |
$132.66
|
| Rate for Payer: Mclaren Commercial |
$903.85
|
| Rate for Payer: Mclaren Medicaid |
$132.66
|
| Rate for Payer: Mclaren Medicare |
$132.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$139.29
|
| Rate for Payer: Meridian Medicaid |
$72.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$145.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$853.64
|
| Rate for Payer: Nomi Health Commercial |
$823.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$753.21
|
| Rate for Payer: PACE Medicare |
$126.03
|
| Rate for Payer: PACE SWMI |
$132.66
|
| Rate for Payer: PHP Commercial |
$145.93
|
| Rate for Payer: PHP Medicaid |
$71.11
|
| Rate for Payer: PHP Medicare Advantage |
$132.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$879.95
|
| Rate for Payer: Priority Health Medicare |
$132.66
|
| Rate for Payer: Priority Health Narrow Network |
$704.00
|
| Rate for Payer: Railroad Medicare Medicare |
$132.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$883.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$132.66
|
| Rate for Payer: UHC Exchange |
$205.62
|
| Rate for Payer: UHC Medicaid |
$69.38
|
| Rate for Payer: UHCCP DNSP |
$132.66
|
| Rate for Payer: UHCCP Medicaid |
$69.38
|
| Rate for Payer: VA VA |
$132.66
|
|
|
HC CONT GLUCOSE MONITOR PATIENT EQUIP
|
Facility
|
IP
|
$387.71
|
|
|
Service Code
|
CPT 95249
|
| Hospital Charge Code |
94200038
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$290.78 |
| Max. Negotiated Rate |
$387.71 |
| Rate for Payer: Aetna Commercial |
$348.94
|
| Rate for Payer: ASR ASR |
$376.08
|
| Rate for Payer: BCBS Trust/PPO |
$318.39
|
| Rate for Payer: BCN Commercial |
$318.39
|
| Rate for Payer: Cash Price |
$310.17
|
| Rate for Payer: Cofinity Commercial |
$364.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$310.17
|
| Rate for Payer: Healthscope Commercial |
$376.08
|
| Rate for Payer: Healthscope Whirlpool |
$387.71
|
| Rate for Payer: Mclaren Commercial |
$348.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$329.55
|
| Rate for Payer: Nomi Health Commercial |
$317.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$290.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$341.18
|
|
|
HC CONT GLUCOSE MONITOR PATIENT EQUIP
|
Facility
|
OP
|
$387.71
|
|
|
Service Code
|
CPT 95249
|
| Hospital Charge Code |
94200038
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$30.74 |
| Max. Negotiated Rate |
$387.71 |
| Rate for Payer: Aetna Commercial |
$348.94
|
| Rate for Payer: Aetna Medicare |
$58.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$73.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$73.47
|
| Rate for Payer: ASR ASR |
$376.08
|
| Rate for Payer: BCBS Complete |
$32.28
|
| Rate for Payer: BCBS MAPPO |
$58.78
|
| Rate for Payer: BCBS Trust/PPO |
$319.67
|
| Rate for Payer: BCN Commercial |
$319.67
|
| Rate for Payer: BCN Medicare Advantage |
$58.78
|
| Rate for Payer: Cash Price |
$310.17
|
| Rate for Payer: Cash Price |
$310.17
|
| Rate for Payer: Cofinity Commercial |
$364.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$310.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.78
|
| Rate for Payer: Healthscope Commercial |
$376.08
|
| Rate for Payer: Healthscope Whirlpool |
$387.71
|
| Rate for Payer: Humana Choice PPO Medicare |
$58.78
|
| Rate for Payer: Mclaren Commercial |
$348.94
|
| Rate for Payer: Mclaren Medicaid |
$58.78
|
| Rate for Payer: Mclaren Medicare |
$58.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.72
|
| Rate for Payer: Meridian Medicaid |
$32.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$67.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$64.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$329.55
|
| Rate for Payer: Nomi Health Commercial |
$317.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$290.78
|
| Rate for Payer: PACE Medicare |
$55.84
|
| Rate for Payer: PACE SWMI |
$58.78
|
| Rate for Payer: PHP Commercial |
$64.66
|
| Rate for Payer: PHP Medicaid |
$31.51
|
| Rate for Payer: PHP Medicare Advantage |
$58.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$70.63
|
| Rate for Payer: Priority Health Medicare |
$58.78
|
| Rate for Payer: Priority Health Narrow Network |
$56.51
|
| Rate for Payer: Railroad Medicare Medicare |
$58.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$341.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$58.78
|
| Rate for Payer: UHC Exchange |
$91.11
|
| Rate for Payer: UHC Medicaid |
$30.74
|
| Rate for Payer: UHCCP DNSP |
$58.78
|
| Rate for Payer: UHCCP Medicaid |
$30.74
|
| Rate for Payer: VA VA |
$58.78
|
|
|
HC CONTINUOUS NEB SUBSEQUENT HR
|
Facility
|
IP
|
$106.62
|
|
|
Service Code
|
CPT 94645
|
| Hospital Charge Code |
41000007
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$79.97 |
| Max. Negotiated Rate |
$106.62 |
| Rate for Payer: Aetna Commercial |
$95.96
|
| Rate for Payer: ASR ASR |
$103.42
|
| Rate for Payer: BCBS Trust/PPO |
$87.56
|
| Rate for Payer: BCN Commercial |
$87.56
|
| Rate for Payer: Cash Price |
$85.30
|
| Rate for Payer: Cofinity Commercial |
$100.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.30
|
| Rate for Payer: Healthscope Commercial |
$103.42
|
| Rate for Payer: Healthscope Whirlpool |
$106.62
|
| Rate for Payer: Mclaren Commercial |
$95.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$90.63
|
| Rate for Payer: Nomi Health Commercial |
$87.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$79.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$93.83
|
|
|
HC CONTINUOUS NEB SUBSEQUENT HR
|
Facility
|
OP
|
$106.62
|
|
|
Service Code
|
CPT 94645
|
| Hospital Charge Code |
41000007
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$39.45 |
| Max. Negotiated Rate |
$128.32 |
| Rate for Payer: Aetna Commercial |
$95.96
|
| Rate for Payer: Aetna Medicare |
$39.45
|
| Rate for Payer: ASR ASR |
$103.42
|
| Rate for Payer: BCBS Complete |
$42.65
|
| Rate for Payer: BCBS Trust/PPO |
$87.91
|
| Rate for Payer: BCN Commercial |
$87.91
|
| Rate for Payer: Cash Price |
$85.30
|
| Rate for Payer: Cash Price |
$85.30
|
| Rate for Payer: Cofinity Commercial |
$100.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.30
|
| Rate for Payer: Healthscope Commercial |
$103.42
|
| Rate for Payer: Healthscope Whirlpool |
$106.62
|
| Rate for Payer: Mclaren Commercial |
$95.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$85.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$90.63
|
| Rate for Payer: Nomi Health Commercial |
$87.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$79.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$128.32
|
| Rate for Payer: Priority Health Narrow Network |
$102.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$93.83
|
|
|
HC CONTINUOUS NEB TX INITIAL HOUR
|
Facility
|
OP
|
$382.93
|
|
|
Service Code
|
CPT 94644
|
| Hospital Charge Code |
41000006
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$69.33 |
| Max. Negotiated Rate |
$382.93 |
| Rate for Payer: Aetna Commercial |
$344.64
|
| Rate for Payer: Aetna Medicare |
$132.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$165.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$165.71
|
| Rate for Payer: ASR ASR |
$371.44
|
| Rate for Payer: BCBS Complete |
$72.81
|
| Rate for Payer: BCBS MAPPO |
$132.57
|
| Rate for Payer: BCBS Trust/PPO |
$315.73
|
| Rate for Payer: BCN Commercial |
$315.73
|
| Rate for Payer: BCN Medicare Advantage |
$132.57
|
| Rate for Payer: Cash Price |
$306.34
|
| Rate for Payer: Cash Price |
$306.34
|
| Rate for Payer: Cofinity Commercial |
$359.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$306.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.57
|
| Rate for Payer: Healthscope Commercial |
$371.44
|
| Rate for Payer: Healthscope Whirlpool |
$382.93
|
| Rate for Payer: Humana Choice PPO Medicare |
$132.57
|
| Rate for Payer: Mclaren Commercial |
$344.64
|
| Rate for Payer: Mclaren Medicaid |
$132.57
|
| Rate for Payer: Mclaren Medicare |
$132.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$139.20
|
| Rate for Payer: Meridian Medicaid |
$72.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$145.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$325.49
|
| Rate for Payer: Nomi Health Commercial |
$314.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$287.20
|
| Rate for Payer: PACE Medicare |
$125.94
|
| Rate for Payer: PACE SWMI |
$132.57
|
| Rate for Payer: PHP Commercial |
$145.83
|
| Rate for Payer: PHP Medicaid |
$71.06
|
| Rate for Payer: PHP Medicare Advantage |
$132.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$313.53
|
| Rate for Payer: Priority Health Medicare |
$132.57
|
| Rate for Payer: Priority Health Narrow Network |
$250.82
|
| Rate for Payer: Railroad Medicare Medicare |
$132.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$336.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$132.57
|
| Rate for Payer: UHC Exchange |
$205.48
|
| Rate for Payer: UHC Medicaid |
$69.33
|
| Rate for Payer: UHCCP DNSP |
$132.57
|
| Rate for Payer: UHCCP Medicaid |
$69.33
|
| Rate for Payer: VA VA |
$132.57
|
|
|
HC CONTINUOUS NEB TX INITIAL HOUR
|
Facility
|
IP
|
$382.93
|
|
|
Service Code
|
CPT 94644
|
| Hospital Charge Code |
41000006
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$287.20 |
| Max. Negotiated Rate |
$382.93 |
| Rate for Payer: Aetna Commercial |
$344.64
|
| Rate for Payer: ASR ASR |
$371.44
|
| Rate for Payer: BCBS Trust/PPO |
$314.46
|
| Rate for Payer: BCN Commercial |
$314.46
|
| Rate for Payer: Cash Price |
$306.34
|
| Rate for Payer: Cofinity Commercial |
$359.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$306.34
|
| Rate for Payer: Healthscope Commercial |
$371.44
|
| Rate for Payer: Healthscope Whirlpool |
$382.93
|
| Rate for Payer: Mclaren Commercial |
$344.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$325.49
|
| Rate for Payer: Nomi Health Commercial |
$314.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$287.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$336.98
|
|
|
HC CONT PHYSICS CONSULT
|
Facility
|
IP
|
$596.39
|
|
|
Service Code
|
CPT 77336
|
| Hospital Charge Code |
33300015
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$447.29 |
| Max. Negotiated Rate |
$596.39 |
| Rate for Payer: Aetna Commercial |
$536.75
|
| Rate for Payer: ASR ASR |
$578.50
|
| Rate for Payer: BCBS Trust/PPO |
$489.76
|
| Rate for Payer: BCN Commercial |
$489.76
|
| Rate for Payer: Cash Price |
$477.11
|
| Rate for Payer: Cofinity Commercial |
$560.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$477.11
|
| Rate for Payer: Healthscope Commercial |
$578.50
|
| Rate for Payer: Healthscope Whirlpool |
$596.39
|
| Rate for Payer: Mclaren Commercial |
$536.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$506.93
|
| Rate for Payer: Nomi Health Commercial |
$489.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$447.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$524.82
|
|
