|
HC CRYPTOCOCCAL ANTIGEN FLUID
|
Facility
|
IP
|
$47.76
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30200210
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$35.82 |
| Max. Negotiated Rate |
$47.76 |
| Rate for Payer: Aetna Commercial |
$42.98
|
| Rate for Payer: ASR ASR |
$46.33
|
| Rate for Payer: BCBS Trust/PPO |
$39.22
|
| Rate for Payer: BCN Commercial |
$39.22
|
| Rate for Payer: Cash Price |
$38.21
|
| Rate for Payer: Cofinity Commercial |
$44.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.21
|
| Rate for Payer: Healthscope Commercial |
$46.33
|
| Rate for Payer: Healthscope Whirlpool |
$47.76
|
| Rate for Payer: Mclaren Commercial |
$42.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.60
|
| Rate for Payer: Nomi Health Commercial |
$39.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$42.03
|
|
|
HC CRYPTOCOCCAL ANTIGEN FLUID
|
Facility
|
OP
|
$47.76
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30200210
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.40 |
| Max. Negotiated Rate |
$47.76 |
| Rate for Payer: Aetna Commercial |
$42.98
|
| Rate for Payer: Aetna Medicare |
$16.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.09
|
| Rate for Payer: ASR ASR |
$46.33
|
| Rate for Payer: BCBS Complete |
$8.83
|
| Rate for Payer: BCBS MAPPO |
$16.07
|
| Rate for Payer: BCBS Trust/PPO |
$39.38
|
| Rate for Payer: BCN Commercial |
$39.38
|
| Rate for Payer: BCN Medicare Advantage |
$16.07
|
| Rate for Payer: Cash Price |
$38.21
|
| Rate for Payer: Cash Price |
$38.21
|
| Rate for Payer: Cofinity Commercial |
$44.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.07
|
| Rate for Payer: Healthscope Commercial |
$46.33
|
| Rate for Payer: Healthscope Whirlpool |
$47.76
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.07
|
| Rate for Payer: Mclaren Commercial |
$42.98
|
| Rate for Payer: Mclaren Medicaid |
$16.07
|
| Rate for Payer: Mclaren Medicare |
$16.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.87
|
| Rate for Payer: Meridian Medicaid |
$8.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.60
|
| Rate for Payer: Nomi Health Commercial |
$39.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.82
|
| Rate for Payer: PACE Medicare |
$15.27
|
| Rate for Payer: PACE SWMI |
$16.07
|
| Rate for Payer: PHP Commercial |
$17.68
|
| Rate for Payer: PHP Medicaid |
$8.61
|
| Rate for Payer: PHP Medicare Advantage |
$16.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$41.16
|
| Rate for Payer: Priority Health Medicare |
$16.07
|
| Rate for Payer: Priority Health Narrow Network |
$32.93
|
| Rate for Payer: Railroad Medicare Medicare |
$16.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$42.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$16.07
|
| Rate for Payer: UHC Exchange |
$24.91
|
| Rate for Payer: UHC Medicaid |
$8.40
|
| Rate for Payer: UHCCP DNSP |
$16.07
|
| Rate for Payer: UHCCP Medicaid |
$8.40
|
| Rate for Payer: VA VA |
$16.07
|
|
|
HC CRYPTOCOCCUS NEOFORMANS GATTII
|
Facility
|
IP
|
$53.06
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600265
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$39.80 |
| Max. Negotiated Rate |
$53.06 |
| Rate for Payer: Aetna Commercial |
$47.75
|
| Rate for Payer: ASR ASR |
$51.47
|
| Rate for Payer: BCBS Trust/PPO |
$43.57
|
| Rate for Payer: BCN Commercial |
$43.57
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$49.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Healthscope Commercial |
$51.47
|
| Rate for Payer: Healthscope Whirlpool |
$53.06
|
| Rate for Payer: Mclaren Commercial |
$47.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.69
|
|
|
HC CRYPTOCOCCUS NEOFORMANS GATTII
|
Facility
|
OP
|
$53.06
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600265
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.35 |
| Max. Negotiated Rate |
$54.39 |
| Rate for Payer: Aetna Commercial |
$47.75
|
| Rate for Payer: Aetna Medicare |
$35.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: ASR ASR |
$51.47
|
| Rate for Payer: BCBS Complete |
$19.27
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$43.75
|
| Rate for Payer: BCN Commercial |
$43.75
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$49.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$51.47
|
| Rate for Payer: Healthscope Whirlpool |
$53.06
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$47.75
|
| Rate for Payer: Mclaren Medicaid |
$35.09
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$19.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$38.60
|
| Rate for Payer: PHP Medicaid |
$18.81
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$46.49
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$37.20
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$35.09
|
| Rate for Payer: UHC Exchange |
$54.39
|
| Rate for Payer: UHC Medicaid |
$18.35
|
| Rate for Payer: UHCCP DNSP |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$18.35
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC CRYPTOSPORIDIUM SCREEN
|
Facility
|
OP
|
$46.70
|
|
|
Service Code
|
CPT 87328
|
| Hospital Charge Code |
30600120
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.23 |
| Max. Negotiated Rate |
$68.40 |
| Rate for Payer: Aetna Commercial |
$42.03
|
| Rate for Payer: Aetna Medicare |
$13.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.27
|
| Rate for Payer: ASR ASR |
$45.30
|
| Rate for Payer: BCBS Complete |
$7.59
|
| Rate for Payer: BCBS MAPPO |
$13.82
|
| Rate for Payer: BCBS Trust/PPO |
$38.50
|
| Rate for Payer: BCN Commercial |
$38.50
|
| Rate for Payer: BCN Medicare Advantage |
$13.82
|
| Rate for Payer: Cash Price |
$37.36
|
| Rate for Payer: Cash Price |
$37.36
|
| Rate for Payer: Cofinity Commercial |
$43.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.82
|
| Rate for Payer: Healthscope Commercial |
$45.30
|
| Rate for Payer: Healthscope Whirlpool |
$46.70
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.82
|
| Rate for Payer: Mclaren Commercial |
$42.03
|
| Rate for Payer: Mclaren Medicaid |
$13.82
|
| Rate for Payer: Mclaren Medicare |
$13.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.51
|
| Rate for Payer: Meridian Medicaid |
$7.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.70
|
| Rate for Payer: Nomi Health Commercial |
$38.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.02
|
| Rate for Payer: PACE Medicare |
$13.13
|
| Rate for Payer: PACE SWMI |
$13.82
|
| Rate for Payer: PHP Commercial |
$15.20
|
| Rate for Payer: PHP Medicaid |
$7.41
|
| Rate for Payer: PHP Medicare Advantage |
$13.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$68.40
|
| Rate for Payer: Priority Health Medicare |
$13.82
|
| Rate for Payer: Priority Health Narrow Network |
$54.72
|
| Rate for Payer: Railroad Medicare Medicare |
$13.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$41.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.82
|
| Rate for Payer: UHC Exchange |
$21.42
|
| Rate for Payer: UHC Medicaid |
$7.23
|
| Rate for Payer: UHCCP DNSP |
$13.82
|
| Rate for Payer: UHCCP Medicaid |
$7.23
|
| Rate for Payer: VA VA |
$13.82
|
|
|
HC CRYPTOSPORIDIUM SCREEN
|
Facility
|
IP
|
$46.70
|
|
|
Service Code
|
CPT 87328
|
| Hospital Charge Code |
30600120
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$35.02 |
| Max. Negotiated Rate |
$46.70 |
| Rate for Payer: Aetna Commercial |
$42.03
|
| Rate for Payer: ASR ASR |
$45.30
|
| Rate for Payer: BCBS Trust/PPO |
$38.35
|
| Rate for Payer: BCN Commercial |
$38.35
|
| Rate for Payer: Cash Price |
$37.36
|
| Rate for Payer: Cofinity Commercial |
$43.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.36
|
| Rate for Payer: Healthscope Commercial |
$45.30
|
| Rate for Payer: Healthscope Whirlpool |
$46.70
|
| Rate for Payer: Mclaren Commercial |
$42.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.70
|
| Rate for Payer: Nomi Health Commercial |
$38.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$41.10
|
|
|
HC CRYSTALS BODY FLUID
|
Facility
|
OP
|
$48.18
|
|
|
Service Code
|
CPT 89060
|
| Hospital Charge Code |
30000002
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$3.83 |
| Max. Negotiated Rate |
$48.18 |
| Rate for Payer: Aetna Commercial |
$43.36
|
| Rate for Payer: Aetna Medicare |
$7.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.16
|
| Rate for Payer: ASR ASR |
$46.73
|
| Rate for Payer: BCBS Complete |
$4.03
|
| Rate for Payer: BCBS MAPPO |
$7.33
|
| Rate for Payer: BCBS Trust/PPO |
$39.72
|
| Rate for Payer: BCN Commercial |
$39.72
|
| Rate for Payer: BCN Medicare Advantage |
$7.33
|
| Rate for Payer: Cash Price |
$38.54
|
| Rate for Payer: Cash Price |
$38.54
|
| Rate for Payer: Cofinity Commercial |
$45.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.33
|
| Rate for Payer: Healthscope Commercial |
$46.73
|
| Rate for Payer: Healthscope Whirlpool |
$48.18
|
| Rate for Payer: Humana Choice PPO Medicare |
$7.33
|
| Rate for Payer: Mclaren Commercial |
$43.36
|
| Rate for Payer: Mclaren Medicaid |
$7.33
|
| Rate for Payer: Mclaren Medicare |
$7.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.70
|
| Rate for Payer: Meridian Medicaid |
$4.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.95
|
| Rate for Payer: Nomi Health Commercial |
$39.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.13
|
| Rate for Payer: PACE Medicare |
$6.96
|
| Rate for Payer: PACE SWMI |
$7.33
|
| Rate for Payer: PHP Commercial |
$8.06
|
| Rate for Payer: PHP Medicaid |
$3.93
|
| Rate for Payer: PHP Medicare Advantage |
$7.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$43.60
|
| Rate for Payer: Priority Health Medicare |
$7.33
|
| Rate for Payer: Priority Health Narrow Network |
$34.88
|
| Rate for Payer: Railroad Medicare Medicare |
$7.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$42.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7.33
|
| Rate for Payer: UHC Exchange |
$11.36
|
| Rate for Payer: UHC Medicaid |
$3.83
|
| Rate for Payer: UHCCP DNSP |
$7.33
|
| Rate for Payer: UHCCP Medicaid |
$3.83
|
| Rate for Payer: VA VA |
$7.33
|
|
|
HC CRYSTALS BODY FLUID
|
Facility
|
IP
|
$48.18
|
|
|
Service Code
|
CPT 89060
|
| Hospital Charge Code |
30000002
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$36.13 |
| Max. Negotiated Rate |
$48.18 |
| Rate for Payer: Aetna Commercial |
$43.36
|
| Rate for Payer: ASR ASR |
$46.73
|
| Rate for Payer: BCBS Trust/PPO |
$39.57
|
| Rate for Payer: BCN Commercial |
$39.57
|
| Rate for Payer: Cash Price |
$38.54
|
| Rate for Payer: Cofinity Commercial |
$45.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.54
|
| Rate for Payer: Healthscope Commercial |
$46.73
|
| Rate for Payer: Healthscope Whirlpool |
$48.18
|
| Rate for Payer: Mclaren Commercial |
$43.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.95
|
| Rate for Payer: Nomi Health Commercial |
$39.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$42.40
|
|
|
HC C-SECTION (OB SURGERY)
|
Facility
|
OP
|
$3,056.08
|
|
| Hospital Charge Code |
36000024
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,130.75 |
| Max. Negotiated Rate |
$3,056.08 |
| Rate for Payer: Aetna Commercial |
$2,750.47
|
| Rate for Payer: Aetna Medicare |
$1,130.75
|
| Rate for Payer: ASR ASR |
$2,964.40
|
| Rate for Payer: BCBS Complete |
$1,222.43
|
| Rate for Payer: BCBS Trust/PPO |
$2,519.74
|
| Rate for Payer: BCN Commercial |
$2,519.74
|
| Rate for Payer: Cash Price |
$2,444.86
|
| Rate for Payer: Cofinity Commercial |
$2,872.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,444.86
|
| Rate for Payer: Healthscope Commercial |
$2,964.40
|
| Rate for Payer: Healthscope Whirlpool |
$3,056.08
|
| Rate for Payer: Mclaren Commercial |
$2,750.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,444.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,597.67
|
| Rate for Payer: Nomi Health Commercial |
$2,505.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,292.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,677.74
|
| Rate for Payer: Priority Health Narrow Network |
$2,142.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,689.35
|
|
|
HC C-SECTION (OB SURGERY)
|
Facility
|
IP
|
$3,056.08
|
|
| Hospital Charge Code |
36000024
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,292.06 |
| Max. Negotiated Rate |
$3,056.08 |
| Rate for Payer: Aetna Commercial |
$2,750.47
|
| Rate for Payer: ASR ASR |
$2,964.40
|
| Rate for Payer: BCBS Trust/PPO |
$2,509.65
|
| Rate for Payer: BCN Commercial |
$2,509.65
|
| Rate for Payer: Cash Price |
$2,444.86
|
| Rate for Payer: Cofinity Commercial |
$2,872.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,444.86
|
| Rate for Payer: Healthscope Commercial |
$2,964.40
|
| Rate for Payer: Healthscope Whirlpool |
$3,056.08
|
| Rate for Payer: Mclaren Commercial |
$2,750.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,597.67
|
| Rate for Payer: Nomi Health Commercial |
$2,505.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,292.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,689.35
|
|
|
HC C-SECTION W/STERIL (OB SURGERY
|
Facility
|
IP
|
$3,753.17
|
|
| Hospital Charge Code |
36000025
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,814.88 |
| Max. Negotiated Rate |
$3,753.17 |
| Rate for Payer: Aetna Commercial |
$3,377.85
|
| Rate for Payer: ASR ASR |
$3,640.57
|
| Rate for Payer: BCBS Trust/PPO |
$3,082.10
|
| Rate for Payer: BCN Commercial |
$3,082.10
|
| Rate for Payer: Cash Price |
$3,002.54
|
| Rate for Payer: Cofinity Commercial |
$3,527.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,002.54
|
| Rate for Payer: Healthscope Commercial |
$3,640.57
|
| Rate for Payer: Healthscope Whirlpool |
$3,753.17
|
| Rate for Payer: Mclaren Commercial |
$3,377.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,190.19
|
| Rate for Payer: Nomi Health Commercial |
$3,077.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,814.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,302.79
|
|
|
HC C-SECTION W/STERIL (OB SURGERY
|
Facility
|
OP
|
$3,753.17
|
|
| Hospital Charge Code |
36000025
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,388.67 |
| Max. Negotiated Rate |
$3,753.17 |
| Rate for Payer: Aetna Commercial |
$3,377.85
|
| Rate for Payer: Aetna Medicare |
$1,388.67
|
| Rate for Payer: ASR ASR |
$3,640.57
|
| Rate for Payer: BCBS Complete |
$1,501.27
|
| Rate for Payer: BCBS Trust/PPO |
$3,094.49
|
| Rate for Payer: BCN Commercial |
$3,094.49
|
| Rate for Payer: Cash Price |
$3,002.54
|
| Rate for Payer: Cofinity Commercial |
$3,527.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,002.54
|
| Rate for Payer: Healthscope Commercial |
$3,640.57
|
| Rate for Payer: Healthscope Whirlpool |
$3,753.17
|
| Rate for Payer: Mclaren Commercial |
$3,377.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,002.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,190.19
|
| Rate for Payer: Nomi Health Commercial |
$3,077.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,814.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,288.53
|
| Rate for Payer: Priority Health Narrow Network |
$2,630.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,302.79
|
|
|
HC CSF LACTATE
|
Facility
|
IP
|
$22.29
|
|
|
Service Code
|
CPT 83605
|
| Hospital Charge Code |
30100482
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.72 |
| Max. Negotiated Rate |
$22.29 |
| Rate for Payer: Aetna Commercial |
$20.06
|
| Rate for Payer: ASR ASR |
$21.62
|
| Rate for Payer: BCBS Trust/PPO |
$18.30
|
| Rate for Payer: BCN Commercial |
$18.30
|
| Rate for Payer: Cash Price |
$17.83
|
| Rate for Payer: Cofinity Commercial |
$20.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.83
|
| Rate for Payer: Healthscope Commercial |
$21.62
|
| Rate for Payer: Healthscope Whirlpool |
$22.29
|
| Rate for Payer: Mclaren Commercial |
$20.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.95
|
| Rate for Payer: Nomi Health Commercial |
$18.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19.62
|
|
|
HC CSF LACTATE
|
Facility
|
OP
|
$22.29
|
|
|
Service Code
|
CPT 83605
|
| Hospital Charge Code |
30100482
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.05 |
| Max. Negotiated Rate |
$76.27 |
| Rate for Payer: Aetna Commercial |
$20.06
|
| Rate for Payer: Aetna Medicare |
$11.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.46
|
| Rate for Payer: ASR ASR |
$21.62
|
| Rate for Payer: BCBS Complete |
$6.35
|
| Rate for Payer: BCBS MAPPO |
$11.57
|
| Rate for Payer: BCBS Trust/PPO |
$18.38
|
| Rate for Payer: BCN Commercial |
$18.38
|
| Rate for Payer: BCN Medicare Advantage |
$11.57
|
| Rate for Payer: Cash Price |
$17.83
|
| Rate for Payer: Cash Price |
$17.83
|
| Rate for Payer: Cofinity Commercial |
$20.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.57
|
| Rate for Payer: Healthscope Commercial |
$21.62
|
| Rate for Payer: Healthscope Whirlpool |
$22.29
|
| Rate for Payer: Humana Choice PPO Medicare |
$11.57
|
| Rate for Payer: Mclaren Commercial |
$20.06
|
| Rate for Payer: Mclaren Medicaid |
$11.57
|
| Rate for Payer: Mclaren Medicare |
$11.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.15
|
| Rate for Payer: Meridian Medicaid |
$6.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.95
|
| Rate for Payer: Nomi Health Commercial |
$18.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.72
|
| Rate for Payer: PACE Medicare |
$10.99
|
| Rate for Payer: PACE SWMI |
$11.57
|
| Rate for Payer: PHP Commercial |
$12.73
|
| Rate for Payer: PHP Medicaid |
$6.20
|
| Rate for Payer: PHP Medicare Advantage |
$11.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$76.27
|
| Rate for Payer: Priority Health Medicare |
$11.57
|
| Rate for Payer: Priority Health Narrow Network |
$61.02
|
| Rate for Payer: Railroad Medicare Medicare |
$11.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11.57
|
| Rate for Payer: UHC Exchange |
$17.93
|
| Rate for Payer: UHC Medicaid |
$6.05
|
| Rate for Payer: UHCCP DNSP |
$11.57
|
| Rate for Payer: UHCCP Medicaid |
$6.05
|
| Rate for Payer: VA VA |
$11.57
|
|
|
HC CSU OBSERVATION PER HOUR
|
Facility
|
IP
|
$160.00
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200016
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$120.00 |
| Max. Negotiated Rate |
$160.00 |
| Rate for Payer: Aetna Commercial |
$144.00
|
| Rate for Payer: ASR ASR |
$155.20
|
| Rate for Payer: BCBS Trust/PPO |
$131.39
|
| Rate for Payer: BCN Commercial |
$131.39
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cofinity Commercial |
$150.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.00
|
| Rate for Payer: Healthscope Commercial |
$155.20
|
| Rate for Payer: Healthscope Whirlpool |
$160.00
|
| Rate for Payer: Mclaren Commercial |
$144.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.00
|
| Rate for Payer: Nomi Health Commercial |
$131.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$120.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$140.80
|
|
|
HC CSU OBSERVATION PER HOUR
|
Facility
|
OP
|
$160.00
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200016
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$54.44 |
| Max. Negotiated Rate |
$1,608.00 |
| Rate for Payer: Aetna Commercial |
$144.00
|
| Rate for Payer: Aetna Medicare |
$59.20
|
| Rate for Payer: ASR ASR |
$155.20
|
| Rate for Payer: BCBS Complete |
$64.00
|
| Rate for Payer: BCBS Trust/PPO |
$131.92
|
| Rate for Payer: BCN Commercial |
$131.92
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cofinity Commercial |
$150.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.00
|
| Rate for Payer: Healthscope Commercial |
$155.20
|
| Rate for Payer: Healthscope Whirlpool |
$160.00
|
| Rate for Payer: Mclaren Commercial |
$144.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$128.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.00
|
| Rate for Payer: Nomi Health Commercial |
$131.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$120.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$68.05
|
| Rate for Payer: Priority Health Narrow Network |
$54.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$140.80
|
| Rate for Payer: UHC Medicaid |
$1,608.00
|
|
|
HC CSU R&B
|
Facility
|
IP
|
$7,454.86
|
|
| Hospital Charge Code |
21000002
|
|
Hospital Revenue Code
|
210
|
| Min. Negotiated Rate |
$5,591.15 |
| Max. Negotiated Rate |
$7,454.86 |
| Rate for Payer: Aetna Commercial |
$6,709.37
|
| Rate for Payer: ASR ASR |
$7,231.21
|
| Rate for Payer: BCBS Trust/PPO |
$6,121.93
|
| Rate for Payer: BCN Commercial |
$6,121.93
|
| Rate for Payer: Cash Price |
$5,963.89
|
| Rate for Payer: Cofinity Commercial |
$7,007.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,963.89
|
| Rate for Payer: Healthscope Commercial |
$7,231.21
|
| Rate for Payer: Healthscope Whirlpool |
$7,454.86
|
| Rate for Payer: Mclaren Commercial |
$6,709.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,336.63
|
| Rate for Payer: Nomi Health Commercial |
$6,112.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,591.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,560.28
|
|
|
HC CT ABDOMEN AND PELVIS W CON
|
Facility
|
OP
|
$3,783.83
|
|
|
Service Code
|
CPT 74177
|
| Hospital Charge Code |
35200027
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$3,783.83 |
| Rate for Payer: Aetna Commercial |
$3,405.45
|
| Rate for Payer: Aetna Medicare |
$347.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$434.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$434.52
|
| Rate for Payer: ASR ASR |
$3,670.32
|
| Rate for Payer: BCBS Complete |
$190.91
|
| Rate for Payer: BCBS MAPPO |
$347.62
|
| Rate for Payer: BCBS Trust/PPO |
$3,119.77
|
| Rate for Payer: BCN Commercial |
$3,119.77
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$3,027.06
|
| Rate for Payer: Cash Price |
$3,027.06
|
| Rate for Payer: Cofinity Commercial |
$3,556.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,027.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$3,670.32
|
| Rate for Payer: Healthscope Whirlpool |
$3,783.83
|
| Rate for Payer: Humana Choice PPO Medicare |
$347.62
|
| Rate for Payer: Mclaren Commercial |
$3,405.45
|
| Rate for Payer: Mclaren Medicaid |
$347.62
|
| Rate for Payer: Mclaren Medicare |
$347.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.00
|
| Rate for Payer: Meridian Medicaid |
$190.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$399.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$382.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,216.26
|
| Rate for Payer: Nomi Health Commercial |
$3,102.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,837.87
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$382.38
|
| Rate for Payer: PHP Medicaid |
$186.32
|
| Rate for Payer: PHP Medicare Advantage |
$347.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,055.52
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,644.42
|
| Rate for Payer: Railroad Medicare Medicare |
$347.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,329.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$538.81
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHCCP DNSP |
$347.62
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: VA VA |
$347.62
|
|
|
HC CT ABDOMEN AND PELVIS W CON
|
Facility
|
IP
|
$3,783.83
|
|
|
Service Code
|
CPT 74177
|
| Hospital Charge Code |
35200027
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$2,837.87 |
| Max. Negotiated Rate |
$3,783.83 |
| Rate for Payer: Aetna Commercial |
$3,405.45
|
| Rate for Payer: ASR ASR |
$3,670.32
|
| Rate for Payer: BCBS Trust/PPO |
$3,107.28
|
| Rate for Payer: BCN Commercial |
$3,107.28
|
| Rate for Payer: Cash Price |
$3,027.06
|
| Rate for Payer: Cofinity Commercial |
$3,556.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,027.06
|
| Rate for Payer: Healthscope Commercial |
$3,670.32
|
| Rate for Payer: Healthscope Whirlpool |
$3,783.83
|
| Rate for Payer: Mclaren Commercial |
$3,405.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,216.26
|
| Rate for Payer: Nomi Health Commercial |
$3,102.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,837.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,329.77
|
|
|
HC CT ABDOMEN AND PELVIS WO CON
|
Facility
|
IP
|
$2,552.31
|
|
|
Service Code
|
CPT 74176
|
| Hospital Charge Code |
35200026
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,914.23 |
| Max. Negotiated Rate |
$2,552.31 |
| Rate for Payer: Aetna Commercial |
$2,297.08
|
| Rate for Payer: ASR ASR |
$2,475.74
|
| Rate for Payer: BCBS Trust/PPO |
$2,095.96
|
| Rate for Payer: BCN Commercial |
$2,095.96
|
| Rate for Payer: Cash Price |
$2,041.85
|
| Rate for Payer: Cofinity Commercial |
$2,399.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,041.85
|
| Rate for Payer: Healthscope Commercial |
$2,475.74
|
| Rate for Payer: Healthscope Whirlpool |
$2,552.31
|
| Rate for Payer: Mclaren Commercial |
$2,297.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,169.46
|
| Rate for Payer: Nomi Health Commercial |
$2,092.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,914.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,246.03
|
|
|
HC CT ABDOMEN AND PELVIS WO CON
|
Facility
|
OP
|
$2,552.31
|
|
|
Service Code
|
CPT 74176
|
| Hospital Charge Code |
35200026
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$2,552.31 |
| Rate for Payer: Aetna Commercial |
$2,297.08
|
| Rate for Payer: Aetna Medicare |
$237.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$297.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$297.18
|
| Rate for Payer: ASR ASR |
$2,475.74
|
| Rate for Payer: BCBS Complete |
$130.57
|
| Rate for Payer: BCBS MAPPO |
$237.74
|
| Rate for Payer: BCBS Trust/PPO |
$2,104.38
|
| Rate for Payer: BCN Commercial |
$2,104.38
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$2,041.85
|
| Rate for Payer: Cash Price |
$2,041.85
|
| Rate for Payer: Cofinity Commercial |
$2,399.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,041.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$2,475.74
|
| Rate for Payer: Healthscope Whirlpool |
$2,552.31
|
| Rate for Payer: Humana Choice PPO Medicare |
$237.74
|
| Rate for Payer: Mclaren Commercial |
$2,297.08
|
| Rate for Payer: Mclaren Medicaid |
$237.74
|
| Rate for Payer: Mclaren Medicare |
$237.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.63
|
| Rate for Payer: Meridian Medicaid |
$130.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$273.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$261.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,169.46
|
| Rate for Payer: Nomi Health Commercial |
$2,092.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,914.23
|
| Rate for Payer: PACE Medicare |
$225.85
|
| Rate for Payer: PACE SWMI |
$237.74
|
| Rate for Payer: PHP Commercial |
$261.51
|
| Rate for Payer: PHP Medicaid |
$127.43
|
| Rate for Payer: PHP Medicare Advantage |
$237.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,939.32
|
| Rate for Payer: Priority Health Medicare |
$237.74
|
| Rate for Payer: Priority Health Narrow Network |
$1,551.45
|
| Rate for Payer: Railroad Medicare Medicare |
$237.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,246.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$237.74
|
| Rate for Payer: UHC Exchange |
$368.50
|
| Rate for Payer: UHC Medicaid |
$124.34
|
| Rate for Payer: UHCCP DNSP |
$237.74
|
| Rate for Payer: UHCCP Medicaid |
$124.34
|
| Rate for Payer: VA VA |
$237.74
|
|
|
HC CT ABDOMEN AND PELVIS WO W CON
|
Facility
|
IP
|
$4,522.30
|
|
|
Service Code
|
CPT 74178
|
| Hospital Charge Code |
35200028
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$3,391.72 |
| Max. Negotiated Rate |
$4,522.30 |
| Rate for Payer: Aetna Commercial |
$4,070.07
|
| Rate for Payer: ASR ASR |
$4,386.63
|
| Rate for Payer: BCBS Trust/PPO |
$3,713.71
|
| Rate for Payer: BCN Commercial |
$3,713.71
|
| Rate for Payer: Cash Price |
$3,617.84
|
| Rate for Payer: Cofinity Commercial |
$4,250.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,617.84
|
| Rate for Payer: Healthscope Commercial |
$4,386.63
|
| Rate for Payer: Healthscope Whirlpool |
$4,522.30
|
| Rate for Payer: Mclaren Commercial |
$4,070.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,843.95
|
| Rate for Payer: Nomi Health Commercial |
$3,708.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,391.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,979.62
|
|
|
HC CT ABDOMEN AND PELVIS WO W CON
|
Facility
|
OP
|
$4,522.30
|
|
|
Service Code
|
CPT 74178
|
| Hospital Charge Code |
35200028
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$181.81 |
| Max. Negotiated Rate |
$4,522.30 |
| Rate for Payer: Aetna Commercial |
$4,070.07
|
| Rate for Payer: Aetna Medicare |
$347.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$434.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$434.52
|
| Rate for Payer: ASR ASR |
$4,386.63
|
| Rate for Payer: BCBS Complete |
$190.91
|
| Rate for Payer: BCBS MAPPO |
$347.62
|
| Rate for Payer: BCBS Trust/PPO |
$3,728.64
|
| Rate for Payer: BCN Commercial |
$3,728.64
|
| Rate for Payer: BCN Medicare Advantage |
$347.62
|
| Rate for Payer: Cash Price |
$3,617.84
|
| Rate for Payer: Cash Price |
$3,617.84
|
| Rate for Payer: Cofinity Commercial |
$4,250.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,617.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.62
|
| Rate for Payer: Healthscope Commercial |
$4,386.63
|
| Rate for Payer: Healthscope Whirlpool |
$4,522.30
|
| Rate for Payer: Humana Choice PPO Medicare |
$347.62
|
| Rate for Payer: Mclaren Commercial |
$4,070.07
|
| Rate for Payer: Mclaren Medicaid |
$347.62
|
| Rate for Payer: Mclaren Medicare |
$347.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.00
|
| Rate for Payer: Meridian Medicaid |
$190.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$399.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$382.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,843.95
|
| Rate for Payer: Nomi Health Commercial |
$3,708.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,391.72
|
| Rate for Payer: PACE Medicare |
$330.24
|
| Rate for Payer: PACE SWMI |
$347.62
|
| Rate for Payer: PHP Commercial |
$382.38
|
| Rate for Payer: PHP Medicaid |
$186.32
|
| Rate for Payer: PHP Medicare Advantage |
$347.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,295.82
|
| Rate for Payer: Priority Health Medicare |
$347.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,836.66
|
| Rate for Payer: Railroad Medicare Medicare |
$347.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,979.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.62
|
| Rate for Payer: UHC Exchange |
$538.81
|
| Rate for Payer: UHC Medicaid |
$181.81
|
| Rate for Payer: UHCCP DNSP |
$347.62
|
| Rate for Payer: UHCCP Medicaid |
$181.81
|
| Rate for Payer: VA VA |
$347.62
|
|
|
HC CT ABDOMEN ANGIO
|
Facility
|
OP
|
$1,119.37
|
|
|
Service Code
|
CPT 74175
|
| Hospital Charge Code |
35200025
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$91.40 |
| Max. Negotiated Rate |
$1,119.37 |
| Rate for Payer: Aetna Commercial |
$1,007.43
|
| Rate for Payer: Aetna Medicare |
$174.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$218.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$218.46
|
| Rate for Payer: ASR ASR |
$1,085.79
|
| Rate for Payer: BCBS Complete |
$95.98
|
| Rate for Payer: BCBS MAPPO |
$174.77
|
| Rate for Payer: BCBS Trust/PPO |
$922.92
|
| Rate for Payer: BCN Commercial |
$922.92
|
| Rate for Payer: BCN Medicare Advantage |
$174.77
|
| Rate for Payer: Cash Price |
$895.50
|
| Rate for Payer: Cash Price |
$895.50
|
| Rate for Payer: Cofinity Commercial |
$1,052.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$895.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.77
|
| Rate for Payer: Healthscope Commercial |
$1,085.79
|
| Rate for Payer: Healthscope Whirlpool |
$1,119.37
|
| Rate for Payer: Humana Choice PPO Medicare |
$174.77
|
| Rate for Payer: Mclaren Commercial |
$1,007.43
|
| Rate for Payer: Mclaren Medicaid |
$174.77
|
| Rate for Payer: Mclaren Medicare |
$174.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.51
|
| Rate for Payer: Meridian Medicaid |
$95.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$200.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$192.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$951.46
|
| Rate for Payer: Nomi Health Commercial |
$917.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$839.53
|
| Rate for Payer: PACE Medicare |
$166.03
|
| Rate for Payer: PACE SWMI |
$174.77
|
| Rate for Payer: PHP Commercial |
$192.25
|
| Rate for Payer: PHP Medicaid |
$93.68
|
| Rate for Payer: PHP Medicare Advantage |
$174.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,000.53
|
| Rate for Payer: Priority Health Medicare |
$174.77
|
| Rate for Payer: Priority Health Narrow Network |
$800.43
|
| Rate for Payer: Railroad Medicare Medicare |
$174.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$985.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$174.77
|
| Rate for Payer: UHC Exchange |
$270.89
|
| Rate for Payer: UHC Medicaid |
$91.40
|
| Rate for Payer: UHCCP DNSP |
$174.77
|
| Rate for Payer: UHCCP Medicaid |
$91.40
|
| Rate for Payer: VA VA |
$174.77
|
|
|
HC CT ABDOMEN ANGIO
|
Facility
|
IP
|
$1,119.37
|
|
|
Service Code
|
CPT 74175
|
| Hospital Charge Code |
35200025
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$839.53 |
| Max. Negotiated Rate |
$1,119.37 |
| Rate for Payer: Aetna Commercial |
$1,007.43
|
| Rate for Payer: ASR ASR |
$1,085.79
|
| Rate for Payer: BCBS Trust/PPO |
$919.23
|
| Rate for Payer: BCN Commercial |
$919.23
|
| Rate for Payer: Cash Price |
$895.50
|
| Rate for Payer: Cofinity Commercial |
$1,052.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$895.50
|
| Rate for Payer: Healthscope Commercial |
$1,085.79
|
| Rate for Payer: Healthscope Whirlpool |
$1,119.37
|
| Rate for Payer: Mclaren Commercial |
$1,007.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$951.46
|
| Rate for Payer: Nomi Health Commercial |
$917.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$839.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$985.05
|
|
