|
HC CONTROL NOSEBLEED ANTERIOR SIMPLE
|
Facility
|
IP
|
$414.64
|
|
|
Service Code
|
CPT 30901
|
| Hospital Charge Code |
45000011
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$269.52 |
| Max. Negotiated Rate |
$414.64 |
| Rate for Payer: Aetna Commercial |
$373.18
|
| Rate for Payer: ASR ASR |
$402.20
|
| Rate for Payer: ASR Commercial |
$402.20
|
| Rate for Payer: BCBS Trust/PPO |
$337.89
|
| Rate for Payer: BCN Commercial |
$321.47
|
| Rate for Payer: Cash Price |
$331.71
|
| Rate for Payer: Cofinity Commercial |
$389.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$331.71
|
| Rate for Payer: Healthscope Commercial |
$414.64
|
| Rate for Payer: Healthscope Whirlpool |
$402.20
|
| Rate for Payer: Mclaren Commercial |
$373.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$352.44
|
| Rate for Payer: Nomi Health Commercial |
$340.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$269.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$364.88
|
|
|
HC CONTROL OROPHARYNGEAL HEM SIMPLE
|
Facility
|
OP
|
$753.77
|
|
|
Service Code
|
CPT 42960
|
| Hospital Charge Code |
45000100
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$266.21 |
| Max. Negotiated Rate |
$769.82 |
| Rate for Payer: Aetna Commercial |
$678.39
|
| Rate for Payer: Aetna Medicare |
$496.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$620.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$620.83
|
| Rate for Payer: ASR ASR |
$731.16
|
| Rate for Payer: ASR Commercial |
$731.16
|
| Rate for Payer: BCBS Complete |
$279.52
|
| Rate for Payer: BCBS MAPPO |
$496.66
|
| Rate for Payer: BCBS Trust/PPO |
$617.26
|
| Rate for Payer: BCN Commercial |
$584.40
|
| Rate for Payer: BCN Medicare Advantage |
$496.66
|
| Rate for Payer: Cash Price |
$603.02
|
| Rate for Payer: Cash Price |
$603.02
|
| Rate for Payer: Cofinity Commercial |
$708.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$603.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$496.66
|
| Rate for Payer: Healthscope Commercial |
$753.77
|
| Rate for Payer: Healthscope Whirlpool |
$731.16
|
| Rate for Payer: Humana Choice PPO Medicare |
$496.66
|
| Rate for Payer: Mclaren Commercial |
$678.39
|
| Rate for Payer: Mclaren Medicaid |
$266.21
|
| Rate for Payer: Mclaren Medicare |
$496.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$521.49
|
| Rate for Payer: Meridian Medicaid |
$279.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$571.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$640.70
|
| Rate for Payer: Nomi Health Commercial |
$618.09
|
| Rate for Payer: PACE Medicare |
$471.83
|
| Rate for Payer: PACE SWMI |
$496.66
|
| Rate for Payer: PHP Commercial |
$546.33
|
| Rate for Payer: PHP Medicaid |
$266.21
|
| Rate for Payer: PHP Medicare Advantage |
$496.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$266.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$489.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$660.45
|
| Rate for Payer: Priority Health Medicare |
$496.66
|
| Rate for Payer: Priority Health Narrow Network |
$528.39
|
| Rate for Payer: Railroad Medicare Medicare |
$496.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$663.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$496.66
|
| Rate for Payer: UHC Exchange |
$769.82
|
| Rate for Payer: UHC Medicare Advantage |
$496.66
|
| Rate for Payer: UHCCP DNSP |
$496.66
|
| Rate for Payer: UHCCP Medicaid |
$266.21
|
| Rate for Payer: VA VA |
$496.66
|
|
|
HC CONTROL OROPHARYNGEAL HEM SIMPLE
|
Facility
|
IP
|
$753.77
|
|
|
Service Code
|
CPT 42960
|
| Hospital Charge Code |
45000100
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$489.95 |
| Max. Negotiated Rate |
$753.77 |
| Rate for Payer: Aetna Commercial |
$678.39
|
| Rate for Payer: ASR ASR |
$731.16
|
| Rate for Payer: ASR Commercial |
$731.16
|
| Rate for Payer: BCBS Trust/PPO |
$614.25
|
| Rate for Payer: BCN Commercial |
$584.40
|
| Rate for Payer: Cash Price |
$603.02
|
| Rate for Payer: Cofinity Commercial |
$708.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$603.02
|
| Rate for Payer: Healthscope Commercial |
$753.77
|
| Rate for Payer: Healthscope Whirlpool |
$731.16
|
| Rate for Payer: Mclaren Commercial |
$678.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$640.70
|
| Rate for Payer: Nomi Health Commercial |
$618.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$489.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$663.32
|
|
|
HC CONTROL OROPHARYNG HEMORRHAGE SIMPLE
|
Facility
|
OP
|
$1,342.32
|
|
|
Service Code
|
CPT 42960
|
| Hospital Charge Code |
76100478
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$266.21 |
| Max. Negotiated Rate |
$1,342.32 |
| Rate for Payer: Aetna Commercial |
$1,208.09
|
| Rate for Payer: Aetna Medicare |
$496.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$620.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$620.83
|
| Rate for Payer: ASR ASR |
$1,302.05
|
| Rate for Payer: ASR Commercial |
$1,302.05
|
| Rate for Payer: BCBS Complete |
$279.52
|
| Rate for Payer: BCBS MAPPO |
$496.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,099.23
|
| Rate for Payer: BCN Commercial |
$1,040.70
|
| Rate for Payer: BCN Medicare Advantage |
$496.66
|
| Rate for Payer: Cash Price |
$1,073.86
|
| Rate for Payer: Cash Price |
$1,073.86
|
| Rate for Payer: Cofinity Commercial |
$1,261.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,073.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$496.66
|
| Rate for Payer: Healthscope Commercial |
$1,342.32
|
| Rate for Payer: Healthscope Whirlpool |
$1,302.05
|
| Rate for Payer: Humana Choice PPO Medicare |
$496.66
|
| Rate for Payer: Mclaren Commercial |
$1,208.09
|
| Rate for Payer: Mclaren Medicaid |
$266.21
|
| Rate for Payer: Mclaren Medicare |
$496.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$521.49
|
| Rate for Payer: Meridian Medicaid |
$279.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$571.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,140.97
|
| Rate for Payer: Nomi Health Commercial |
$1,100.70
|
| Rate for Payer: PACE Medicare |
$471.83
|
| Rate for Payer: PACE SWMI |
$496.66
|
| Rate for Payer: PHP Commercial |
$546.33
|
| Rate for Payer: PHP Medicaid |
$266.21
|
| Rate for Payer: PHP Medicare Advantage |
$496.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$266.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$872.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,176.14
|
| Rate for Payer: Priority Health Medicare |
$496.66
|
| Rate for Payer: Priority Health Narrow Network |
$940.97
|
| Rate for Payer: Railroad Medicare Medicare |
$496.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,181.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$496.66
|
| Rate for Payer: UHC Exchange |
$769.82
|
| Rate for Payer: UHC Medicare Advantage |
$496.66
|
| Rate for Payer: UHCCP DNSP |
$496.66
|
| Rate for Payer: UHCCP Medicaid |
$266.21
|
| Rate for Payer: VA VA |
$496.66
|
|
|
HC CONTROL OROPHARYNG HEMORRHAGE SIMPLE
|
Facility
|
IP
|
$1,342.32
|
|
|
Service Code
|
CPT 42960
|
| Hospital Charge Code |
76100478
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$872.51 |
| Max. Negotiated Rate |
$1,342.32 |
| Rate for Payer: Aetna Commercial |
$1,208.09
|
| Rate for Payer: ASR ASR |
$1,302.05
|
| Rate for Payer: ASR Commercial |
$1,302.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,093.86
|
| Rate for Payer: BCN Commercial |
$1,040.70
|
| Rate for Payer: Cash Price |
$1,073.86
|
| Rate for Payer: Cofinity Commercial |
$1,261.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,073.86
|
| Rate for Payer: Healthscope Commercial |
$1,342.32
|
| Rate for Payer: Healthscope Whirlpool |
$1,302.05
|
| Rate for Payer: Mclaren Commercial |
$1,208.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,140.97
|
| Rate for Payer: Nomi Health Commercial |
$1,100.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$872.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,181.24
|
|
|
HC CONVERT EXTERNAL BILIARY DRAIN TO INTERNAL EXTERNAL
|
Facility
|
IP
|
$3,683.04
|
|
|
Service Code
|
CPT 47535
|
| Hospital Charge Code |
36100492
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,393.98 |
| Max. Negotiated Rate |
$3,683.04 |
| Rate for Payer: Aetna Commercial |
$3,314.74
|
| Rate for Payer: ASR ASR |
$3,572.55
|
| Rate for Payer: ASR Commercial |
$3,572.55
|
| Rate for Payer: BCBS Trust/PPO |
$3,001.31
|
| Rate for Payer: BCN Commercial |
$2,855.46
|
| Rate for Payer: Cash Price |
$2,946.43
|
| Rate for Payer: Cofinity Commercial |
$3,462.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,946.43
|
| Rate for Payer: Healthscope Commercial |
$3,683.04
|
| Rate for Payer: Healthscope Whirlpool |
$3,572.55
|
| Rate for Payer: Mclaren Commercial |
$3,314.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,130.58
|
| Rate for Payer: Nomi Health Commercial |
$3,020.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,393.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,241.08
|
|
|
HC CONVERT EXTERNAL BILIARY DRAIN TO INTERNAL EXTERNAL
|
Facility
|
OP
|
$3,683.04
|
|
|
Service Code
|
CPT 47535
|
| Hospital Charge Code |
36100492
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,844.82 |
| Max. Negotiated Rate |
$5,334.82 |
| Rate for Payer: Aetna Commercial |
$3,314.74
|
| Rate for Payer: Aetna Medicare |
$3,441.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,302.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,302.27
|
| Rate for Payer: ASR ASR |
$3,572.55
|
| Rate for Payer: ASR Commercial |
$3,572.55
|
| Rate for Payer: BCBS Complete |
$1,937.06
|
| Rate for Payer: BCBS MAPPO |
$3,441.82
|
| Rate for Payer: BCBS Trust/PPO |
$3,016.04
|
| Rate for Payer: BCN Commercial |
$2,855.46
|
| Rate for Payer: BCN Medicare Advantage |
$3,441.82
|
| Rate for Payer: Cash Price |
$2,946.43
|
| Rate for Payer: Cash Price |
$2,946.43
|
| Rate for Payer: Cofinity Commercial |
$3,462.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,946.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,441.82
|
| Rate for Payer: Healthscope Commercial |
$3,683.04
|
| Rate for Payer: Healthscope Whirlpool |
$3,572.55
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,441.82
|
| Rate for Payer: Mclaren Commercial |
$3,314.74
|
| Rate for Payer: Mclaren Medicaid |
$1,844.82
|
| Rate for Payer: Mclaren Medicare |
$3,441.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,613.91
|
| Rate for Payer: Meridian Medicaid |
$1,937.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,958.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,130.58
|
| Rate for Payer: Nomi Health Commercial |
$3,020.09
|
| Rate for Payer: PACE Medicare |
$3,269.73
|
| Rate for Payer: PACE SWMI |
$3,441.82
|
| Rate for Payer: PHP Commercial |
$3,786.00
|
| Rate for Payer: PHP Medicaid |
$1,844.82
|
| Rate for Payer: PHP Medicare Advantage |
$3,441.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,844.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,393.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,227.08
|
| Rate for Payer: Priority Health Medicare |
$3,441.82
|
| Rate for Payer: Priority Health Narrow Network |
$2,581.81
|
| Rate for Payer: Railroad Medicare Medicare |
$3,441.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,241.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,441.82
|
| Rate for Payer: UHC Exchange |
$5,334.82
|
| Rate for Payer: UHC Medicare Advantage |
$3,441.82
|
| Rate for Payer: UHCCP DNSP |
$3,441.82
|
| Rate for Payer: UHCCP Medicaid |
$1,844.82
|
| Rate for Payer: VA VA |
$3,441.82
|
|
|
HC CONVERT NEPHROSTOMY TO NEPHROURETERAL CATH
|
Facility
|
OP
|
$1,204.40
|
|
|
Service Code
|
CPT 50434
|
| Hospital Charge Code |
36100506
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$782.86 |
| Max. Negotiated Rate |
$3,096.70 |
| Rate for Payer: Aetna Commercial |
$1,083.96
|
| Rate for Payer: Aetna Medicare |
$1,997.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,497.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,497.34
|
| Rate for Payer: ASR ASR |
$1,168.27
|
| Rate for Payer: ASR Commercial |
$1,168.27
|
| Rate for Payer: BCBS Complete |
$1,124.40
|
| Rate for Payer: BCBS MAPPO |
$1,997.87
|
| Rate for Payer: BCBS Trust/PPO |
$986.28
|
| Rate for Payer: BCN Commercial |
$933.77
|
| Rate for Payer: BCN Medicare Advantage |
$1,997.87
|
| Rate for Payer: Cash Price |
$963.52
|
| Rate for Payer: Cash Price |
$963.52
|
| Rate for Payer: Cofinity Commercial |
$1,132.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$963.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,997.87
|
| Rate for Payer: Healthscope Commercial |
$1,204.40
|
| Rate for Payer: Healthscope Whirlpool |
$1,168.27
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,997.87
|
| Rate for Payer: Mclaren Commercial |
$1,083.96
|
| Rate for Payer: Mclaren Medicaid |
$1,070.86
|
| Rate for Payer: Mclaren Medicare |
$1,997.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,097.76
|
| Rate for Payer: Meridian Medicaid |
$1,124.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,297.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,023.74
|
| Rate for Payer: Nomi Health Commercial |
$987.61
|
| Rate for Payer: PACE Medicare |
$1,897.98
|
| Rate for Payer: PACE SWMI |
$1,997.87
|
| Rate for Payer: PHP Commercial |
$2,197.66
|
| Rate for Payer: PHP Medicaid |
$1,070.86
|
| Rate for Payer: PHP Medicare Advantage |
$1,997.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,070.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$782.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,055.30
|
| Rate for Payer: Priority Health Medicare |
$1,997.87
|
| Rate for Payer: Priority Health Narrow Network |
$844.28
|
| Rate for Payer: Railroad Medicare Medicare |
$1,997.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,059.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,997.87
|
| Rate for Payer: UHC Exchange |
$3,096.70
|
| Rate for Payer: UHC Medicare Advantage |
$1,997.87
|
| Rate for Payer: UHCCP DNSP |
$1,997.87
|
| Rate for Payer: UHCCP Medicaid |
$1,070.86
|
| Rate for Payer: VA VA |
$1,997.87
|
|
|
HC CONVERT NEPHROSTOMY TO NEPHROURETERAL CATH
|
Facility
|
IP
|
$1,204.40
|
|
|
Service Code
|
CPT 50434
|
| Hospital Charge Code |
36100506
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$782.86 |
| Max. Negotiated Rate |
$1,204.40 |
| Rate for Payer: Aetna Commercial |
$1,083.96
|
| Rate for Payer: ASR ASR |
$1,168.27
|
| Rate for Payer: ASR Commercial |
$1,168.27
|
| Rate for Payer: BCBS Trust/PPO |
$981.47
|
| Rate for Payer: BCN Commercial |
$933.77
|
| Rate for Payer: Cash Price |
$963.52
|
| Rate for Payer: Cofinity Commercial |
$1,132.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$963.52
|
| Rate for Payer: Healthscope Commercial |
$1,204.40
|
| Rate for Payer: Healthscope Whirlpool |
$1,168.27
|
| Rate for Payer: Mclaren Commercial |
$1,083.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,023.74
|
| Rate for Payer: Nomi Health Commercial |
$987.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$782.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,059.87
|
|
|
HC CONVEX WAFER
|
Facility
|
OP
|
$57.04
|
|
| Hospital Charge Code |
27000049
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$22.82 |
| Max. Negotiated Rate |
$57.04 |
| Rate for Payer: Aetna Commercial |
$51.34
|
| Rate for Payer: Aetna Medicare |
$28.52
|
| Rate for Payer: ASR ASR |
$55.33
|
| Rate for Payer: ASR Commercial |
$55.33
|
| Rate for Payer: BCBS Complete |
$22.82
|
| Rate for Payer: BCBS Trust/PPO |
$46.71
|
| Rate for Payer: BCN Commercial |
$44.22
|
| Rate for Payer: Cash Price |
$45.63
|
| Rate for Payer: Cofinity Commercial |
$53.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.63
|
| Rate for Payer: Healthscope Commercial |
$57.04
|
| Rate for Payer: Healthscope Whirlpool |
$55.33
|
| Rate for Payer: Mclaren Commercial |
$51.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.48
|
| Rate for Payer: Nomi Health Commercial |
$46.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$49.98
|
| Rate for Payer: Priority Health Narrow Network |
$39.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$50.20
|
|
|
HC CONVEX WAFER
|
Facility
|
IP
|
$57.04
|
|
| Hospital Charge Code |
27000049
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$37.08 |
| Max. Negotiated Rate |
$57.04 |
| Rate for Payer: Aetna Commercial |
$51.34
|
| Rate for Payer: ASR ASR |
$55.33
|
| Rate for Payer: ASR Commercial |
$55.33
|
| Rate for Payer: BCBS Trust/PPO |
$46.48
|
| Rate for Payer: BCN Commercial |
$44.22
|
| Rate for Payer: Cash Price |
$45.63
|
| Rate for Payer: Cofinity Commercial |
$53.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.63
|
| Rate for Payer: Healthscope Commercial |
$57.04
|
| Rate for Payer: Healthscope Whirlpool |
$55.33
|
| Rate for Payer: Mclaren Commercial |
$51.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.48
|
| Rate for Payer: Nomi Health Commercial |
$46.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$50.20
|
|
|
HC COOK GUIDEWIRE
|
Facility
|
OP
|
$47.87
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200019
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.15 |
| Max. Negotiated Rate |
$47.87 |
| Rate for Payer: Aetna Commercial |
$43.08
|
| Rate for Payer: Aetna Medicare |
$23.93
|
| Rate for Payer: ASR ASR |
$46.43
|
| Rate for Payer: ASR Commercial |
$46.43
|
| Rate for Payer: BCBS Complete |
$19.15
|
| Rate for Payer: BCBS Trust/PPO |
$39.20
|
| Rate for Payer: BCN Commercial |
$37.11
|
| Rate for Payer: Cash Price |
$38.30
|
| Rate for Payer: Cofinity Commercial |
$45.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.30
|
| Rate for Payer: Healthscope Commercial |
$47.87
|
| Rate for Payer: Healthscope Whirlpool |
$46.43
|
| Rate for Payer: Mclaren Commercial |
$43.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.69
|
| Rate for Payer: Nomi Health Commercial |
$39.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$41.94
|
| Rate for Payer: Priority Health Narrow Network |
$33.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$42.13
|
|
|
HC COOK GUIDEWIRE
|
Facility
|
IP
|
$47.87
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200019
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.12 |
| Max. Negotiated Rate |
$47.87 |
| Rate for Payer: Aetna Commercial |
$43.08
|
| Rate for Payer: ASR ASR |
$46.43
|
| Rate for Payer: ASR Commercial |
$46.43
|
| Rate for Payer: BCBS Trust/PPO |
$39.01
|
| Rate for Payer: BCN Commercial |
$37.11
|
| Rate for Payer: Cash Price |
$38.30
|
| Rate for Payer: Cofinity Commercial |
$45.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.30
|
| Rate for Payer: Healthscope Commercial |
$47.87
|
| Rate for Payer: Healthscope Whirlpool |
$46.43
|
| Rate for Payer: Mclaren Commercial |
$43.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.69
|
| Rate for Payer: Nomi Health Commercial |
$39.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$42.13
|
|
|
HC COOK PIGTAIL
|
Facility
|
IP
|
$468.32
|
|
| Hospital Charge Code |
27200233
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$304.41 |
| Max. Negotiated Rate |
$468.32 |
| Rate for Payer: Aetna Commercial |
$421.49
|
| Rate for Payer: ASR ASR |
$454.27
|
| Rate for Payer: ASR Commercial |
$454.27
|
| Rate for Payer: BCBS Trust/PPO |
$381.63
|
| Rate for Payer: BCN Commercial |
$363.09
|
| Rate for Payer: Cash Price |
$374.66
|
| Rate for Payer: Cofinity Commercial |
$440.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$374.66
|
| Rate for Payer: Healthscope Commercial |
$468.32
|
| Rate for Payer: Healthscope Whirlpool |
$454.27
|
| Rate for Payer: Mclaren Commercial |
$421.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$398.07
|
| Rate for Payer: Nomi Health Commercial |
$384.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$304.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$412.12
|
|
|
HC COOK PIGTAIL
|
Facility
|
OP
|
$468.32
|
|
| Hospital Charge Code |
27200233
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$187.33 |
| Max. Negotiated Rate |
$468.32 |
| Rate for Payer: Aetna Commercial |
$421.49
|
| Rate for Payer: Aetna Medicare |
$234.16
|
| Rate for Payer: ASR ASR |
$454.27
|
| Rate for Payer: ASR Commercial |
$454.27
|
| Rate for Payer: BCBS Complete |
$187.33
|
| Rate for Payer: BCBS Trust/PPO |
$383.51
|
| Rate for Payer: BCN Commercial |
$363.09
|
| Rate for Payer: Cash Price |
$374.66
|
| Rate for Payer: Cofinity Commercial |
$440.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$374.66
|
| Rate for Payer: Healthscope Commercial |
$468.32
|
| Rate for Payer: Healthscope Whirlpool |
$454.27
|
| Rate for Payer: Mclaren Commercial |
$421.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$398.07
|
| Rate for Payer: Nomi Health Commercial |
$384.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$304.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$410.34
|
| Rate for Payer: Priority Health Narrow Network |
$328.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$412.12
|
|
|
HC COOLIEF RF PROBE
|
Facility
|
OP
|
$1,912.50
|
|
| Hospital Charge Code |
27200355
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$765.00 |
| Max. Negotiated Rate |
$1,912.50 |
| Rate for Payer: Aetna Commercial |
$1,721.25
|
| Rate for Payer: Aetna Medicare |
$956.25
|
| Rate for Payer: ASR ASR |
$1,855.12
|
| Rate for Payer: ASR Commercial |
$1,855.12
|
| Rate for Payer: BCBS Complete |
$765.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,566.15
|
| Rate for Payer: BCN Commercial |
$1,482.76
|
| Rate for Payer: Cash Price |
$1,530.00
|
| Rate for Payer: Cofinity Commercial |
$1,797.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,530.00
|
| Rate for Payer: Healthscope Commercial |
$1,912.50
|
| Rate for Payer: Healthscope Whirlpool |
$1,855.12
|
| Rate for Payer: Mclaren Commercial |
$1,721.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,625.62
|
| Rate for Payer: Nomi Health Commercial |
$1,568.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,243.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,675.73
|
| Rate for Payer: Priority Health Narrow Network |
$1,340.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,683.00
|
|
|
HC COOLIEF RF PROBE
|
Facility
|
IP
|
$1,912.50
|
|
| Hospital Charge Code |
27200355
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,243.12 |
| Max. Negotiated Rate |
$1,912.50 |
| Rate for Payer: Aetna Commercial |
$1,721.25
|
| Rate for Payer: ASR ASR |
$1,855.12
|
| Rate for Payer: ASR Commercial |
$1,855.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,558.50
|
| Rate for Payer: BCN Commercial |
$1,482.76
|
| Rate for Payer: Cash Price |
$1,530.00
|
| Rate for Payer: Cofinity Commercial |
$1,797.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,530.00
|
| Rate for Payer: Healthscope Commercial |
$1,912.50
|
| Rate for Payer: Healthscope Whirlpool |
$1,855.12
|
| Rate for Payer: Mclaren Commercial |
$1,721.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,625.62
|
| Rate for Payer: Nomi Health Commercial |
$1,568.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,243.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,683.00
|
|
|
HC COPPER SERUM
|
Facility
|
OP
|
$44.88
|
|
|
Service Code
|
CPT 82525
|
| Hospital Charge Code |
30100170
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.65 |
| Max. Negotiated Rate |
$44.88 |
| Rate for Payer: Aetna Commercial |
$40.39
|
| Rate for Payer: Aetna Medicare |
$12.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.51
|
| Rate for Payer: ASR ASR |
$43.53
|
| Rate for Payer: ASR Commercial |
$43.53
|
| Rate for Payer: BCBS Complete |
$6.98
|
| Rate for Payer: BCBS MAPPO |
$12.41
|
| Rate for Payer: BCBS Trust/PPO |
$36.75
|
| Rate for Payer: BCN Commercial |
$34.80
|
| Rate for Payer: BCN Medicare Advantage |
$12.41
|
| Rate for Payer: Cash Price |
$35.90
|
| Rate for Payer: Cash Price |
$35.90
|
| Rate for Payer: Cofinity Commercial |
$42.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.41
|
| Rate for Payer: Healthscope Commercial |
$44.88
|
| Rate for Payer: Healthscope Whirlpool |
$43.53
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.41
|
| Rate for Payer: Mclaren Commercial |
$40.39
|
| Rate for Payer: Mclaren Medicaid |
$6.65
|
| Rate for Payer: Mclaren Medicare |
$12.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.03
|
| Rate for Payer: Meridian Medicaid |
$6.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.15
|
| Rate for Payer: Nomi Health Commercial |
$36.80
|
| Rate for Payer: PACE Medicare |
$11.79
|
| Rate for Payer: PACE SWMI |
$12.41
|
| Rate for Payer: PHP Commercial |
$13.65
|
| Rate for Payer: PHP Medicaid |
$6.65
|
| Rate for Payer: PHP Medicare Advantage |
$12.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.32
|
| Rate for Payer: Priority Health Medicare |
$12.41
|
| Rate for Payer: Priority Health Narrow Network |
$31.46
|
| Rate for Payer: Railroad Medicare Medicare |
$12.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$39.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.41
|
| Rate for Payer: UHC Exchange |
$19.24
|
| Rate for Payer: UHC Medicare Advantage |
$12.41
|
| Rate for Payer: UHCCP DNSP |
$12.41
|
| Rate for Payer: UHCCP Medicaid |
$6.65
|
| Rate for Payer: VA VA |
$12.41
|
|
|
HC COPPER SERUM
|
Facility
|
IP
|
$44.88
|
|
|
Service Code
|
CPT 82525
|
| Hospital Charge Code |
30100170
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$29.17 |
| Max. Negotiated Rate |
$44.88 |
| Rate for Payer: Aetna Commercial |
$40.39
|
| Rate for Payer: ASR ASR |
$43.53
|
| Rate for Payer: ASR Commercial |
$43.53
|
| Rate for Payer: BCBS Trust/PPO |
$36.57
|
| Rate for Payer: BCN Commercial |
$34.80
|
| Rate for Payer: Cash Price |
$35.90
|
| Rate for Payer: Cofinity Commercial |
$42.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.90
|
| Rate for Payer: Healthscope Commercial |
$44.88
|
| Rate for Payer: Healthscope Whirlpool |
$43.53
|
| Rate for Payer: Mclaren Commercial |
$40.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.15
|
| Rate for Payer: Nomi Health Commercial |
$36.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$39.49
|
|
|
HC COPPER URINE
|
Facility
|
OP
|
$63.24
|
|
|
Service Code
|
CPT 82525
|
| Hospital Charge Code |
30100171
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.65 |
| Max. Negotiated Rate |
$63.24 |
| Rate for Payer: Aetna Commercial |
$56.92
|
| Rate for Payer: Aetna Medicare |
$12.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.51
|
| Rate for Payer: ASR ASR |
$61.34
|
| Rate for Payer: ASR Commercial |
$61.34
|
| Rate for Payer: BCBS Complete |
$6.98
|
| Rate for Payer: BCBS MAPPO |
$12.41
|
| Rate for Payer: BCBS Trust/PPO |
$51.79
|
| Rate for Payer: BCN Commercial |
$49.03
|
| Rate for Payer: BCN Medicare Advantage |
$12.41
|
| Rate for Payer: Cash Price |
$50.59
|
| Rate for Payer: Cash Price |
$50.59
|
| Rate for Payer: Cofinity Commercial |
$59.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.41
|
| Rate for Payer: Healthscope Commercial |
$63.24
|
| Rate for Payer: Healthscope Whirlpool |
$61.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.41
|
| Rate for Payer: Mclaren Commercial |
$56.92
|
| Rate for Payer: Mclaren Medicaid |
$6.65
|
| Rate for Payer: Mclaren Medicare |
$12.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.03
|
| Rate for Payer: Meridian Medicaid |
$6.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.75
|
| Rate for Payer: Nomi Health Commercial |
$51.86
|
| Rate for Payer: PACE Medicare |
$11.79
|
| Rate for Payer: PACE SWMI |
$12.41
|
| Rate for Payer: PHP Commercial |
$13.65
|
| Rate for Payer: PHP Medicaid |
$6.65
|
| Rate for Payer: PHP Medicare Advantage |
$12.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$55.41
|
| Rate for Payer: Priority Health Medicare |
$12.41
|
| Rate for Payer: Priority Health Narrow Network |
$44.33
|
| Rate for Payer: Railroad Medicare Medicare |
$12.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$55.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.41
|
| Rate for Payer: UHC Exchange |
$19.24
|
| Rate for Payer: UHC Medicare Advantage |
$12.41
|
| Rate for Payer: UHCCP DNSP |
$12.41
|
| Rate for Payer: UHCCP Medicaid |
$6.65
|
| Rate for Payer: VA VA |
$12.41
|
|
|
HC COPPER URINE
|
Facility
|
IP
|
$63.24
|
|
|
Service Code
|
CPT 82525
|
| Hospital Charge Code |
30100171
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$41.11 |
| Max. Negotiated Rate |
$63.24 |
| Rate for Payer: Aetna Commercial |
$56.92
|
| Rate for Payer: ASR ASR |
$61.34
|
| Rate for Payer: ASR Commercial |
$61.34
|
| Rate for Payer: BCBS Trust/PPO |
$51.53
|
| Rate for Payer: BCN Commercial |
$49.03
|
| Rate for Payer: Cash Price |
$50.59
|
| Rate for Payer: Cofinity Commercial |
$59.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.59
|
| Rate for Payer: Healthscope Commercial |
$63.24
|
| Rate for Payer: Healthscope Whirlpool |
$61.34
|
| Rate for Payer: Mclaren Commercial |
$56.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.75
|
| Rate for Payer: Nomi Health Commercial |
$51.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$55.65
|
|
|
HC CORDIS CATHETER
|
Facility
|
IP
|
$196.62
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200021
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$127.80 |
| Max. Negotiated Rate |
$196.62 |
| Rate for Payer: Aetna Commercial |
$176.96
|
| Rate for Payer: ASR ASR |
$190.72
|
| Rate for Payer: ASR Commercial |
$190.72
|
| Rate for Payer: BCBS Trust/PPO |
$160.23
|
| Rate for Payer: BCN Commercial |
$152.44
|
| Rate for Payer: Cash Price |
$157.30
|
| Rate for Payer: Cofinity Commercial |
$184.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$157.30
|
| Rate for Payer: Healthscope Commercial |
$196.62
|
| Rate for Payer: Healthscope Whirlpool |
$190.72
|
| Rate for Payer: Mclaren Commercial |
$176.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$167.13
|
| Rate for Payer: Nomi Health Commercial |
$161.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$127.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$173.03
|
|
|
HC CORDIS CATHETER
|
Facility
|
OP
|
$196.62
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200021
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$78.65 |
| Max. Negotiated Rate |
$196.62 |
| Rate for Payer: Aetna Commercial |
$176.96
|
| Rate for Payer: Aetna Medicare |
$98.31
|
| Rate for Payer: ASR ASR |
$190.72
|
| Rate for Payer: ASR Commercial |
$190.72
|
| Rate for Payer: BCBS Complete |
$78.65
|
| Rate for Payer: BCBS Trust/PPO |
$161.01
|
| Rate for Payer: BCN Commercial |
$152.44
|
| Rate for Payer: Cash Price |
$157.30
|
| Rate for Payer: Cofinity Commercial |
$184.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$157.30
|
| Rate for Payer: Healthscope Commercial |
$196.62
|
| Rate for Payer: Healthscope Whirlpool |
$190.72
|
| Rate for Payer: Mclaren Commercial |
$176.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$167.13
|
| Rate for Payer: Nomi Health Commercial |
$161.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$127.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$172.28
|
| Rate for Payer: Priority Health Narrow Network |
$137.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$173.03
|
|
|
HC COREWELL DRUG ANALYSIS
|
Facility
|
OP
|
$94.53
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100740
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.31 |
| Max. Negotiated Rate |
$96.32 |
| Rate for Payer: Aetna Commercial |
$85.08
|
| Rate for Payer: Aetna Medicare |
$62.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.67
|
| Rate for Payer: ASR ASR |
$91.69
|
| Rate for Payer: ASR Commercial |
$91.69
|
| Rate for Payer: BCBS Complete |
$34.97
|
| Rate for Payer: BCBS MAPPO |
$62.14
|
| Rate for Payer: BCBS Trust/PPO |
$77.41
|
| Rate for Payer: BCN Commercial |
$73.29
|
| Rate for Payer: BCN Medicare Advantage |
$62.14
|
| Rate for Payer: Cash Price |
$75.62
|
| Rate for Payer: Cash Price |
$75.62
|
| Rate for Payer: Cofinity Commercial |
$88.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.14
|
| Rate for Payer: Healthscope Commercial |
$94.53
|
| Rate for Payer: Healthscope Whirlpool |
$91.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$62.14
|
| Rate for Payer: Mclaren Commercial |
$85.08
|
| 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 |
$80.35
|
| Rate for Payer: Nomi Health Commercial |
$77.51
|
| 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 |
$61.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$82.83
|
| Rate for Payer: Priority Health Medicare |
$62.14
|
| Rate for Payer: Priority Health Narrow Network |
$66.27
|
| Rate for Payer: Railroad Medicare Medicare |
$62.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$83.19
|
| 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 COREWELL DRUG ANALYSIS
|
Facility
|
IP
|
$94.53
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100740
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$61.44 |
| Max. Negotiated Rate |
$94.53 |
| Rate for Payer: Aetna Commercial |
$85.08
|
| Rate for Payer: ASR ASR |
$91.69
|
| Rate for Payer: ASR Commercial |
$91.69
|
| Rate for Payer: BCBS Trust/PPO |
$77.03
|
| Rate for Payer: BCN Commercial |
$73.29
|
| Rate for Payer: Cash Price |
$75.62
|
| Rate for Payer: Cofinity Commercial |
$88.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.62
|
| Rate for Payer: Healthscope Commercial |
$94.53
|
| Rate for Payer: Healthscope Whirlpool |
$91.69
|
| Rate for Payer: Mclaren Commercial |
$85.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.35
|
| Rate for Payer: Nomi Health Commercial |
$77.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$83.19
|
|
