|
HC COLPOSCOPY CERVIX W ADJ VAGINA W BX
|
Facility
|
OP
|
$426.04
|
|
|
Service Code
|
CPT 57455
|
| Hospital Charge Code |
76100205
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$157.18 |
| Max. Negotiated Rate |
$461.96 |
| Rate for Payer: Aetna Commercial |
$383.44
|
| Rate for Payer: Aetna Medicare |
$298.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$372.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$372.55
|
| Rate for Payer: ASR ASR |
$413.26
|
| Rate for Payer: ASR Commercial |
$413.26
|
| Rate for Payer: BCBS Complete |
$167.74
|
| Rate for Payer: BCBS MAPPO |
$298.04
|
| Rate for Payer: BCBS Trust/PPO |
$348.88
|
| Rate for Payer: BCCCP Commercial |
$157.18
|
| Rate for Payer: BCN Commercial |
$330.31
|
| Rate for Payer: BCN Medicare Advantage |
$298.04
|
| Rate for Payer: Cash Price |
$340.83
|
| Rate for Payer: Cash Price |
$340.83
|
| Rate for Payer: Cofinity Commercial |
$400.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$340.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$298.04
|
| Rate for Payer: Healthscope Commercial |
$426.04
|
| Rate for Payer: Healthscope Whirlpool |
$413.26
|
| Rate for Payer: Humana Choice PPO Medicare |
$298.04
|
| Rate for Payer: Mclaren Commercial |
$383.44
|
| Rate for Payer: Mclaren Medicaid |
$159.75
|
| Rate for Payer: Mclaren Medicare |
$298.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$312.94
|
| Rate for Payer: Meridian Medicaid |
$167.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$342.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$362.13
|
| Rate for Payer: Nomi Health Commercial |
$349.35
|
| Rate for Payer: PACE Medicare |
$283.14
|
| Rate for Payer: PACE SWMI |
$298.04
|
| Rate for Payer: PHP Commercial |
$327.84
|
| Rate for Payer: PHP Medicaid |
$159.75
|
| Rate for Payer: PHP Medicare Advantage |
$298.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$159.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$276.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$373.30
|
| Rate for Payer: Priority Health Medicare |
$298.04
|
| Rate for Payer: Priority Health Narrow Network |
$298.65
|
| Rate for Payer: Railroad Medicare Medicare |
$298.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$374.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$298.04
|
| Rate for Payer: UHC Exchange |
$461.96
|
| Rate for Payer: UHC Medicare Advantage |
$298.04
|
| Rate for Payer: UHCCP DNSP |
$298.04
|
| Rate for Payer: UHCCP Medicaid |
$159.75
|
| Rate for Payer: VA VA |
$298.04
|
|
|
HC COLPOSCOPY OF CERVIX/VAGINA W/BIOPSY AND CURETTAGE
|
Facility
|
OP
|
$368.30
|
|
|
Service Code
|
CPT 57454
|
| Hospital Charge Code |
76100140
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$159.75 |
| Max. Negotiated Rate |
$461.96 |
| Rate for Payer: Aetna Commercial |
$331.47
|
| Rate for Payer: Aetna Medicare |
$298.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$372.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$372.55
|
| Rate for Payer: ASR ASR |
$357.25
|
| Rate for Payer: ASR Commercial |
$357.25
|
| Rate for Payer: BCBS Complete |
$167.74
|
| Rate for Payer: BCBS MAPPO |
$298.04
|
| Rate for Payer: BCBS Trust/PPO |
$301.60
|
| Rate for Payer: BCCCP Commercial |
$164.88
|
| Rate for Payer: BCN Commercial |
$285.54
|
| Rate for Payer: BCN Medicare Advantage |
$298.04
|
| Rate for Payer: Cash Price |
$294.64
|
| Rate for Payer: Cash Price |
$294.64
|
| Rate for Payer: Cofinity Commercial |
$346.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$294.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$298.04
|
| Rate for Payer: Healthscope Commercial |
$368.30
|
| Rate for Payer: Healthscope Whirlpool |
$357.25
|
| Rate for Payer: Humana Choice PPO Medicare |
$298.04
|
| Rate for Payer: Mclaren Commercial |
$331.47
|
| Rate for Payer: Mclaren Medicaid |
$159.75
|
| Rate for Payer: Mclaren Medicare |
$298.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$312.94
|
| Rate for Payer: Meridian Medicaid |
$167.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$342.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$313.06
|
| Rate for Payer: Nomi Health Commercial |
$302.01
|
| Rate for Payer: PACE Medicare |
$283.14
|
| Rate for Payer: PACE SWMI |
$298.04
|
| Rate for Payer: PHP Commercial |
$327.84
|
| Rate for Payer: PHP Medicaid |
$159.75
|
| Rate for Payer: PHP Medicare Advantage |
$298.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$159.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$239.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$322.70
|
| Rate for Payer: Priority Health Medicare |
$298.04
|
| Rate for Payer: Priority Health Narrow Network |
$258.18
|
| Rate for Payer: Railroad Medicare Medicare |
$298.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$324.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$298.04
|
| Rate for Payer: UHC Exchange |
$461.96
|
| Rate for Payer: UHC Medicare Advantage |
$298.04
|
| Rate for Payer: UHCCP DNSP |
$298.04
|
| Rate for Payer: UHCCP Medicaid |
$159.75
|
| Rate for Payer: VA VA |
$298.04
|
|
|
HC COLPOSCOPY OF CERVIX/VAGINA W/BIOPSY AND CURETTAGE
|
Facility
|
IP
|
$368.30
|
|
|
Service Code
|
CPT 57454
|
| Hospital Charge Code |
76100140
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$239.40 |
| Max. Negotiated Rate |
$368.30 |
| Rate for Payer: Aetna Commercial |
$331.47
|
| Rate for Payer: ASR ASR |
$357.25
|
| Rate for Payer: ASR Commercial |
$357.25
|
| Rate for Payer: BCBS Trust/PPO |
$300.13
|
| Rate for Payer: BCN Commercial |
$285.54
|
| Rate for Payer: Cash Price |
$294.64
|
| Rate for Payer: Cofinity Commercial |
$346.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$294.64
|
| Rate for Payer: Healthscope Commercial |
$368.30
|
| Rate for Payer: Healthscope Whirlpool |
$357.25
|
| Rate for Payer: Mclaren Commercial |
$331.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$313.06
|
| Rate for Payer: Nomi Health Commercial |
$302.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$239.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$324.10
|
|
|
HC COLPOSCOPY VAGINA W/BIOPSY
|
Facility
|
IP
|
$870.81
|
|
|
Service Code
|
CPT 57421
|
| Hospital Charge Code |
76100223
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$566.03 |
| Max. Negotiated Rate |
$870.81 |
| Rate for Payer: Aetna Commercial |
$783.73
|
| Rate for Payer: ASR ASR |
$844.69
|
| Rate for Payer: ASR Commercial |
$844.69
|
| Rate for Payer: BCBS Trust/PPO |
$709.62
|
| Rate for Payer: BCN Commercial |
$675.14
|
| Rate for Payer: Cash Price |
$696.65
|
| Rate for Payer: Cofinity Commercial |
$818.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$696.65
|
| Rate for Payer: Healthscope Commercial |
$870.81
|
| Rate for Payer: Healthscope Whirlpool |
$844.69
|
| Rate for Payer: Mclaren Commercial |
$783.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$740.19
|
| Rate for Payer: Nomi Health Commercial |
$714.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$566.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$766.31
|
|
|
HC COLPOSCOPY VAGINA W/BIOPSY
|
Facility
|
OP
|
$870.81
|
|
|
Service Code
|
CPT 57421
|
| Hospital Charge Code |
76100223
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$457.28 |
| Max. Negotiated Rate |
$1,322.35 |
| Rate for Payer: Aetna Commercial |
$783.73
|
| Rate for Payer: Aetna Medicare |
$853.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,066.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,066.41
|
| Rate for Payer: ASR ASR |
$844.69
|
| Rate for Payer: ASR Commercial |
$844.69
|
| Rate for Payer: BCBS Complete |
$480.14
|
| Rate for Payer: BCBS MAPPO |
$853.13
|
| Rate for Payer: BCBS Trust/PPO |
$713.11
|
| Rate for Payer: BCN Commercial |
$675.14
|
| Rate for Payer: BCN Medicare Advantage |
$853.13
|
| Rate for Payer: Cash Price |
$696.65
|
| Rate for Payer: Cash Price |
$696.65
|
| Rate for Payer: Cofinity Commercial |
$818.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$696.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$853.13
|
| Rate for Payer: Healthscope Commercial |
$870.81
|
| Rate for Payer: Healthscope Whirlpool |
$844.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$853.13
|
| Rate for Payer: Mclaren Commercial |
$783.73
|
| Rate for Payer: Mclaren Medicaid |
$457.28
|
| Rate for Payer: Mclaren Medicare |
$853.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$895.79
|
| Rate for Payer: Meridian Medicaid |
$480.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$981.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$740.19
|
| Rate for Payer: Nomi Health Commercial |
$714.06
|
| Rate for Payer: PACE Medicare |
$810.47
|
| Rate for Payer: PACE SWMI |
$853.13
|
| Rate for Payer: PHP Commercial |
$938.44
|
| Rate for Payer: PHP Medicaid |
$457.28
|
| Rate for Payer: PHP Medicare Advantage |
$853.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$457.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$566.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$763.00
|
| Rate for Payer: Priority Health Medicare |
$853.13
|
| Rate for Payer: Priority Health Narrow Network |
$610.44
|
| Rate for Payer: Railroad Medicare Medicare |
$853.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$766.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$853.13
|
| Rate for Payer: UHC Exchange |
$1,322.35
|
| Rate for Payer: UHC Medicare Advantage |
$853.13
|
| Rate for Payer: UHCCP DNSP |
$853.13
|
| Rate for Payer: UHCCP Medicaid |
$457.28
|
| Rate for Payer: VA VA |
$853.13
|
|
|
HC COLPOSCOPY VAGINA W/O BIOPSY
|
Facility
|
IP
|
$422.48
|
|
|
Service Code
|
CPT 57420
|
| Hospital Charge Code |
76100254
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$274.61 |
| Max. Negotiated Rate |
$422.48 |
| Rate for Payer: Aetna Commercial |
$380.23
|
| Rate for Payer: ASR ASR |
$409.81
|
| Rate for Payer: ASR Commercial |
$409.81
|
| Rate for Payer: BCBS Trust/PPO |
$344.28
|
| Rate for Payer: BCN Commercial |
$327.55
|
| Rate for Payer: Cash Price |
$337.98
|
| Rate for Payer: Cofinity Commercial |
$397.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$337.98
|
| Rate for Payer: Healthscope Commercial |
$422.48
|
| Rate for Payer: Healthscope Whirlpool |
$409.81
|
| Rate for Payer: Mclaren Commercial |
$380.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$359.11
|
| Rate for Payer: Nomi Health Commercial |
$346.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$274.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$371.78
|
|
|
HC COLPOSCOPY VAGINA W/O BIOPSY
|
Facility
|
OP
|
$422.48
|
|
|
Service Code
|
CPT 57420
|
| Hospital Charge Code |
76100254
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$159.75 |
| Max. Negotiated Rate |
$461.96 |
| Rate for Payer: Aetna Commercial |
$380.23
|
| Rate for Payer: Aetna Medicare |
$298.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$372.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$372.55
|
| Rate for Payer: ASR ASR |
$409.81
|
| Rate for Payer: ASR Commercial |
$409.81
|
| Rate for Payer: BCBS Complete |
$167.74
|
| Rate for Payer: BCBS MAPPO |
$298.04
|
| Rate for Payer: BCBS Trust/PPO |
$345.97
|
| Rate for Payer: BCN Commercial |
$327.55
|
| Rate for Payer: BCN Medicare Advantage |
$298.04
|
| Rate for Payer: Cash Price |
$337.98
|
| Rate for Payer: Cash Price |
$337.98
|
| Rate for Payer: Cofinity Commercial |
$397.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$337.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$298.04
|
| Rate for Payer: Healthscope Commercial |
$422.48
|
| Rate for Payer: Healthscope Whirlpool |
$409.81
|
| Rate for Payer: Humana Choice PPO Medicare |
$298.04
|
| Rate for Payer: Mclaren Commercial |
$380.23
|
| Rate for Payer: Mclaren Medicaid |
$159.75
|
| Rate for Payer: Mclaren Medicare |
$298.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$312.94
|
| Rate for Payer: Meridian Medicaid |
$167.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$342.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$359.11
|
| Rate for Payer: Nomi Health Commercial |
$346.43
|
| Rate for Payer: PACE Medicare |
$283.14
|
| Rate for Payer: PACE SWMI |
$298.04
|
| Rate for Payer: PHP Commercial |
$327.84
|
| Rate for Payer: PHP Medicaid |
$159.75
|
| Rate for Payer: PHP Medicare Advantage |
$298.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$159.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$274.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$370.18
|
| Rate for Payer: Priority Health Medicare |
$298.04
|
| Rate for Payer: Priority Health Narrow Network |
$296.16
|
| Rate for Payer: Railroad Medicare Medicare |
$298.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$371.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$298.04
|
| Rate for Payer: UHC Exchange |
$461.96
|
| Rate for Payer: UHC Medicare Advantage |
$298.04
|
| Rate for Payer: UHCCP DNSP |
$298.04
|
| Rate for Payer: UHCCP Medicaid |
$159.75
|
| Rate for Payer: VA VA |
$298.04
|
|
|
HC COLPOSCOPY, VULVA
|
Facility
|
OP
|
$328.77
|
|
|
Service Code
|
CPT 56820
|
| Hospital Charge Code |
76100258
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$105.65 |
| Max. Negotiated Rate |
$328.77 |
| Rate for Payer: Aetna Commercial |
$295.89
|
| Rate for Payer: Aetna Medicare |
$197.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$246.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$246.38
|
| Rate for Payer: ASR ASR |
$318.91
|
| Rate for Payer: ASR Commercial |
$318.91
|
| Rate for Payer: BCBS Complete |
$110.93
|
| Rate for Payer: BCBS MAPPO |
$197.10
|
| Rate for Payer: BCBS Trust/PPO |
$269.23
|
| Rate for Payer: BCN Commercial |
$254.90
|
| Rate for Payer: BCN Medicare Advantage |
$197.10
|
| Rate for Payer: Cash Price |
$263.02
|
| Rate for Payer: Cash Price |
$263.02
|
| Rate for Payer: Cofinity Commercial |
$309.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$263.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$197.10
|
| Rate for Payer: Healthscope Commercial |
$328.77
|
| Rate for Payer: Healthscope Whirlpool |
$318.91
|
| Rate for Payer: Humana Choice PPO Medicare |
$197.10
|
| Rate for Payer: Mclaren Commercial |
$295.89
|
| Rate for Payer: Mclaren Medicaid |
$105.65
|
| Rate for Payer: Mclaren Medicare |
$197.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$206.96
|
| Rate for Payer: Meridian Medicaid |
$110.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$226.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$279.45
|
| Rate for Payer: Nomi Health Commercial |
$269.59
|
| Rate for Payer: PACE Medicare |
$187.24
|
| Rate for Payer: PACE SWMI |
$197.10
|
| Rate for Payer: PHP Commercial |
$216.81
|
| Rate for Payer: PHP Medicaid |
$105.65
|
| Rate for Payer: PHP Medicare Advantage |
$197.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$105.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$213.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$288.07
|
| Rate for Payer: Priority Health Medicare |
$197.10
|
| Rate for Payer: Priority Health Narrow Network |
$230.47
|
| Rate for Payer: Railroad Medicare Medicare |
$197.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$289.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$197.10
|
| Rate for Payer: UHC Exchange |
$305.50
|
| Rate for Payer: UHC Medicare Advantage |
$197.10
|
| Rate for Payer: UHCCP DNSP |
$197.10
|
| Rate for Payer: UHCCP Medicaid |
$105.65
|
| Rate for Payer: VA VA |
$197.10
|
|
|
HC COLPOSCOPY, VULVA
|
Facility
|
IP
|
$328.77
|
|
|
Service Code
|
CPT 56820
|
| Hospital Charge Code |
76100258
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$213.70 |
| Max. Negotiated Rate |
$328.77 |
| Rate for Payer: Aetna Commercial |
$295.89
|
| Rate for Payer: ASR ASR |
$318.91
|
| Rate for Payer: ASR Commercial |
$318.91
|
| Rate for Payer: BCBS Trust/PPO |
$267.91
|
| Rate for Payer: BCN Commercial |
$254.90
|
| Rate for Payer: Cash Price |
$263.02
|
| Rate for Payer: Cofinity Commercial |
$309.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$263.02
|
| Rate for Payer: Healthscope Commercial |
$328.77
|
| Rate for Payer: Healthscope Whirlpool |
$318.91
|
| Rate for Payer: Mclaren Commercial |
$295.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$279.45
|
| Rate for Payer: Nomi Health Commercial |
$269.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$213.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$289.32
|
|
|
HC COLPOSCOPY VULVA W/BIOPSY
|
Facility
|
IP
|
$854.17
|
|
|
Service Code
|
CPT 56821
|
| Hospital Charge Code |
76100332
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$555.21 |
| Max. Negotiated Rate |
$854.17 |
| Rate for Payer: Aetna Commercial |
$768.75
|
| Rate for Payer: ASR ASR |
$828.54
|
| Rate for Payer: ASR Commercial |
$828.54
|
| Rate for Payer: BCBS Trust/PPO |
$696.06
|
| Rate for Payer: BCN Commercial |
$662.24
|
| Rate for Payer: Cash Price |
$683.34
|
| Rate for Payer: Cofinity Commercial |
$802.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$683.34
|
| Rate for Payer: Healthscope Commercial |
$854.17
|
| Rate for Payer: Healthscope Whirlpool |
$828.54
|
| Rate for Payer: Mclaren Commercial |
$768.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$726.04
|
| Rate for Payer: Nomi Health Commercial |
$700.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$555.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$751.67
|
|
|
HC COLPOSCOPY VULVA W/BIOPSY
|
Facility
|
OP
|
$854.17
|
|
|
Service Code
|
CPT 56821
|
| Hospital Charge Code |
76100332
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$159.75 |
| Max. Negotiated Rate |
$854.17 |
| Rate for Payer: Aetna Commercial |
$768.75
|
| Rate for Payer: Aetna Medicare |
$298.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$372.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$372.55
|
| Rate for Payer: ASR ASR |
$828.54
|
| Rate for Payer: ASR Commercial |
$828.54
|
| Rate for Payer: BCBS Complete |
$167.74
|
| Rate for Payer: BCBS MAPPO |
$298.04
|
| Rate for Payer: BCBS Trust/PPO |
$699.48
|
| Rate for Payer: BCN Commercial |
$662.24
|
| Rate for Payer: BCN Medicare Advantage |
$298.04
|
| Rate for Payer: Cash Price |
$683.34
|
| Rate for Payer: Cash Price |
$683.34
|
| Rate for Payer: Cofinity Commercial |
$802.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$683.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$298.04
|
| Rate for Payer: Healthscope Commercial |
$854.17
|
| Rate for Payer: Healthscope Whirlpool |
$828.54
|
| Rate for Payer: Humana Choice PPO Medicare |
$298.04
|
| Rate for Payer: Mclaren Commercial |
$768.75
|
| Rate for Payer: Mclaren Medicaid |
$159.75
|
| Rate for Payer: Mclaren Medicare |
$298.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$312.94
|
| Rate for Payer: Meridian Medicaid |
$167.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$342.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$726.04
|
| Rate for Payer: Nomi Health Commercial |
$700.42
|
| Rate for Payer: PACE Medicare |
$283.14
|
| Rate for Payer: PACE SWMI |
$298.04
|
| Rate for Payer: PHP Commercial |
$327.84
|
| Rate for Payer: PHP Medicaid |
$159.75
|
| Rate for Payer: PHP Medicare Advantage |
$298.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$159.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$555.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$748.42
|
| Rate for Payer: Priority Health Medicare |
$298.04
|
| Rate for Payer: Priority Health Narrow Network |
$598.77
|
| Rate for Payer: Railroad Medicare Medicare |
$298.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$751.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$298.04
|
| Rate for Payer: UHC Exchange |
$461.96
|
| Rate for Payer: UHC Medicare Advantage |
$298.04
|
| Rate for Payer: UHCCP DNSP |
$298.04
|
| Rate for Payer: UHCCP Medicaid |
$159.75
|
| Rate for Payer: VA VA |
$298.04
|
|
|
HC COMBI CATH SUPPLY
|
Facility
|
OP
|
$123.46
|
|
| Hospital Charge Code |
27200116
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.38 |
| Max. Negotiated Rate |
$123.46 |
| Rate for Payer: Aetna Commercial |
$111.11
|
| Rate for Payer: Aetna Medicare |
$61.73
|
| Rate for Payer: ASR ASR |
$119.76
|
| Rate for Payer: ASR Commercial |
$119.76
|
| Rate for Payer: BCBS Complete |
$49.38
|
| Rate for Payer: BCBS Trust/PPO |
$101.10
|
| Rate for Payer: BCN Commercial |
$95.72
|
| Rate for Payer: Cash Price |
$98.77
|
| Rate for Payer: Cofinity Commercial |
$116.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$98.77
|
| Rate for Payer: Healthscope Commercial |
$123.46
|
| Rate for Payer: Healthscope Whirlpool |
$119.76
|
| Rate for Payer: Mclaren Commercial |
$111.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.94
|
| Rate for Payer: Nomi Health Commercial |
$101.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$108.18
|
| Rate for Payer: Priority Health Narrow Network |
$86.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$108.64
|
|
|
HC COMBI CATH SUPPLY
|
Facility
|
IP
|
$123.46
|
|
| Hospital Charge Code |
27200116
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$80.25 |
| Max. Negotiated Rate |
$123.46 |
| Rate for Payer: Aetna Commercial |
$111.11
|
| Rate for Payer: ASR ASR |
$119.76
|
| Rate for Payer: ASR Commercial |
$119.76
|
| Rate for Payer: BCBS Trust/PPO |
$100.61
|
| Rate for Payer: BCN Commercial |
$95.72
|
| Rate for Payer: Cash Price |
$98.77
|
| Rate for Payer: Cofinity Commercial |
$116.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$98.77
|
| Rate for Payer: Healthscope Commercial |
$123.46
|
| Rate for Payer: Healthscope Whirlpool |
$119.76
|
| Rate for Payer: Mclaren Commercial |
$111.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.94
|
| Rate for Payer: Nomi Health Commercial |
$101.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$108.64
|
|
|
HC COMBINED VACCINE, MMR+VARICELLA, SUBQ
|
Facility
|
OP
|
$213.28
|
|
|
Service Code
|
CPT 90710
|
| Hospital Charge Code |
63600206
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$85.31 |
| Max. Negotiated Rate |
$316.53 |
| Rate for Payer: Aetna Commercial |
$191.95
|
| Rate for Payer: Aetna Medicare |
$106.64
|
| Rate for Payer: ASR ASR |
$206.88
|
| Rate for Payer: ASR Commercial |
$206.88
|
| Rate for Payer: BCBS Complete |
$85.31
|
| Rate for Payer: BCBS Trust/PPO |
$174.65
|
| Rate for Payer: BCN Commercial |
$165.36
|
| Rate for Payer: Cash Price |
$170.62
|
| Rate for Payer: Cash Price |
$170.62
|
| Rate for Payer: Cofinity Commercial |
$200.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$170.62
|
| Rate for Payer: Healthscope Commercial |
$213.28
|
| Rate for Payer: Healthscope Whirlpool |
$206.88
|
| Rate for Payer: Mclaren Commercial |
$191.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$181.29
|
| Rate for Payer: Nomi Health Commercial |
$174.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$138.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$316.53
|
| Rate for Payer: Priority Health Narrow Network |
$253.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$187.69
|
|
|
HC COMBINED VACCINE, MMR+VARICELLA, SUBQ
|
Facility
|
IP
|
$213.28
|
|
|
Service Code
|
CPT 90710
|
| Hospital Charge Code |
63600206
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$138.63 |
| Max. Negotiated Rate |
$213.28 |
| Rate for Payer: Aetna Commercial |
$191.95
|
| Rate for Payer: ASR ASR |
$206.88
|
| Rate for Payer: ASR Commercial |
$206.88
|
| Rate for Payer: BCBS Trust/PPO |
$173.80
|
| Rate for Payer: BCN Commercial |
$165.36
|
| Rate for Payer: Cash Price |
$170.62
|
| Rate for Payer: Cofinity Commercial |
$200.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$170.62
|
| Rate for Payer: Healthscope Commercial |
$213.28
|
| Rate for Payer: Healthscope Whirlpool |
$206.88
|
| Rate for Payer: Mclaren Commercial |
$191.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$181.29
|
| Rate for Payer: Nomi Health Commercial |
$174.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$138.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$187.69
|
|
|
HC COMMON REED IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200080
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$25.39 |
| Rate for Payer: Aetna Commercial |
$22.85
|
| Rate for Payer: ASR ASR |
$24.63
|
| Rate for Payer: ASR Commercial |
$24.63
|
| Rate for Payer: BCBS Trust/PPO |
$20.69
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$23.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$25.39
|
| Rate for Payer: Healthscope Whirlpool |
$24.63
|
| Rate for Payer: Mclaren Commercial |
$22.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.34
|
|
|
HC COMMON REED IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200080
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$25.39 |
| Rate for Payer: Aetna Commercial |
$22.85
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: ASR ASR |
$24.63
|
| Rate for Payer: ASR Commercial |
$24.63
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$20.79
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$23.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$25.39
|
| Rate for Payer: Healthscope Whirlpool |
$24.63
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$22.85
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$5.74
|
| Rate for Payer: PHP Medicaid |
$2.80
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.25
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$17.80
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP DNSP |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.80
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC COMM WORK REINTEGRATION EA 15 MIN
|
Facility
|
OP
|
$96.90
|
|
|
Service Code
|
CPT 97537
|
| Hospital Charge Code |
42000031
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$38.76 |
| Max. Negotiated Rate |
$96.90 |
| Rate for Payer: Aetna Commercial |
$87.21
|
| Rate for Payer: Aetna Medicare |
$48.45
|
| Rate for Payer: ASR ASR |
$93.99
|
| Rate for Payer: ASR Commercial |
$93.99
|
| Rate for Payer: BCBS Complete |
$38.76
|
| Rate for Payer: BCBS Trust/PPO |
$79.35
|
| Rate for Payer: BCN Commercial |
$75.13
|
| Rate for Payer: Cash Price |
$77.52
|
| Rate for Payer: Cash Price |
$77.52
|
| Rate for Payer: Cofinity Commercial |
$91.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.52
|
| Rate for Payer: Healthscope Commercial |
$96.90
|
| Rate for Payer: Healthscope Whirlpool |
$93.99
|
| Rate for Payer: Mclaren Commercial |
$87.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.36
|
| Rate for Payer: Nomi Health Commercial |
$79.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$60.39
|
| Rate for Payer: Priority Health Narrow Network |
$48.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$85.27
|
|
|
HC COMM WORK REINTEGRATION EA 15 MIN
|
Facility
|
IP
|
$96.90
|
|
|
Service Code
|
CPT 97537
|
| Hospital Charge Code |
42000031
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$62.98 |
| Max. Negotiated Rate |
$96.90 |
| Rate for Payer: Aetna Commercial |
$87.21
|
| Rate for Payer: ASR ASR |
$93.99
|
| Rate for Payer: ASR Commercial |
$93.99
|
| Rate for Payer: BCBS Trust/PPO |
$78.96
|
| Rate for Payer: BCN Commercial |
$75.13
|
| Rate for Payer: Cash Price |
$77.52
|
| Rate for Payer: Cofinity Commercial |
$91.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.52
|
| Rate for Payer: Healthscope Commercial |
$96.90
|
| Rate for Payer: Healthscope Whirlpool |
$93.99
|
| Rate for Payer: Mclaren Commercial |
$87.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.36
|
| Rate for Payer: Nomi Health Commercial |
$79.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$85.27
|
|
|
HC COMPARTMENT PRESSURE CHECK
|
Facility
|
OP
|
$658.62
|
|
| Hospital Charge Code |
27000045
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$263.45 |
| Max. Negotiated Rate |
$658.62 |
| Rate for Payer: Aetna Commercial |
$592.76
|
| Rate for Payer: Aetna Medicare |
$329.31
|
| Rate for Payer: ASR ASR |
$638.86
|
| Rate for Payer: ASR Commercial |
$638.86
|
| Rate for Payer: BCBS Complete |
$263.45
|
| Rate for Payer: BCBS Trust/PPO |
$539.34
|
| Rate for Payer: BCN Commercial |
$510.63
|
| Rate for Payer: Cash Price |
$526.90
|
| Rate for Payer: Cofinity Commercial |
$619.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$526.90
|
| Rate for Payer: Healthscope Commercial |
$658.62
|
| Rate for Payer: Healthscope Whirlpool |
$638.86
|
| Rate for Payer: Mclaren Commercial |
$592.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$559.83
|
| Rate for Payer: Nomi Health Commercial |
$540.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$428.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$577.08
|
| Rate for Payer: Priority Health Narrow Network |
$461.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$579.59
|
|
|
HC COMPARTMENT PRESSURE CHECK
|
Facility
|
IP
|
$658.62
|
|
| Hospital Charge Code |
27000045
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$428.10 |
| Max. Negotiated Rate |
$658.62 |
| Rate for Payer: Aetna Commercial |
$592.76
|
| Rate for Payer: ASR ASR |
$638.86
|
| Rate for Payer: ASR Commercial |
$638.86
|
| Rate for Payer: BCBS Trust/PPO |
$536.71
|
| Rate for Payer: BCN Commercial |
$510.63
|
| Rate for Payer: Cash Price |
$526.90
|
| Rate for Payer: Cofinity Commercial |
$619.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$526.90
|
| Rate for Payer: Healthscope Commercial |
$658.62
|
| Rate for Payer: Healthscope Whirlpool |
$638.86
|
| Rate for Payer: Mclaren Commercial |
$592.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$559.83
|
| Rate for Payer: Nomi Health Commercial |
$540.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$428.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$579.59
|
|
|
HC COMP BURN GARM 2 LEGS-WAIST
|
Facility
|
IP
|
$238.68
|
|
|
Service Code
|
HCPCS A6511
|
| Hospital Charge Code |
98300142
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$155.14 |
| Max. Negotiated Rate |
$238.68 |
| Rate for Payer: Aetna Commercial |
$214.81
|
| Rate for Payer: ASR ASR |
$231.52
|
| Rate for Payer: ASR Commercial |
$231.52
|
| Rate for Payer: BCBS Trust/PPO |
$194.50
|
| Rate for Payer: BCN Commercial |
$185.05
|
| Rate for Payer: Cash Price |
$190.94
|
| Rate for Payer: Cofinity Commercial |
$224.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$190.94
|
| Rate for Payer: Healthscope Commercial |
$238.68
|
| Rate for Payer: Healthscope Whirlpool |
$231.52
|
| Rate for Payer: Mclaren Commercial |
$214.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$202.88
|
| Rate for Payer: Nomi Health Commercial |
$195.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$155.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$210.04
|
|
|
HC COMP BURN GARM 2 LEGS-WAIST
|
Facility
|
OP
|
$238.68
|
|
|
Service Code
|
HCPCS A6511
|
| Hospital Charge Code |
98300142
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$95.47 |
| Max. Negotiated Rate |
$238.68 |
| Rate for Payer: Aetna Commercial |
$214.81
|
| Rate for Payer: Aetna Medicare |
$119.34
|
| Rate for Payer: ASR ASR |
$231.52
|
| Rate for Payer: ASR Commercial |
$231.52
|
| Rate for Payer: BCBS Complete |
$95.47
|
| Rate for Payer: BCBS Trust/PPO |
$195.46
|
| Rate for Payer: BCN Commercial |
$185.05
|
| Rate for Payer: Cash Price |
$190.94
|
| Rate for Payer: Cofinity Commercial |
$224.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$190.94
|
| Rate for Payer: Healthscope Commercial |
$238.68
|
| Rate for Payer: Healthscope Whirlpool |
$231.52
|
| Rate for Payer: Mclaren Commercial |
$214.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$202.88
|
| Rate for Payer: Nomi Health Commercial |
$195.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$155.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$209.13
|
| Rate for Payer: Priority Health Narrow Network |
$167.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$210.04
|
|
|
HC COMP BURN GARM 2 OR MORE FAB/C
|
Facility
|
IP
|
$12.24
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300143
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.96 |
| Max. Negotiated Rate |
$12.24 |
| Rate for Payer: Aetna Commercial |
$11.02
|
| Rate for Payer: ASR ASR |
$11.87
|
| Rate for Payer: ASR Commercial |
$11.87
|
| Rate for Payer: BCBS Trust/PPO |
$9.97
|
| Rate for Payer: BCN Commercial |
$9.49
|
| Rate for Payer: Cash Price |
$9.79
|
| Rate for Payer: Cofinity Commercial |
$11.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.79
|
| Rate for Payer: Healthscope Commercial |
$12.24
|
| Rate for Payer: Healthscope Whirlpool |
$11.87
|
| Rate for Payer: Mclaren Commercial |
$11.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.40
|
| Rate for Payer: Nomi Health Commercial |
$10.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10.77
|
|
|
HC COMP BURN GARM 2 OR MORE FAB/C
|
Facility
|
OP
|
$12.24
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300143
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.90 |
| Max. Negotiated Rate |
$12.24 |
| Rate for Payer: Aetna Commercial |
$11.02
|
| Rate for Payer: Aetna Medicare |
$6.12
|
| Rate for Payer: ASR ASR |
$11.87
|
| Rate for Payer: ASR Commercial |
$11.87
|
| Rate for Payer: BCBS Complete |
$4.90
|
| Rate for Payer: BCBS Trust/PPO |
$10.02
|
| Rate for Payer: BCN Commercial |
$9.49
|
| Rate for Payer: Cash Price |
$9.79
|
| Rate for Payer: Cofinity Commercial |
$11.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.79
|
| Rate for Payer: Healthscope Commercial |
$12.24
|
| Rate for Payer: Healthscope Whirlpool |
$11.87
|
| Rate for Payer: Mclaren Commercial |
$11.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.40
|
| Rate for Payer: Nomi Health Commercial |
$10.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10.72
|
| Rate for Payer: Priority Health Narrow Network |
$8.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10.77
|
|
