|
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 |
$534.30 |
| Max. Negotiated Rate |
$2,150.51 |
| Rate for Payer: Aetna Commercial |
$1,935.46
|
| Rate for Payer: Aetna Medicare |
$996.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,246.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,246.02
|
| Rate for Payer: ASR ASR |
$2,085.99
|
| Rate for Payer: ASR Commercial |
$2,085.99
|
| Rate for Payer: BCBS Complete |
$561.01
|
| Rate for Payer: BCBS MAPPO |
$996.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,761.05
|
| Rate for Payer: BCN Commercial |
$1,667.29
|
| Rate for Payer: BCN Medicare Advantage |
$996.82
|
| 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 |
$996.82
|
| Rate for Payer: Healthscope Commercial |
$2,150.51
|
| Rate for Payer: Healthscope Whirlpool |
$2,085.99
|
| Rate for Payer: Humana Choice PPO Medicare |
$996.82
|
| Rate for Payer: Mclaren Commercial |
$1,935.46
|
| Rate for Payer: Mclaren Medicaid |
$534.30
|
| Rate for Payer: Mclaren Medicare |
$996.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,046.66
|
| Rate for Payer: Meridian Medicaid |
$561.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,146.34
|
| 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 |
$946.98
|
| Rate for Payer: PACE SWMI |
$996.82
|
| Rate for Payer: PHP Commercial |
$1,096.50
|
| Rate for Payer: PHP Medicaid |
$534.30
|
| Rate for Payer: PHP Medicare Advantage |
$996.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$534.30
|
| 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 |
$996.82
|
| Rate for Payer: Priority Health Narrow Network |
$1,507.51
|
| Rate for Payer: Railroad Medicare Medicare |
$996.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,892.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$996.82
|
| Rate for Payer: UHC Exchange |
$1,545.07
|
| Rate for Payer: UHC Medicare Advantage |
$996.82
|
| Rate for Payer: UHCCP DNSP |
$996.82
|
| Rate for Payer: UHCCP Medicaid |
$534.30
|
| Rate for Payer: VA VA |
$996.82
|
|
|
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
|
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 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 |
$17.12
|
| Rate for Payer: Meridian Medicaid |
$9.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.74
|
| 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 |
$50.51
|
| Rate for Payer: Priority Health Medicare |
$16.30
|
| Rate for Payer: Priority Health Narrow Network |
$40.41
|
| 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 |
$25.26
|
| 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 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 |
$17.12
|
| Rate for Payer: Meridian Medicaid |
$9.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.36
|
| 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 |
$43.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$50.51
|
| Rate for Payer: Priority Health Medicare |
$16.30
|
| Rate for Payer: Priority Health Narrow Network |
$40.41
|
| 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 |
$25.26
|
| 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 CORTISOL, SALIVA
|
Facility
|
IP
|
$66.30
|
|
|
Service Code
|
CPT 82533
|
| Hospital Charge Code |
30100750
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$43.10 |
| 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 |
$56.36
|
| Rate for Payer: Nomi Health Commercial |
$54.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$58.34
|
|
|
HC CORTISOL SERUM
|
Facility
|
IP
|
$67.63
|
|
|
Service Code
|
CPT 82533
|
| Hospital Charge Code |
30100174
|
|
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 SERUM
|
Facility
|
OP
|
$67.63
|
|
|
Service Code
|
CPT 82533
|
| Hospital Charge Code |
30100174
|
|
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 |
$17.12
|
| Rate for Payer: Meridian Medicaid |
$9.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.74
|
| 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 |
$50.51
|
| Rate for Payer: Priority Health Medicare |
$16.30
|
| Rate for Payer: Priority Health Narrow Network |
$40.41
|
| 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 |
$25.26
|
| 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 CORTISOL URINE
|
Facility
|
OP
|
$47.86
|
|
|
Service Code
|
CPT 82530
|
| Hospital Charge Code |
30100172
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.96 |
| Max. Negotiated Rate |
$47.86 |
| Rate for Payer: Aetna Commercial |
$43.07
|
| Rate for Payer: Aetna Medicare |
$16.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.89
|
| Rate for Payer: ASR ASR |
$46.42
|
| Rate for Payer: ASR Commercial |
$46.42
|
| Rate for Payer: BCBS Complete |
$9.40
|
| Rate for Payer: BCBS MAPPO |
$16.71
|
| Rate for Payer: BCBS Trust/PPO |
$39.19
|
| Rate for Payer: BCN Commercial |
$37.11
|
| Rate for Payer: BCN Medicare Advantage |
$16.71
|
| Rate for Payer: Cash Price |
$38.29
|
| Rate for Payer: Cash Price |
$38.29
|
| Rate for Payer: Cofinity Commercial |
$44.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.71
|
| Rate for Payer: Healthscope Commercial |
$47.86
|
| Rate for Payer: Healthscope Whirlpool |
$46.42
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.71
|
| Rate for Payer: Mclaren Commercial |
$43.07
|
| Rate for Payer: Mclaren Medicaid |
$8.96
|
| Rate for Payer: Mclaren Medicare |
$16.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.55
|
| Rate for Payer: Meridian Medicaid |
$9.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.68
|
| Rate for Payer: Nomi Health Commercial |
$39.25
|
| Rate for Payer: PACE Medicare |
$15.87
|
| Rate for Payer: PACE SWMI |
$16.71
|
| Rate for Payer: PHP Commercial |
$18.38
|
| Rate for Payer: PHP Medicaid |
$8.96
|
| Rate for Payer: PHP Medicare Advantage |
$16.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$41.93
|
| Rate for Payer: Priority Health Medicare |
$16.71
|
| Rate for Payer: Priority Health Narrow Network |
$33.55
|
| Rate for Payer: Railroad Medicare Medicare |
$16.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$42.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.71
|
| Rate for Payer: UHC Exchange |
$25.90
|
| Rate for Payer: UHC Medicare Advantage |
$16.71
|
| Rate for Payer: UHCCP DNSP |
$16.71
|
| Rate for Payer: UHCCP Medicaid |
$8.96
|
| Rate for Payer: VA VA |
$16.71
|
|
|
HC CORTISOL URINE
|
Facility
|
IP
|
$47.86
|
|
|
Service Code
|
CPT 82530
|
| Hospital Charge Code |
30100172
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.11 |
| Max. Negotiated Rate |
$47.86 |
| Rate for Payer: Aetna Commercial |
$43.07
|
| Rate for Payer: ASR ASR |
$46.42
|
| Rate for Payer: ASR Commercial |
$46.42
|
| Rate for Payer: BCBS Trust/PPO |
$39.00
|
| Rate for Payer: BCN Commercial |
$37.11
|
| Rate for Payer: Cash Price |
$38.29
|
| Rate for Payer: Cofinity Commercial |
$44.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.29
|
| Rate for Payer: Healthscope Commercial |
$47.86
|
| Rate for Payer: Healthscope Whirlpool |
$46.42
|
| Rate for Payer: Mclaren Commercial |
$43.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.68
|
| Rate for Payer: Nomi Health Commercial |
$39.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$42.12
|
|
|
HC CORTISOL URINE RANDOM
|
Facility
|
OP
|
$74.89
|
|
|
Service Code
|
CPT 82530
|
| Hospital Charge Code |
30100473
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.96 |
| Max. Negotiated Rate |
$74.89 |
| Rate for Payer: Aetna Commercial |
$67.40
|
| Rate for Payer: Aetna Medicare |
$16.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.89
|
| Rate for Payer: ASR ASR |
$72.64
|
| Rate for Payer: ASR Commercial |
$72.64
|
| Rate for Payer: BCBS Complete |
$9.40
|
| Rate for Payer: BCBS MAPPO |
$16.71
|
| Rate for Payer: BCBS Trust/PPO |
$61.33
|
| Rate for Payer: BCN Commercial |
$58.06
|
| Rate for Payer: BCN Medicare Advantage |
$16.71
|
| Rate for Payer: Cash Price |
$59.91
|
| Rate for Payer: Cash Price |
$59.91
|
| Rate for Payer: Cofinity Commercial |
$70.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.71
|
| Rate for Payer: Healthscope Commercial |
$74.89
|
| Rate for Payer: Healthscope Whirlpool |
$72.64
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.71
|
| Rate for Payer: Mclaren Commercial |
$67.40
|
| Rate for Payer: Mclaren Medicaid |
$8.96
|
| Rate for Payer: Mclaren Medicare |
$16.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.55
|
| Rate for Payer: Meridian Medicaid |
$9.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.66
|
| Rate for Payer: Nomi Health Commercial |
$61.41
|
| Rate for Payer: PACE Medicare |
$15.87
|
| Rate for Payer: PACE SWMI |
$16.71
|
| Rate for Payer: PHP Commercial |
$18.38
|
| Rate for Payer: PHP Medicaid |
$8.96
|
| Rate for Payer: PHP Medicare Advantage |
$16.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$65.62
|
| Rate for Payer: Priority Health Medicare |
$16.71
|
| Rate for Payer: Priority Health Narrow Network |
$52.50
|
| Rate for Payer: Railroad Medicare Medicare |
$16.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$65.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.71
|
| Rate for Payer: UHC Exchange |
$25.90
|
| Rate for Payer: UHC Medicare Advantage |
$16.71
|
| Rate for Payer: UHCCP DNSP |
$16.71
|
| Rate for Payer: UHCCP Medicaid |
$8.96
|
| Rate for Payer: VA VA |
$16.71
|
|
|
HC CORTISOL URINE RANDOM
|
Facility
|
IP
|
$74.89
|
|
|
Service Code
|
CPT 82530
|
| Hospital Charge Code |
30100473
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$48.68 |
| Max. Negotiated Rate |
$74.89 |
| Rate for Payer: Aetna Commercial |
$67.40
|
| Rate for Payer: ASR ASR |
$72.64
|
| Rate for Payer: ASR Commercial |
$72.64
|
| Rate for Payer: BCBS Trust/PPO |
$61.03
|
| Rate for Payer: BCN Commercial |
$58.06
|
| Rate for Payer: Cash Price |
$59.91
|
| Rate for Payer: Cofinity Commercial |
$70.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.91
|
| Rate for Payer: Healthscope Commercial |
$74.89
|
| Rate for Payer: Healthscope Whirlpool |
$72.64
|
| Rate for Payer: Mclaren Commercial |
$67.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.66
|
| Rate for Payer: Nomi Health Commercial |
$61.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$65.90
|
|
|
HC CORTISOL URINE RANDOM CMPT
|
Facility
|
OP
|
$27.47
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
30100289
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.91 |
| Max. Negotiated Rate |
$37.34 |
| Rate for Payer: Aetna Commercial |
$24.72
|
| Rate for Payer: Aetna Medicare |
$24.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.11
|
| Rate for Payer: ASR ASR |
$26.65
|
| Rate for Payer: ASR Commercial |
$26.65
|
| Rate for Payer: BCBS Complete |
$13.56
|
| Rate for Payer: BCBS MAPPO |
$24.09
|
| Rate for Payer: BCBS Trust/PPO |
$22.50
|
| Rate for Payer: BCN Commercial |
$21.30
|
| Rate for Payer: BCN Medicare Advantage |
$24.09
|
| Rate for Payer: Cash Price |
$21.98
|
| Rate for Payer: Cash Price |
$21.98
|
| Rate for Payer: Cofinity Commercial |
$25.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.09
|
| Rate for Payer: Healthscope Commercial |
$27.47
|
| Rate for Payer: Healthscope Whirlpool |
$26.65
|
| Rate for Payer: Humana Choice PPO Medicare |
$24.09
|
| Rate for Payer: Mclaren Commercial |
$24.72
|
| Rate for Payer: Mclaren Medicaid |
$12.91
|
| Rate for Payer: Mclaren Medicare |
$24.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.29
|
| Rate for Payer: Meridian Medicaid |
$13.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.35
|
| Rate for Payer: Nomi Health Commercial |
$22.53
|
| Rate for Payer: PACE Medicare |
$22.89
|
| Rate for Payer: PACE SWMI |
$24.09
|
| Rate for Payer: PHP Commercial |
$26.50
|
| Rate for Payer: PHP Medicaid |
$12.91
|
| Rate for Payer: PHP Medicare Advantage |
$24.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.07
|
| Rate for Payer: Priority Health Medicare |
$24.09
|
| Rate for Payer: Priority Health Narrow Network |
$19.26
|
| Rate for Payer: Railroad Medicare Medicare |
$24.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$24.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.09
|
| Rate for Payer: UHC Exchange |
$37.34
|
| Rate for Payer: UHC Medicare Advantage |
$24.09
|
| Rate for Payer: UHCCP DNSP |
$24.09
|
| Rate for Payer: UHCCP Medicaid |
$12.91
|
| Rate for Payer: VA VA |
$24.09
|
|
|
HC CORTISOL URINE RANDOM CMPT
|
Facility
|
IP
|
$27.47
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
30100289
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.86 |
| Max. Negotiated Rate |
$27.47 |
| Rate for Payer: Aetna Commercial |
$24.72
|
| Rate for Payer: ASR ASR |
$26.65
|
| Rate for Payer: ASR Commercial |
$26.65
|
| Rate for Payer: BCBS Trust/PPO |
$22.39
|
| Rate for Payer: BCN Commercial |
$21.30
|
| Rate for Payer: Cash Price |
$21.98
|
| Rate for Payer: Cofinity Commercial |
$25.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.98
|
| Rate for Payer: Healthscope Commercial |
$27.47
|
| Rate for Payer: Healthscope Whirlpool |
$26.65
|
| Rate for Payer: Mclaren Commercial |
$24.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.35
|
| Rate for Payer: Nomi Health Commercial |
$22.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$24.17
|
|
|
HC COTTONWOOD IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200082
|
|
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 COTTONWOOD IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200082
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$25.39 |
| Rate for Payer: Aetna Commercial |
$22.85
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: ASR ASR |
$24.63
|
| Rate for Payer: ASR Commercial |
$24.63
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$20.79
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$23.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$25.39
|
| Rate for Payer: Healthscope Whirlpool |
$24.63
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$22.85
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$5.74
|
| Rate for Payer: PHP Medicaid |
$2.80
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.25
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$17.80
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP DNSP |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.80
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC COUNSELING LUNG CA SCREENING
|
Facility
|
IP
|
$219.30
|
|
|
Service Code
|
HCPCS G0296
|
| Hospital Charge Code |
77000011
|
|
Hospital Revenue Code
|
770
|
| Min. Negotiated Rate |
$142.54 |
| Max. Negotiated Rate |
$219.30 |
| Rate for Payer: Aetna Commercial |
$197.37
|
| Rate for Payer: ASR ASR |
$212.72
|
| Rate for Payer: ASR Commercial |
$212.72
|
| Rate for Payer: BCBS Trust/PPO |
$178.71
|
| Rate for Payer: BCN Commercial |
$170.02
|
| Rate for Payer: Cash Price |
$175.44
|
| Rate for Payer: Cofinity Commercial |
$206.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$175.44
|
| Rate for Payer: Healthscope Commercial |
$219.30
|
| Rate for Payer: Healthscope Whirlpool |
$212.72
|
| Rate for Payer: Mclaren Commercial |
$197.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$186.40
|
| Rate for Payer: Nomi Health Commercial |
$179.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$142.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$192.98
|
|
|
HC COUNSELING LUNG CA SCREENING
|
Facility
|
OP
|
$219.30
|
|
|
Service Code
|
HCPCS G0296
|
| Hospital Charge Code |
77000011
|
|
Hospital Revenue Code
|
770
|
| Min. Negotiated Rate |
$48.58 |
| Max. Negotiated Rate |
$219.30 |
| Rate for Payer: Aetna Commercial |
$197.37
|
| Rate for Payer: Aetna Medicare |
$90.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$113.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$113.29
|
| Rate for Payer: ASR ASR |
$212.72
|
| Rate for Payer: ASR Commercial |
$212.72
|
| Rate for Payer: BCBS Complete |
$51.01
|
| Rate for Payer: BCBS MAPPO |
$90.63
|
| Rate for Payer: BCBS Trust/PPO |
$179.58
|
| Rate for Payer: BCN Commercial |
$170.02
|
| Rate for Payer: BCN Medicare Advantage |
$90.63
|
| Rate for Payer: Cash Price |
$175.44
|
| Rate for Payer: Cash Price |
$175.44
|
| Rate for Payer: Cofinity Commercial |
$206.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$175.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$90.63
|
| Rate for Payer: Healthscope Commercial |
$219.30
|
| Rate for Payer: Healthscope Whirlpool |
$212.72
|
| Rate for Payer: Humana Choice PPO Medicare |
$90.63
|
| Rate for Payer: Mclaren Commercial |
$197.37
|
| Rate for Payer: Mclaren Medicaid |
$48.58
|
| Rate for Payer: Mclaren Medicare |
$90.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$95.16
|
| Rate for Payer: Meridian Medicaid |
$51.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$104.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$186.40
|
| Rate for Payer: Nomi Health Commercial |
$179.83
|
| Rate for Payer: PACE Medicare |
$86.10
|
| Rate for Payer: PACE SWMI |
$90.63
|
| Rate for Payer: PHP Commercial |
$99.69
|
| Rate for Payer: PHP Medicaid |
$48.58
|
| Rate for Payer: PHP Medicare Advantage |
$90.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$142.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$192.15
|
| Rate for Payer: Priority Health Medicare |
$90.63
|
| Rate for Payer: Priority Health Narrow Network |
$153.73
|
| Rate for Payer: Railroad Medicare Medicare |
$90.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$192.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$90.63
|
| Rate for Payer: UHC Exchange |
$140.48
|
| Rate for Payer: UHC Medicare Advantage |
$90.63
|
| Rate for Payer: UHCCP DNSP |
$90.63
|
| Rate for Payer: UHCCP Medicaid |
$48.58
|
| Rate for Payer: VA VA |
$90.63
|
|
|
HC COURT ORDERED BLOOD ALCOHOL
|
Facility
|
IP
|
$76.50
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
30100733
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$49.72 |
| Max. Negotiated Rate |
$76.50 |
| Rate for Payer: Aetna Commercial |
$68.85
|
| Rate for Payer: ASR ASR |
$74.20
|
| Rate for Payer: ASR Commercial |
$74.20
|
| Rate for Payer: BCBS Trust/PPO |
$62.34
|
| Rate for Payer: BCN Commercial |
$59.31
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$71.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Healthscope Commercial |
$76.50
|
| Rate for Payer: Healthscope Whirlpool |
$74.20
|
| Rate for Payer: Mclaren Commercial |
$68.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.02
|
| Rate for Payer: Nomi Health Commercial |
$62.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$67.32
|
|
|
HC COURT ORDERED BLOOD ALCOHOL
|
Facility
|
OP
|
$76.50
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
30100733
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$30.60 |
| Max. Negotiated Rate |
$76.50 |
| Rate for Payer: Aetna Commercial |
$68.85
|
| Rate for Payer: Aetna Medicare |
$38.25
|
| Rate for Payer: ASR ASR |
$74.20
|
| Rate for Payer: ASR Commercial |
$74.20
|
| Rate for Payer: BCBS Complete |
$30.60
|
| Rate for Payer: BCBS Trust/PPO |
$62.65
|
| Rate for Payer: BCN Commercial |
$59.31
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$71.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Healthscope Commercial |
$76.50
|
| Rate for Payer: Healthscope Whirlpool |
$74.20
|
| Rate for Payer: Mclaren Commercial |
$68.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.02
|
| Rate for Payer: Nomi Health Commercial |
$62.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$67.03
|
| Rate for Payer: Priority Health Narrow Network |
$53.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$67.32
|
|
|
HC COVERED STENT GRAFT
|
Facility
|
OP
|
$6,524.94
|
|
|
Service Code
|
HCPCS C1874
|
| Hospital Charge Code |
27800009
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,609.98 |
| Max. Negotiated Rate |
$6,524.94 |
| Rate for Payer: Aetna Commercial |
$5,872.45
|
| Rate for Payer: Aetna Medicare |
$3,262.47
|
| Rate for Payer: ASR ASR |
$6,329.19
|
| Rate for Payer: ASR Commercial |
$6,329.19
|
| Rate for Payer: BCBS Complete |
$2,609.98
|
| Rate for Payer: BCBS Trust/PPO |
$5,343.27
|
| Rate for Payer: BCN Commercial |
$5,058.79
|
| Rate for Payer: Cash Price |
$5,219.95
|
| Rate for Payer: Cofinity Commercial |
$6,133.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,219.95
|
| Rate for Payer: Healthscope Commercial |
$6,524.94
|
| Rate for Payer: Healthscope Whirlpool |
$6,329.19
|
| Rate for Payer: Mclaren Commercial |
$5,872.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,546.20
|
| Rate for Payer: Nomi Health Commercial |
$5,350.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,241.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,717.15
|
| Rate for Payer: Priority Health Narrow Network |
$4,573.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,741.95
|
|
