|
HC CRYOABLATION STANDBY
|
Facility
|
OP
|
$8,343.84
|
|
| Hospital Charge Code |
27200283
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,087.22 |
| Max. Negotiated Rate |
$8,343.84 |
| Rate for Payer: Aetna Commercial |
$7,509.46
|
| Rate for Payer: Aetna Medicare |
$3,087.22
|
| Rate for Payer: ASR ASR |
$8,093.52
|
| Rate for Payer: BCBS Complete |
$3,337.54
|
| Rate for Payer: BCBS Trust/PPO |
$6,879.50
|
| Rate for Payer: BCN Commercial |
$6,879.50
|
| Rate for Payer: Cash Price |
$6,675.07
|
| Rate for Payer: Cofinity Commercial |
$7,843.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,675.07
|
| Rate for Payer: Healthscope Commercial |
$8,093.52
|
| Rate for Payer: Healthscope Whirlpool |
$8,343.84
|
| Rate for Payer: Mclaren Commercial |
$7,509.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,675.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,092.26
|
| Rate for Payer: Nomi Health Commercial |
$6,841.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,257.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$7,310.87
|
| Rate for Payer: Priority Health Narrow Network |
$5,849.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,342.58
|
|
|
HC CRYOABLATION SUPPLIES
|
Facility
|
OP
|
$12,517.61
|
|
|
Service Code
|
HCPCS C2618
|
| Hospital Charge Code |
27200284
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4,631.52 |
| Max. Negotiated Rate |
$12,517.61 |
| Rate for Payer: Aetna Commercial |
$11,265.85
|
| Rate for Payer: Aetna Medicare |
$4,631.52
|
| Rate for Payer: ASR ASR |
$12,142.08
|
| Rate for Payer: BCBS Complete |
$5,007.04
|
| Rate for Payer: BCBS Trust/PPO |
$10,320.77
|
| Rate for Payer: BCN Commercial |
$10,320.77
|
| Rate for Payer: Cash Price |
$10,014.09
|
| Rate for Payer: Cofinity Commercial |
$11,766.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,014.09
|
| Rate for Payer: Healthscope Commercial |
$12,142.08
|
| Rate for Payer: Healthscope Whirlpool |
$12,517.61
|
| Rate for Payer: Mclaren Commercial |
$11,265.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,014.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,639.97
|
| Rate for Payer: Nomi Health Commercial |
$10,264.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,388.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$10,967.93
|
| Rate for Payer: Priority Health Narrow Network |
$8,774.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11,015.50
|
|
|
HC CRYOABLATION SUPPLIES
|
Facility
|
IP
|
$12,517.61
|
|
|
Service Code
|
HCPCS C2618
|
| Hospital Charge Code |
27200284
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9,388.21 |
| Max. Negotiated Rate |
$12,517.61 |
| Rate for Payer: Aetna Commercial |
$11,265.85
|
| Rate for Payer: ASR ASR |
$12,142.08
|
| Rate for Payer: BCBS Trust/PPO |
$10,279.46
|
| Rate for Payer: BCN Commercial |
$10,279.46
|
| Rate for Payer: Cash Price |
$10,014.09
|
| Rate for Payer: Cofinity Commercial |
$11,766.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,014.09
|
| Rate for Payer: Healthscope Commercial |
$12,142.08
|
| Rate for Payer: Healthscope Whirlpool |
$12,517.61
|
| Rate for Payer: Mclaren Commercial |
$11,265.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,639.97
|
| Rate for Payer: Nomi Health Commercial |
$10,264.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,388.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11,015.50
|
|
|
HC CRYOGLOBULINS
|
Facility
|
IP
|
$20.17
|
|
|
Service Code
|
CPT 82595
|
| Hospital Charge Code |
30100184
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.13 |
| Max. Negotiated Rate |
$20.17 |
| Rate for Payer: Aetna Commercial |
$18.15
|
| Rate for Payer: ASR ASR |
$19.56
|
| Rate for Payer: BCBS Trust/PPO |
$16.56
|
| Rate for Payer: BCN Commercial |
$16.56
|
| Rate for Payer: Cash Price |
$16.14
|
| Rate for Payer: Cofinity Commercial |
$18.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.14
|
| Rate for Payer: Healthscope Commercial |
$19.56
|
| Rate for Payer: Healthscope Whirlpool |
$20.17
|
| Rate for Payer: Mclaren Commercial |
$18.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.14
|
| Rate for Payer: Nomi Health Commercial |
$16.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17.75
|
|
|
HC CRYOGLOBULINS
|
Facility
|
OP
|
$20.17
|
|
|
Service Code
|
CPT 82595
|
| Hospital Charge Code |
30100184
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.38 |
| Max. Negotiated Rate |
$95.62 |
| Rate for Payer: Aetna Commercial |
$18.15
|
| Rate for Payer: Aetna Medicare |
$6.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: ASR ASR |
$19.56
|
| Rate for Payer: BCBS Complete |
$3.55
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCBS Trust/PPO |
$16.63
|
| Rate for Payer: BCN Commercial |
$16.63
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$16.14
|
| Rate for Payer: Cash Price |
$16.14
|
| Rate for Payer: Cofinity Commercial |
$18.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$19.56
|
| Rate for Payer: Healthscope Whirlpool |
$20.17
|
| Rate for Payer: Humana Choice PPO Medicare |
$6.47
|
| Rate for Payer: Mclaren Commercial |
$18.15
|
| Rate for Payer: Mclaren Medicaid |
$6.47
|
| Rate for Payer: Mclaren Medicare |
$6.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.79
|
| Rate for Payer: Meridian Medicaid |
$3.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.14
|
| Rate for Payer: Nomi Health Commercial |
$16.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.13
|
| Rate for Payer: PACE Medicare |
$6.15
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$7.12
|
| Rate for Payer: PHP Medicaid |
$3.47
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$95.62
|
| Rate for Payer: Priority Health Medicare |
$6.47
|
| Rate for Payer: Priority Health Narrow Network |
$76.50
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6.47
|
| Rate for Payer: UHC Exchange |
$10.03
|
| Rate for Payer: UHC Medicaid |
$3.38
|
| Rate for Payer: UHCCP DNSP |
$6.47
|
| Rate for Payer: UHCCP Medicaid |
$3.38
|
| Rate for Payer: VA VA |
$6.47
|
|
|
HC CRYOGLOBULINS CMPT
|
Facility
|
OP
|
$25.32
|
|
|
Service Code
|
CPT 82585
|
| Hospital Charge Code |
30100183
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.40 |
| Max. Negotiated Rate |
$25.32 |
| Rate for Payer: Aetna Commercial |
$22.79
|
| Rate for Payer: Aetna Medicare |
$14.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.68
|
| Rate for Payer: ASR ASR |
$24.56
|
| Rate for Payer: BCBS Complete |
$7.77
|
| Rate for Payer: BCBS MAPPO |
$14.14
|
| Rate for Payer: BCBS Trust/PPO |
$20.88
|
| Rate for Payer: BCN Commercial |
$20.88
|
| Rate for Payer: BCN Medicare Advantage |
$14.14
|
| Rate for Payer: Cash Price |
$20.26
|
| Rate for Payer: Cash Price |
$20.26
|
| Rate for Payer: Cofinity Commercial |
$23.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.14
|
| Rate for Payer: Healthscope Commercial |
$24.56
|
| Rate for Payer: Healthscope Whirlpool |
$25.32
|
| Rate for Payer: Humana Choice PPO Medicare |
$14.14
|
| Rate for Payer: Mclaren Commercial |
$22.79
|
| Rate for Payer: Mclaren Medicaid |
$14.14
|
| Rate for Payer: Mclaren Medicare |
$14.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.85
|
| Rate for Payer: Meridian Medicaid |
$7.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.52
|
| Rate for Payer: Nomi Health Commercial |
$20.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.99
|
| Rate for Payer: PACE Medicare |
$13.43
|
| Rate for Payer: PACE SWMI |
$14.14
|
| Rate for Payer: PHP Commercial |
$15.55
|
| Rate for Payer: PHP Medicaid |
$7.58
|
| Rate for Payer: PHP Medicare Advantage |
$14.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$22.19
|
| Rate for Payer: Priority Health Medicare |
$14.14
|
| Rate for Payer: Priority Health Narrow Network |
$17.75
|
| Rate for Payer: Railroad Medicare Medicare |
$14.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$14.14
|
| Rate for Payer: UHC Exchange |
$21.92
|
| Rate for Payer: UHC Medicaid |
$7.40
|
| Rate for Payer: UHCCP DNSP |
$14.14
|
| Rate for Payer: UHCCP Medicaid |
$7.40
|
| Rate for Payer: VA VA |
$14.14
|
|
|
HC CRYOGLOBULINS CMPT
|
Facility
|
IP
|
$25.32
|
|
|
Service Code
|
CPT 82585
|
| Hospital Charge Code |
30100183
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.99 |
| Max. Negotiated Rate |
$25.32 |
| Rate for Payer: Aetna Commercial |
$22.79
|
| Rate for Payer: ASR ASR |
$24.56
|
| Rate for Payer: BCBS Trust/PPO |
$20.79
|
| Rate for Payer: BCN Commercial |
$20.79
|
| Rate for Payer: Cash Price |
$20.26
|
| Rate for Payer: Cofinity Commercial |
$23.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.26
|
| Rate for Payer: Healthscope Commercial |
$24.56
|
| Rate for Payer: Healthscope Whirlpool |
$25.32
|
| Rate for Payer: Mclaren Commercial |
$22.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.52
|
| Rate for Payer: Nomi Health Commercial |
$20.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.28
|
|
|
HC CRYOGLOBULIN, SERUM
|
Facility
|
IP
|
$44.74
|
|
|
Service Code
|
CPT 82595
|
| Hospital Charge Code |
30100600
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.55 |
| Max. Negotiated Rate |
$44.74 |
| Rate for Payer: Aetna Commercial |
$40.27
|
| Rate for Payer: ASR ASR |
$43.40
|
| Rate for Payer: BCBS Trust/PPO |
$36.74
|
| Rate for Payer: BCN Commercial |
$36.74
|
| Rate for Payer: Cash Price |
$35.79
|
| Rate for Payer: Cofinity Commercial |
$42.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.79
|
| Rate for Payer: Healthscope Commercial |
$43.40
|
| Rate for Payer: Healthscope Whirlpool |
$44.74
|
| Rate for Payer: Mclaren Commercial |
$40.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.03
|
| Rate for Payer: Nomi Health Commercial |
$36.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$39.37
|
|
|
HC CRYOGLOBULIN, SERUM
|
Facility
|
OP
|
$44.74
|
|
|
Service Code
|
CPT 82595
|
| Hospital Charge Code |
30100600
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.38 |
| Max. Negotiated Rate |
$95.62 |
| Rate for Payer: Aetna Commercial |
$40.27
|
| Rate for Payer: Aetna Medicare |
$6.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: ASR ASR |
$43.40
|
| Rate for Payer: BCBS Complete |
$3.55
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCBS Trust/PPO |
$36.89
|
| Rate for Payer: BCN Commercial |
$36.89
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$35.79
|
| Rate for Payer: Cash Price |
$35.79
|
| Rate for Payer: Cofinity Commercial |
$42.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$43.40
|
| Rate for Payer: Healthscope Whirlpool |
$44.74
|
| Rate for Payer: Humana Choice PPO Medicare |
$6.47
|
| Rate for Payer: Mclaren Commercial |
$40.27
|
| Rate for Payer: Mclaren Medicaid |
$6.47
|
| Rate for Payer: Mclaren Medicare |
$6.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.79
|
| Rate for Payer: Meridian Medicaid |
$3.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.03
|
| Rate for Payer: Nomi Health Commercial |
$36.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.55
|
| Rate for Payer: PACE Medicare |
$6.15
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$7.12
|
| Rate for Payer: PHP Medicaid |
$3.47
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$95.62
|
| Rate for Payer: Priority Health Medicare |
$6.47
|
| Rate for Payer: Priority Health Narrow Network |
$76.50
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$39.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6.47
|
| Rate for Payer: UHC Exchange |
$10.03
|
| Rate for Payer: UHC Medicaid |
$3.38
|
| Rate for Payer: UHCCP DNSP |
$6.47
|
| Rate for Payer: UHCCP Medicaid |
$3.38
|
| Rate for Payer: VA VA |
$6.47
|
|
|
HC CRYOPRECIPITATE
|
Facility
|
IP
|
$146.02
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000042
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$109.52 |
| Max. Negotiated Rate |
$146.02 |
| Rate for Payer: Aetna Commercial |
$131.42
|
| Rate for Payer: ASR ASR |
$141.64
|
| Rate for Payer: BCBS Trust/PPO |
$119.91
|
| Rate for Payer: BCN Commercial |
$119.91
|
| Rate for Payer: Cash Price |
$116.82
|
| Rate for Payer: Cofinity Commercial |
$137.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.82
|
| Rate for Payer: Healthscope Commercial |
$141.64
|
| Rate for Payer: Healthscope Whirlpool |
$146.02
|
| Rate for Payer: Mclaren Commercial |
$131.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$124.12
|
| Rate for Payer: Nomi Health Commercial |
$119.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$109.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$128.50
|
|
|
HC CRYOPRECIPITATE
|
Facility
|
OP
|
$146.02
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000042
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$36.70 |
| Max. Negotiated Rate |
$146.02 |
| Rate for Payer: Aetna Commercial |
$131.42
|
| Rate for Payer: Aetna Medicare |
$70.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$87.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$87.71
|
| Rate for Payer: ASR ASR |
$141.64
|
| Rate for Payer: BCBS Complete |
$38.54
|
| Rate for Payer: BCBS MAPPO |
$70.17
|
| Rate for Payer: BCBS Trust/PPO |
$120.39
|
| Rate for Payer: BCN Commercial |
$120.39
|
| Rate for Payer: BCN Medicare Advantage |
$70.17
|
| Rate for Payer: Cash Price |
$116.82
|
| Rate for Payer: Cash Price |
$116.82
|
| Rate for Payer: Cofinity Commercial |
$137.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$70.17
|
| Rate for Payer: Healthscope Commercial |
$141.64
|
| Rate for Payer: Healthscope Whirlpool |
$146.02
|
| Rate for Payer: Humana Choice PPO Medicare |
$70.17
|
| Rate for Payer: Mclaren Commercial |
$131.42
|
| Rate for Payer: Mclaren Medicaid |
$70.17
|
| Rate for Payer: Mclaren Medicare |
$70.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$73.68
|
| Rate for Payer: Meridian Medicaid |
$38.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$80.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$77.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$124.12
|
| Rate for Payer: Nomi Health Commercial |
$119.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$109.52
|
| Rate for Payer: PACE Medicare |
$66.66
|
| Rate for Payer: PACE SWMI |
$70.17
|
| Rate for Payer: PHP Commercial |
$77.19
|
| Rate for Payer: PHP Medicaid |
$37.61
|
| Rate for Payer: PHP Medicare Advantage |
$70.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$102.80
|
| Rate for Payer: Priority Health Medicare |
$70.17
|
| Rate for Payer: Priority Health Narrow Network |
$82.24
|
| Rate for Payer: Railroad Medicare Medicare |
$70.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$128.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$70.17
|
| Rate for Payer: UHC Exchange |
$108.76
|
| Rate for Payer: UHC Medicaid |
$36.70
|
| Rate for Payer: UHCCP DNSP |
$70.17
|
| Rate for Payer: UHCCP Medicaid |
$36.70
|
| Rate for Payer: VA VA |
$70.17
|
|
|
HC CRYOPRECIPITATE DIRECT
|
Facility
|
OP
|
$347.60
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000043
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$36.70 |
| Max. Negotiated Rate |
$347.60 |
| Rate for Payer: Aetna Commercial |
$312.84
|
| Rate for Payer: Aetna Medicare |
$70.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$87.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$87.71
|
| Rate for Payer: ASR ASR |
$337.17
|
| Rate for Payer: BCBS Complete |
$38.54
|
| Rate for Payer: BCBS MAPPO |
$70.17
|
| Rate for Payer: BCBS Trust/PPO |
$286.60
|
| Rate for Payer: BCN Commercial |
$286.60
|
| Rate for Payer: BCN Medicare Advantage |
$70.17
|
| Rate for Payer: Cash Price |
$278.08
|
| Rate for Payer: Cash Price |
$278.08
|
| Rate for Payer: Cofinity Commercial |
$326.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$278.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$70.17
|
| Rate for Payer: Healthscope Commercial |
$337.17
|
| Rate for Payer: Healthscope Whirlpool |
$347.60
|
| Rate for Payer: Humana Choice PPO Medicare |
$70.17
|
| Rate for Payer: Mclaren Commercial |
$312.84
|
| Rate for Payer: Mclaren Medicaid |
$70.17
|
| Rate for Payer: Mclaren Medicare |
$70.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$73.68
|
| Rate for Payer: Meridian Medicaid |
$38.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$80.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$77.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$295.46
|
| Rate for Payer: Nomi Health Commercial |
$285.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$260.70
|
| Rate for Payer: PACE Medicare |
$66.66
|
| Rate for Payer: PACE SWMI |
$70.17
|
| Rate for Payer: PHP Commercial |
$77.19
|
| Rate for Payer: PHP Medicaid |
$37.61
|
| Rate for Payer: PHP Medicare Advantage |
$70.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$102.80
|
| Rate for Payer: Priority Health Medicare |
$70.17
|
| Rate for Payer: Priority Health Narrow Network |
$82.24
|
| Rate for Payer: Railroad Medicare Medicare |
$70.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$305.89
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$70.17
|
| Rate for Payer: UHC Exchange |
$108.76
|
| Rate for Payer: UHC Medicaid |
$36.70
|
| Rate for Payer: UHCCP DNSP |
$70.17
|
| Rate for Payer: UHCCP Medicaid |
$36.70
|
| Rate for Payer: VA VA |
$70.17
|
|
|
HC CRYOPRECIPITATE DIRECT
|
Facility
|
IP
|
$347.60
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000043
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$260.70 |
| Max. Negotiated Rate |
$347.60 |
| Rate for Payer: Aetna Commercial |
$312.84
|
| Rate for Payer: ASR ASR |
$337.17
|
| Rate for Payer: BCBS Trust/PPO |
$285.45
|
| Rate for Payer: BCN Commercial |
$285.45
|
| Rate for Payer: Cash Price |
$278.08
|
| Rate for Payer: Cofinity Commercial |
$326.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$278.08
|
| Rate for Payer: Healthscope Commercial |
$337.17
|
| Rate for Payer: Healthscope Whirlpool |
$347.60
|
| Rate for Payer: Mclaren Commercial |
$312.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$295.46
|
| Rate for Payer: Nomi Health Commercial |
$285.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$260.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$305.89
|
|
|
HC CRYOPRECIPITATE POOL
|
Facility
|
IP
|
$253.78
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000044
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$190.34 |
| Max. Negotiated Rate |
$253.78 |
| Rate for Payer: Aetna Commercial |
$228.40
|
| Rate for Payer: ASR ASR |
$246.17
|
| Rate for Payer: BCBS Trust/PPO |
$208.40
|
| Rate for Payer: BCN Commercial |
$208.40
|
| Rate for Payer: Cash Price |
$203.02
|
| Rate for Payer: Cofinity Commercial |
$238.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.02
|
| Rate for Payer: Healthscope Commercial |
$246.17
|
| Rate for Payer: Healthscope Whirlpool |
$253.78
|
| Rate for Payer: Mclaren Commercial |
$228.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$215.71
|
| Rate for Payer: Nomi Health Commercial |
$208.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$190.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$223.33
|
|
|
HC CRYOPRECIPITATE POOL
|
Facility
|
OP
|
$253.78
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000044
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$36.70 |
| Max. Negotiated Rate |
$253.78 |
| Rate for Payer: Aetna Commercial |
$228.40
|
| Rate for Payer: Aetna Medicare |
$70.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$87.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$87.71
|
| Rate for Payer: ASR ASR |
$246.17
|
| Rate for Payer: BCBS Complete |
$38.54
|
| Rate for Payer: BCBS MAPPO |
$70.17
|
| Rate for Payer: BCBS Trust/PPO |
$209.24
|
| Rate for Payer: BCN Commercial |
$209.24
|
| Rate for Payer: BCN Medicare Advantage |
$70.17
|
| Rate for Payer: Cash Price |
$203.02
|
| Rate for Payer: Cash Price |
$203.02
|
| Rate for Payer: Cofinity Commercial |
$238.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$70.17
|
| Rate for Payer: Healthscope Commercial |
$246.17
|
| Rate for Payer: Healthscope Whirlpool |
$253.78
|
| Rate for Payer: Humana Choice PPO Medicare |
$70.17
|
| Rate for Payer: Mclaren Commercial |
$228.40
|
| Rate for Payer: Mclaren Medicaid |
$70.17
|
| Rate for Payer: Mclaren Medicare |
$70.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$73.68
|
| Rate for Payer: Meridian Medicaid |
$38.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$80.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$77.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$215.71
|
| Rate for Payer: Nomi Health Commercial |
$208.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$190.34
|
| Rate for Payer: PACE Medicare |
$66.66
|
| Rate for Payer: PACE SWMI |
$70.17
|
| Rate for Payer: PHP Commercial |
$77.19
|
| Rate for Payer: PHP Medicaid |
$37.61
|
| Rate for Payer: PHP Medicare Advantage |
$70.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$102.80
|
| Rate for Payer: Priority Health Medicare |
$70.17
|
| Rate for Payer: Priority Health Narrow Network |
$82.24
|
| Rate for Payer: Railroad Medicare Medicare |
$70.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$223.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$70.17
|
| Rate for Payer: UHC Exchange |
$108.76
|
| Rate for Payer: UHC Medicaid |
$36.70
|
| Rate for Payer: UHCCP DNSP |
$70.17
|
| Rate for Payer: UHCCP Medicaid |
$36.70
|
| Rate for Payer: VA VA |
$70.17
|
|
|
HC CRYOPRECIPITATE POOL CMPT1
|
Facility
|
IP
|
$253.78
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000045
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$190.34 |
| Max. Negotiated Rate |
$253.78 |
| Rate for Payer: Aetna Commercial |
$228.40
|
| Rate for Payer: ASR ASR |
$246.17
|
| Rate for Payer: BCBS Trust/PPO |
$208.40
|
| Rate for Payer: BCN Commercial |
$208.40
|
| Rate for Payer: Cash Price |
$203.02
|
| Rate for Payer: Cofinity Commercial |
$238.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.02
|
| Rate for Payer: Healthscope Commercial |
$246.17
|
| Rate for Payer: Healthscope Whirlpool |
$253.78
|
| Rate for Payer: Mclaren Commercial |
$228.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$215.71
|
| Rate for Payer: Nomi Health Commercial |
$208.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$190.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$223.33
|
|
|
HC CRYOPRECIPITATE POOL CMPT1
|
Facility
|
OP
|
$253.78
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000045
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$36.70 |
| Max. Negotiated Rate |
$253.78 |
| Rate for Payer: Aetna Commercial |
$228.40
|
| Rate for Payer: Aetna Medicare |
$70.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$87.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$87.71
|
| Rate for Payer: ASR ASR |
$246.17
|
| Rate for Payer: BCBS Complete |
$38.54
|
| Rate for Payer: BCBS MAPPO |
$70.17
|
| Rate for Payer: BCBS Trust/PPO |
$209.24
|
| Rate for Payer: BCN Commercial |
$209.24
|
| Rate for Payer: BCN Medicare Advantage |
$70.17
|
| Rate for Payer: Cash Price |
$203.02
|
| Rate for Payer: Cash Price |
$203.02
|
| Rate for Payer: Cofinity Commercial |
$238.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$70.17
|
| Rate for Payer: Healthscope Commercial |
$246.17
|
| Rate for Payer: Healthscope Whirlpool |
$253.78
|
| Rate for Payer: Humana Choice PPO Medicare |
$70.17
|
| Rate for Payer: Mclaren Commercial |
$228.40
|
| Rate for Payer: Mclaren Medicaid |
$70.17
|
| Rate for Payer: Mclaren Medicare |
$70.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$73.68
|
| Rate for Payer: Meridian Medicaid |
$38.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$80.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$77.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$215.71
|
| Rate for Payer: Nomi Health Commercial |
$208.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$190.34
|
| Rate for Payer: PACE Medicare |
$66.66
|
| Rate for Payer: PACE SWMI |
$70.17
|
| Rate for Payer: PHP Commercial |
$77.19
|
| Rate for Payer: PHP Medicaid |
$37.61
|
| Rate for Payer: PHP Medicare Advantage |
$70.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$102.80
|
| Rate for Payer: Priority Health Medicare |
$70.17
|
| Rate for Payer: Priority Health Narrow Network |
$82.24
|
| Rate for Payer: Railroad Medicare Medicare |
$70.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$223.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$70.17
|
| Rate for Payer: UHC Exchange |
$108.76
|
| Rate for Payer: UHC Medicaid |
$36.70
|
| Rate for Payer: UHCCP DNSP |
$70.17
|
| Rate for Payer: UHCCP Medicaid |
$36.70
|
| Rate for Payer: VA VA |
$70.17
|
|
|
HC CRYOPRECIPITATE POOL CMPT2
|
Facility
|
IP
|
$253.78
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000046
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$190.34 |
| Max. Negotiated Rate |
$253.78 |
| Rate for Payer: Aetna Commercial |
$228.40
|
| Rate for Payer: ASR ASR |
$246.17
|
| Rate for Payer: BCBS Trust/PPO |
$208.40
|
| Rate for Payer: BCN Commercial |
$208.40
|
| Rate for Payer: Cash Price |
$203.02
|
| Rate for Payer: Cofinity Commercial |
$238.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.02
|
| Rate for Payer: Healthscope Commercial |
$246.17
|
| Rate for Payer: Healthscope Whirlpool |
$253.78
|
| Rate for Payer: Mclaren Commercial |
$228.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$215.71
|
| Rate for Payer: Nomi Health Commercial |
$208.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$190.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$223.33
|
|
|
HC CRYOPRECIPITATE POOL CMPT2
|
Facility
|
OP
|
$253.78
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000046
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$36.70 |
| Max. Negotiated Rate |
$253.78 |
| Rate for Payer: Aetna Commercial |
$228.40
|
| Rate for Payer: Aetna Medicare |
$70.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$87.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$87.71
|
| Rate for Payer: ASR ASR |
$246.17
|
| Rate for Payer: BCBS Complete |
$38.54
|
| Rate for Payer: BCBS MAPPO |
$70.17
|
| Rate for Payer: BCBS Trust/PPO |
$209.24
|
| Rate for Payer: BCN Commercial |
$209.24
|
| Rate for Payer: BCN Medicare Advantage |
$70.17
|
| Rate for Payer: Cash Price |
$203.02
|
| Rate for Payer: Cash Price |
$203.02
|
| Rate for Payer: Cofinity Commercial |
$238.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$70.17
|
| Rate for Payer: Healthscope Commercial |
$246.17
|
| Rate for Payer: Healthscope Whirlpool |
$253.78
|
| Rate for Payer: Humana Choice PPO Medicare |
$70.17
|
| Rate for Payer: Mclaren Commercial |
$228.40
|
| Rate for Payer: Mclaren Medicaid |
$70.17
|
| Rate for Payer: Mclaren Medicare |
$70.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$73.68
|
| Rate for Payer: Meridian Medicaid |
$38.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$80.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$77.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$215.71
|
| Rate for Payer: Nomi Health Commercial |
$208.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$190.34
|
| Rate for Payer: PACE Medicare |
$66.66
|
| Rate for Payer: PACE SWMI |
$70.17
|
| Rate for Payer: PHP Commercial |
$77.19
|
| Rate for Payer: PHP Medicaid |
$37.61
|
| Rate for Payer: PHP Medicare Advantage |
$70.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$102.80
|
| Rate for Payer: Priority Health Medicare |
$70.17
|
| Rate for Payer: Priority Health Narrow Network |
$82.24
|
| Rate for Payer: Railroad Medicare Medicare |
$70.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$223.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$70.17
|
| Rate for Payer: UHC Exchange |
$108.76
|
| Rate for Payer: UHC Medicaid |
$36.70
|
| Rate for Payer: UHCCP DNSP |
$70.17
|
| Rate for Payer: UHCCP Medicaid |
$36.70
|
| Rate for Payer: VA VA |
$70.17
|
|
|
HC CRYOPRECIPITATE POOL CMPT3
|
Facility
|
IP
|
$253.78
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000047
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$190.34 |
| Max. Negotiated Rate |
$253.78 |
| Rate for Payer: Aetna Commercial |
$228.40
|
| Rate for Payer: ASR ASR |
$246.17
|
| Rate for Payer: BCBS Trust/PPO |
$208.40
|
| Rate for Payer: BCN Commercial |
$208.40
|
| Rate for Payer: Cash Price |
$203.02
|
| Rate for Payer: Cofinity Commercial |
$238.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.02
|
| Rate for Payer: Healthscope Commercial |
$246.17
|
| Rate for Payer: Healthscope Whirlpool |
$253.78
|
| Rate for Payer: Mclaren Commercial |
$228.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$215.71
|
| Rate for Payer: Nomi Health Commercial |
$208.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$190.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$223.33
|
|
|
HC CRYOPRECIPITATE POOL CMPT3
|
Facility
|
OP
|
$253.78
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000047
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$36.70 |
| Max. Negotiated Rate |
$253.78 |
| Rate for Payer: Aetna Commercial |
$228.40
|
| Rate for Payer: Aetna Medicare |
$70.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$87.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$87.71
|
| Rate for Payer: ASR ASR |
$246.17
|
| Rate for Payer: BCBS Complete |
$38.54
|
| Rate for Payer: BCBS MAPPO |
$70.17
|
| Rate for Payer: BCBS Trust/PPO |
$209.24
|
| Rate for Payer: BCN Commercial |
$209.24
|
| Rate for Payer: BCN Medicare Advantage |
$70.17
|
| Rate for Payer: Cash Price |
$203.02
|
| Rate for Payer: Cash Price |
$203.02
|
| Rate for Payer: Cofinity Commercial |
$238.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$70.17
|
| Rate for Payer: Healthscope Commercial |
$246.17
|
| Rate for Payer: Healthscope Whirlpool |
$253.78
|
| Rate for Payer: Humana Choice PPO Medicare |
$70.17
|
| Rate for Payer: Mclaren Commercial |
$228.40
|
| Rate for Payer: Mclaren Medicaid |
$70.17
|
| Rate for Payer: Mclaren Medicare |
$70.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$73.68
|
| Rate for Payer: Meridian Medicaid |
$38.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$80.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$77.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$215.71
|
| Rate for Payer: Nomi Health Commercial |
$208.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$190.34
|
| Rate for Payer: PACE Medicare |
$66.66
|
| Rate for Payer: PACE SWMI |
$70.17
|
| Rate for Payer: PHP Commercial |
$77.19
|
| Rate for Payer: PHP Medicaid |
$37.61
|
| Rate for Payer: PHP Medicare Advantage |
$70.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$102.80
|
| Rate for Payer: Priority Health Medicare |
$70.17
|
| Rate for Payer: Priority Health Narrow Network |
$82.24
|
| Rate for Payer: Railroad Medicare Medicare |
$70.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$223.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$70.17
|
| Rate for Payer: UHC Exchange |
$108.76
|
| Rate for Payer: UHC Medicaid |
$36.70
|
| Rate for Payer: UHCCP DNSP |
$70.17
|
| Rate for Payer: UHCCP Medicaid |
$36.70
|
| Rate for Payer: VA VA |
$70.17
|
|
|
HC CRYOPRECIPITATE POOL CMPT4
|
Facility
|
IP
|
$253.78
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000048
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$190.34 |
| Max. Negotiated Rate |
$253.78 |
| Rate for Payer: Aetna Commercial |
$228.40
|
| Rate for Payer: ASR ASR |
$246.17
|
| Rate for Payer: BCBS Trust/PPO |
$208.40
|
| Rate for Payer: BCN Commercial |
$208.40
|
| Rate for Payer: Cash Price |
$203.02
|
| Rate for Payer: Cofinity Commercial |
$238.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.02
|
| Rate for Payer: Healthscope Commercial |
$246.17
|
| Rate for Payer: Healthscope Whirlpool |
$253.78
|
| Rate for Payer: Mclaren Commercial |
$228.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$215.71
|
| Rate for Payer: Nomi Health Commercial |
$208.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$190.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$223.33
|
|
|
HC CRYOPRECIPITATE POOL CMPT4
|
Facility
|
OP
|
$253.78
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000048
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$36.70 |
| Max. Negotiated Rate |
$253.78 |
| Rate for Payer: Aetna Commercial |
$228.40
|
| Rate for Payer: Aetna Medicare |
$70.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$87.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$87.71
|
| Rate for Payer: ASR ASR |
$246.17
|
| Rate for Payer: BCBS Complete |
$38.54
|
| Rate for Payer: BCBS MAPPO |
$70.17
|
| Rate for Payer: BCBS Trust/PPO |
$209.24
|
| Rate for Payer: BCN Commercial |
$209.24
|
| Rate for Payer: BCN Medicare Advantage |
$70.17
|
| Rate for Payer: Cash Price |
$203.02
|
| Rate for Payer: Cash Price |
$203.02
|
| Rate for Payer: Cofinity Commercial |
$238.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$70.17
|
| Rate for Payer: Healthscope Commercial |
$246.17
|
| Rate for Payer: Healthscope Whirlpool |
$253.78
|
| Rate for Payer: Humana Choice PPO Medicare |
$70.17
|
| Rate for Payer: Mclaren Commercial |
$228.40
|
| Rate for Payer: Mclaren Medicaid |
$70.17
|
| Rate for Payer: Mclaren Medicare |
$70.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$73.68
|
| Rate for Payer: Meridian Medicaid |
$38.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$80.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$77.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$215.71
|
| Rate for Payer: Nomi Health Commercial |
$208.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$190.34
|
| Rate for Payer: PACE Medicare |
$66.66
|
| Rate for Payer: PACE SWMI |
$70.17
|
| Rate for Payer: PHP Commercial |
$77.19
|
| Rate for Payer: PHP Medicaid |
$37.61
|
| Rate for Payer: PHP Medicare Advantage |
$70.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$102.80
|
| Rate for Payer: Priority Health Medicare |
$70.17
|
| Rate for Payer: Priority Health Narrow Network |
$82.24
|
| Rate for Payer: Railroad Medicare Medicare |
$70.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$223.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$70.17
|
| Rate for Payer: UHC Exchange |
$108.76
|
| Rate for Payer: UHC Medicaid |
$36.70
|
| Rate for Payer: UHCCP DNSP |
$70.17
|
| Rate for Payer: UHCCP Medicaid |
$36.70
|
| Rate for Payer: VA VA |
$70.17
|
|
|
HC CRYOSURGERY ANAL LESION(S)
|
Facility
|
IP
|
$564.42
|
|
|
Service Code
|
CPT 46916
|
| Hospital Charge Code |
76100353
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$423.31 |
| Max. Negotiated Rate |
$564.42 |
| Rate for Payer: Aetna Commercial |
$507.98
|
| Rate for Payer: ASR ASR |
$547.49
|
| Rate for Payer: BCBS Trust/PPO |
$463.50
|
| Rate for Payer: BCN Commercial |
$463.50
|
| Rate for Payer: Cash Price |
$451.54
|
| Rate for Payer: Cofinity Commercial |
$530.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$451.54
|
| Rate for Payer: Healthscope Commercial |
$547.49
|
| Rate for Payer: Healthscope Whirlpool |
$564.42
|
| Rate for Payer: Mclaren Commercial |
$507.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$479.76
|
| Rate for Payer: Nomi Health Commercial |
$462.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$423.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$496.69
|
|
|
HC CRYOSURGERY ANAL LESION(S)
|
Facility
|
OP
|
$564.42
|
|
|
Service Code
|
CPT 46916
|
| Hospital Charge Code |
76100353
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$104.55 |
| Max. Negotiated Rate |
$564.42 |
| Rate for Payer: Aetna Commercial |
$507.98
|
| Rate for Payer: Aetna Medicare |
$199.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$249.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$249.89
|
| Rate for Payer: ASR ASR |
$547.49
|
| Rate for Payer: BCBS Complete |
$109.79
|
| Rate for Payer: BCBS MAPPO |
$199.91
|
| Rate for Payer: BCBS Trust/PPO |
$465.36
|
| Rate for Payer: BCN Commercial |
$465.36
|
| Rate for Payer: BCN Medicare Advantage |
$199.91
|
| Rate for Payer: Cash Price |
$451.54
|
| Rate for Payer: Cash Price |
$451.54
|
| Rate for Payer: Cofinity Commercial |
$530.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$451.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$199.91
|
| Rate for Payer: Healthscope Commercial |
$547.49
|
| Rate for Payer: Healthscope Whirlpool |
$564.42
|
| Rate for Payer: Humana Choice PPO Medicare |
$199.91
|
| Rate for Payer: Mclaren Commercial |
$507.98
|
| Rate for Payer: Mclaren Medicaid |
$199.91
|
| Rate for Payer: Mclaren Medicare |
$199.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$209.91
|
| Rate for Payer: Meridian Medicaid |
$109.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$229.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$219.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$479.76
|
| Rate for Payer: Nomi Health Commercial |
$462.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$423.31
|
| Rate for Payer: PACE Medicare |
$189.91
|
| Rate for Payer: PACE SWMI |
$199.91
|
| Rate for Payer: PHP Commercial |
$219.90
|
| Rate for Payer: PHP Medicaid |
$107.15
|
| Rate for Payer: PHP Medicare Advantage |
$199.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$494.54
|
| Rate for Payer: Priority Health Medicare |
$199.91
|
| Rate for Payer: Priority Health Narrow Network |
$395.66
|
| Rate for Payer: Railroad Medicare Medicare |
$199.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$496.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$199.91
|
| Rate for Payer: UHC Exchange |
$309.86
|
| Rate for Payer: UHC Medicaid |
$104.55
|
| Rate for Payer: UHCCP DNSP |
$199.91
|
| Rate for Payer: UHCCP Medicaid |
$104.55
|
| Rate for Payer: VA VA |
$199.91
|
|
