|
HC CONDITIONING PLAY AUDIOMETRY
|
Facility
|
OP
|
$148.92
|
|
|
Service Code
|
CPT 92582
|
| Hospital Charge Code |
76100512
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$82.17 |
| Max. Negotiated Rate |
$237.62 |
| Rate for Payer: Aetna Commercial |
$134.03
|
| Rate for Payer: Aetna Medicare |
$153.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$191.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$191.62
|
| Rate for Payer: ASR ASR |
$144.45
|
| Rate for Payer: ASR Commercial |
$144.45
|
| Rate for Payer: BCBS Complete |
$86.28
|
| Rate for Payer: BCBS MAPPO |
$153.30
|
| Rate for Payer: BCBS Trust/PPO |
$121.95
|
| Rate for Payer: BCN Commercial |
$115.46
|
| Rate for Payer: BCN Medicare Advantage |
$153.30
|
| Rate for Payer: Cash Price |
$119.14
|
| Rate for Payer: Cash Price |
$119.14
|
| Rate for Payer: Cofinity Commercial |
$139.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$119.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.30
|
| Rate for Payer: Healthscope Commercial |
$148.92
|
| Rate for Payer: Healthscope Whirlpool |
$144.45
|
| Rate for Payer: Humana Choice PPO Medicare |
$153.30
|
| Rate for Payer: Mclaren Commercial |
$134.03
|
| Rate for Payer: Mclaren Medicaid |
$82.17
|
| Rate for Payer: Mclaren Medicare |
$153.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.96
|
| Rate for Payer: Meridian Medicaid |
$86.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$176.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$126.58
|
| Rate for Payer: Nomi Health Commercial |
$122.11
|
| Rate for Payer: PACE Medicare |
$145.64
|
| Rate for Payer: PACE SWMI |
$153.30
|
| Rate for Payer: PHP Commercial |
$168.63
|
| Rate for Payer: PHP Medicaid |
$82.17
|
| Rate for Payer: PHP Medicare Advantage |
$153.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$96.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$130.48
|
| Rate for Payer: Priority Health Medicare |
$153.30
|
| Rate for Payer: Priority Health Narrow Network |
$104.39
|
| Rate for Payer: Railroad Medicare Medicare |
$153.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$131.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.30
|
| Rate for Payer: UHC Exchange |
$237.62
|
| Rate for Payer: UHC Medicare Advantage |
$153.30
|
| Rate for Payer: UHCCP DNSP |
$153.30
|
| Rate for Payer: UHCCP Medicaid |
$82.17
|
| Rate for Payer: VA VA |
$153.30
|
|
|
HC CONDITIONING PLAY AUDIOMETRY
|
Facility
|
IP
|
$148.92
|
|
|
Service Code
|
CPT 92582
|
| Hospital Charge Code |
76100512
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$96.80 |
| Max. Negotiated Rate |
$148.92 |
| Rate for Payer: Aetna Commercial |
$134.03
|
| Rate for Payer: ASR ASR |
$144.45
|
| Rate for Payer: ASR Commercial |
$144.45
|
| Rate for Payer: BCBS Trust/PPO |
$121.35
|
| Rate for Payer: BCN Commercial |
$115.46
|
| Rate for Payer: Cash Price |
$119.14
|
| Rate for Payer: Cofinity Commercial |
$139.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$119.14
|
| Rate for Payer: Healthscope Commercial |
$148.92
|
| Rate for Payer: Healthscope Whirlpool |
$144.45
|
| Rate for Payer: Mclaren Commercial |
$134.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$126.58
|
| Rate for Payer: Nomi Health Commercial |
$122.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$96.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$131.05
|
|
|
HC CONFIRMED DRUG ABUSE PANEL 9 U
|
Facility
|
OP
|
$104.04
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100643
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.31 |
| Max. Negotiated Rate |
$104.04 |
| Rate for Payer: Aetna Commercial |
$93.64
|
| Rate for Payer: Aetna Medicare |
$62.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.68
|
| Rate for Payer: ASR ASR |
$100.92
|
| Rate for Payer: ASR Commercial |
$100.92
|
| Rate for Payer: BCBS Complete |
$34.97
|
| Rate for Payer: BCBS MAPPO |
$62.14
|
| Rate for Payer: BCBS Trust/PPO |
$85.20
|
| Rate for Payer: BCN Commercial |
$80.66
|
| Rate for Payer: BCN Medicare Advantage |
$62.14
|
| Rate for Payer: Cash Price |
$83.23
|
| Rate for Payer: Cash Price |
$83.23
|
| Rate for Payer: Cofinity Commercial |
$97.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.14
|
| Rate for Payer: Healthscope Commercial |
$104.04
|
| Rate for Payer: Healthscope Whirlpool |
$100.92
|
| Rate for Payer: Humana Choice PPO Medicare |
$62.14
|
| Rate for Payer: Mclaren Commercial |
$93.64
|
| Rate for Payer: Mclaren Medicaid |
$33.31
|
| Rate for Payer: Mclaren Medicare |
$62.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.25
|
| Rate for Payer: Meridian Medicaid |
$34.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.43
|
| Rate for Payer: Nomi Health Commercial |
$85.31
|
| Rate for Payer: PACE Medicare |
$59.03
|
| Rate for Payer: PACE SWMI |
$62.14
|
| Rate for Payer: PHP Commercial |
$68.35
|
| Rate for Payer: PHP Medicaid |
$33.31
|
| Rate for Payer: PHP Medicare Advantage |
$62.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$91.16
|
| Rate for Payer: Priority Health Medicare |
$62.14
|
| Rate for Payer: Priority Health Narrow Network |
$72.93
|
| Rate for Payer: Railroad Medicare Medicare |
$62.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$91.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.14
|
| Rate for Payer: UHC Exchange |
$96.32
|
| Rate for Payer: UHC Medicare Advantage |
$62.14
|
| Rate for Payer: UHCCP DNSP |
$62.14
|
| Rate for Payer: UHCCP Medicaid |
$33.31
|
| Rate for Payer: VA VA |
$62.14
|
|
|
HC CONFIRMED DRUG ABUSE PANEL 9 U
|
Facility
|
IP
|
$104.04
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100643
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$67.63 |
| Max. Negotiated Rate |
$104.04 |
| Rate for Payer: Aetna Commercial |
$93.64
|
| Rate for Payer: ASR ASR |
$100.92
|
| Rate for Payer: ASR Commercial |
$100.92
|
| Rate for Payer: BCBS Trust/PPO |
$84.78
|
| Rate for Payer: BCN Commercial |
$80.66
|
| Rate for Payer: Cash Price |
$83.23
|
| Rate for Payer: Cofinity Commercial |
$97.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.23
|
| Rate for Payer: Healthscope Commercial |
$104.04
|
| Rate for Payer: Healthscope Whirlpool |
$100.92
|
| Rate for Payer: Mclaren Commercial |
$93.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.43
|
| Rate for Payer: Nomi Health Commercial |
$85.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$91.56
|
|
|
HC CONIZ CERVIX W/WO D&C RPR ELTRD EXC
|
Facility
|
OP
|
$7,945.53
|
|
|
Service Code
|
CPT 57522
|
| Hospital Charge Code |
76100334
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$293.81 |
| Max. Negotiated Rate |
$7,945.53 |
| Rate for Payer: Aetna Commercial |
$7,150.98
|
| Rate for Payer: Aetna Medicare |
$3,115.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,894.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,894.05
|
| Rate for Payer: ASR ASR |
$7,707.16
|
| Rate for Payer: ASR Commercial |
$7,707.16
|
| Rate for Payer: BCBS Complete |
$1,753.26
|
| Rate for Payer: BCBS MAPPO |
$3,115.24
|
| Rate for Payer: BCBS Trust/PPO |
$6,506.59
|
| Rate for Payer: BCCCP Commercial |
$293.81
|
| Rate for Payer: BCN Commercial |
$6,160.17
|
| Rate for Payer: BCN Medicare Advantage |
$3,115.24
|
| Rate for Payer: Cash Price |
$6,356.42
|
| Rate for Payer: Cash Price |
$6,356.42
|
| Rate for Payer: Cofinity Commercial |
$7,468.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,356.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,115.24
|
| Rate for Payer: Healthscope Commercial |
$7,945.53
|
| Rate for Payer: Healthscope Whirlpool |
$7,707.16
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,115.24
|
| Rate for Payer: Mclaren Commercial |
$7,150.98
|
| Rate for Payer: Mclaren Medicaid |
$1,669.77
|
| Rate for Payer: Mclaren Medicare |
$3,115.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,271.00
|
| Rate for Payer: Meridian Medicaid |
$1,753.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,582.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,753.70
|
| Rate for Payer: Nomi Health Commercial |
$6,515.33
|
| Rate for Payer: PACE Medicare |
$2,959.48
|
| Rate for Payer: PACE SWMI |
$3,115.24
|
| Rate for Payer: PHP Commercial |
$3,426.76
|
| Rate for Payer: PHP Medicaid |
$1,669.77
|
| Rate for Payer: PHP Medicare Advantage |
$3,115.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,669.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,164.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,961.87
|
| Rate for Payer: Priority Health Medicare |
$3,115.24
|
| Rate for Payer: Priority Health Narrow Network |
$5,569.82
|
| Rate for Payer: Railroad Medicare Medicare |
$3,115.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,992.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,115.24
|
| Rate for Payer: UHC Exchange |
$4,828.62
|
| Rate for Payer: UHC Medicare Advantage |
$3,115.24
|
| Rate for Payer: UHCCP DNSP |
$3,115.24
|
| Rate for Payer: UHCCP Medicaid |
$1,669.77
|
| Rate for Payer: VA VA |
$3,115.24
|
|
|
HC CONIZ CERVIX W/WO D&C RPR ELTRD EXC
|
Facility
|
IP
|
$7,945.53
|
|
|
Service Code
|
CPT 57522
|
| Hospital Charge Code |
76100334
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,164.59 |
| Max. Negotiated Rate |
$7,945.53 |
| Rate for Payer: Aetna Commercial |
$7,150.98
|
| Rate for Payer: ASR ASR |
$7,707.16
|
| Rate for Payer: ASR Commercial |
$7,707.16
|
| Rate for Payer: BCBS Trust/PPO |
$6,474.81
|
| Rate for Payer: BCN Commercial |
$6,160.17
|
| Rate for Payer: Cash Price |
$6,356.42
|
| Rate for Payer: Cofinity Commercial |
$7,468.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,356.42
|
| Rate for Payer: Healthscope Commercial |
$7,945.53
|
| Rate for Payer: Healthscope Whirlpool |
$7,707.16
|
| Rate for Payer: Mclaren Commercial |
$7,150.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,753.70
|
| Rate for Payer: Nomi Health Commercial |
$6,515.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,164.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,992.07
|
|
|
HC CONNECTIVE TISSUE CASCADE ANA & CCP
|
Facility
|
OP
|
$31.83
|
|
|
Service Code
|
CPT 86200
|
| Hospital Charge Code |
30200156
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.94 |
| Max. Negotiated Rate |
$148.23 |
| Rate for Payer: Aetna Commercial |
$28.65
|
| Rate for Payer: Aetna Medicare |
$12.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.19
|
| Rate for Payer: ASR ASR |
$30.88
|
| Rate for Payer: ASR Commercial |
$30.88
|
| Rate for Payer: BCBS Complete |
$7.29
|
| Rate for Payer: BCBS MAPPO |
$12.95
|
| Rate for Payer: BCBS Trust/PPO |
$26.07
|
| Rate for Payer: BCN Commercial |
$24.68
|
| Rate for Payer: BCN Medicare Advantage |
$12.95
|
| Rate for Payer: Cash Price |
$25.46
|
| Rate for Payer: Cash Price |
$25.46
|
| Rate for Payer: Cofinity Commercial |
$29.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.95
|
| Rate for Payer: Healthscope Commercial |
$31.83
|
| Rate for Payer: Healthscope Whirlpool |
$30.88
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.95
|
| Rate for Payer: Mclaren Commercial |
$28.65
|
| Rate for Payer: Mclaren Medicaid |
$6.94
|
| Rate for Payer: Mclaren Medicare |
$12.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.60
|
| Rate for Payer: Meridian Medicaid |
$7.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.06
|
| Rate for Payer: Nomi Health Commercial |
$26.10
|
| Rate for Payer: PACE Medicare |
$12.30
|
| Rate for Payer: PACE SWMI |
$12.95
|
| Rate for Payer: PHP Commercial |
$14.24
|
| Rate for Payer: PHP Medicaid |
$6.94
|
| Rate for Payer: PHP Medicare Advantage |
$12.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$148.23
|
| Rate for Payer: Priority Health Medicare |
$12.95
|
| Rate for Payer: Priority Health Narrow Network |
$118.58
|
| Rate for Payer: Railroad Medicare Medicare |
$12.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.95
|
| Rate for Payer: UHC Exchange |
$20.07
|
| Rate for Payer: UHC Medicare Advantage |
$12.95
|
| Rate for Payer: UHCCP DNSP |
$12.95
|
| Rate for Payer: UHCCP Medicaid |
$6.94
|
| Rate for Payer: VA VA |
$12.95
|
|
|
HC CONNECTIVE TISSUE CASCADE ANA & CCP
|
Facility
|
IP
|
$31.83
|
|
|
Service Code
|
CPT 86200
|
| Hospital Charge Code |
30200156
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$20.69 |
| Max. Negotiated Rate |
$31.83 |
| Rate for Payer: Aetna Commercial |
$28.65
|
| Rate for Payer: ASR ASR |
$30.88
|
| Rate for Payer: ASR Commercial |
$30.88
|
| Rate for Payer: BCBS Trust/PPO |
$25.94
|
| Rate for Payer: BCN Commercial |
$24.68
|
| Rate for Payer: Cash Price |
$25.46
|
| Rate for Payer: Cofinity Commercial |
$29.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.46
|
| Rate for Payer: Healthscope Commercial |
$31.83
|
| Rate for Payer: Healthscope Whirlpool |
$30.88
|
| Rate for Payer: Mclaren Commercial |
$28.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.06
|
| Rate for Payer: Nomi Health Commercial |
$26.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.01
|
|
|
HC CONNECTOR 3/8 W/ LL
|
Facility
|
OP
|
$5.36
|
|
| Hospital Charge Code |
27000448
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.14 |
| Max. Negotiated Rate |
$5.36 |
| Rate for Payer: Aetna Commercial |
$4.82
|
| Rate for Payer: Aetna Medicare |
$2.68
|
| Rate for Payer: ASR ASR |
$5.20
|
| Rate for Payer: ASR Commercial |
$5.20
|
| Rate for Payer: BCBS Complete |
$2.14
|
| Rate for Payer: BCBS Trust/PPO |
$4.39
|
| Rate for Payer: BCN Commercial |
$4.16
|
| Rate for Payer: Cash Price |
$4.29
|
| Rate for Payer: Cofinity Commercial |
$5.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.29
|
| Rate for Payer: Healthscope Commercial |
$5.36
|
| Rate for Payer: Healthscope Whirlpool |
$5.20
|
| Rate for Payer: Mclaren Commercial |
$4.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.56
|
| Rate for Payer: Nomi Health Commercial |
$4.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4.70
|
| Rate for Payer: Priority Health Narrow Network |
$3.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4.72
|
|
|
HC CONNECTOR 3/8 W/ LL
|
Facility
|
IP
|
$5.36
|
|
| Hospital Charge Code |
27000448
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.48 |
| Max. Negotiated Rate |
$5.36 |
| Rate for Payer: Aetna Commercial |
$4.82
|
| Rate for Payer: ASR ASR |
$5.20
|
| Rate for Payer: ASR Commercial |
$5.20
|
| Rate for Payer: BCBS Trust/PPO |
$4.37
|
| Rate for Payer: BCN Commercial |
$4.16
|
| Rate for Payer: Cash Price |
$4.29
|
| Rate for Payer: Cofinity Commercial |
$5.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.29
|
| Rate for Payer: Healthscope Commercial |
$5.36
|
| Rate for Payer: Healthscope Whirlpool |
$5.20
|
| Rate for Payer: Mclaren Commercial |
$4.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.56
|
| Rate for Payer: Nomi Health Commercial |
$4.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4.72
|
|
|
HC CONNECTOR REDUCER
|
Facility
|
IP
|
$5.36
|
|
| Hospital Charge Code |
27000651
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.48 |
| Max. Negotiated Rate |
$5.36 |
| Rate for Payer: Aetna Commercial |
$4.82
|
| Rate for Payer: ASR ASR |
$5.20
|
| Rate for Payer: ASR Commercial |
$5.20
|
| Rate for Payer: BCBS Trust/PPO |
$4.37
|
| Rate for Payer: BCN Commercial |
$4.16
|
| Rate for Payer: Cash Price |
$4.29
|
| Rate for Payer: Cofinity Commercial |
$5.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.29
|
| Rate for Payer: Healthscope Commercial |
$5.36
|
| Rate for Payer: Healthscope Whirlpool |
$5.20
|
| Rate for Payer: Mclaren Commercial |
$4.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.56
|
| Rate for Payer: Nomi Health Commercial |
$4.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4.72
|
|
|
HC CONNECTOR REDUCER
|
Facility
|
OP
|
$5.36
|
|
| Hospital Charge Code |
27000651
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.14 |
| Max. Negotiated Rate |
$5.36 |
| Rate for Payer: Aetna Commercial |
$4.82
|
| Rate for Payer: Aetna Medicare |
$2.68
|
| Rate for Payer: ASR ASR |
$5.20
|
| Rate for Payer: ASR Commercial |
$5.20
|
| Rate for Payer: BCBS Complete |
$2.14
|
| Rate for Payer: BCBS Trust/PPO |
$4.39
|
| Rate for Payer: BCN Commercial |
$4.16
|
| Rate for Payer: Cash Price |
$4.29
|
| Rate for Payer: Cofinity Commercial |
$5.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.29
|
| Rate for Payer: Healthscope Commercial |
$5.36
|
| Rate for Payer: Healthscope Whirlpool |
$5.20
|
| Rate for Payer: Mclaren Commercial |
$4.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.56
|
| Rate for Payer: Nomi Health Commercial |
$4.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4.70
|
| Rate for Payer: Priority Health Narrow Network |
$3.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4.72
|
|
|
HC CONNECTOR ST 1/2 X 1/2
|
Facility
|
IP
|
$7.65
|
|
| Hospital Charge Code |
27000047
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.97 |
| Max. Negotiated Rate |
$7.65 |
| Rate for Payer: Aetna Commercial |
$6.88
|
| Rate for Payer: ASR ASR |
$7.42
|
| Rate for Payer: ASR Commercial |
$7.42
|
| Rate for Payer: BCBS Trust/PPO |
$6.23
|
| Rate for Payer: BCN Commercial |
$5.93
|
| Rate for Payer: Cash Price |
$6.12
|
| Rate for Payer: Cofinity Commercial |
$7.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.12
|
| Rate for Payer: Healthscope Commercial |
$7.65
|
| Rate for Payer: Healthscope Whirlpool |
$7.42
|
| Rate for Payer: Mclaren Commercial |
$6.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.50
|
| Rate for Payer: Nomi Health Commercial |
$6.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6.73
|
|
|
HC CONNECTOR ST 1/2 X 1/2
|
Facility
|
OP
|
$7.65
|
|
| Hospital Charge Code |
27000047
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.06 |
| Max. Negotiated Rate |
$7.65 |
| Rate for Payer: Aetna Commercial |
$6.88
|
| Rate for Payer: Aetna Medicare |
$3.82
|
| Rate for Payer: ASR ASR |
$7.42
|
| Rate for Payer: ASR Commercial |
$7.42
|
| Rate for Payer: BCBS Complete |
$3.06
|
| Rate for Payer: BCBS Trust/PPO |
$6.26
|
| Rate for Payer: BCN Commercial |
$5.93
|
| Rate for Payer: Cash Price |
$6.12
|
| Rate for Payer: Cofinity Commercial |
$7.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.12
|
| Rate for Payer: Healthscope Commercial |
$7.65
|
| Rate for Payer: Healthscope Whirlpool |
$7.42
|
| Rate for Payer: Mclaren Commercial |
$6.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.50
|
| Rate for Payer: Nomi Health Commercial |
$6.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6.70
|
| Rate for Payer: Priority Health Narrow Network |
$5.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6.73
|
|
|
HC CONNECTOR ST 3/8 OR 1/4
|
Facility
|
OP
|
$5.36
|
|
| Hospital Charge Code |
27000685
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.14 |
| Max. Negotiated Rate |
$5.36 |
| Rate for Payer: Aetna Commercial |
$4.82
|
| Rate for Payer: Aetna Medicare |
$2.68
|
| Rate for Payer: ASR ASR |
$5.20
|
| Rate for Payer: ASR Commercial |
$5.20
|
| Rate for Payer: BCBS Complete |
$2.14
|
| Rate for Payer: BCBS Trust/PPO |
$4.39
|
| Rate for Payer: BCN Commercial |
$4.16
|
| Rate for Payer: Cash Price |
$4.29
|
| Rate for Payer: Cofinity Commercial |
$5.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.29
|
| Rate for Payer: Healthscope Commercial |
$5.36
|
| Rate for Payer: Healthscope Whirlpool |
$5.20
|
| Rate for Payer: Mclaren Commercial |
$4.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.56
|
| Rate for Payer: Nomi Health Commercial |
$4.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4.70
|
| Rate for Payer: Priority Health Narrow Network |
$3.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4.72
|
|
|
HC CONNECTOR ST 3/8 OR 1/4
|
Facility
|
IP
|
$5.36
|
|
| Hospital Charge Code |
27000685
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.48 |
| Max. Negotiated Rate |
$5.36 |
| Rate for Payer: Aetna Commercial |
$4.82
|
| Rate for Payer: ASR ASR |
$5.20
|
| Rate for Payer: ASR Commercial |
$5.20
|
| Rate for Payer: BCBS Trust/PPO |
$4.37
|
| Rate for Payer: BCN Commercial |
$4.16
|
| Rate for Payer: Cash Price |
$4.29
|
| Rate for Payer: Cofinity Commercial |
$5.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.29
|
| Rate for Payer: Healthscope Commercial |
$5.36
|
| Rate for Payer: Healthscope Whirlpool |
$5.20
|
| Rate for Payer: Mclaren Commercial |
$4.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.56
|
| Rate for Payer: Nomi Health Commercial |
$4.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4.72
|
|
|
HC CONNECTOR V
|
Facility
|
IP
|
$7.65
|
|
| Hospital Charge Code |
27000678
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.97 |
| Max. Negotiated Rate |
$7.65 |
| Rate for Payer: Aetna Commercial |
$6.88
|
| Rate for Payer: ASR ASR |
$7.42
|
| Rate for Payer: ASR Commercial |
$7.42
|
| Rate for Payer: BCBS Trust/PPO |
$6.23
|
| Rate for Payer: BCN Commercial |
$5.93
|
| Rate for Payer: Cash Price |
$6.12
|
| Rate for Payer: Cofinity Commercial |
$7.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.12
|
| Rate for Payer: Healthscope Commercial |
$7.65
|
| Rate for Payer: Healthscope Whirlpool |
$7.42
|
| Rate for Payer: Mclaren Commercial |
$6.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.50
|
| Rate for Payer: Nomi Health Commercial |
$6.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6.73
|
|
|
HC CONNECTOR V
|
Facility
|
OP
|
$7.65
|
|
| Hospital Charge Code |
27000678
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.06 |
| Max. Negotiated Rate |
$7.65 |
| Rate for Payer: Aetna Commercial |
$6.88
|
| Rate for Payer: Aetna Medicare |
$3.82
|
| Rate for Payer: ASR ASR |
$7.42
|
| Rate for Payer: ASR Commercial |
$7.42
|
| Rate for Payer: BCBS Complete |
$3.06
|
| Rate for Payer: BCBS Trust/PPO |
$6.26
|
| Rate for Payer: BCN Commercial |
$5.93
|
| Rate for Payer: Cash Price |
$6.12
|
| Rate for Payer: Cofinity Commercial |
$7.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.12
|
| Rate for Payer: Healthscope Commercial |
$7.65
|
| Rate for Payer: Healthscope Whirlpool |
$7.42
|
| Rate for Payer: Mclaren Commercial |
$6.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.50
|
| Rate for Payer: Nomi Health Commercial |
$6.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6.70
|
| Rate for Payer: Priority Health Narrow Network |
$5.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6.73
|
|
|
HC CONNECTOR Y
|
Facility
|
OP
|
$5.36
|
|
| Hospital Charge Code |
27000048
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.14 |
| Max. Negotiated Rate |
$5.36 |
| Rate for Payer: Aetna Commercial |
$4.82
|
| Rate for Payer: Aetna Medicare |
$2.68
|
| Rate for Payer: ASR ASR |
$5.20
|
| Rate for Payer: ASR Commercial |
$5.20
|
| Rate for Payer: BCBS Complete |
$2.14
|
| Rate for Payer: BCBS Trust/PPO |
$4.39
|
| Rate for Payer: BCN Commercial |
$4.16
|
| Rate for Payer: Cash Price |
$4.29
|
| Rate for Payer: Cofinity Commercial |
$5.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.29
|
| Rate for Payer: Healthscope Commercial |
$5.36
|
| Rate for Payer: Healthscope Whirlpool |
$5.20
|
| Rate for Payer: Mclaren Commercial |
$4.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.56
|
| Rate for Payer: Nomi Health Commercial |
$4.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4.70
|
| Rate for Payer: Priority Health Narrow Network |
$3.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4.72
|
|
|
HC CONNECTOR Y
|
Facility
|
IP
|
$5.36
|
|
| Hospital Charge Code |
27000048
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.48 |
| Max. Negotiated Rate |
$5.36 |
| Rate for Payer: Aetna Commercial |
$4.82
|
| Rate for Payer: ASR ASR |
$5.20
|
| Rate for Payer: ASR Commercial |
$5.20
|
| Rate for Payer: BCBS Trust/PPO |
$4.37
|
| Rate for Payer: BCN Commercial |
$4.16
|
| Rate for Payer: Cash Price |
$4.29
|
| Rate for Payer: Cofinity Commercial |
$5.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.29
|
| Rate for Payer: Healthscope Commercial |
$5.36
|
| Rate for Payer: Healthscope Whirlpool |
$5.20
|
| Rate for Payer: Mclaren Commercial |
$4.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.56
|
| Rate for Payer: Nomi Health Commercial |
$4.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4.72
|
|
|
HC CONSULT NUTRITIONAL
|
Facility
|
IP
|
$34.96
|
|
| Hospital Charge Code |
94200010
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$22.72 |
| Max. Negotiated Rate |
$34.96 |
| Rate for Payer: Aetna Commercial |
$31.46
|
| Rate for Payer: ASR ASR |
$33.91
|
| Rate for Payer: ASR Commercial |
$33.91
|
| Rate for Payer: BCBS Trust/PPO |
$28.49
|
| Rate for Payer: BCN Commercial |
$27.10
|
| Rate for Payer: Cash Price |
$27.97
|
| Rate for Payer: Cofinity Commercial |
$32.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.97
|
| Rate for Payer: Healthscope Commercial |
$34.96
|
| Rate for Payer: Healthscope Whirlpool |
$33.91
|
| Rate for Payer: Mclaren Commercial |
$31.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.72
|
| Rate for Payer: Nomi Health Commercial |
$28.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$30.76
|
|
|
HC CONSULT NUTRITIONAL
|
Facility
|
OP
|
$34.96
|
|
| Hospital Charge Code |
94200010
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$13.98 |
| Max. Negotiated Rate |
$34.96 |
| Rate for Payer: Aetna Commercial |
$31.46
|
| Rate for Payer: Aetna Medicare |
$17.48
|
| Rate for Payer: ASR ASR |
$33.91
|
| Rate for Payer: ASR Commercial |
$33.91
|
| Rate for Payer: BCBS Complete |
$13.98
|
| Rate for Payer: BCBS Trust/PPO |
$28.63
|
| Rate for Payer: BCN Commercial |
$27.10
|
| Rate for Payer: Cash Price |
$27.97
|
| Rate for Payer: Cofinity Commercial |
$32.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.97
|
| Rate for Payer: Healthscope Commercial |
$34.96
|
| Rate for Payer: Healthscope Whirlpool |
$33.91
|
| Rate for Payer: Mclaren Commercial |
$31.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.72
|
| Rate for Payer: Nomi Health Commercial |
$28.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30.63
|
| Rate for Payer: Priority Health Narrow Network |
$24.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$30.76
|
|
|
HC CONT GLUCOSE MONITOR OFFICE EQUIP
|
Facility
|
IP
|
$984.59
|
|
|
Service Code
|
CPT 95250
|
| Hospital Charge Code |
94200001
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$639.98 |
| Max. Negotiated Rate |
$984.59 |
| Rate for Payer: Aetna Commercial |
$886.13
|
| Rate for Payer: ASR ASR |
$955.05
|
| Rate for Payer: ASR Commercial |
$955.05
|
| Rate for Payer: BCBS Trust/PPO |
$802.34
|
| Rate for Payer: BCN Commercial |
$763.35
|
| Rate for Payer: Cash Price |
$787.67
|
| Rate for Payer: Cofinity Commercial |
$925.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$787.67
|
| Rate for Payer: Healthscope Commercial |
$984.59
|
| Rate for Payer: Healthscope Whirlpool |
$955.05
|
| Rate for Payer: Mclaren Commercial |
$886.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$836.90
|
| Rate for Payer: Nomi Health Commercial |
$807.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$639.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$866.44
|
|
|
HC CONT GLUCOSE MONITOR OFFICE EQUIP
|
Facility
|
OP
|
$984.59
|
|
|
Service Code
|
CPT 95250
|
| Hospital Charge Code |
94200001
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$67.68 |
| Max. Negotiated Rate |
$984.59 |
| Rate for Payer: Aetna Commercial |
$886.13
|
| Rate for Payer: Aetna Medicare |
$126.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.82
|
| Rate for Payer: ASR ASR |
$955.05
|
| Rate for Payer: ASR Commercial |
$955.05
|
| Rate for Payer: BCBS Complete |
$71.06
|
| Rate for Payer: BCBS MAPPO |
$126.26
|
| Rate for Payer: BCBS Trust/PPO |
$806.28
|
| Rate for Payer: BCN Commercial |
$763.35
|
| Rate for Payer: BCN Medicare Advantage |
$126.26
|
| Rate for Payer: Cash Price |
$787.67
|
| Rate for Payer: Cash Price |
$787.67
|
| Rate for Payer: Cofinity Commercial |
$925.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$787.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.26
|
| Rate for Payer: Healthscope Commercial |
$984.59
|
| Rate for Payer: Healthscope Whirlpool |
$955.05
|
| Rate for Payer: Humana Choice PPO Medicare |
$126.26
|
| Rate for Payer: Mclaren Commercial |
$886.13
|
| Rate for Payer: Mclaren Medicaid |
$67.68
|
| Rate for Payer: Mclaren Medicare |
$126.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.57
|
| Rate for Payer: Meridian Medicaid |
$71.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$145.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$836.90
|
| Rate for Payer: Nomi Health Commercial |
$807.36
|
| Rate for Payer: PACE Medicare |
$119.95
|
| Rate for Payer: PACE SWMI |
$126.26
|
| Rate for Payer: PHP Commercial |
$138.89
|
| Rate for Payer: PHP Medicaid |
$67.68
|
| Rate for Payer: PHP Medicare Advantage |
$126.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$639.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$862.70
|
| Rate for Payer: Priority Health Medicare |
$126.26
|
| Rate for Payer: Priority Health Narrow Network |
$690.20
|
| Rate for Payer: Railroad Medicare Medicare |
$126.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$866.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$126.26
|
| Rate for Payer: UHC Exchange |
$195.70
|
| Rate for Payer: UHC Medicare Advantage |
$126.26
|
| Rate for Payer: UHCCP DNSP |
$126.26
|
| Rate for Payer: UHCCP Medicaid |
$67.68
|
| Rate for Payer: VA VA |
$126.26
|
|
|
HC CONT GLUCOSE MONITOR PATIENT EQUIP
|
Facility
|
IP
|
$384.44
|
|
|
Service Code
|
CPT 95249
|
| Hospital Charge Code |
94200038
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$249.89 |
| Max. Negotiated Rate |
$384.44 |
| Rate for Payer: Aetna Commercial |
$346.00
|
| Rate for Payer: ASR ASR |
$372.91
|
| Rate for Payer: ASR Commercial |
$372.91
|
| Rate for Payer: BCBS Trust/PPO |
$313.28
|
| Rate for Payer: BCN Commercial |
$298.06
|
| Rate for Payer: Cash Price |
$307.55
|
| Rate for Payer: Cofinity Commercial |
$361.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$307.55
|
| Rate for Payer: Healthscope Commercial |
$384.44
|
| Rate for Payer: Healthscope Whirlpool |
$372.91
|
| Rate for Payer: Mclaren Commercial |
$346.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$326.77
|
| Rate for Payer: Nomi Health Commercial |
$315.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$249.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$338.31
|
|
