|
HC COREWELL DRUG ANALYSIS ALCOHOL
|
Facility
|
IP
|
$45.90
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
30100739
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$29.84 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$41.31
|
| Rate for Payer: ASR ASR |
$44.52
|
| Rate for Payer: ASR Commercial |
$44.52
|
| Rate for Payer: BCBS Trust/PPO |
$37.40
|
| Rate for Payer: BCN Commercial |
$35.59
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cofinity Commercial |
$43.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.72
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Healthscope Whirlpool |
$44.52
|
| Rate for Payer: Mclaren Commercial |
$41.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.02
|
| Rate for Payer: Nomi Health Commercial |
$37.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.39
|
|
|
HC COREWELL DRUG ANALYSIS ALCOHOL
|
Facility
|
OP
|
$45.90
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
30100739
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.36 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$41.31
|
| Rate for Payer: Aetna Medicare |
$22.95
|
| Rate for Payer: ASR ASR |
$44.52
|
| Rate for Payer: ASR Commercial |
$44.52
|
| Rate for Payer: BCBS Complete |
$18.36
|
| Rate for Payer: BCBS Trust/PPO |
$37.59
|
| Rate for Payer: BCN Commercial |
$35.59
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cofinity Commercial |
$43.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.72
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Healthscope Whirlpool |
$44.52
|
| Rate for Payer: Mclaren Commercial |
$41.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.02
|
| Rate for Payer: Nomi Health Commercial |
$37.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$40.22
|
| Rate for Payer: Priority Health Narrow Network |
$32.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.39
|
|
|
HC CORN IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200036
|
|
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 |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| 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 CORN IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200036
|
|
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 CORN POLLEN IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200081
|
|
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 CORN POLLEN IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200081
|
|
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 |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| 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 CORO ANGIOS W RHC
|
Facility
|
IP
|
$8,964.41
|
|
|
Service Code
|
CPT 93456
|
| Hospital Charge Code |
48100015
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,826.87 |
| Max. Negotiated Rate |
$8,964.41 |
| Rate for Payer: Aetna Commercial |
$8,067.97
|
| Rate for Payer: ASR ASR |
$8,695.48
|
| Rate for Payer: ASR Commercial |
$8,695.48
|
| Rate for Payer: BCBS Trust/PPO |
$7,305.10
|
| Rate for Payer: BCN Commercial |
$6,950.11
|
| Rate for Payer: Cash Price |
$7,171.53
|
| Rate for Payer: Cofinity Commercial |
$8,426.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,171.53
|
| Rate for Payer: Healthscope Commercial |
$8,964.41
|
| Rate for Payer: Healthscope Whirlpool |
$8,695.48
|
| Rate for Payer: Mclaren Commercial |
$8,067.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,619.75
|
| Rate for Payer: Nomi Health Commercial |
$7,350.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,826.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,888.68
|
|
|
HC CORO ANGIOS W RHC
|
Facility
|
OP
|
$8,964.41
|
|
|
Service Code
|
CPT 93456
|
| Hospital Charge Code |
48100015
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,681.38 |
| Max. Negotiated Rate |
$8,964.41 |
| Rate for Payer: Aetna Commercial |
$8,067.97
|
| Rate for Payer: Aetna Medicare |
$3,136.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,921.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,921.12
|
| Rate for Payer: ASR ASR |
$8,695.48
|
| Rate for Payer: ASR Commercial |
$8,695.48
|
| Rate for Payer: BCBS Complete |
$1,765.45
|
| Rate for Payer: BCBS MAPPO |
$3,136.90
|
| Rate for Payer: BCBS Trust/PPO |
$7,340.96
|
| Rate for Payer: BCN Commercial |
$6,950.11
|
| Rate for Payer: BCN Medicare Advantage |
$3,136.90
|
| Rate for Payer: Cash Price |
$7,171.53
|
| Rate for Payer: Cash Price |
$7,171.53
|
| Rate for Payer: Cofinity Commercial |
$8,426.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,171.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,136.90
|
| Rate for Payer: Healthscope Commercial |
$8,964.41
|
| Rate for Payer: Healthscope Whirlpool |
$8,695.48
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,136.90
|
| Rate for Payer: Mclaren Commercial |
$8,067.97
|
| Rate for Payer: Mclaren Medicaid |
$1,681.38
|
| Rate for Payer: Mclaren Medicare |
$3,136.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,293.74
|
| Rate for Payer: Meridian Medicaid |
$1,765.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,607.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,619.75
|
| Rate for Payer: Nomi Health Commercial |
$7,350.82
|
| Rate for Payer: PACE Medicare |
$2,980.05
|
| Rate for Payer: PACE SWMI |
$3,136.90
|
| Rate for Payer: PHP Commercial |
$3,450.59
|
| Rate for Payer: PHP Medicaid |
$1,681.38
|
| Rate for Payer: PHP Medicare Advantage |
$3,136.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,681.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,826.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,854.62
|
| Rate for Payer: Priority Health Medicare |
$3,136.90
|
| Rate for Payer: Priority Health Narrow Network |
$6,284.05
|
| Rate for Payer: Railroad Medicare Medicare |
$3,136.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,888.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,136.90
|
| Rate for Payer: UHC Exchange |
$4,862.19
|
| Rate for Payer: UHC Medicare Advantage |
$3,136.90
|
| Rate for Payer: UHCCP DNSP |
$3,136.90
|
| Rate for Payer: UHCCP Medicaid |
$1,681.38
|
| Rate for Payer: VA VA |
$3,136.90
|
|
|
HC CORO/CABG ANGIOS W RHC
|
Facility
|
OP
|
$7,111.94
|
|
|
Service Code
|
CPT 93457
|
| Hospital Charge Code |
48100016
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,681.38 |
| Max. Negotiated Rate |
$7,111.94 |
| Rate for Payer: Aetna Commercial |
$6,400.75
|
| Rate for Payer: Aetna Medicare |
$3,136.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,921.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,921.12
|
| Rate for Payer: ASR ASR |
$6,898.58
|
| Rate for Payer: ASR Commercial |
$6,898.58
|
| Rate for Payer: BCBS Complete |
$1,765.45
|
| Rate for Payer: BCBS MAPPO |
$3,136.90
|
| Rate for Payer: BCBS Trust/PPO |
$5,823.97
|
| Rate for Payer: BCN Commercial |
$5,513.89
|
| Rate for Payer: BCN Medicare Advantage |
$3,136.90
|
| Rate for Payer: Cash Price |
$5,689.55
|
| Rate for Payer: Cash Price |
$5,689.55
|
| Rate for Payer: Cofinity Commercial |
$6,685.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,689.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,136.90
|
| Rate for Payer: Healthscope Commercial |
$7,111.94
|
| Rate for Payer: Healthscope Whirlpool |
$6,898.58
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,136.90
|
| Rate for Payer: Mclaren Commercial |
$6,400.75
|
| Rate for Payer: Mclaren Medicaid |
$1,681.38
|
| Rate for Payer: Mclaren Medicare |
$3,136.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,293.74
|
| Rate for Payer: Meridian Medicaid |
$1,765.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,607.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,045.15
|
| Rate for Payer: Nomi Health Commercial |
$5,831.79
|
| Rate for Payer: PACE Medicare |
$2,980.05
|
| Rate for Payer: PACE SWMI |
$3,136.90
|
| Rate for Payer: PHP Commercial |
$3,450.59
|
| Rate for Payer: PHP Medicaid |
$1,681.38
|
| Rate for Payer: PHP Medicare Advantage |
$3,136.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,681.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,622.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,231.48
|
| Rate for Payer: Priority Health Medicare |
$3,136.90
|
| Rate for Payer: Priority Health Narrow Network |
$4,985.47
|
| Rate for Payer: Railroad Medicare Medicare |
$3,136.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,258.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,136.90
|
| Rate for Payer: UHC Exchange |
$4,862.19
|
| Rate for Payer: UHC Medicare Advantage |
$3,136.90
|
| Rate for Payer: UHCCP DNSP |
$3,136.90
|
| Rate for Payer: UHCCP Medicaid |
$1,681.38
|
| Rate for Payer: VA VA |
$3,136.90
|
|
|
HC CORO/CABG ANGIOS W RHC
|
Facility
|
IP
|
$7,111.94
|
|
|
Service Code
|
CPT 93457
|
| Hospital Charge Code |
48100016
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,622.76 |
| Max. Negotiated Rate |
$7,111.94 |
| Rate for Payer: Aetna Commercial |
$6,400.75
|
| Rate for Payer: ASR ASR |
$6,898.58
|
| Rate for Payer: ASR Commercial |
$6,898.58
|
| Rate for Payer: BCBS Trust/PPO |
$5,795.52
|
| Rate for Payer: BCN Commercial |
$5,513.89
|
| Rate for Payer: Cash Price |
$5,689.55
|
| Rate for Payer: Cofinity Commercial |
$6,685.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,689.55
|
| Rate for Payer: Healthscope Commercial |
$7,111.94
|
| Rate for Payer: Healthscope Whirlpool |
$6,898.58
|
| Rate for Payer: Mclaren Commercial |
$6,400.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,045.15
|
| Rate for Payer: Nomi Health Commercial |
$5,831.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,622.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,258.51
|
|
|
HC CORONARY ANGIOS ONLY
|
Facility
|
IP
|
$7,550.37
|
|
|
Service Code
|
CPT 93454
|
| Hospital Charge Code |
48100013
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,907.74 |
| Max. Negotiated Rate |
$7,550.37 |
| Rate for Payer: Aetna Commercial |
$6,795.33
|
| Rate for Payer: ASR ASR |
$7,323.86
|
| Rate for Payer: ASR Commercial |
$7,323.86
|
| Rate for Payer: BCBS Trust/PPO |
$6,152.80
|
| Rate for Payer: BCN Commercial |
$5,853.80
|
| Rate for Payer: Cash Price |
$6,040.30
|
| Rate for Payer: Cofinity Commercial |
$7,097.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,040.30
|
| Rate for Payer: Healthscope Commercial |
$7,550.37
|
| Rate for Payer: Healthscope Whirlpool |
$7,323.86
|
| Rate for Payer: Mclaren Commercial |
$6,795.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,417.81
|
| Rate for Payer: Nomi Health Commercial |
$6,191.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,907.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,644.33
|
|
|
HC CORONARY ANGIOS ONLY
|
Facility
|
OP
|
$7,550.37
|
|
|
Service Code
|
CPT 93454
|
| Hospital Charge Code |
48100013
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,681.38 |
| Max. Negotiated Rate |
$7,550.37 |
| Rate for Payer: Aetna Commercial |
$6,795.33
|
| Rate for Payer: Aetna Medicare |
$3,136.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,921.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,921.12
|
| Rate for Payer: ASR ASR |
$7,323.86
|
| Rate for Payer: ASR Commercial |
$7,323.86
|
| Rate for Payer: BCBS Complete |
$1,765.45
|
| Rate for Payer: BCBS MAPPO |
$3,136.90
|
| Rate for Payer: BCBS Trust/PPO |
$6,183.00
|
| Rate for Payer: BCN Commercial |
$5,853.80
|
| Rate for Payer: BCN Medicare Advantage |
$3,136.90
|
| Rate for Payer: Cash Price |
$6,040.30
|
| Rate for Payer: Cash Price |
$6,040.30
|
| Rate for Payer: Cofinity Commercial |
$7,097.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,040.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,136.90
|
| Rate for Payer: Healthscope Commercial |
$7,550.37
|
| Rate for Payer: Healthscope Whirlpool |
$7,323.86
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,136.90
|
| Rate for Payer: Mclaren Commercial |
$6,795.33
|
| Rate for Payer: Mclaren Medicaid |
$1,681.38
|
| Rate for Payer: Mclaren Medicare |
$3,136.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,293.74
|
| Rate for Payer: Meridian Medicaid |
$1,765.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,607.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,417.81
|
| Rate for Payer: Nomi Health Commercial |
$6,191.30
|
| Rate for Payer: PACE Medicare |
$2,980.05
|
| Rate for Payer: PACE SWMI |
$3,136.90
|
| Rate for Payer: PHP Commercial |
$3,450.59
|
| Rate for Payer: PHP Medicaid |
$1,681.38
|
| Rate for Payer: PHP Medicare Advantage |
$3,136.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,681.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,907.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,615.63
|
| Rate for Payer: Priority Health Medicare |
$3,136.90
|
| Rate for Payer: Priority Health Narrow Network |
$5,292.81
|
| Rate for Payer: Railroad Medicare Medicare |
$3,136.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,644.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,136.90
|
| Rate for Payer: UHC Exchange |
$4,862.19
|
| Rate for Payer: UHC Medicare Advantage |
$3,136.90
|
| Rate for Payer: UHCCP DNSP |
$3,136.90
|
| Rate for Payer: UHCCP Medicaid |
$1,681.38
|
| Rate for Payer: VA VA |
$3,136.90
|
|
|
HC CORONARY CRITICAL CARE R&B
|
Facility
|
IP
|
$6,337.46
|
|
| Hospital Charge Code |
21000001
|
|
Hospital Revenue Code
|
210
|
| Min. Negotiated Rate |
$4,119.35 |
| Max. Negotiated Rate |
$6,337.46 |
| Rate for Payer: Aetna Commercial |
$5,703.71
|
| Rate for Payer: ASR ASR |
$6,147.34
|
| Rate for Payer: ASR Commercial |
$6,147.34
|
| Rate for Payer: BCBS Trust/PPO |
$5,164.40
|
| Rate for Payer: BCN Commercial |
$4,913.43
|
| Rate for Payer: Cash Price |
$5,069.97
|
| Rate for Payer: Cofinity Commercial |
$5,957.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,069.97
|
| Rate for Payer: Healthscope Commercial |
$6,337.46
|
| Rate for Payer: Healthscope Whirlpool |
$6,147.34
|
| Rate for Payer: Mclaren Commercial |
$5,703.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,386.84
|
| Rate for Payer: Nomi Health Commercial |
$5,196.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,119.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,576.96
|
|
|
HC CORONARY SINUS CATHETER
|
Facility
|
OP
|
$1,561.51
|
|
|
Service Code
|
HCPCS C1733
|
| Hospital Charge Code |
27200023
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$624.60 |
| Max. Negotiated Rate |
$1,561.51 |
| Rate for Payer: Aetna Commercial |
$1,405.36
|
| Rate for Payer: Aetna Medicare |
$780.75
|
| Rate for Payer: ASR ASR |
$1,514.66
|
| Rate for Payer: ASR Commercial |
$1,514.66
|
| Rate for Payer: BCBS Complete |
$624.60
|
| Rate for Payer: BCBS Trust/PPO |
$1,278.72
|
| Rate for Payer: BCN Commercial |
$1,210.64
|
| Rate for Payer: Cash Price |
$1,249.21
|
| Rate for Payer: Cofinity Commercial |
$1,467.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,249.21
|
| Rate for Payer: Healthscope Commercial |
$1,561.51
|
| Rate for Payer: Healthscope Whirlpool |
$1,514.66
|
| Rate for Payer: Mclaren Commercial |
$1,405.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,327.28
|
| Rate for Payer: Nomi Health Commercial |
$1,280.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,014.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,368.20
|
| Rate for Payer: Priority Health Narrow Network |
$1,094.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,374.13
|
|
|
HC CORONARY SINUS CATHETER
|
Facility
|
IP
|
$1,561.51
|
|
|
Service Code
|
HCPCS C1733
|
| Hospital Charge Code |
27200023
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,014.98 |
| Max. Negotiated Rate |
$1,561.51 |
| Rate for Payer: Aetna Commercial |
$1,405.36
|
| Rate for Payer: ASR ASR |
$1,514.66
|
| Rate for Payer: ASR Commercial |
$1,514.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,272.47
|
| Rate for Payer: BCN Commercial |
$1,210.64
|
| Rate for Payer: Cash Price |
$1,249.21
|
| Rate for Payer: Cofinity Commercial |
$1,467.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,249.21
|
| Rate for Payer: Healthscope Commercial |
$1,561.51
|
| Rate for Payer: Healthscope Whirlpool |
$1,514.66
|
| Rate for Payer: Mclaren Commercial |
$1,405.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,327.28
|
| Rate for Payer: Nomi Health Commercial |
$1,280.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,014.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,374.13
|
|
|
HC CORONARY STENT DRUG ELUTING
|
Facility
|
OP
|
$11,118.36
|
|
|
Service Code
|
HCPCS C1874
|
| Hospital Charge Code |
27800008
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,447.34 |
| Max. Negotiated Rate |
$11,118.36 |
| Rate for Payer: Aetna Commercial |
$10,006.52
|
| Rate for Payer: Aetna Medicare |
$5,559.18
|
| Rate for Payer: ASR ASR |
$10,784.81
|
| Rate for Payer: ASR Commercial |
$10,784.81
|
| Rate for Payer: BCBS Complete |
$4,447.34
|
| Rate for Payer: BCBS Trust/PPO |
$9,104.83
|
| Rate for Payer: BCN Commercial |
$8,620.06
|
| Rate for Payer: Cash Price |
$8,894.69
|
| Rate for Payer: Cofinity Commercial |
$10,451.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,894.69
|
| Rate for Payer: Healthscope Commercial |
$11,118.36
|
| Rate for Payer: Healthscope Whirlpool |
$10,784.81
|
| Rate for Payer: Mclaren Commercial |
$10,006.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,450.61
|
| Rate for Payer: Nomi Health Commercial |
$9,117.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,226.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,741.91
|
| Rate for Payer: Priority Health Narrow Network |
$7,793.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9,784.16
|
|
|
HC CORONARY STENT DRUG ELUTING
|
Facility
|
IP
|
$11,118.36
|
|
|
Service Code
|
HCPCS C1874
|
| Hospital Charge Code |
27800008
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,226.93 |
| Max. Negotiated Rate |
$11,118.36 |
| Rate for Payer: Aetna Commercial |
$10,006.52
|
| Rate for Payer: ASR ASR |
$10,784.81
|
| Rate for Payer: ASR Commercial |
$10,784.81
|
| Rate for Payer: BCBS Trust/PPO |
$9,060.35
|
| Rate for Payer: BCN Commercial |
$8,620.06
|
| Rate for Payer: Cash Price |
$8,894.69
|
| Rate for Payer: Cofinity Commercial |
$10,451.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,894.69
|
| Rate for Payer: Healthscope Commercial |
$11,118.36
|
| Rate for Payer: Healthscope Whirlpool |
$10,784.81
|
| Rate for Payer: Mclaren Commercial |
$10,006.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,450.61
|
| Rate for Payer: Nomi Health Commercial |
$9,117.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,226.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9,784.16
|
|
|
HC CORONARY THROMBECTOMY
|
Facility
|
OP
|
$4,063.96
|
|
|
Service Code
|
CPT 92973
|
| Hospital Charge Code |
48100001
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,625.58 |
| Max. Negotiated Rate |
$4,063.96 |
| Rate for Payer: Aetna Commercial |
$3,657.56
|
| Rate for Payer: Aetna Medicare |
$2,031.98
|
| Rate for Payer: ASR ASR |
$3,942.04
|
| Rate for Payer: ASR Commercial |
$3,942.04
|
| Rate for Payer: BCBS Complete |
$1,625.58
|
| Rate for Payer: BCBS Trust/PPO |
$3,327.98
|
| Rate for Payer: BCN Commercial |
$3,150.79
|
| Rate for Payer: Cash Price |
$3,251.17
|
| Rate for Payer: Cofinity Commercial |
$3,820.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,251.17
|
| Rate for Payer: Healthscope Commercial |
$4,063.96
|
| Rate for Payer: Healthscope Whirlpool |
$3,942.04
|
| Rate for Payer: Mclaren Commercial |
$3,657.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,454.37
|
| Rate for Payer: Nomi Health Commercial |
$3,332.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,641.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,560.84
|
| Rate for Payer: Priority Health Narrow Network |
$2,848.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,576.28
|
|
|
HC CORONARY THROMBECTOMY
|
Facility
|
IP
|
$4,063.96
|
|
|
Service Code
|
CPT 92973
|
| Hospital Charge Code |
48100001
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,641.57 |
| Max. Negotiated Rate |
$4,063.96 |
| Rate for Payer: Aetna Commercial |
$3,657.56
|
| Rate for Payer: ASR ASR |
$3,942.04
|
| Rate for Payer: ASR Commercial |
$3,942.04
|
| Rate for Payer: BCBS Trust/PPO |
$3,311.72
|
| Rate for Payer: BCN Commercial |
$3,150.79
|
| Rate for Payer: Cash Price |
$3,251.17
|
| Rate for Payer: Cofinity Commercial |
$3,820.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,251.17
|
| Rate for Payer: Healthscope Commercial |
$4,063.96
|
| Rate for Payer: Healthscope Whirlpool |
$3,942.04
|
| Rate for Payer: Mclaren Commercial |
$3,657.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,454.37
|
| Rate for Payer: Nomi Health Commercial |
$3,332.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,641.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,576.28
|
|
|
HC CORTICAL MAPPING
|
Facility
|
OP
|
$2,150.51
|
|
|
Service Code
|
CPT 95961
|
| Hospital Charge Code |
92000009
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$531.84 |
| Max. Negotiated Rate |
$2,150.51 |
| Rate for Payer: Aetna Commercial |
$1,935.46
|
| Rate for Payer: Aetna Medicare |
$992.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,240.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,240.30
|
| Rate for Payer: ASR ASR |
$2,085.99
|
| Rate for Payer: ASR Commercial |
$2,085.99
|
| Rate for Payer: BCBS Complete |
$558.43
|
| Rate for Payer: BCBS MAPPO |
$992.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,761.05
|
| Rate for Payer: BCN Commercial |
$1,667.29
|
| Rate for Payer: BCN Medicare Advantage |
$992.24
|
| Rate for Payer: Cash Price |
$1,720.41
|
| Rate for Payer: Cash Price |
$1,720.41
|
| Rate for Payer: Cofinity Commercial |
$2,021.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,720.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$992.24
|
| Rate for Payer: Healthscope Commercial |
$2,150.51
|
| Rate for Payer: Healthscope Whirlpool |
$2,085.99
|
| Rate for Payer: Humana Choice PPO Medicare |
$992.24
|
| Rate for Payer: Mclaren Commercial |
$1,935.46
|
| Rate for Payer: Mclaren Medicaid |
$531.84
|
| Rate for Payer: Mclaren Medicare |
$992.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,041.85
|
| Rate for Payer: Meridian Medicaid |
$558.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,141.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,827.93
|
| Rate for Payer: Nomi Health Commercial |
$1,763.42
|
| Rate for Payer: PACE Medicare |
$942.63
|
| Rate for Payer: PACE SWMI |
$992.24
|
| Rate for Payer: PHP Commercial |
$1,091.46
|
| Rate for Payer: PHP Medicaid |
$531.84
|
| Rate for Payer: PHP Medicare Advantage |
$992.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$531.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,397.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,884.28
|
| Rate for Payer: Priority Health Medicare |
$992.24
|
| Rate for Payer: Priority Health Narrow Network |
$1,507.51
|
| Rate for Payer: Railroad Medicare Medicare |
$992.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,892.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$992.24
|
| Rate for Payer: UHC Exchange |
$1,537.97
|
| Rate for Payer: UHC Medicare Advantage |
$992.24
|
| Rate for Payer: UHCCP DNSP |
$992.24
|
| Rate for Payer: UHCCP Medicaid |
$531.84
|
| Rate for Payer: VA VA |
$992.24
|
|
|
HC CORTICAL MAPPING
|
Facility
|
IP
|
$2,150.51
|
|
|
Service Code
|
CPT 95961
|
| Hospital Charge Code |
92000009
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$1,397.83 |
| Max. Negotiated Rate |
$2,150.51 |
| Rate for Payer: Aetna Commercial |
$1,935.46
|
| Rate for Payer: ASR ASR |
$2,085.99
|
| Rate for Payer: ASR Commercial |
$2,085.99
|
| Rate for Payer: BCBS Trust/PPO |
$1,752.45
|
| Rate for Payer: BCN Commercial |
$1,667.29
|
| Rate for Payer: Cash Price |
$1,720.41
|
| Rate for Payer: Cofinity Commercial |
$2,021.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,720.41
|
| Rate for Payer: Healthscope Commercial |
$2,150.51
|
| Rate for Payer: Healthscope Whirlpool |
$2,085.99
|
| Rate for Payer: Mclaren Commercial |
$1,935.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,827.93
|
| Rate for Payer: Nomi Health Commercial |
$1,763.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,397.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,892.45
|
|
|
HC CORTICOL SALIVA
|
Facility
|
OP
|
$67.63
|
|
|
Service Code
|
CPT 82533
|
| Hospital Charge Code |
30100618
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.74 |
| Max. Negotiated Rate |
$67.63 |
| Rate for Payer: Aetna Commercial |
$60.87
|
| Rate for Payer: Aetna Medicare |
$16.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.38
|
| Rate for Payer: ASR ASR |
$65.60
|
| Rate for Payer: ASR Commercial |
$65.60
|
| Rate for Payer: BCBS Complete |
$9.17
|
| Rate for Payer: BCBS MAPPO |
$16.30
|
| Rate for Payer: BCBS Trust/PPO |
$55.38
|
| Rate for Payer: BCN Commercial |
$52.43
|
| Rate for Payer: BCN Medicare Advantage |
$16.30
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cofinity Commercial |
$63.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.30
|
| Rate for Payer: Healthscope Commercial |
$67.63
|
| Rate for Payer: Healthscope Whirlpool |
$65.60
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.30
|
| Rate for Payer: Mclaren Commercial |
$60.87
|
| Rate for Payer: Mclaren Medicaid |
$8.74
|
| Rate for Payer: Mclaren Medicare |
$16.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.11
|
| Rate for Payer: Meridian Medicaid |
$9.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.49
|
| Rate for Payer: Nomi Health Commercial |
$55.46
|
| Rate for Payer: PACE Medicare |
$15.48
|
| Rate for Payer: PACE SWMI |
$16.30
|
| Rate for Payer: PHP Commercial |
$17.93
|
| Rate for Payer: PHP Medicaid |
$8.74
|
| Rate for Payer: PHP Medicare Advantage |
$16.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$59.26
|
| Rate for Payer: Priority Health Medicare |
$16.30
|
| Rate for Payer: Priority Health Narrow Network |
$47.41
|
| Rate for Payer: Railroad Medicare Medicare |
$16.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$59.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.30
|
| Rate for Payer: UHC Exchange |
$25.27
|
| Rate for Payer: UHC Medicare Advantage |
$16.30
|
| Rate for Payer: UHCCP DNSP |
$16.30
|
| Rate for Payer: UHCCP Medicaid |
$8.74
|
| Rate for Payer: VA VA |
$16.30
|
|
|
HC CORTICOL SALIVA
|
Facility
|
IP
|
$67.63
|
|
|
Service Code
|
CPT 82533
|
| Hospital Charge Code |
30100618
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$43.96 |
| Max. Negotiated Rate |
$67.63 |
| Rate for Payer: Aetna Commercial |
$60.87
|
| Rate for Payer: ASR ASR |
$65.60
|
| Rate for Payer: ASR Commercial |
$65.60
|
| Rate for Payer: BCBS Trust/PPO |
$55.11
|
| Rate for Payer: BCN Commercial |
$52.43
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cofinity Commercial |
$63.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.10
|
| Rate for Payer: Healthscope Commercial |
$67.63
|
| Rate for Payer: Healthscope Whirlpool |
$65.60
|
| Rate for Payer: Mclaren Commercial |
$60.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.49
|
| Rate for Payer: Nomi Health Commercial |
$55.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$59.51
|
|
|
HC CORTISOL, SALIVA
|
Facility
|
IP
|
$66.30
|
|
|
Service Code
|
CPT 82533
|
| Hospital Charge Code |
30100750
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$43.09 |
| Max. Negotiated Rate |
$66.30 |
| Rate for Payer: Aetna Commercial |
$59.67
|
| Rate for Payer: ASR ASR |
$64.31
|
| Rate for Payer: ASR Commercial |
$64.31
|
| Rate for Payer: BCBS Trust/PPO |
$54.03
|
| Rate for Payer: BCN Commercial |
$51.40
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cofinity Commercial |
$62.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.04
|
| Rate for Payer: Healthscope Commercial |
$66.30
|
| Rate for Payer: Healthscope Whirlpool |
$64.31
|
| Rate for Payer: Mclaren Commercial |
$59.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.35
|
| Rate for Payer: Nomi Health Commercial |
$54.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$58.34
|
|
|
HC CORTISOL, SALIVA
|
Facility
|
OP
|
$66.30
|
|
|
Service Code
|
CPT 82533
|
| Hospital Charge Code |
30100750
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.74 |
| Max. Negotiated Rate |
$66.30 |
| Rate for Payer: Aetna Commercial |
$59.67
|
| Rate for Payer: Aetna Medicare |
$16.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.38
|
| Rate for Payer: ASR ASR |
$64.31
|
| Rate for Payer: ASR Commercial |
$64.31
|
| Rate for Payer: BCBS Complete |
$9.17
|
| Rate for Payer: BCBS MAPPO |
$16.30
|
| Rate for Payer: BCBS Trust/PPO |
$54.29
|
| Rate for Payer: BCN Commercial |
$51.40
|
| Rate for Payer: BCN Medicare Advantage |
$16.30
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cofinity Commercial |
$62.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.30
|
| Rate for Payer: Healthscope Commercial |
$66.30
|
| Rate for Payer: Healthscope Whirlpool |
$64.31
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.30
|
| Rate for Payer: Mclaren Commercial |
$59.67
|
| Rate for Payer: Mclaren Medicaid |
$8.74
|
| Rate for Payer: Mclaren Medicare |
$16.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.11
|
| Rate for Payer: Meridian Medicaid |
$9.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.35
|
| Rate for Payer: Nomi Health Commercial |
$54.37
|
| Rate for Payer: PACE Medicare |
$15.48
|
| Rate for Payer: PACE SWMI |
$16.30
|
| Rate for Payer: PHP Commercial |
$17.93
|
| Rate for Payer: PHP Medicaid |
$8.74
|
| Rate for Payer: PHP Medicare Advantage |
$16.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$58.09
|
| Rate for Payer: Priority Health Medicare |
$16.30
|
| Rate for Payer: Priority Health Narrow Network |
$46.48
|
| Rate for Payer: Railroad Medicare Medicare |
$16.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$58.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.30
|
| Rate for Payer: UHC Exchange |
$25.27
|
| Rate for Payer: UHC Medicare Advantage |
$16.30
|
| Rate for Payer: UHCCP DNSP |
$16.30
|
| Rate for Payer: UHCCP Medicaid |
$8.74
|
| Rate for Payer: VA VA |
$16.30
|
|
