|
HC DUCK FEATHERS IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200083
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.43 |
| Max. Negotiated Rate |
$25.90 |
| Rate for Payer: Aetna Commercial |
$23.31
|
| Rate for Payer: ASR ASR |
$25.12
|
| Rate for Payer: BCBS Trust/PPO |
$21.27
|
| Rate for Payer: BCN Commercial |
$21.27
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$24.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$25.12
|
| Rate for Payer: Healthscope Whirlpool |
$25.90
|
| Rate for Payer: Mclaren Commercial |
$23.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.79
|
|
|
HC DUODENOSCOPY/COLONOSCOPY
|
Facility
|
OP
|
$4,487.77
|
|
| Hospital Charge Code |
36000033
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,660.47 |
| Max. Negotiated Rate |
$4,487.77 |
| Rate for Payer: Aetna Commercial |
$4,038.99
|
| Rate for Payer: Aetna Medicare |
$1,660.47
|
| Rate for Payer: ASR ASR |
$4,353.14
|
| Rate for Payer: BCBS Complete |
$1,795.11
|
| Rate for Payer: BCBS Trust/PPO |
$3,700.17
|
| Rate for Payer: BCN Commercial |
$3,700.17
|
| Rate for Payer: Cash Price |
$3,590.22
|
| Rate for Payer: Cofinity Commercial |
$4,218.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,590.22
|
| Rate for Payer: Healthscope Commercial |
$4,353.14
|
| Rate for Payer: Healthscope Whirlpool |
$4,487.77
|
| Rate for Payer: Mclaren Commercial |
$4,038.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,590.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,814.60
|
| Rate for Payer: Nomi Health Commercial |
$3,679.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,365.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,932.18
|
| Rate for Payer: Priority Health Narrow Network |
$3,145.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,949.24
|
|
|
HC DUODENOSCOPY/COLONOSCOPY
|
Facility
|
IP
|
$4,487.77
|
|
| Hospital Charge Code |
36000033
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,365.83 |
| Max. Negotiated Rate |
$4,487.77 |
| Rate for Payer: Aetna Commercial |
$4,038.99
|
| Rate for Payer: ASR ASR |
$4,353.14
|
| Rate for Payer: BCBS Trust/PPO |
$3,685.36
|
| Rate for Payer: BCN Commercial |
$3,685.36
|
| Rate for Payer: Cash Price |
$3,590.22
|
| Rate for Payer: Cofinity Commercial |
$4,218.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,590.22
|
| Rate for Payer: Healthscope Commercial |
$4,353.14
|
| Rate for Payer: Healthscope Whirlpool |
$4,487.77
|
| Rate for Payer: Mclaren Commercial |
$4,038.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,814.60
|
| Rate for Payer: Nomi Health Commercial |
$3,679.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,365.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,949.24
|
|
|
HC DUODENOSCOPY (EGD)
|
Facility
|
IP
|
$2,237.45
|
|
| Hospital Charge Code |
36000029
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,678.09 |
| Max. Negotiated Rate |
$2,237.45 |
| Rate for Payer: Aetna Commercial |
$2,013.70
|
| Rate for Payer: ASR ASR |
$2,170.33
|
| Rate for Payer: BCBS Trust/PPO |
$1,837.39
|
| Rate for Payer: BCN Commercial |
$1,837.39
|
| Rate for Payer: Cash Price |
$1,789.96
|
| Rate for Payer: Cofinity Commercial |
$2,103.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,789.96
|
| Rate for Payer: Healthscope Commercial |
$2,170.33
|
| Rate for Payer: Healthscope Whirlpool |
$2,237.45
|
| Rate for Payer: Mclaren Commercial |
$2,013.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,901.83
|
| Rate for Payer: Nomi Health Commercial |
$1,834.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,678.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,968.96
|
|
|
HC DUODENOSCOPY (EGD)
|
Facility
|
OP
|
$2,237.45
|
|
| Hospital Charge Code |
36000029
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$827.86 |
| Max. Negotiated Rate |
$2,237.45 |
| Rate for Payer: Aetna Commercial |
$2,013.70
|
| Rate for Payer: Aetna Medicare |
$827.86
|
| Rate for Payer: ASR ASR |
$2,170.33
|
| Rate for Payer: BCBS Complete |
$894.98
|
| Rate for Payer: BCBS Trust/PPO |
$1,844.78
|
| Rate for Payer: BCN Commercial |
$1,844.78
|
| Rate for Payer: Cash Price |
$1,789.96
|
| Rate for Payer: Cofinity Commercial |
$2,103.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,789.96
|
| Rate for Payer: Healthscope Commercial |
$2,170.33
|
| Rate for Payer: Healthscope Whirlpool |
$2,237.45
|
| Rate for Payer: Mclaren Commercial |
$2,013.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,789.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,901.83
|
| Rate for Payer: Nomi Health Commercial |
$1,834.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,678.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,960.45
|
| Rate for Payer: Priority Health Narrow Network |
$1,568.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,968.96
|
|
|
HC DUODENUM/FLEX SIGMOID
|
Facility
|
OP
|
$3,971.88
|
|
| Hospital Charge Code |
36000034
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,469.60 |
| Max. Negotiated Rate |
$3,971.88 |
| Rate for Payer: Aetna Commercial |
$3,574.69
|
| Rate for Payer: Aetna Medicare |
$1,469.60
|
| Rate for Payer: ASR ASR |
$3,852.72
|
| Rate for Payer: BCBS Complete |
$1,588.75
|
| Rate for Payer: BCBS Trust/PPO |
$3,274.82
|
| Rate for Payer: BCN Commercial |
$3,274.82
|
| Rate for Payer: Cash Price |
$3,177.50
|
| Rate for Payer: Cofinity Commercial |
$3,733.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,177.50
|
| Rate for Payer: Healthscope Commercial |
$3,852.72
|
| Rate for Payer: Healthscope Whirlpool |
$3,971.88
|
| Rate for Payer: Mclaren Commercial |
$3,574.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,177.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,376.10
|
| Rate for Payer: Nomi Health Commercial |
$3,256.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,978.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,480.16
|
| Rate for Payer: Priority Health Narrow Network |
$2,784.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,495.25
|
|
|
HC DUODENUM/FLEX SIGMOID
|
Facility
|
IP
|
$3,971.88
|
|
| Hospital Charge Code |
36000034
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,978.91 |
| Max. Negotiated Rate |
$3,971.88 |
| Rate for Payer: Aetna Commercial |
$3,574.69
|
| Rate for Payer: ASR ASR |
$3,852.72
|
| Rate for Payer: BCBS Trust/PPO |
$3,261.71
|
| Rate for Payer: BCN Commercial |
$3,261.71
|
| Rate for Payer: Cash Price |
$3,177.50
|
| Rate for Payer: Cofinity Commercial |
$3,733.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,177.50
|
| Rate for Payer: Healthscope Commercial |
$3,852.72
|
| Rate for Payer: Healthscope Whirlpool |
$3,971.88
|
| Rate for Payer: Mclaren Commercial |
$3,574.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,376.10
|
| Rate for Payer: Nomi Health Commercial |
$3,256.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,978.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,495.25
|
|
|
HC DUODERM CGF 4X4
|
Facility
|
OP
|
$48.68
|
|
| Hospital Charge Code |
27100010
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$18.01 |
| Max. Negotiated Rate |
$48.68 |
| Rate for Payer: Aetna Commercial |
$43.81
|
| Rate for Payer: Aetna Medicare |
$18.01
|
| Rate for Payer: ASR ASR |
$47.22
|
| Rate for Payer: BCBS Complete |
$19.47
|
| Rate for Payer: BCBS Trust/PPO |
$40.14
|
| Rate for Payer: BCN Commercial |
$40.14
|
| Rate for Payer: Cash Price |
$38.94
|
| Rate for Payer: Cofinity Commercial |
$45.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.94
|
| Rate for Payer: Healthscope Commercial |
$47.22
|
| Rate for Payer: Healthscope Whirlpool |
$48.68
|
| Rate for Payer: Mclaren Commercial |
$43.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.38
|
| Rate for Payer: Nomi Health Commercial |
$39.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$42.65
|
| Rate for Payer: Priority Health Narrow Network |
$34.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$42.84
|
|
|
HC DUODERM CGF 4X4
|
Facility
|
IP
|
$48.68
|
|
| Hospital Charge Code |
27100010
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$36.51 |
| Max. Negotiated Rate |
$48.68 |
| Rate for Payer: Aetna Commercial |
$43.81
|
| Rate for Payer: ASR ASR |
$47.22
|
| Rate for Payer: BCBS Trust/PPO |
$39.98
|
| Rate for Payer: BCN Commercial |
$39.98
|
| Rate for Payer: Cash Price |
$38.94
|
| Rate for Payer: Cofinity Commercial |
$45.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.94
|
| Rate for Payer: Healthscope Commercial |
$47.22
|
| Rate for Payer: Healthscope Whirlpool |
$48.68
|
| Rate for Payer: Mclaren Commercial |
$43.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.38
|
| Rate for Payer: Nomi Health Commercial |
$39.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$42.84
|
|
|
HC DUODERM CGF 6X6
|
Facility
|
OP
|
$77.11
|
|
| Hospital Charge Code |
27100011
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$28.53 |
| Max. Negotiated Rate |
$77.11 |
| Rate for Payer: Aetna Commercial |
$69.40
|
| Rate for Payer: Aetna Medicare |
$28.53
|
| Rate for Payer: ASR ASR |
$74.80
|
| Rate for Payer: BCBS Complete |
$30.84
|
| Rate for Payer: BCBS Trust/PPO |
$63.58
|
| Rate for Payer: BCN Commercial |
$63.58
|
| Rate for Payer: Cash Price |
$61.69
|
| Rate for Payer: Cofinity Commercial |
$72.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.69
|
| Rate for Payer: Healthscope Commercial |
$74.80
|
| Rate for Payer: Healthscope Whirlpool |
$77.11
|
| Rate for Payer: Mclaren Commercial |
$69.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$61.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.54
|
| Rate for Payer: Nomi Health Commercial |
$63.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$67.56
|
| Rate for Payer: Priority Health Narrow Network |
$54.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$67.86
|
|
|
HC DUODERM CGF 6X6
|
Facility
|
IP
|
$77.11
|
|
| Hospital Charge Code |
27100011
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$57.83 |
| Max. Negotiated Rate |
$77.11 |
| Rate for Payer: Aetna Commercial |
$69.40
|
| Rate for Payer: ASR ASR |
$74.80
|
| Rate for Payer: BCBS Trust/PPO |
$63.32
|
| Rate for Payer: BCN Commercial |
$63.32
|
| Rate for Payer: Cash Price |
$61.69
|
| Rate for Payer: Cofinity Commercial |
$72.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.69
|
| Rate for Payer: Healthscope Commercial |
$74.80
|
| Rate for Payer: Healthscope Whirlpool |
$77.11
|
| Rate for Payer: Mclaren Commercial |
$69.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.54
|
| Rate for Payer: Nomi Health Commercial |
$63.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$67.86
|
|
|
HC DUODERM CGF 8X8
|
Facility
|
OP
|
$107.64
|
|
| Hospital Charge Code |
27100012
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$39.83 |
| Max. Negotiated Rate |
$107.64 |
| Rate for Payer: Aetna Commercial |
$96.88
|
| Rate for Payer: Aetna Medicare |
$39.83
|
| Rate for Payer: ASR ASR |
$104.41
|
| Rate for Payer: BCBS Complete |
$43.06
|
| Rate for Payer: BCBS Trust/PPO |
$88.75
|
| Rate for Payer: BCN Commercial |
$88.75
|
| Rate for Payer: Cash Price |
$86.11
|
| Rate for Payer: Cofinity Commercial |
$101.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.11
|
| Rate for Payer: Healthscope Commercial |
$104.41
|
| Rate for Payer: Healthscope Whirlpool |
$107.64
|
| Rate for Payer: Mclaren Commercial |
$96.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$86.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.49
|
| Rate for Payer: Nomi Health Commercial |
$88.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$80.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$94.31
|
| Rate for Payer: Priority Health Narrow Network |
$75.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$94.72
|
|
|
HC DUODERM CGF 8X8
|
Facility
|
IP
|
$107.64
|
|
| Hospital Charge Code |
27100012
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$80.73 |
| Max. Negotiated Rate |
$107.64 |
| Rate for Payer: Aetna Commercial |
$96.88
|
| Rate for Payer: ASR ASR |
$104.41
|
| Rate for Payer: BCBS Trust/PPO |
$88.39
|
| Rate for Payer: BCN Commercial |
$88.39
|
| Rate for Payer: Cash Price |
$86.11
|
| Rate for Payer: Cofinity Commercial |
$101.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.11
|
| Rate for Payer: Healthscope Commercial |
$104.41
|
| Rate for Payer: Healthscope Whirlpool |
$107.64
|
| Rate for Payer: Mclaren Commercial |
$96.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.49
|
| Rate for Payer: Nomi Health Commercial |
$88.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$80.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$94.72
|
|
|
HC DUOGLIDE CATHETER
|
Facility
|
OP
|
$663.22
|
|
|
Service Code
|
HCPCS C1752
|
| Hospital Charge Code |
27200176
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$245.39 |
| Max. Negotiated Rate |
$663.22 |
| Rate for Payer: Aetna Commercial |
$596.90
|
| Rate for Payer: Aetna Medicare |
$245.39
|
| Rate for Payer: ASR ASR |
$643.32
|
| Rate for Payer: BCBS Complete |
$265.29
|
| Rate for Payer: BCBS Trust/PPO |
$546.82
|
| Rate for Payer: BCN Commercial |
$546.82
|
| Rate for Payer: Cash Price |
$530.58
|
| Rate for Payer: Cofinity Commercial |
$623.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$530.58
|
| Rate for Payer: Healthscope Commercial |
$643.32
|
| Rate for Payer: Healthscope Whirlpool |
$663.22
|
| Rate for Payer: Mclaren Commercial |
$596.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$530.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$563.74
|
| Rate for Payer: Nomi Health Commercial |
$543.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$497.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$581.11
|
| Rate for Payer: Priority Health Narrow Network |
$464.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$583.63
|
|
|
HC DUOGLIDE CATHETER
|
Facility
|
IP
|
$663.22
|
|
|
Service Code
|
HCPCS C1752
|
| Hospital Charge Code |
27200176
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$497.42 |
| Max. Negotiated Rate |
$663.22 |
| Rate for Payer: Aetna Commercial |
$596.90
|
| Rate for Payer: ASR ASR |
$643.32
|
| Rate for Payer: BCBS Trust/PPO |
$544.64
|
| Rate for Payer: BCN Commercial |
$544.64
|
| Rate for Payer: Cash Price |
$530.58
|
| Rate for Payer: Cofinity Commercial |
$623.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$530.58
|
| Rate for Payer: Healthscope Commercial |
$643.32
|
| Rate for Payer: Healthscope Whirlpool |
$663.22
|
| Rate for Payer: Mclaren Commercial |
$596.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$563.74
|
| Rate for Payer: Nomi Health Commercial |
$543.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$497.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$583.63
|
|
|
HC DUPLX HEMODIALYSIS ACCESS
|
Facility
|
OP
|
$986.77
|
|
|
Service Code
|
CPT 93990
|
| Hospital Charge Code |
92100017
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$986.77 |
| Rate for Payer: Aetna Commercial |
$888.09
|
| Rate for Payer: Aetna Medicare |
$104.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: ASR ASR |
$957.17
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$813.59
|
| Rate for Payer: BCN Commercial |
$813.59
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$789.42
|
| Rate for Payer: Cash Price |
$789.42
|
| Rate for Payer: Cofinity Commercial |
$927.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$789.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$957.17
|
| Rate for Payer: Healthscope Whirlpool |
$986.77
|
| Rate for Payer: Humana Choice PPO Medicare |
$104.17
|
| Rate for Payer: Mclaren Commercial |
$888.09
|
| Rate for Payer: Mclaren Medicaid |
$104.17
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$57.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$838.75
|
| Rate for Payer: Nomi Health Commercial |
$809.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$740.08
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$114.59
|
| Rate for Payer: PHP Medicaid |
$55.84
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$864.61
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health Narrow Network |
$691.73
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$868.36
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$161.46
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP DNSP |
$104.17
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: VA VA |
$104.17
|
|
|
HC DUPLX HEMODIALYSIS ACCESS
|
Facility
|
IP
|
$986.77
|
|
|
Service Code
|
CPT 93990
|
| Hospital Charge Code |
92100017
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$740.08 |
| Max. Negotiated Rate |
$986.77 |
| Rate for Payer: Aetna Commercial |
$888.09
|
| Rate for Payer: ASR ASR |
$957.17
|
| Rate for Payer: BCBS Trust/PPO |
$810.34
|
| Rate for Payer: BCN Commercial |
$810.34
|
| Rate for Payer: Cash Price |
$789.42
|
| Rate for Payer: Cofinity Commercial |
$927.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$789.42
|
| Rate for Payer: Healthscope Commercial |
$957.17
|
| Rate for Payer: Healthscope Whirlpool |
$986.77
|
| Rate for Payer: Mclaren Commercial |
$888.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$838.75
|
| Rate for Payer: Nomi Health Commercial |
$809.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$740.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$868.36
|
|
|
HC DUST MITE DF IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200039
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.43 |
| Max. Negotiated Rate |
$25.90 |
| Rate for Payer: Aetna Commercial |
$23.31
|
| Rate for Payer: ASR ASR |
$25.12
|
| Rate for Payer: BCBS Trust/PPO |
$21.27
|
| Rate for Payer: BCN Commercial |
$21.27
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$24.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$25.12
|
| Rate for Payer: Healthscope Whirlpool |
$25.90
|
| Rate for Payer: Mclaren Commercial |
$23.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.79
|
|
|
HC DUST MITE DF IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200039
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$25.90 |
| Rate for Payer: Aetna Commercial |
$23.31
|
| 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 |
$25.12
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$21.35
|
| Rate for Payer: BCN Commercial |
$21.35
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$24.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$25.12
|
| Rate for Payer: Healthscope Whirlpool |
$25.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$23.31
|
| Rate for Payer: Mclaren Medicaid |
$5.22
|
| 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 |
$2.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| 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 |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$22.69
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$18.16
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP DNSP |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC DUST MITE DP IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200040
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$25.90 |
| Rate for Payer: Aetna Commercial |
$23.31
|
| 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 |
$25.12
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$21.35
|
| Rate for Payer: BCN Commercial |
$21.35
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$24.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$25.12
|
| Rate for Payer: Healthscope Whirlpool |
$25.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$23.31
|
| Rate for Payer: Mclaren Medicaid |
$5.22
|
| 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 |
$2.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| 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 |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$22.69
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$18.16
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP DNSP |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC DUST MITE DP IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200040
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.43 |
| Max. Negotiated Rate |
$25.90 |
| Rate for Payer: Aetna Commercial |
$23.31
|
| Rate for Payer: ASR ASR |
$25.12
|
| Rate for Payer: BCBS Trust/PPO |
$21.27
|
| Rate for Payer: BCN Commercial |
$21.27
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$24.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$25.12
|
| Rate for Payer: Healthscope Whirlpool |
$25.90
|
| Rate for Payer: Mclaren Commercial |
$23.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.79
|
|
|
HC DXA BONE DENSITY W FX ASSESS
|
Facility
|
IP
|
$798.52
|
|
|
Service Code
|
CPT 77085
|
| Hospital Charge Code |
32000304
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$598.89 |
| Max. Negotiated Rate |
$798.52 |
| Rate for Payer: Aetna Commercial |
$718.67
|
| Rate for Payer: ASR ASR |
$774.56
|
| Rate for Payer: BCBS Trust/PPO |
$655.74
|
| Rate for Payer: BCN Commercial |
$655.74
|
| Rate for Payer: Cash Price |
$638.82
|
| Rate for Payer: Cofinity Commercial |
$750.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$638.82
|
| Rate for Payer: Healthscope Commercial |
$774.56
|
| Rate for Payer: Healthscope Whirlpool |
$798.52
|
| Rate for Payer: Mclaren Commercial |
$718.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$678.74
|
| Rate for Payer: Nomi Health Commercial |
$654.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$598.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$702.70
|
|
|
HC DXA BONE DENSITY W FX ASSESS
|
Facility
|
OP
|
$798.52
|
|
|
Service Code
|
CPT 77085
|
| Hospital Charge Code |
32000304
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$798.52 |
| Rate for Payer: Aetna Commercial |
$718.67
|
| Rate for Payer: Aetna Medicare |
$104.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: ASR ASR |
$774.56
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$658.38
|
| Rate for Payer: BCN Commercial |
$658.38
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$638.82
|
| Rate for Payer: Cash Price |
$638.82
|
| Rate for Payer: Cofinity Commercial |
$750.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$638.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$774.56
|
| Rate for Payer: Healthscope Whirlpool |
$798.52
|
| Rate for Payer: Humana Choice PPO Medicare |
$104.17
|
| Rate for Payer: Mclaren Commercial |
$718.67
|
| Rate for Payer: Mclaren Medicaid |
$104.17
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$57.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$678.74
|
| Rate for Payer: Nomi Health Commercial |
$654.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$598.89
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$114.59
|
| Rate for Payer: PHP Medicaid |
$55.84
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$699.66
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health Narrow Network |
$559.76
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$702.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$161.46
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP DNSP |
$104.17
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: VA VA |
$104.17
|
|
|
HC E72 MOUSE URINE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200452
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$25.90 |
| Rate for Payer: Aetna Commercial |
$23.31
|
| 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 |
$25.12
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$21.35
|
| Rate for Payer: BCN Commercial |
$21.35
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$24.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$25.12
|
| Rate for Payer: Healthscope Whirlpool |
$25.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$23.31
|
| Rate for Payer: Mclaren Medicaid |
$5.22
|
| 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 |
$2.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| 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 |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$22.69
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$18.16
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP DNSP |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC E72 MOUSE URINE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200452
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.43 |
| Max. Negotiated Rate |
$25.90 |
| Rate for Payer: Aetna Commercial |
$23.31
|
| Rate for Payer: ASR ASR |
$25.12
|
| Rate for Payer: BCBS Trust/PPO |
$21.27
|
| Rate for Payer: BCN Commercial |
$21.27
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$24.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$25.12
|
| Rate for Payer: Healthscope Whirlpool |
$25.90
|
| Rate for Payer: Mclaren Commercial |
$23.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.79
|
|
