|
HC CRYOABLATION NASAL TISSUE OR NERVES UNI OR BIL
|
Facility
|
IP
|
$10,891.56
|
|
|
Service Code
|
CPT 31243
|
| Hospital Charge Code |
76100399
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$7,079.51 |
| Max. Negotiated Rate |
$10,891.56 |
| Rate for Payer: Aetna Commercial |
$9,802.40
|
| Rate for Payer: ASR ASR |
$10,564.81
|
| Rate for Payer: ASR Commercial |
$10,564.81
|
| Rate for Payer: BCBS Trust/PPO |
$8,875.53
|
| Rate for Payer: BCN Commercial |
$8,444.23
|
| Rate for Payer: Cash Price |
$8,713.25
|
| Rate for Payer: Cofinity Commercial |
$10,238.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,713.25
|
| Rate for Payer: Healthscope Commercial |
$10,891.56
|
| Rate for Payer: Healthscope Whirlpool |
$10,564.81
|
| Rate for Payer: Mclaren Commercial |
$9,802.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,257.83
|
| Rate for Payer: Nomi Health Commercial |
$8,931.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,079.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9,584.57
|
|
|
HC CRYOABLATION NEEDLE/PROBE
|
Facility
|
OP
|
$3,526.96
|
|
|
Service Code
|
HCPCS C2618
|
| Hospital Charge Code |
27200244
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,410.78 |
| Max. Negotiated Rate |
$3,526.96 |
| Rate for Payer: Aetna Commercial |
$3,174.26
|
| Rate for Payer: Aetna Medicare |
$1,763.48
|
| Rate for Payer: ASR ASR |
$3,421.15
|
| Rate for Payer: ASR Commercial |
$3,421.15
|
| Rate for Payer: BCBS Complete |
$1,410.78
|
| Rate for Payer: BCBS Trust/PPO |
$2,888.23
|
| Rate for Payer: BCN Commercial |
$2,734.45
|
| Rate for Payer: Cash Price |
$2,821.57
|
| Rate for Payer: Cofinity Commercial |
$3,315.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,821.57
|
| Rate for Payer: Healthscope Commercial |
$3,526.96
|
| Rate for Payer: Healthscope Whirlpool |
$3,421.15
|
| Rate for Payer: Mclaren Commercial |
$3,174.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,997.92
|
| Rate for Payer: Nomi Health Commercial |
$2,892.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,292.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,090.32
|
| Rate for Payer: Priority Health Narrow Network |
$2,472.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,103.72
|
|
|
HC CRYOABLATION NEEDLE/PROBE
|
Facility
|
IP
|
$3,526.96
|
|
|
Service Code
|
HCPCS C2618
|
| Hospital Charge Code |
27200244
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,292.52 |
| Max. Negotiated Rate |
$3,526.96 |
| Rate for Payer: Aetna Commercial |
$3,174.26
|
| Rate for Payer: ASR ASR |
$3,421.15
|
| Rate for Payer: ASR Commercial |
$3,421.15
|
| Rate for Payer: BCBS Trust/PPO |
$2,874.12
|
| Rate for Payer: BCN Commercial |
$2,734.45
|
| Rate for Payer: Cash Price |
$2,821.57
|
| Rate for Payer: Cofinity Commercial |
$3,315.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,821.57
|
| Rate for Payer: Healthscope Commercial |
$3,526.96
|
| Rate for Payer: Healthscope Whirlpool |
$3,421.15
|
| Rate for Payer: Mclaren Commercial |
$3,174.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,997.92
|
| Rate for Payer: Nomi Health Commercial |
$2,892.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,292.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,103.72
|
|
|
HC CRYOABLATION STANDBY
|
Facility
|
OP
|
$8,180.24
|
|
| Hospital Charge Code |
27200283
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,272.10 |
| Max. Negotiated Rate |
$8,180.24 |
| Rate for Payer: Aetna Commercial |
$7,362.22
|
| Rate for Payer: Aetna Medicare |
$4,090.12
|
| Rate for Payer: ASR ASR |
$7,934.83
|
| Rate for Payer: ASR Commercial |
$7,934.83
|
| Rate for Payer: BCBS Complete |
$3,272.10
|
| Rate for Payer: BCBS Trust/PPO |
$6,698.80
|
| Rate for Payer: BCN Commercial |
$6,342.14
|
| Rate for Payer: Cash Price |
$6,544.19
|
| Rate for Payer: Cofinity Commercial |
$7,689.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,544.19
|
| Rate for Payer: Healthscope Commercial |
$8,180.24
|
| Rate for Payer: Healthscope Whirlpool |
$7,934.83
|
| Rate for Payer: Mclaren Commercial |
$7,362.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,953.20
|
| Rate for Payer: Nomi Health Commercial |
$6,707.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,317.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,167.53
|
| Rate for Payer: Priority Health Narrow Network |
$5,734.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,198.61
|
|
|
HC CRYOABLATION STANDBY
|
Facility
|
IP
|
$8,180.24
|
|
| Hospital Charge Code |
27200283
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5,317.16 |
| Max. Negotiated Rate |
$8,180.24 |
| Rate for Payer: Aetna Commercial |
$7,362.22
|
| Rate for Payer: ASR ASR |
$7,934.83
|
| Rate for Payer: ASR Commercial |
$7,934.83
|
| Rate for Payer: BCBS Trust/PPO |
$6,666.08
|
| Rate for Payer: BCN Commercial |
$6,342.14
|
| Rate for Payer: Cash Price |
$6,544.19
|
| Rate for Payer: Cofinity Commercial |
$7,689.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,544.19
|
| Rate for Payer: Healthscope Commercial |
$8,180.24
|
| Rate for Payer: Healthscope Whirlpool |
$7,934.83
|
| Rate for Payer: Mclaren Commercial |
$7,362.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,953.20
|
| Rate for Payer: Nomi Health Commercial |
$6,707.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,317.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,198.61
|
|
|
HC CRYOABLATION SUPPLIES
|
Facility
|
IP
|
$12,272.17
|
|
|
Service Code
|
HCPCS C2618
|
| Hospital Charge Code |
27200284
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7,976.91 |
| Max. Negotiated Rate |
$12,272.17 |
| Rate for Payer: Aetna Commercial |
$11,044.95
|
| Rate for Payer: ASR ASR |
$11,904.00
|
| Rate for Payer: ASR Commercial |
$11,904.00
|
| Rate for Payer: BCBS Trust/PPO |
$10,000.59
|
| Rate for Payer: BCN Commercial |
$9,514.61
|
| Rate for Payer: Cash Price |
$9,817.74
|
| Rate for Payer: Cofinity Commercial |
$11,535.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,817.74
|
| Rate for Payer: Healthscope Commercial |
$12,272.17
|
| Rate for Payer: Healthscope Whirlpool |
$11,904.00
|
| Rate for Payer: Mclaren Commercial |
$11,044.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,431.34
|
| Rate for Payer: Nomi Health Commercial |
$10,063.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,976.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,799.51
|
|
|
HC CRYOABLATION SUPPLIES
|
Facility
|
OP
|
$12,272.17
|
|
|
Service Code
|
HCPCS C2618
|
| Hospital Charge Code |
27200284
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4,908.87 |
| Max. Negotiated Rate |
$12,272.17 |
| Rate for Payer: Aetna Commercial |
$11,044.95
|
| Rate for Payer: Aetna Medicare |
$6,136.08
|
| Rate for Payer: ASR ASR |
$11,904.00
|
| Rate for Payer: ASR Commercial |
$11,904.00
|
| Rate for Payer: BCBS Complete |
$4,908.87
|
| Rate for Payer: BCBS Trust/PPO |
$10,049.68
|
| Rate for Payer: BCN Commercial |
$9,514.61
|
| Rate for Payer: Cash Price |
$9,817.74
|
| Rate for Payer: Cofinity Commercial |
$11,535.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,817.74
|
| Rate for Payer: Healthscope Commercial |
$12,272.17
|
| Rate for Payer: Healthscope Whirlpool |
$11,904.00
|
| Rate for Payer: Mclaren Commercial |
$11,044.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,431.34
|
| Rate for Payer: Nomi Health Commercial |
$10,063.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,976.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,752.88
|
| Rate for Payer: Priority Health Narrow Network |
$8,602.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,799.51
|
|
|
HC CRYOGLOBULINS
|
Facility
|
OP
|
$19.77
|
|
|
Service Code
|
CPT 82595
|
| Hospital Charge Code |
30100184
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.47 |
| Max. Negotiated Rate |
$86.73 |
| Rate for Payer: Aetna Commercial |
$17.79
|
| Rate for Payer: Aetna Medicare |
$6.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: ASR ASR |
$19.18
|
| Rate for Payer: ASR Commercial |
$19.18
|
| Rate for Payer: BCBS Complete |
$3.64
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCBS Trust/PPO |
$16.19
|
| Rate for Payer: BCN Commercial |
$15.33
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$15.82
|
| Rate for Payer: Cash Price |
$15.82
|
| Rate for Payer: Cofinity Commercial |
$18.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$19.77
|
| Rate for Payer: Healthscope Whirlpool |
$19.18
|
| Rate for Payer: Humana Choice PPO Medicare |
$6.47
|
| Rate for Payer: Mclaren Commercial |
$17.79
|
| Rate for Payer: Mclaren Medicaid |
$3.47
|
| Rate for Payer: Mclaren Medicare |
$6.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.79
|
| Rate for Payer: Meridian Medicaid |
$3.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.80
|
| Rate for Payer: Nomi Health Commercial |
$16.21
|
| Rate for Payer: PACE Medicare |
$6.15
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$7.12
|
| Rate for Payer: PHP Medicaid |
$3.47
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$86.73
|
| Rate for Payer: Priority Health Medicare |
$6.47
|
| Rate for Payer: Priority Health Narrow Network |
$69.38
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.47
|
| Rate for Payer: UHC Exchange |
$10.03
|
| Rate for Payer: UHC Medicare Advantage |
$6.47
|
| Rate for Payer: UHCCP DNSP |
$6.47
|
| Rate for Payer: UHCCP Medicaid |
$3.47
|
| Rate for Payer: VA VA |
$6.47
|
|
|
HC CRYOGLOBULINS
|
Facility
|
IP
|
$19.77
|
|
|
Service Code
|
CPT 82595
|
| Hospital Charge Code |
30100184
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.85 |
| Max. Negotiated Rate |
$19.77 |
| Rate for Payer: Aetna Commercial |
$17.79
|
| Rate for Payer: ASR ASR |
$19.18
|
| Rate for Payer: ASR Commercial |
$19.18
|
| Rate for Payer: BCBS Trust/PPO |
$16.11
|
| Rate for Payer: BCN Commercial |
$15.33
|
| Rate for Payer: Cash Price |
$15.82
|
| Rate for Payer: Cofinity Commercial |
$18.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.82
|
| Rate for Payer: Healthscope Commercial |
$19.77
|
| Rate for Payer: Healthscope Whirlpool |
$19.18
|
| Rate for Payer: Mclaren Commercial |
$17.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.80
|
| Rate for Payer: Nomi Health Commercial |
$16.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17.40
|
|
|
HC CRYOGLOBULINS CMPT
|
Facility
|
IP
|
$23.14
|
|
|
Service Code
|
CPT 82585
|
| Hospital Charge Code |
30100183
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.04 |
| Max. Negotiated Rate |
$23.14 |
| Rate for Payer: Aetna Commercial |
$20.83
|
| Rate for Payer: ASR ASR |
$22.45
|
| Rate for Payer: ASR Commercial |
$22.45
|
| Rate for Payer: BCBS Trust/PPO |
$18.86
|
| Rate for Payer: BCN Commercial |
$17.94
|
| Rate for Payer: Cash Price |
$18.51
|
| Rate for Payer: Cofinity Commercial |
$21.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.51
|
| Rate for Payer: Healthscope Commercial |
$23.14
|
| Rate for Payer: Healthscope Whirlpool |
$22.45
|
| Rate for Payer: Mclaren Commercial |
$20.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.67
|
| Rate for Payer: Nomi Health Commercial |
$18.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$20.36
|
|
|
HC CRYOGLOBULINS CMPT
|
Facility
|
OP
|
$23.14
|
|
|
Service Code
|
CPT 82585
|
| Hospital Charge Code |
30100183
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.58 |
| Max. Negotiated Rate |
$23.14 |
| Rate for Payer: Aetna Commercial |
$20.83
|
| Rate for Payer: Aetna Medicare |
$14.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.68
|
| Rate for Payer: ASR ASR |
$22.45
|
| Rate for Payer: ASR Commercial |
$22.45
|
| Rate for Payer: BCBS Complete |
$7.96
|
| Rate for Payer: BCBS MAPPO |
$14.14
|
| Rate for Payer: BCBS Trust/PPO |
$18.95
|
| Rate for Payer: BCN Commercial |
$17.94
|
| Rate for Payer: BCN Medicare Advantage |
$14.14
|
| Rate for Payer: Cash Price |
$18.51
|
| Rate for Payer: Cash Price |
$18.51
|
| Rate for Payer: Cofinity Commercial |
$21.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.14
|
| Rate for Payer: Healthscope Commercial |
$23.14
|
| Rate for Payer: Healthscope Whirlpool |
$22.45
|
| Rate for Payer: Humana Choice PPO Medicare |
$14.14
|
| Rate for Payer: Mclaren Commercial |
$20.83
|
| Rate for Payer: Mclaren Medicaid |
$7.58
|
| Rate for Payer: Mclaren Medicare |
$14.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.85
|
| Rate for Payer: Meridian Medicaid |
$7.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.67
|
| Rate for Payer: Nomi Health Commercial |
$18.97
|
| Rate for Payer: PACE Medicare |
$13.43
|
| Rate for Payer: PACE SWMI |
$14.14
|
| Rate for Payer: PHP Commercial |
$15.55
|
| Rate for Payer: PHP Medicaid |
$7.58
|
| Rate for Payer: PHP Medicare Advantage |
$14.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20.28
|
| Rate for Payer: Priority Health Medicare |
$14.14
|
| Rate for Payer: Priority Health Narrow Network |
$16.22
|
| Rate for Payer: Railroad Medicare Medicare |
$14.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$20.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.14
|
| Rate for Payer: UHC Exchange |
$21.92
|
| Rate for Payer: UHC Medicare Advantage |
$14.14
|
| Rate for Payer: UHCCP DNSP |
$14.14
|
| Rate for Payer: UHCCP Medicaid |
$7.58
|
| Rate for Payer: VA VA |
$14.14
|
|
|
HC CRYOGLOBULIN, SERUM
|
Facility
|
OP
|
$43.86
|
|
|
Service Code
|
CPT 82595
|
| Hospital Charge Code |
30100600
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.47 |
| Max. Negotiated Rate |
$86.73 |
| Rate for Payer: Aetna Commercial |
$39.47
|
| Rate for Payer: Aetna Medicare |
$6.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: ASR ASR |
$42.54
|
| Rate for Payer: ASR Commercial |
$42.54
|
| Rate for Payer: BCBS Complete |
$3.64
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCBS Trust/PPO |
$35.92
|
| Rate for Payer: BCN Commercial |
$34.00
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$35.09
|
| Rate for Payer: Cash Price |
$35.09
|
| Rate for Payer: Cofinity Commercial |
$41.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$43.86
|
| Rate for Payer: Healthscope Whirlpool |
$42.54
|
| Rate for Payer: Humana Choice PPO Medicare |
$6.47
|
| Rate for Payer: Mclaren Commercial |
$39.47
|
| Rate for Payer: Mclaren Medicaid |
$3.47
|
| Rate for Payer: Mclaren Medicare |
$6.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.79
|
| Rate for Payer: Meridian Medicaid |
$3.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.28
|
| Rate for Payer: Nomi Health Commercial |
$35.97
|
| Rate for Payer: PACE Medicare |
$6.15
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$7.12
|
| Rate for Payer: PHP Medicaid |
$3.47
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$86.73
|
| Rate for Payer: Priority Health Medicare |
$6.47
|
| Rate for Payer: Priority Health Narrow Network |
$69.38
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$38.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.47
|
| Rate for Payer: UHC Exchange |
$10.03
|
| Rate for Payer: UHC Medicare Advantage |
$6.47
|
| Rate for Payer: UHCCP DNSP |
$6.47
|
| Rate for Payer: UHCCP Medicaid |
$3.47
|
| Rate for Payer: VA VA |
$6.47
|
|
|
HC CRYOGLOBULIN, SERUM
|
Facility
|
IP
|
$43.86
|
|
|
Service Code
|
CPT 82595
|
| Hospital Charge Code |
30100600
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$28.51 |
| Max. Negotiated Rate |
$43.86 |
| Rate for Payer: Aetna Commercial |
$39.47
|
| Rate for Payer: ASR ASR |
$42.54
|
| Rate for Payer: ASR Commercial |
$42.54
|
| Rate for Payer: BCBS Trust/PPO |
$35.74
|
| Rate for Payer: BCN Commercial |
$34.00
|
| Rate for Payer: Cash Price |
$35.09
|
| Rate for Payer: Cofinity Commercial |
$41.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$43.86
|
| Rate for Payer: Healthscope Whirlpool |
$42.54
|
| Rate for Payer: Mclaren Commercial |
$39.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.28
|
| Rate for Payer: Nomi Health Commercial |
$35.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$38.60
|
|
|
HC CRYOPRECIPITATE
|
Facility
|
IP
|
$143.16
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000042
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$93.05 |
| Max. Negotiated Rate |
$143.16 |
| Rate for Payer: Aetna Commercial |
$128.84
|
| Rate for Payer: ASR ASR |
$138.87
|
| Rate for Payer: ASR Commercial |
$138.87
|
| Rate for Payer: BCBS Trust/PPO |
$116.66
|
| Rate for Payer: BCN Commercial |
$110.99
|
| Rate for Payer: Cash Price |
$114.53
|
| Rate for Payer: Cofinity Commercial |
$134.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.53
|
| Rate for Payer: Healthscope Commercial |
$143.16
|
| Rate for Payer: Healthscope Whirlpool |
$138.87
|
| Rate for Payer: Mclaren Commercial |
$128.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$121.69
|
| Rate for Payer: Nomi Health Commercial |
$117.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$93.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$125.98
|
|
|
HC CRYOPRECIPITATE
|
Facility
|
OP
|
$143.16
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000042
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$33.38 |
| Max. Negotiated Rate |
$143.16 |
| Rate for Payer: Aetna Commercial |
$128.84
|
| Rate for Payer: Aetna Medicare |
$62.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.85
|
| Rate for Payer: ASR ASR |
$138.87
|
| Rate for Payer: ASR Commercial |
$138.87
|
| Rate for Payer: BCBS Complete |
$35.05
|
| Rate for Payer: BCBS MAPPO |
$62.28
|
| Rate for Payer: BCBS Trust/PPO |
$117.23
|
| Rate for Payer: BCN Commercial |
$110.99
|
| Rate for Payer: BCN Medicare Advantage |
$62.28
|
| Rate for Payer: Cash Price |
$114.53
|
| Rate for Payer: Cash Price |
$114.53
|
| Rate for Payer: Cofinity Commercial |
$134.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.28
|
| Rate for Payer: Healthscope Commercial |
$143.16
|
| Rate for Payer: Healthscope Whirlpool |
$138.87
|
| Rate for Payer: Humana Choice PPO Medicare |
$62.28
|
| Rate for Payer: Mclaren Commercial |
$128.84
|
| Rate for Payer: Mclaren Medicaid |
$33.38
|
| Rate for Payer: Mclaren Medicare |
$62.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.39
|
| Rate for Payer: Meridian Medicaid |
$35.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$121.69
|
| Rate for Payer: Nomi Health Commercial |
$117.39
|
| Rate for Payer: PACE Medicare |
$59.17
|
| Rate for Payer: PACE SWMI |
$62.28
|
| Rate for Payer: PHP Commercial |
$68.51
|
| Rate for Payer: PHP Medicaid |
$33.38
|
| Rate for Payer: PHP Medicare Advantage |
$62.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$93.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$93.24
|
| Rate for Payer: Priority Health Medicare |
$62.28
|
| Rate for Payer: Priority Health Narrow Network |
$74.59
|
| Rate for Payer: Railroad Medicare Medicare |
$62.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$125.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.28
|
| Rate for Payer: UHC Exchange |
$96.53
|
| Rate for Payer: UHC Medicare Advantage |
$62.28
|
| Rate for Payer: UHCCP DNSP |
$62.28
|
| Rate for Payer: UHCCP Medicaid |
$33.38
|
| Rate for Payer: VA VA |
$62.28
|
|
|
HC CRYOPRECIPITATE DIRECT
|
Facility
|
OP
|
$340.78
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000043
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$33.38 |
| Max. Negotiated Rate |
$340.78 |
| Rate for Payer: Aetna Commercial |
$306.70
|
| Rate for Payer: Aetna Medicare |
$62.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.85
|
| Rate for Payer: ASR ASR |
$330.56
|
| Rate for Payer: ASR Commercial |
$330.56
|
| Rate for Payer: BCBS Complete |
$35.05
|
| Rate for Payer: BCBS MAPPO |
$62.28
|
| Rate for Payer: BCBS Trust/PPO |
$279.06
|
| Rate for Payer: BCN Commercial |
$264.21
|
| Rate for Payer: BCN Medicare Advantage |
$62.28
|
| Rate for Payer: Cash Price |
$272.62
|
| Rate for Payer: Cash Price |
$272.62
|
| Rate for Payer: Cofinity Commercial |
$320.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$272.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.28
|
| Rate for Payer: Healthscope Commercial |
$340.78
|
| Rate for Payer: Healthscope Whirlpool |
$330.56
|
| Rate for Payer: Humana Choice PPO Medicare |
$62.28
|
| Rate for Payer: Mclaren Commercial |
$306.70
|
| Rate for Payer: Mclaren Medicaid |
$33.38
|
| Rate for Payer: Mclaren Medicare |
$62.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.39
|
| Rate for Payer: Meridian Medicaid |
$35.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$289.66
|
| Rate for Payer: Nomi Health Commercial |
$279.44
|
| Rate for Payer: PACE Medicare |
$59.17
|
| Rate for Payer: PACE SWMI |
$62.28
|
| Rate for Payer: PHP Commercial |
$68.51
|
| Rate for Payer: PHP Medicaid |
$33.38
|
| Rate for Payer: PHP Medicare Advantage |
$62.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$221.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$93.24
|
| Rate for Payer: Priority Health Medicare |
$62.28
|
| Rate for Payer: Priority Health Narrow Network |
$74.59
|
| Rate for Payer: Railroad Medicare Medicare |
$62.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$299.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.28
|
| Rate for Payer: UHC Exchange |
$96.53
|
| Rate for Payer: UHC Medicare Advantage |
$62.28
|
| Rate for Payer: UHCCP DNSP |
$62.28
|
| Rate for Payer: UHCCP Medicaid |
$33.38
|
| Rate for Payer: VA VA |
$62.28
|
|
|
HC CRYOPRECIPITATE DIRECT
|
Facility
|
IP
|
$340.78
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000043
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$221.51 |
| Max. Negotiated Rate |
$340.78 |
| Rate for Payer: Aetna Commercial |
$306.70
|
| Rate for Payer: ASR ASR |
$330.56
|
| Rate for Payer: ASR Commercial |
$330.56
|
| Rate for Payer: BCBS Trust/PPO |
$277.70
|
| Rate for Payer: BCN Commercial |
$264.21
|
| Rate for Payer: Cash Price |
$272.62
|
| Rate for Payer: Cofinity Commercial |
$320.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$272.62
|
| Rate for Payer: Healthscope Commercial |
$340.78
|
| Rate for Payer: Healthscope Whirlpool |
$330.56
|
| Rate for Payer: Mclaren Commercial |
$306.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$289.66
|
| Rate for Payer: Nomi Health Commercial |
$279.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$221.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$299.89
|
|
|
HC CRYOPRECIPITATE POOL
|
Facility
|
IP
|
$248.80
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000044
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$161.72 |
| Max. Negotiated Rate |
$248.80 |
| Rate for Payer: Aetna Commercial |
$223.92
|
| Rate for Payer: ASR ASR |
$241.34
|
| Rate for Payer: ASR Commercial |
$241.34
|
| Rate for Payer: BCBS Trust/PPO |
$202.75
|
| Rate for Payer: BCN Commercial |
$192.89
|
| Rate for Payer: Cash Price |
$199.04
|
| Rate for Payer: Cofinity Commercial |
$233.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.04
|
| Rate for Payer: Healthscope Commercial |
$248.80
|
| Rate for Payer: Healthscope Whirlpool |
$241.34
|
| Rate for Payer: Mclaren Commercial |
$223.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.48
|
| Rate for Payer: Nomi Health Commercial |
$204.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$218.94
|
|
|
HC CRYOPRECIPITATE POOL
|
Facility
|
OP
|
$248.80
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000044
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$33.38 |
| Max. Negotiated Rate |
$248.80 |
| Rate for Payer: Aetna Commercial |
$223.92
|
| Rate for Payer: Aetna Medicare |
$62.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.85
|
| Rate for Payer: ASR ASR |
$241.34
|
| Rate for Payer: ASR Commercial |
$241.34
|
| Rate for Payer: BCBS Complete |
$35.05
|
| Rate for Payer: BCBS MAPPO |
$62.28
|
| Rate for Payer: BCBS Trust/PPO |
$203.74
|
| Rate for Payer: BCN Commercial |
$192.89
|
| Rate for Payer: BCN Medicare Advantage |
$62.28
|
| Rate for Payer: Cash Price |
$199.04
|
| Rate for Payer: Cash Price |
$199.04
|
| Rate for Payer: Cofinity Commercial |
$233.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.28
|
| Rate for Payer: Healthscope Commercial |
$248.80
|
| Rate for Payer: Healthscope Whirlpool |
$241.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$62.28
|
| Rate for Payer: Mclaren Commercial |
$223.92
|
| Rate for Payer: Mclaren Medicaid |
$33.38
|
| Rate for Payer: Mclaren Medicare |
$62.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.39
|
| Rate for Payer: Meridian Medicaid |
$35.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.48
|
| Rate for Payer: Nomi Health Commercial |
$204.02
|
| Rate for Payer: PACE Medicare |
$59.17
|
| Rate for Payer: PACE SWMI |
$62.28
|
| Rate for Payer: PHP Commercial |
$68.51
|
| Rate for Payer: PHP Medicaid |
$33.38
|
| Rate for Payer: PHP Medicare Advantage |
$62.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$93.24
|
| Rate for Payer: Priority Health Medicare |
$62.28
|
| Rate for Payer: Priority Health Narrow Network |
$74.59
|
| Rate for Payer: Railroad Medicare Medicare |
$62.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$218.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.28
|
| Rate for Payer: UHC Exchange |
$96.53
|
| Rate for Payer: UHC Medicare Advantage |
$62.28
|
| Rate for Payer: UHCCP DNSP |
$62.28
|
| Rate for Payer: UHCCP Medicaid |
$33.38
|
| Rate for Payer: VA VA |
$62.28
|
|
|
HC CRYOPRECIPITATE POOL CMPT1
|
Facility
|
OP
|
$248.80
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000045
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$33.38 |
| Max. Negotiated Rate |
$248.80 |
| Rate for Payer: Aetna Commercial |
$223.92
|
| Rate for Payer: Aetna Medicare |
$62.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.85
|
| Rate for Payer: ASR ASR |
$241.34
|
| Rate for Payer: ASR Commercial |
$241.34
|
| Rate for Payer: BCBS Complete |
$35.05
|
| Rate for Payer: BCBS MAPPO |
$62.28
|
| Rate for Payer: BCBS Trust/PPO |
$203.74
|
| Rate for Payer: BCN Commercial |
$192.89
|
| Rate for Payer: BCN Medicare Advantage |
$62.28
|
| Rate for Payer: Cash Price |
$199.04
|
| Rate for Payer: Cash Price |
$199.04
|
| Rate for Payer: Cofinity Commercial |
$233.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.28
|
| Rate for Payer: Healthscope Commercial |
$248.80
|
| Rate for Payer: Healthscope Whirlpool |
$241.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$62.28
|
| Rate for Payer: Mclaren Commercial |
$223.92
|
| Rate for Payer: Mclaren Medicaid |
$33.38
|
| Rate for Payer: Mclaren Medicare |
$62.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.39
|
| Rate for Payer: Meridian Medicaid |
$35.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.48
|
| Rate for Payer: Nomi Health Commercial |
$204.02
|
| Rate for Payer: PACE Medicare |
$59.17
|
| Rate for Payer: PACE SWMI |
$62.28
|
| Rate for Payer: PHP Commercial |
$68.51
|
| Rate for Payer: PHP Medicaid |
$33.38
|
| Rate for Payer: PHP Medicare Advantage |
$62.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$93.24
|
| Rate for Payer: Priority Health Medicare |
$62.28
|
| Rate for Payer: Priority Health Narrow Network |
$74.59
|
| Rate for Payer: Railroad Medicare Medicare |
$62.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$218.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.28
|
| Rate for Payer: UHC Exchange |
$96.53
|
| Rate for Payer: UHC Medicare Advantage |
$62.28
|
| Rate for Payer: UHCCP DNSP |
$62.28
|
| Rate for Payer: UHCCP Medicaid |
$33.38
|
| Rate for Payer: VA VA |
$62.28
|
|
|
HC CRYOPRECIPITATE POOL CMPT1
|
Facility
|
IP
|
$248.80
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000045
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$161.72 |
| Max. Negotiated Rate |
$248.80 |
| Rate for Payer: Aetna Commercial |
$223.92
|
| Rate for Payer: ASR ASR |
$241.34
|
| Rate for Payer: ASR Commercial |
$241.34
|
| Rate for Payer: BCBS Trust/PPO |
$202.75
|
| Rate for Payer: BCN Commercial |
$192.89
|
| Rate for Payer: Cash Price |
$199.04
|
| Rate for Payer: Cofinity Commercial |
$233.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.04
|
| Rate for Payer: Healthscope Commercial |
$248.80
|
| Rate for Payer: Healthscope Whirlpool |
$241.34
|
| Rate for Payer: Mclaren Commercial |
$223.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.48
|
| Rate for Payer: Nomi Health Commercial |
$204.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$218.94
|
|
|
HC CRYOPRECIPITATE POOL CMPT2
|
Facility
|
OP
|
$248.80
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000046
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$33.38 |
| Max. Negotiated Rate |
$248.80 |
| Rate for Payer: Aetna Commercial |
$223.92
|
| Rate for Payer: Aetna Medicare |
$62.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.85
|
| Rate for Payer: ASR ASR |
$241.34
|
| Rate for Payer: ASR Commercial |
$241.34
|
| Rate for Payer: BCBS Complete |
$35.05
|
| Rate for Payer: BCBS MAPPO |
$62.28
|
| Rate for Payer: BCBS Trust/PPO |
$203.74
|
| Rate for Payer: BCN Commercial |
$192.89
|
| Rate for Payer: BCN Medicare Advantage |
$62.28
|
| Rate for Payer: Cash Price |
$199.04
|
| Rate for Payer: Cash Price |
$199.04
|
| Rate for Payer: Cofinity Commercial |
$233.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.28
|
| Rate for Payer: Healthscope Commercial |
$248.80
|
| Rate for Payer: Healthscope Whirlpool |
$241.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$62.28
|
| Rate for Payer: Mclaren Commercial |
$223.92
|
| Rate for Payer: Mclaren Medicaid |
$33.38
|
| Rate for Payer: Mclaren Medicare |
$62.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.39
|
| Rate for Payer: Meridian Medicaid |
$35.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.48
|
| Rate for Payer: Nomi Health Commercial |
$204.02
|
| Rate for Payer: PACE Medicare |
$59.17
|
| Rate for Payer: PACE SWMI |
$62.28
|
| Rate for Payer: PHP Commercial |
$68.51
|
| Rate for Payer: PHP Medicaid |
$33.38
|
| Rate for Payer: PHP Medicare Advantage |
$62.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$93.24
|
| Rate for Payer: Priority Health Medicare |
$62.28
|
| Rate for Payer: Priority Health Narrow Network |
$74.59
|
| Rate for Payer: Railroad Medicare Medicare |
$62.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$218.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.28
|
| Rate for Payer: UHC Exchange |
$96.53
|
| Rate for Payer: UHC Medicare Advantage |
$62.28
|
| Rate for Payer: UHCCP DNSP |
$62.28
|
| Rate for Payer: UHCCP Medicaid |
$33.38
|
| Rate for Payer: VA VA |
$62.28
|
|
|
HC CRYOPRECIPITATE POOL CMPT2
|
Facility
|
IP
|
$248.80
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000046
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$161.72 |
| Max. Negotiated Rate |
$248.80 |
| Rate for Payer: Aetna Commercial |
$223.92
|
| Rate for Payer: ASR ASR |
$241.34
|
| Rate for Payer: ASR Commercial |
$241.34
|
| Rate for Payer: BCBS Trust/PPO |
$202.75
|
| Rate for Payer: BCN Commercial |
$192.89
|
| Rate for Payer: Cash Price |
$199.04
|
| Rate for Payer: Cofinity Commercial |
$233.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.04
|
| Rate for Payer: Healthscope Commercial |
$248.80
|
| Rate for Payer: Healthscope Whirlpool |
$241.34
|
| Rate for Payer: Mclaren Commercial |
$223.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.48
|
| Rate for Payer: Nomi Health Commercial |
$204.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$218.94
|
|
|
HC CRYOPRECIPITATE POOL CMPT3
|
Facility
|
IP
|
$248.80
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000047
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$161.72 |
| Max. Negotiated Rate |
$248.80 |
| Rate for Payer: Aetna Commercial |
$223.92
|
| Rate for Payer: ASR ASR |
$241.34
|
| Rate for Payer: ASR Commercial |
$241.34
|
| Rate for Payer: BCBS Trust/PPO |
$202.75
|
| Rate for Payer: BCN Commercial |
$192.89
|
| Rate for Payer: Cash Price |
$199.04
|
| Rate for Payer: Cofinity Commercial |
$233.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.04
|
| Rate for Payer: Healthscope Commercial |
$248.80
|
| Rate for Payer: Healthscope Whirlpool |
$241.34
|
| Rate for Payer: Mclaren Commercial |
$223.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.48
|
| Rate for Payer: Nomi Health Commercial |
$204.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$218.94
|
|
|
HC CRYOPRECIPITATE POOL CMPT3
|
Facility
|
OP
|
$248.80
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000047
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$33.38 |
| Max. Negotiated Rate |
$248.80 |
| Rate for Payer: Aetna Commercial |
$223.92
|
| Rate for Payer: Aetna Medicare |
$62.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.85
|
| Rate for Payer: ASR ASR |
$241.34
|
| Rate for Payer: ASR Commercial |
$241.34
|
| Rate for Payer: BCBS Complete |
$35.05
|
| Rate for Payer: BCBS MAPPO |
$62.28
|
| Rate for Payer: BCBS Trust/PPO |
$203.74
|
| Rate for Payer: BCN Commercial |
$192.89
|
| Rate for Payer: BCN Medicare Advantage |
$62.28
|
| Rate for Payer: Cash Price |
$199.04
|
| Rate for Payer: Cash Price |
$199.04
|
| Rate for Payer: Cofinity Commercial |
$233.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.28
|
| Rate for Payer: Healthscope Commercial |
$248.80
|
| Rate for Payer: Healthscope Whirlpool |
$241.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$62.28
|
| Rate for Payer: Mclaren Commercial |
$223.92
|
| Rate for Payer: Mclaren Medicaid |
$33.38
|
| Rate for Payer: Mclaren Medicare |
$62.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.39
|
| Rate for Payer: Meridian Medicaid |
$35.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.48
|
| Rate for Payer: Nomi Health Commercial |
$204.02
|
| Rate for Payer: PACE Medicare |
$59.17
|
| Rate for Payer: PACE SWMI |
$62.28
|
| Rate for Payer: PHP Commercial |
$68.51
|
| Rate for Payer: PHP Medicaid |
$33.38
|
| Rate for Payer: PHP Medicare Advantage |
$62.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$93.24
|
| Rate for Payer: Priority Health Medicare |
$62.28
|
| Rate for Payer: Priority Health Narrow Network |
$74.59
|
| Rate for Payer: Railroad Medicare Medicare |
$62.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$218.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.28
|
| Rate for Payer: UHC Exchange |
$96.53
|
| Rate for Payer: UHC Medicare Advantage |
$62.28
|
| Rate for Payer: UHCCP DNSP |
$62.28
|
| Rate for Payer: UHCCP Medicaid |
$33.38
|
| Rate for Payer: VA VA |
$62.28
|
|
