|
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
|
|
|
HC CONTRAST BATHS EACH 15 MIN
|
Facility
|
IP
|
$107.89
|
|
|
Service Code
|
CPT 97034
|
| Hospital Charge Code |
42000017
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$80.92 |
| Max. Negotiated Rate |
$107.89 |
| Rate for Payer: Aetna Commercial |
$97.10
|
| Rate for Payer: ASR ASR |
$104.65
|
| Rate for Payer: BCBS Trust/PPO |
$88.60
|
| Rate for Payer: BCN Commercial |
$88.60
|
| Rate for Payer: Cash Price |
$86.31
|
| Rate for Payer: Cofinity Commercial |
$101.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.31
|
| Rate for Payer: Healthscope Commercial |
$104.65
|
| Rate for Payer: Healthscope Whirlpool |
$107.89
|
| Rate for Payer: Mclaren Commercial |
$97.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.71
|
| Rate for Payer: Nomi Health Commercial |
$88.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$80.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$94.94
|
|
|
HC CONTRAST BATHS EACH 15 MIN
|
Facility
|
OP
|
$107.89
|
|
|
Service Code
|
CPT 97034
|
| Hospital Charge Code |
42000017
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$31.00 |
| Max. Negotiated Rate |
$107.89 |
| Rate for Payer: Aetna Commercial |
$97.10
|
| Rate for Payer: Aetna Medicare |
$39.92
|
| Rate for Payer: ASR ASR |
$104.65
|
| Rate for Payer: BCBS Complete |
$43.16
|
| Rate for Payer: BCBS Trust/PPO |
$88.96
|
| Rate for Payer: BCN Commercial |
$88.96
|
| Rate for Payer: Cash Price |
$86.31
|
| Rate for Payer: Cash Price |
$86.31
|
| Rate for Payer: Cofinity Commercial |
$101.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.31
|
| Rate for Payer: Healthscope Commercial |
$104.65
|
| Rate for Payer: Healthscope Whirlpool |
$107.89
|
| Rate for Payer: Mclaren Commercial |
$97.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$86.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.71
|
| Rate for Payer: Nomi Health Commercial |
$88.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$80.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$38.74
|
| Rate for Payer: Priority Health Narrow Network |
$31.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$94.94
|
|
|
HC CONTROL NASAL HEMORR POST PACK/CAUTERY INIT
|
Facility
|
IP
|
$461.04
|
|
|
Service Code
|
CPT 30905
|
| Hospital Charge Code |
76100530
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$345.78 |
| Max. Negotiated Rate |
$461.04 |
| Rate for Payer: Aetna Commercial |
$414.94
|
| Rate for Payer: ASR ASR |
$447.21
|
| Rate for Payer: BCBS Trust/PPO |
$378.61
|
| Rate for Payer: BCN Commercial |
$378.61
|
| Rate for Payer: Cash Price |
$368.83
|
| Rate for Payer: Cofinity Commercial |
$433.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$368.83
|
| Rate for Payer: Healthscope Commercial |
$447.21
|
| Rate for Payer: Healthscope Whirlpool |
$461.04
|
| Rate for Payer: Mclaren Commercial |
$414.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$391.88
|
| Rate for Payer: Nomi Health Commercial |
$378.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$345.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$405.72
|
|
|
HC CONTROL NASAL HEMORR POST PACK/CAUTERY INIT
|
Facility
|
OP
|
$461.04
|
|
|
Service Code
|
CPT 30905
|
| Hospital Charge Code |
76100530
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$69.33 |
| Max. Negotiated Rate |
$461.04 |
| Rate for Payer: Aetna Commercial |
$414.94
|
| 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 |
$447.21
|
| Rate for Payer: BCBS Complete |
$72.81
|
| Rate for Payer: BCBS MAPPO |
$132.57
|
| Rate for Payer: BCBS Trust/PPO |
$380.13
|
| Rate for Payer: BCN Commercial |
$380.13
|
| Rate for Payer: BCN Medicare Advantage |
$132.57
|
| Rate for Payer: Cash Price |
$368.83
|
| Rate for Payer: Cash Price |
$368.83
|
| Rate for Payer: Cofinity Commercial |
$433.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$368.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.57
|
| Rate for Payer: Healthscope Commercial |
$447.21
|
| Rate for Payer: Healthscope Whirlpool |
$461.04
|
| Rate for Payer: Humana Choice PPO Medicare |
$132.57
|
| Rate for Payer: Mclaren Commercial |
$414.94
|
| 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 |
$391.88
|
| Rate for Payer: Nomi Health Commercial |
$378.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$345.78
|
| 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 |
$236.95
|
| Rate for Payer: Priority Health Medicare |
$132.57
|
| Rate for Payer: Priority Health Narrow Network |
$189.56
|
| Rate for Payer: Railroad Medicare Medicare |
$132.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$405.72
|
| 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 CONTROL NOSEBLEED ANTERIOR SIMPLE
|
Facility
|
OP
|
$422.93
|
|
|
Service Code
|
CPT 30901
|
| Hospital Charge Code |
45000011
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$69.33 |
| Max. Negotiated Rate |
$422.93 |
| Rate for Payer: Aetna Commercial |
$380.64
|
| 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 |
$410.24
|
| Rate for Payer: BCBS Complete |
$72.81
|
| Rate for Payer: BCBS MAPPO |
$132.57
|
| Rate for Payer: BCBS Trust/PPO |
$348.71
|
| Rate for Payer: BCN Commercial |
$348.71
|
| Rate for Payer: BCN Medicare Advantage |
$132.57
|
| Rate for Payer: Cash Price |
$338.34
|
| Rate for Payer: Cash Price |
$338.34
|
| Rate for Payer: Cofinity Commercial |
$397.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$338.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.57
|
| Rate for Payer: Healthscope Commercial |
$410.24
|
| Rate for Payer: Healthscope Whirlpool |
$422.93
|
| Rate for Payer: Humana Choice PPO Medicare |
$132.57
|
| Rate for Payer: Mclaren Commercial |
$380.64
|
| 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 |
$359.49
|
| Rate for Payer: Nomi Health Commercial |
$346.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$317.20
|
| 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 |
$236.95
|
| Rate for Payer: Priority Health Medicare |
$132.57
|
| Rate for Payer: Priority Health Narrow Network |
$189.56
|
| Rate for Payer: Railroad Medicare Medicare |
$132.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$372.18
|
| 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 CONTROL NOSEBLEED ANTERIOR SIMPLE
|
Facility
|
IP
|
$422.93
|
|
|
Service Code
|
CPT 30901
|
| Hospital Charge Code |
45000011
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$317.20 |
| Max. Negotiated Rate |
$422.93 |
| Rate for Payer: Aetna Commercial |
$380.64
|
| Rate for Payer: ASR ASR |
$410.24
|
| Rate for Payer: BCBS Trust/PPO |
$347.31
|
| Rate for Payer: BCN Commercial |
$347.31
|
| Rate for Payer: Cash Price |
$338.34
|
| Rate for Payer: Cofinity Commercial |
$397.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$338.34
|
| Rate for Payer: Healthscope Commercial |
$410.24
|
| Rate for Payer: Healthscope Whirlpool |
$422.93
|
| Rate for Payer: Mclaren Commercial |
$380.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$359.49
|
| Rate for Payer: Nomi Health Commercial |
$346.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$317.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$372.18
|
|
|
HC CONTROL OROPHARYNGEAL HEM SIMPLE
|
Facility
|
OP
|
$768.85
|
|
|
Service Code
|
CPT 42960
|
| Hospital Charge Code |
45000100
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$281.05 |
| Max. Negotiated Rate |
$832.95 |
| Rate for Payer: Aetna Commercial |
$691.97
|
| Rate for Payer: Aetna Medicare |
$537.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$671.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$671.74
|
| Rate for Payer: ASR ASR |
$745.78
|
| Rate for Payer: BCBS Complete |
$295.13
|
| Rate for Payer: BCBS MAPPO |
$537.39
|
| Rate for Payer: BCBS Trust/PPO |
$633.92
|
| Rate for Payer: BCN Commercial |
$633.92
|
| Rate for Payer: BCN Medicare Advantage |
$537.39
|
| Rate for Payer: Cash Price |
$615.08
|
| Rate for Payer: Cash Price |
$615.08
|
| Rate for Payer: Cofinity Commercial |
$722.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$615.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$537.39
|
| Rate for Payer: Healthscope Commercial |
$745.78
|
| Rate for Payer: Healthscope Whirlpool |
$768.85
|
| Rate for Payer: Humana Choice PPO Medicare |
$537.39
|
| Rate for Payer: Mclaren Commercial |
$691.97
|
| Rate for Payer: Mclaren Medicaid |
$537.39
|
| Rate for Payer: Mclaren Medicare |
$537.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$564.26
|
| Rate for Payer: Meridian Medicaid |
$295.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$618.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$591.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$653.52
|
| Rate for Payer: Nomi Health Commercial |
$630.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$576.64
|
| Rate for Payer: PACE Medicare |
$510.52
|
| Rate for Payer: PACE SWMI |
$537.39
|
| Rate for Payer: PHP Commercial |
$591.13
|
| Rate for Payer: PHP Medicaid |
$288.04
|
| Rate for Payer: PHP Medicare Advantage |
$537.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$281.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$673.67
|
| Rate for Payer: Priority Health Medicare |
$537.39
|
| Rate for Payer: Priority Health Narrow Network |
$538.96
|
| Rate for Payer: Railroad Medicare Medicare |
$537.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$676.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$537.39
|
| Rate for Payer: UHC Exchange |
$832.95
|
| Rate for Payer: UHC Medicaid |
$281.05
|
| Rate for Payer: UHCCP DNSP |
$537.39
|
| Rate for Payer: UHCCP Medicaid |
$281.05
|
| Rate for Payer: VA VA |
$537.39
|
|
|
HC CONTROL OROPHARYNGEAL HEM SIMPLE
|
Facility
|
IP
|
$768.85
|
|
|
Service Code
|
CPT 42960
|
| Hospital Charge Code |
45000100
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$576.64 |
| Max. Negotiated Rate |
$768.85 |
| Rate for Payer: Aetna Commercial |
$691.97
|
| Rate for Payer: ASR ASR |
$745.78
|
| Rate for Payer: BCBS Trust/PPO |
$631.38
|
| Rate for Payer: BCN Commercial |
$631.38
|
| Rate for Payer: Cash Price |
$615.08
|
| Rate for Payer: Cofinity Commercial |
$722.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$615.08
|
| Rate for Payer: Healthscope Commercial |
$745.78
|
| Rate for Payer: Healthscope Whirlpool |
$768.85
|
| Rate for Payer: Mclaren Commercial |
$691.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$653.52
|
| Rate for Payer: Nomi Health Commercial |
$630.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$576.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$676.59
|
|
|
HC CONTROL OROPHARYNG HEMORRHAGE SIMPLE
|
Facility
|
IP
|
$1,369.17
|
|
|
Service Code
|
CPT 42960
|
| Hospital Charge Code |
76100478
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,026.88 |
| Max. Negotiated Rate |
$1,369.17 |
| Rate for Payer: Aetna Commercial |
$1,232.25
|
| Rate for Payer: ASR ASR |
$1,328.09
|
| Rate for Payer: BCBS Trust/PPO |
$1,124.36
|
| Rate for Payer: BCN Commercial |
$1,124.36
|
| Rate for Payer: Cash Price |
$1,095.34
|
| Rate for Payer: Cofinity Commercial |
$1,287.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,095.34
|
| Rate for Payer: Healthscope Commercial |
$1,328.09
|
| Rate for Payer: Healthscope Whirlpool |
$1,369.17
|
| Rate for Payer: Mclaren Commercial |
$1,232.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,163.79
|
| Rate for Payer: Nomi Health Commercial |
$1,122.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,026.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,204.87
|
|
|
HC CONTROL OROPHARYNG HEMORRHAGE SIMPLE
|
Facility
|
OP
|
$1,369.17
|
|
|
Service Code
|
CPT 42960
|
| Hospital Charge Code |
76100478
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$281.05 |
| Max. Negotiated Rate |
$1,369.17 |
| Rate for Payer: Aetna Commercial |
$1,232.25
|
| Rate for Payer: Aetna Medicare |
$537.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$671.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$671.74
|
| Rate for Payer: ASR ASR |
$1,328.09
|
| Rate for Payer: BCBS Complete |
$295.13
|
| Rate for Payer: BCBS MAPPO |
$537.39
|
| Rate for Payer: BCBS Trust/PPO |
$1,128.88
|
| Rate for Payer: BCN Commercial |
$1,128.88
|
| Rate for Payer: BCN Medicare Advantage |
$537.39
|
| Rate for Payer: Cash Price |
$1,095.34
|
| Rate for Payer: Cash Price |
$1,095.34
|
| Rate for Payer: Cofinity Commercial |
$1,287.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,095.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$537.39
|
| Rate for Payer: Healthscope Commercial |
$1,328.09
|
| Rate for Payer: Healthscope Whirlpool |
$1,369.17
|
| Rate for Payer: Humana Choice PPO Medicare |
$537.39
|
| Rate for Payer: Mclaren Commercial |
$1,232.25
|
| Rate for Payer: Mclaren Medicaid |
$537.39
|
| Rate for Payer: Mclaren Medicare |
$537.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$564.26
|
| Rate for Payer: Meridian Medicaid |
$295.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$618.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$591.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,163.79
|
| Rate for Payer: Nomi Health Commercial |
$1,122.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,026.88
|
| Rate for Payer: PACE Medicare |
$510.52
|
| Rate for Payer: PACE SWMI |
$537.39
|
| Rate for Payer: PHP Commercial |
$591.13
|
| Rate for Payer: PHP Medicaid |
$288.04
|
| Rate for Payer: PHP Medicare Advantage |
$537.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$281.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,199.67
|
| Rate for Payer: Priority Health Medicare |
$537.39
|
| Rate for Payer: Priority Health Narrow Network |
$959.79
|
| Rate for Payer: Railroad Medicare Medicare |
$537.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,204.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$537.39
|
| Rate for Payer: UHC Exchange |
$832.95
|
| Rate for Payer: UHC Medicaid |
$281.05
|
| Rate for Payer: UHCCP DNSP |
$537.39
|
| Rate for Payer: UHCCP Medicaid |
$281.05
|
| Rate for Payer: VA VA |
$537.39
|
|
|
HC CONVERT EXTERNAL BILIARY DRAIN TO INTERNAL EXTERNAL
|
Facility
|
IP
|
$3,867.19
|
|
|
Service Code
|
CPT 47535
|
| Hospital Charge Code |
36100492
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,900.39 |
| Max. Negotiated Rate |
$3,867.19 |
| Rate for Payer: Aetna Commercial |
$3,480.47
|
| Rate for Payer: ASR ASR |
$3,751.17
|
| Rate for Payer: BCBS Trust/PPO |
$3,175.74
|
| Rate for Payer: BCN Commercial |
$3,175.74
|
| Rate for Payer: Cash Price |
$3,093.75
|
| Rate for Payer: Cofinity Commercial |
$3,635.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,093.75
|
| Rate for Payer: Healthscope Commercial |
$3,751.17
|
| Rate for Payer: Healthscope Whirlpool |
$3,867.19
|
| Rate for Payer: Mclaren Commercial |
$3,480.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,287.11
|
| Rate for Payer: Nomi Health Commercial |
$3,171.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,900.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,403.13
|
|
|
HC CONVERT EXTERNAL BILIARY DRAIN TO INTERNAL EXTERNAL
|
Facility
|
OP
|
$3,867.19
|
|
|
Service Code
|
CPT 47535
|
| Hospital Charge Code |
36100492
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,865.82 |
| Max. Negotiated Rate |
$5,529.67 |
| Rate for Payer: Aetna Commercial |
$3,480.47
|
| Rate for Payer: Aetna Medicare |
$3,567.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,459.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,459.41
|
| Rate for Payer: ASR ASR |
$3,751.17
|
| Rate for Payer: BCBS Complete |
$1,959.29
|
| Rate for Payer: BCBS MAPPO |
$3,567.53
|
| Rate for Payer: BCBS Trust/PPO |
$3,188.50
|
| Rate for Payer: BCN Commercial |
$3,188.50
|
| Rate for Payer: BCN Medicare Advantage |
$3,567.53
|
| Rate for Payer: Cash Price |
$3,093.75
|
| Rate for Payer: Cash Price |
$3,093.75
|
| Rate for Payer: Cofinity Commercial |
$3,635.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,093.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,567.53
|
| Rate for Payer: Healthscope Commercial |
$3,751.17
|
| Rate for Payer: Healthscope Whirlpool |
$3,867.19
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,567.53
|
| Rate for Payer: Mclaren Commercial |
$3,480.47
|
| Rate for Payer: Mclaren Medicaid |
$3,567.53
|
| Rate for Payer: Mclaren Medicare |
$3,567.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,745.91
|
| Rate for Payer: Meridian Medicaid |
$1,959.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,102.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,924.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,287.11
|
| Rate for Payer: Nomi Health Commercial |
$3,171.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,900.39
|
| Rate for Payer: PACE Medicare |
$3,389.15
|
| Rate for Payer: PACE SWMI |
$3,567.53
|
| Rate for Payer: PHP Commercial |
$3,924.28
|
| Rate for Payer: PHP Medicaid |
$1,912.20
|
| Rate for Payer: PHP Medicare Advantage |
$3,567.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,865.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,388.43
|
| Rate for Payer: Priority Health Medicare |
$3,567.53
|
| Rate for Payer: Priority Health Narrow Network |
$2,710.90
|
| Rate for Payer: Railroad Medicare Medicare |
$3,567.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,403.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,567.53
|
| Rate for Payer: UHC Exchange |
$5,529.67
|
| Rate for Payer: UHC Medicaid |
$1,865.82
|
| Rate for Payer: UHCCP DNSP |
$3,567.53
|
| Rate for Payer: UHCCP Medicaid |
$1,865.82
|
| Rate for Payer: VA VA |
$3,567.53
|
|
|
HC CONVERT NEPHROSTOMY TO NEPHROURETERAL CATH
|
Facility
|
OP
|
$1,228.49
|
|
|
Service Code
|
CPT 50434
|
| Hospital Charge Code |
36100506
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$861.17 |
| Max. Negotiated Rate |
$3,228.45 |
| Rate for Payer: Aetna Commercial |
$1,105.64
|
| Rate for Payer: Aetna Medicare |
$2,082.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,603.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,603.59
|
| Rate for Payer: ASR ASR |
$1,191.64
|
| Rate for Payer: BCBS Complete |
$1,143.91
|
| Rate for Payer: BCBS MAPPO |
$2,082.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,012.89
|
| Rate for Payer: BCN Commercial |
$1,012.89
|
| Rate for Payer: BCN Medicare Advantage |
$2,082.87
|
| Rate for Payer: Cash Price |
$982.79
|
| Rate for Payer: Cash Price |
$982.79
|
| Rate for Payer: Cofinity Commercial |
$1,154.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$982.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,082.87
|
| Rate for Payer: Healthscope Commercial |
$1,191.64
|
| Rate for Payer: Healthscope Whirlpool |
$1,228.49
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,082.87
|
| Rate for Payer: Mclaren Commercial |
$1,105.64
|
| Rate for Payer: Mclaren Medicaid |
$2,082.87
|
| Rate for Payer: Mclaren Medicare |
$2,082.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,187.01
|
| Rate for Payer: Meridian Medicaid |
$1,143.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,395.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,291.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,044.22
|
| Rate for Payer: Nomi Health Commercial |
$1,007.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$921.37
|
| Rate for Payer: PACE Medicare |
$1,978.73
|
| Rate for Payer: PACE SWMI |
$2,082.87
|
| Rate for Payer: PHP Commercial |
$2,291.16
|
| Rate for Payer: PHP Medicaid |
$1,116.42
|
| Rate for Payer: PHP Medicare Advantage |
$2,082.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,089.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,076.40
|
| Rate for Payer: Priority Health Medicare |
$2,082.87
|
| Rate for Payer: Priority Health Narrow Network |
$861.17
|
| Rate for Payer: Railroad Medicare Medicare |
$2,082.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,081.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,082.87
|
| Rate for Payer: UHC Exchange |
$3,228.45
|
| Rate for Payer: UHC Medicaid |
$1,089.34
|
| Rate for Payer: UHCCP DNSP |
$2,082.87
|
| Rate for Payer: UHCCP Medicaid |
$1,089.34
|
| Rate for Payer: VA VA |
$2,082.87
|
|
|
HC CONVERT NEPHROSTOMY TO NEPHROURETERAL CATH
|
Facility
|
IP
|
$1,228.49
|
|
|
Service Code
|
CPT 50434
|
| Hospital Charge Code |
36100506
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$921.37 |
| Max. Negotiated Rate |
$1,228.49 |
| Rate for Payer: Aetna Commercial |
$1,105.64
|
| Rate for Payer: ASR ASR |
$1,191.64
|
| Rate for Payer: BCBS Trust/PPO |
$1,008.84
|
| Rate for Payer: BCN Commercial |
$1,008.84
|
| Rate for Payer: Cash Price |
$982.79
|
| Rate for Payer: Cofinity Commercial |
$1,154.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$982.79
|
| Rate for Payer: Healthscope Commercial |
$1,191.64
|
| Rate for Payer: Healthscope Whirlpool |
$1,228.49
|
| Rate for Payer: Mclaren Commercial |
$1,105.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,044.22
|
| Rate for Payer: Nomi Health Commercial |
$1,007.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$921.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,081.07
|
|
|
HC CONVEX WAFER
|
Facility
|
OP
|
$58.18
|
|
| Hospital Charge Code |
27000049
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$21.53 |
| Max. Negotiated Rate |
$58.18 |
| Rate for Payer: Aetna Commercial |
$52.36
|
| Rate for Payer: Aetna Medicare |
$21.53
|
| Rate for Payer: ASR ASR |
$56.43
|
| Rate for Payer: BCBS Complete |
$23.27
|
| Rate for Payer: BCBS Trust/PPO |
$47.97
|
| Rate for Payer: BCN Commercial |
$47.97
|
| Rate for Payer: Cash Price |
$46.54
|
| Rate for Payer: Cofinity Commercial |
$54.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.54
|
| Rate for Payer: Healthscope Commercial |
$56.43
|
| Rate for Payer: Healthscope Whirlpool |
$58.18
|
| Rate for Payer: Mclaren Commercial |
$52.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.45
|
| Rate for Payer: Nomi Health Commercial |
$47.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$50.98
|
| Rate for Payer: Priority Health Narrow Network |
$40.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$51.20
|
|
|
HC CONVEX WAFER
|
Facility
|
IP
|
$58.18
|
|
| Hospital Charge Code |
27000049
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$43.63 |
| Max. Negotiated Rate |
$58.18 |
| Rate for Payer: Aetna Commercial |
$52.36
|
| Rate for Payer: ASR ASR |
$56.43
|
| Rate for Payer: BCBS Trust/PPO |
$47.78
|
| Rate for Payer: BCN Commercial |
$47.78
|
| Rate for Payer: Cash Price |
$46.54
|
| Rate for Payer: Cofinity Commercial |
$54.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.54
|
| Rate for Payer: Healthscope Commercial |
$56.43
|
| Rate for Payer: Healthscope Whirlpool |
$58.18
|
| Rate for Payer: Mclaren Commercial |
$52.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.45
|
| Rate for Payer: Nomi Health Commercial |
$47.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$51.20
|
|
|
HC COOK GUIDEWIRE
|
Facility
|
OP
|
$48.83
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200019
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$18.07 |
| Max. Negotiated Rate |
$48.83 |
| Rate for Payer: Aetna Commercial |
$43.95
|
| Rate for Payer: Aetna Medicare |
$18.07
|
| Rate for Payer: ASR ASR |
$47.37
|
| Rate for Payer: BCBS Complete |
$19.53
|
| Rate for Payer: BCBS Trust/PPO |
$40.26
|
| Rate for Payer: BCN Commercial |
$40.26
|
| Rate for Payer: Cash Price |
$39.06
|
| Rate for Payer: Cofinity Commercial |
$45.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.06
|
| Rate for Payer: Healthscope Commercial |
$47.37
|
| Rate for Payer: Healthscope Whirlpool |
$48.83
|
| Rate for Payer: Mclaren Commercial |
$43.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$39.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.51
|
| Rate for Payer: Nomi Health Commercial |
$40.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$42.78
|
| Rate for Payer: Priority Health Narrow Network |
$34.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$42.97
|
|
|
HC COOK GUIDEWIRE
|
Facility
|
IP
|
$48.83
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200019
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$36.62 |
| Max. Negotiated Rate |
$48.83 |
| Rate for Payer: Aetna Commercial |
$43.95
|
| Rate for Payer: ASR ASR |
$47.37
|
| Rate for Payer: BCBS Trust/PPO |
$40.10
|
| Rate for Payer: BCN Commercial |
$40.10
|
| Rate for Payer: Cash Price |
$39.06
|
| Rate for Payer: Cofinity Commercial |
$45.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.06
|
| Rate for Payer: Healthscope Commercial |
$47.37
|
| Rate for Payer: Healthscope Whirlpool |
$48.83
|
| Rate for Payer: Mclaren Commercial |
$43.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.51
|
| Rate for Payer: Nomi Health Commercial |
$40.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$42.97
|
|
|
HC COOK PIGTAIL
|
Facility
|
IP
|
$477.69
|
|
| Hospital Charge Code |
27200233
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$358.27 |
| Max. Negotiated Rate |
$477.69 |
| Rate for Payer: Aetna Commercial |
$429.92
|
| Rate for Payer: ASR ASR |
$463.36
|
| Rate for Payer: BCBS Trust/PPO |
$392.28
|
| Rate for Payer: BCN Commercial |
$392.28
|
| Rate for Payer: Cash Price |
$382.15
|
| Rate for Payer: Cofinity Commercial |
$449.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$382.15
|
| Rate for Payer: Healthscope Commercial |
$463.36
|
| Rate for Payer: Healthscope Whirlpool |
$477.69
|
| Rate for Payer: Mclaren Commercial |
$429.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$406.04
|
| Rate for Payer: Nomi Health Commercial |
$391.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$358.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$420.37
|
|
|
HC COOK PIGTAIL
|
Facility
|
OP
|
$477.69
|
|
| Hospital Charge Code |
27200233
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$176.75 |
| Max. Negotiated Rate |
$477.69 |
| Rate for Payer: Aetna Commercial |
$429.92
|
| Rate for Payer: Aetna Medicare |
$176.75
|
| Rate for Payer: ASR ASR |
$463.36
|
| Rate for Payer: BCBS Complete |
$191.08
|
| Rate for Payer: BCBS Trust/PPO |
$393.86
|
| Rate for Payer: BCN Commercial |
$393.86
|
| Rate for Payer: Cash Price |
$382.15
|
| Rate for Payer: Cofinity Commercial |
$449.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$382.15
|
| Rate for Payer: Healthscope Commercial |
$463.36
|
| Rate for Payer: Healthscope Whirlpool |
$477.69
|
| Rate for Payer: Mclaren Commercial |
$429.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$382.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$406.04
|
| Rate for Payer: Nomi Health Commercial |
$391.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$358.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$418.55
|
| Rate for Payer: Priority Health Narrow Network |
$334.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$420.37
|
|
|
HC COOLIEF RF PROBE
|
Facility
|
OP
|
$1,950.75
|
|
| Hospital Charge Code |
27200355
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$721.78 |
| Max. Negotiated Rate |
$1,950.75 |
| Rate for Payer: Aetna Commercial |
$1,755.67
|
| Rate for Payer: Aetna Medicare |
$721.78
|
| Rate for Payer: ASR ASR |
$1,892.23
|
| Rate for Payer: BCBS Complete |
$780.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,608.39
|
| Rate for Payer: BCN Commercial |
$1,608.39
|
| Rate for Payer: Cash Price |
$1,560.60
|
| Rate for Payer: Cofinity Commercial |
$1,833.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,560.60
|
| Rate for Payer: Healthscope Commercial |
$1,892.23
|
| Rate for Payer: Healthscope Whirlpool |
$1,950.75
|
| Rate for Payer: Mclaren Commercial |
$1,755.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,560.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,658.14
|
| Rate for Payer: Nomi Health Commercial |
$1,599.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,463.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,709.25
|
| Rate for Payer: Priority Health Narrow Network |
$1,367.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,716.66
|
|
|
HC COOLIEF RF PROBE
|
Facility
|
IP
|
$1,950.75
|
|
| Hospital Charge Code |
27200355
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,463.06 |
| Max. Negotiated Rate |
$1,950.75 |
| Rate for Payer: Aetna Commercial |
$1,755.67
|
| Rate for Payer: ASR ASR |
$1,892.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,601.96
|
| Rate for Payer: BCN Commercial |
$1,601.96
|
| Rate for Payer: Cash Price |
$1,560.60
|
| Rate for Payer: Cofinity Commercial |
$1,833.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,560.60
|
| Rate for Payer: Healthscope Commercial |
$1,892.23
|
| Rate for Payer: Healthscope Whirlpool |
$1,950.75
|
| Rate for Payer: Mclaren Commercial |
$1,755.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,658.14
|
| Rate for Payer: Nomi Health Commercial |
$1,599.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,463.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,716.66
|
|
|
HC COPPER SERUM
|
Facility
|
OP
|
$45.78
|
|
|
Service Code
|
CPT 82525
|
| Hospital Charge Code |
30100170
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.49 |
| Max. Negotiated Rate |
$72.63 |
| Rate for Payer: Aetna Commercial |
$41.20
|
| Rate for Payer: Aetna Medicare |
$12.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.51
|
| Rate for Payer: ASR ASR |
$44.41
|
| Rate for Payer: BCBS Complete |
$6.82
|
| Rate for Payer: BCBS MAPPO |
$12.41
|
| Rate for Payer: BCBS Trust/PPO |
$37.75
|
| Rate for Payer: BCN Commercial |
$37.75
|
| Rate for Payer: BCN Medicare Advantage |
$12.41
|
| Rate for Payer: Cash Price |
$36.62
|
| Rate for Payer: Cash Price |
$36.62
|
| Rate for Payer: Cofinity Commercial |
$43.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.41
|
| Rate for Payer: Healthscope Commercial |
$44.41
|
| Rate for Payer: Healthscope Whirlpool |
$45.78
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.41
|
| Rate for Payer: Mclaren Commercial |
$41.20
|
| Rate for Payer: Mclaren Medicaid |
$12.41
|
| Rate for Payer: Mclaren Medicare |
$12.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.03
|
| Rate for Payer: Meridian Medicaid |
$6.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.91
|
| Rate for Payer: Nomi Health Commercial |
$37.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.34
|
| Rate for Payer: PACE Medicare |
$11.79
|
| Rate for Payer: PACE SWMI |
$12.41
|
| Rate for Payer: PHP Commercial |
$13.65
|
| Rate for Payer: PHP Medicaid |
$6.65
|
| Rate for Payer: PHP Medicare Advantage |
$12.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$72.63
|
| Rate for Payer: Priority Health Medicare |
$12.41
|
| Rate for Payer: Priority Health Narrow Network |
$58.10
|
| Rate for Payer: Railroad Medicare Medicare |
$12.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.41
|
| Rate for Payer: UHC Exchange |
$19.24
|
| Rate for Payer: UHC Medicaid |
$6.49
|
| Rate for Payer: UHCCP DNSP |
$12.41
|
| Rate for Payer: UHCCP Medicaid |
$6.49
|
| Rate for Payer: VA VA |
$12.41
|
|
|
HC COPPER SERUM
|
Facility
|
IP
|
$45.78
|
|
|
Service Code
|
CPT 82525
|
| Hospital Charge Code |
30100170
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$34.34 |
| Max. Negotiated Rate |
$45.78 |
| Rate for Payer: Aetna Commercial |
$41.20
|
| Rate for Payer: ASR ASR |
$44.41
|
| Rate for Payer: BCBS Trust/PPO |
$37.59
|
| Rate for Payer: BCN Commercial |
$37.59
|
| Rate for Payer: Cash Price |
$36.62
|
| Rate for Payer: Cofinity Commercial |
$43.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.62
|
| Rate for Payer: Healthscope Commercial |
$44.41
|
| Rate for Payer: Healthscope Whirlpool |
$45.78
|
| Rate for Payer: Mclaren Commercial |
$41.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.91
|
| Rate for Payer: Nomi Health Commercial |
$37.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.29
|
|
