|
HC CT Z ABSCESS S T NECK THORAX
|
Facility
|
OP
|
$2,645.38
|
|
|
Service Code
|
CPT 21501
|
| Hospital Charge Code |
36100319
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,496.14 |
| Max. Negotiated Rate |
$4,326.52 |
| Rate for Payer: Aetna Commercial |
$2,380.84
|
| Rate for Payer: Aetna Medicare |
$2,791.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,489.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,489.12
|
| Rate for Payer: ASR ASR |
$2,566.02
|
| Rate for Payer: ASR Commercial |
$2,566.02
|
| Rate for Payer: BCBS Complete |
$1,570.94
|
| Rate for Payer: BCBS MAPPO |
$2,791.30
|
| Rate for Payer: BCBS Trust/PPO |
$2,166.30
|
| Rate for Payer: BCN Commercial |
$2,050.96
|
| Rate for Payer: BCN Medicare Advantage |
$2,791.30
|
| Rate for Payer: Cash Price |
$2,116.30
|
| Rate for Payer: Cash Price |
$2,116.30
|
| Rate for Payer: Cofinity Commercial |
$2,486.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,116.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,791.30
|
| Rate for Payer: Healthscope Commercial |
$2,645.38
|
| Rate for Payer: Healthscope Whirlpool |
$2,566.02
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,791.30
|
| Rate for Payer: Mclaren Commercial |
$2,380.84
|
| Rate for Payer: Mclaren Medicaid |
$1,496.14
|
| Rate for Payer: Mclaren Medicare |
$2,791.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,930.86
|
| Rate for Payer: Meridian Medicaid |
$1,570.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,209.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,248.57
|
| Rate for Payer: Nomi Health Commercial |
$2,169.21
|
| Rate for Payer: PACE Medicare |
$2,651.74
|
| Rate for Payer: PACE SWMI |
$2,791.30
|
| Rate for Payer: PHP Commercial |
$3,070.43
|
| Rate for Payer: PHP Medicaid |
$1,496.14
|
| Rate for Payer: PHP Medicare Advantage |
$2,791.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,496.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,719.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,317.88
|
| Rate for Payer: Priority Health Medicare |
$2,791.30
|
| Rate for Payer: Priority Health Narrow Network |
$1,854.41
|
| Rate for Payer: Railroad Medicare Medicare |
$2,791.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,327.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,791.30
|
| Rate for Payer: UHC Exchange |
$4,326.52
|
| Rate for Payer: UHC Medicare Advantage |
$2,791.30
|
| Rate for Payer: UHCCP DNSP |
$2,791.30
|
| Rate for Payer: UHCCP Medicaid |
$1,496.14
|
| Rate for Payer: VA VA |
$2,791.30
|
|
|
HC CT Z ABSCESS S T NECK THORAX
|
Facility
|
IP
|
$2,645.38
|
|
|
Service Code
|
CPT 21501
|
| Hospital Charge Code |
36100319
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,719.50 |
| Max. Negotiated Rate |
$2,645.38 |
| Rate for Payer: Aetna Commercial |
$2,380.84
|
| Rate for Payer: ASR ASR |
$2,566.02
|
| Rate for Payer: ASR Commercial |
$2,566.02
|
| Rate for Payer: BCBS Trust/PPO |
$2,155.72
|
| Rate for Payer: BCN Commercial |
$2,050.96
|
| Rate for Payer: Cash Price |
$2,116.30
|
| Rate for Payer: Cofinity Commercial |
$2,486.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,116.30
|
| Rate for Payer: Healthscope Commercial |
$2,645.38
|
| Rate for Payer: Healthscope Whirlpool |
$2,566.02
|
| Rate for Payer: Mclaren Commercial |
$2,380.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,248.57
|
| Rate for Payer: Nomi Health Commercial |
$2,169.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,719.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,327.93
|
|
|
HC CULTURE ADDITIONAL ID
|
Facility
|
IP
|
$52.34
|
|
|
Service Code
|
CPT 87077
|
| Hospital Charge Code |
30600078
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$34.02 |
| Max. Negotiated Rate |
$52.34 |
| Rate for Payer: Aetna Commercial |
$47.11
|
| Rate for Payer: ASR ASR |
$50.77
|
| Rate for Payer: ASR Commercial |
$50.77
|
| Rate for Payer: BCBS Trust/PPO |
$42.65
|
| Rate for Payer: BCN Commercial |
$40.58
|
| Rate for Payer: Cash Price |
$41.87
|
| Rate for Payer: Cofinity Commercial |
$49.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.87
|
| Rate for Payer: Healthscope Commercial |
$52.34
|
| Rate for Payer: Healthscope Whirlpool |
$50.77
|
| Rate for Payer: Mclaren Commercial |
$47.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.49
|
| Rate for Payer: Nomi Health Commercial |
$42.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.06
|
|
|
HC CULTURE ADDITIONAL ID
|
Facility
|
OP
|
$52.34
|
|
|
Service Code
|
CPT 87077
|
| Hospital Charge Code |
30600078
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.33 |
| Max. Negotiated Rate |
$52.34 |
| Rate for Payer: Aetna Commercial |
$47.11
|
| Rate for Payer: Aetna Medicare |
$8.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.10
|
| Rate for Payer: ASR ASR |
$50.77
|
| Rate for Payer: ASR Commercial |
$50.77
|
| Rate for Payer: BCBS Complete |
$4.55
|
| Rate for Payer: BCBS MAPPO |
$8.08
|
| Rate for Payer: BCBS Trust/PPO |
$42.86
|
| Rate for Payer: BCN Commercial |
$40.58
|
| Rate for Payer: BCN Medicare Advantage |
$8.08
|
| Rate for Payer: Cash Price |
$41.87
|
| Rate for Payer: Cash Price |
$41.87
|
| Rate for Payer: Cofinity Commercial |
$49.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.08
|
| Rate for Payer: Healthscope Commercial |
$52.34
|
| Rate for Payer: Healthscope Whirlpool |
$50.77
|
| Rate for Payer: Humana Choice PPO Medicare |
$8.08
|
| Rate for Payer: Mclaren Commercial |
$47.11
|
| Rate for Payer: Mclaren Medicaid |
$4.33
|
| Rate for Payer: Mclaren Medicare |
$8.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.48
|
| Rate for Payer: Meridian Medicaid |
$4.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.49
|
| Rate for Payer: Nomi Health Commercial |
$42.92
|
| Rate for Payer: PACE Medicare |
$7.68
|
| Rate for Payer: PACE SWMI |
$8.08
|
| Rate for Payer: PHP Commercial |
$8.89
|
| Rate for Payer: PHP Medicaid |
$4.33
|
| Rate for Payer: PHP Medicare Advantage |
$8.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45.86
|
| Rate for Payer: Priority Health Medicare |
$8.08
|
| Rate for Payer: Priority Health Narrow Network |
$36.69
|
| Rate for Payer: Railroad Medicare Medicare |
$8.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.08
|
| Rate for Payer: UHC Exchange |
$12.52
|
| Rate for Payer: UHC Medicare Advantage |
$8.08
|
| Rate for Payer: UHCCP DNSP |
$8.08
|
| Rate for Payer: UHCCP Medicaid |
$4.33
|
| Rate for Payer: VA VA |
$8.08
|
|
|
HC CULTURE ENTERIC PATH STOOL
|
Facility
|
IP
|
$41.66
|
|
|
Service Code
|
CPT 87045
|
| Hospital Charge Code |
30600323
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$27.08 |
| Max. Negotiated Rate |
$41.66 |
| Rate for Payer: Aetna Commercial |
$37.49
|
| Rate for Payer: ASR ASR |
$40.41
|
| Rate for Payer: ASR Commercial |
$40.41
|
| Rate for Payer: BCBS Trust/PPO |
$33.95
|
| Rate for Payer: BCN Commercial |
$32.30
|
| Rate for Payer: Cash Price |
$33.33
|
| Rate for Payer: Cofinity Commercial |
$39.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.33
|
| Rate for Payer: Healthscope Commercial |
$41.66
|
| Rate for Payer: Healthscope Whirlpool |
$40.41
|
| Rate for Payer: Mclaren Commercial |
$37.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.41
|
| Rate for Payer: Nomi Health Commercial |
$34.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$36.66
|
|
|
HC CULTURE ENTERIC PATH STOOL
|
Facility
|
OP
|
$41.66
|
|
|
Service Code
|
CPT 87045
|
| Hospital Charge Code |
30600323
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.06 |
| Max. Negotiated Rate |
$41.66 |
| Rate for Payer: Aetna Commercial |
$37.49
|
| Rate for Payer: Aetna Medicare |
$9.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.80
|
| Rate for Payer: ASR ASR |
$40.41
|
| Rate for Payer: ASR Commercial |
$40.41
|
| Rate for Payer: BCBS Complete |
$5.31
|
| Rate for Payer: BCBS MAPPO |
$9.44
|
| Rate for Payer: BCBS Trust/PPO |
$34.12
|
| Rate for Payer: BCN Commercial |
$32.30
|
| Rate for Payer: BCN Medicare Advantage |
$9.44
|
| Rate for Payer: Cash Price |
$33.33
|
| Rate for Payer: Cash Price |
$33.33
|
| Rate for Payer: Cofinity Commercial |
$39.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.44
|
| Rate for Payer: Healthscope Commercial |
$41.66
|
| Rate for Payer: Healthscope Whirlpool |
$40.41
|
| Rate for Payer: Humana Choice PPO Medicare |
$9.44
|
| Rate for Payer: Mclaren Commercial |
$37.49
|
| Rate for Payer: Mclaren Medicaid |
$5.06
|
| Rate for Payer: Mclaren Medicare |
$9.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.91
|
| Rate for Payer: Meridian Medicaid |
$5.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.41
|
| Rate for Payer: Nomi Health Commercial |
$34.16
|
| Rate for Payer: PACE Medicare |
$8.97
|
| Rate for Payer: PACE SWMI |
$9.44
|
| Rate for Payer: PHP Commercial |
$10.38
|
| Rate for Payer: PHP Medicaid |
$5.06
|
| Rate for Payer: PHP Medicare Advantage |
$9.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$36.50
|
| Rate for Payer: Priority Health Medicare |
$9.44
|
| Rate for Payer: Priority Health Narrow Network |
$29.20
|
| Rate for Payer: Railroad Medicare Medicare |
$9.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$36.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.44
|
| Rate for Payer: UHC Exchange |
$14.63
|
| Rate for Payer: UHC Medicare Advantage |
$9.44
|
| Rate for Payer: UHCCP DNSP |
$9.44
|
| Rate for Payer: UHCCP Medicaid |
$5.06
|
| Rate for Payer: VA VA |
$9.44
|
|
|
HC CULTURE ENTERIC PATH STOOL CMPT
|
Facility
|
IP
|
$15.65
|
|
|
Service Code
|
CPT 87046
|
| Hospital Charge Code |
30600324
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$10.17 |
| Max. Negotiated Rate |
$15.65 |
| Rate for Payer: Aetna Commercial |
$14.09
|
| Rate for Payer: ASR ASR |
$15.18
|
| Rate for Payer: ASR Commercial |
$15.18
|
| Rate for Payer: BCBS Trust/PPO |
$12.75
|
| Rate for Payer: BCN Commercial |
$12.13
|
| Rate for Payer: Cash Price |
$12.52
|
| Rate for Payer: Cofinity Commercial |
$14.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.52
|
| Rate for Payer: Healthscope Commercial |
$15.65
|
| Rate for Payer: Healthscope Whirlpool |
$15.18
|
| Rate for Payer: Mclaren Commercial |
$14.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.30
|
| Rate for Payer: Nomi Health Commercial |
$12.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$13.77
|
|
|
HC CULTURE ENTERIC PATH STOOL CMPT
|
Facility
|
OP
|
$15.65
|
|
|
Service Code
|
CPT 87046
|
| Hospital Charge Code |
30600324
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.06 |
| Max. Negotiated Rate |
$15.65 |
| Rate for Payer: Aetna Commercial |
$14.09
|
| Rate for Payer: Aetna Medicare |
$9.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.80
|
| Rate for Payer: ASR ASR |
$15.18
|
| Rate for Payer: ASR Commercial |
$15.18
|
| Rate for Payer: BCBS Complete |
$5.31
|
| Rate for Payer: BCBS MAPPO |
$9.44
|
| Rate for Payer: BCBS Trust/PPO |
$12.82
|
| Rate for Payer: BCN Commercial |
$12.13
|
| Rate for Payer: BCN Medicare Advantage |
$9.44
|
| Rate for Payer: Cash Price |
$12.52
|
| Rate for Payer: Cash Price |
$12.52
|
| Rate for Payer: Cofinity Commercial |
$14.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.44
|
| Rate for Payer: Healthscope Commercial |
$15.65
|
| Rate for Payer: Healthscope Whirlpool |
$15.18
|
| Rate for Payer: Humana Choice PPO Medicare |
$9.44
|
| Rate for Payer: Mclaren Commercial |
$14.09
|
| Rate for Payer: Mclaren Medicaid |
$5.06
|
| Rate for Payer: Mclaren Medicare |
$9.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.91
|
| Rate for Payer: Meridian Medicaid |
$5.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.30
|
| Rate for Payer: Nomi Health Commercial |
$12.83
|
| Rate for Payer: PACE Medicare |
$8.97
|
| Rate for Payer: PACE SWMI |
$9.44
|
| Rate for Payer: PHP Commercial |
$10.38
|
| Rate for Payer: PHP Medicaid |
$5.06
|
| Rate for Payer: PHP Medicare Advantage |
$9.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.71
|
| Rate for Payer: Priority Health Medicare |
$9.44
|
| Rate for Payer: Priority Health Narrow Network |
$10.97
|
| Rate for Payer: Railroad Medicare Medicare |
$9.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$13.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.44
|
| Rate for Payer: UHC Exchange |
$14.63
|
| Rate for Payer: UHC Medicare Advantage |
$9.44
|
| Rate for Payer: UHCCP DNSP |
$9.44
|
| Rate for Payer: UHCCP Medicaid |
$5.06
|
| Rate for Payer: VA VA |
$9.44
|
|
|
HC CULTURE FUNGAL OTHER SOURCE
|
Facility
|
IP
|
$80.58
|
|
|
Service Code
|
CPT 87102
|
| Hospital Charge Code |
30600083
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$52.38 |
| Max. Negotiated Rate |
$80.58 |
| Rate for Payer: Aetna Commercial |
$72.52
|
| Rate for Payer: ASR ASR |
$78.16
|
| Rate for Payer: ASR Commercial |
$78.16
|
| Rate for Payer: BCBS Trust/PPO |
$65.66
|
| Rate for Payer: BCN Commercial |
$62.47
|
| Rate for Payer: Cash Price |
$64.46
|
| Rate for Payer: Cofinity Commercial |
$75.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.46
|
| Rate for Payer: Healthscope Commercial |
$80.58
|
| Rate for Payer: Healthscope Whirlpool |
$78.16
|
| Rate for Payer: Mclaren Commercial |
$72.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.49
|
| Rate for Payer: Nomi Health Commercial |
$66.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$70.91
|
|
|
HC CULTURE FUNGAL OTHER SOURCE
|
Facility
|
OP
|
$80.58
|
|
|
Service Code
|
CPT 87102
|
| Hospital Charge Code |
30600083
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.51 |
| Max. Negotiated Rate |
$80.58 |
| Rate for Payer: Aetna Commercial |
$72.52
|
| Rate for Payer: Aetna Medicare |
$8.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.51
|
| Rate for Payer: ASR ASR |
$78.16
|
| Rate for Payer: ASR Commercial |
$78.16
|
| Rate for Payer: BCBS Complete |
$4.73
|
| Rate for Payer: BCBS MAPPO |
$8.41
|
| Rate for Payer: BCBS Trust/PPO |
$65.99
|
| Rate for Payer: BCN Commercial |
$62.47
|
| Rate for Payer: BCN Medicare Advantage |
$8.41
|
| Rate for Payer: Cash Price |
$64.46
|
| Rate for Payer: Cash Price |
$64.46
|
| Rate for Payer: Cofinity Commercial |
$75.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.41
|
| Rate for Payer: Healthscope Commercial |
$80.58
|
| Rate for Payer: Healthscope Whirlpool |
$78.16
|
| Rate for Payer: Humana Choice PPO Medicare |
$8.41
|
| Rate for Payer: Mclaren Commercial |
$72.52
|
| Rate for Payer: Mclaren Medicaid |
$4.51
|
| Rate for Payer: Mclaren Medicare |
$8.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.83
|
| Rate for Payer: Meridian Medicaid |
$4.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.49
|
| Rate for Payer: Nomi Health Commercial |
$66.08
|
| Rate for Payer: PACE Medicare |
$7.99
|
| Rate for Payer: PACE SWMI |
$8.41
|
| Rate for Payer: PHP Commercial |
$9.25
|
| Rate for Payer: PHP Medicaid |
$4.51
|
| Rate for Payer: PHP Medicare Advantage |
$8.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$70.60
|
| Rate for Payer: Priority Health Medicare |
$8.41
|
| Rate for Payer: Priority Health Narrow Network |
$56.49
|
| Rate for Payer: Railroad Medicare Medicare |
$8.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$70.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.41
|
| Rate for Payer: UHC Exchange |
$13.04
|
| Rate for Payer: UHC Medicare Advantage |
$8.41
|
| Rate for Payer: UHCCP DNSP |
$8.41
|
| Rate for Payer: UHCCP Medicaid |
$4.51
|
| Rate for Payer: VA VA |
$8.41
|
|
|
HC CULTURE FUNGAL SKIN, HAIR, NAIL
|
Facility
|
IP
|
$80.58
|
|
|
Service Code
|
CPT 87101
|
| Hospital Charge Code |
30600082
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$52.38 |
| Max. Negotiated Rate |
$80.58 |
| Rate for Payer: Aetna Commercial |
$72.52
|
| Rate for Payer: ASR ASR |
$78.16
|
| Rate for Payer: ASR Commercial |
$78.16
|
| Rate for Payer: BCBS Trust/PPO |
$65.66
|
| Rate for Payer: BCN Commercial |
$62.47
|
| Rate for Payer: Cash Price |
$64.46
|
| Rate for Payer: Cofinity Commercial |
$75.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.46
|
| Rate for Payer: Healthscope Commercial |
$80.58
|
| Rate for Payer: Healthscope Whirlpool |
$78.16
|
| Rate for Payer: Mclaren Commercial |
$72.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.49
|
| Rate for Payer: Nomi Health Commercial |
$66.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$70.91
|
|
|
HC CULTURE FUNGAL SKIN, HAIR, NAIL
|
Facility
|
OP
|
$80.58
|
|
|
Service Code
|
CPT 87101
|
| Hospital Charge Code |
30600082
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.13 |
| Max. Negotiated Rate |
$80.58 |
| Rate for Payer: Aetna Commercial |
$72.52
|
| Rate for Payer: Aetna Medicare |
$7.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.64
|
| Rate for Payer: ASR ASR |
$78.16
|
| Rate for Payer: ASR Commercial |
$78.16
|
| Rate for Payer: BCBS Complete |
$4.34
|
| Rate for Payer: BCBS MAPPO |
$7.71
|
| Rate for Payer: BCBS Trust/PPO |
$65.99
|
| Rate for Payer: BCN Commercial |
$62.47
|
| Rate for Payer: BCN Medicare Advantage |
$7.71
|
| Rate for Payer: Cash Price |
$64.46
|
| Rate for Payer: Cash Price |
$64.46
|
| Rate for Payer: Cofinity Commercial |
$75.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.71
|
| Rate for Payer: Healthscope Commercial |
$80.58
|
| Rate for Payer: Healthscope Whirlpool |
$78.16
|
| Rate for Payer: Humana Choice PPO Medicare |
$7.71
|
| Rate for Payer: Mclaren Commercial |
$72.52
|
| Rate for Payer: Mclaren Medicaid |
$4.13
|
| Rate for Payer: Mclaren Medicare |
$7.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.10
|
| Rate for Payer: Meridian Medicaid |
$4.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.49
|
| Rate for Payer: Nomi Health Commercial |
$66.08
|
| Rate for Payer: PACE Medicare |
$7.32
|
| Rate for Payer: PACE SWMI |
$7.71
|
| Rate for Payer: PHP Commercial |
$8.48
|
| Rate for Payer: PHP Medicaid |
$4.13
|
| Rate for Payer: PHP Medicare Advantage |
$7.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$70.60
|
| Rate for Payer: Priority Health Medicare |
$7.71
|
| Rate for Payer: Priority Health Narrow Network |
$56.49
|
| Rate for Payer: Railroad Medicare Medicare |
$7.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$70.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.71
|
| Rate for Payer: UHC Exchange |
$11.95
|
| Rate for Payer: UHC Medicare Advantage |
$7.71
|
| Rate for Payer: UHCCP DNSP |
$7.71
|
| Rate for Payer: UHCCP Medicaid |
$4.13
|
| Rate for Payer: VA VA |
$7.71
|
|
|
HC CULTURE ID BLOOD PATHOGEN BY NUCLEIC ACID
|
Facility
|
OP
|
$624.24
|
|
|
Service Code
|
CPT 87154
|
| Hospital Charge Code |
30600329
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$116.88 |
| Max. Negotiated Rate |
$624.24 |
| Rate for Payer: Aetna Commercial |
$561.82
|
| Rate for Payer: Aetna Medicare |
$218.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$272.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$272.57
|
| Rate for Payer: ASR ASR |
$605.51
|
| Rate for Payer: ASR Commercial |
$605.51
|
| Rate for Payer: BCBS Complete |
$122.72
|
| Rate for Payer: BCBS MAPPO |
$218.06
|
| Rate for Payer: BCBS Trust/PPO |
$511.19
|
| Rate for Payer: BCN Commercial |
$483.97
|
| Rate for Payer: BCN Medicare Advantage |
$218.06
|
| Rate for Payer: Cash Price |
$499.39
|
| Rate for Payer: Cash Price |
$499.39
|
| Rate for Payer: Cofinity Commercial |
$586.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$499.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$218.06
|
| Rate for Payer: Healthscope Commercial |
$624.24
|
| Rate for Payer: Healthscope Whirlpool |
$605.51
|
| Rate for Payer: Humana Choice PPO Medicare |
$218.06
|
| Rate for Payer: Mclaren Commercial |
$561.82
|
| Rate for Payer: Mclaren Medicaid |
$116.88
|
| Rate for Payer: Mclaren Medicare |
$218.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$228.96
|
| Rate for Payer: Meridian Medicaid |
$122.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$250.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$530.60
|
| Rate for Payer: Nomi Health Commercial |
$511.88
|
| Rate for Payer: PACE Medicare |
$207.16
|
| Rate for Payer: PACE SWMI |
$218.06
|
| Rate for Payer: PHP Commercial |
$239.87
|
| Rate for Payer: PHP Medicaid |
$116.88
|
| Rate for Payer: PHP Medicare Advantage |
$218.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$116.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$405.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$546.96
|
| Rate for Payer: Priority Health Medicare |
$218.06
|
| Rate for Payer: Priority Health Narrow Network |
$437.59
|
| Rate for Payer: Railroad Medicare Medicare |
$218.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$549.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$218.06
|
| Rate for Payer: UHC Exchange |
$337.99
|
| Rate for Payer: UHC Medicare Advantage |
$218.06
|
| Rate for Payer: UHCCP DNSP |
$218.06
|
| Rate for Payer: UHCCP Medicaid |
$116.88
|
| Rate for Payer: VA VA |
$218.06
|
|
|
HC CULTURE ID BLOOD PATHOGEN BY NUCLEIC ACID
|
Facility
|
IP
|
$624.24
|
|
|
Service Code
|
CPT 87154
|
| Hospital Charge Code |
30600329
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$405.76 |
| Max. Negotiated Rate |
$624.24 |
| Rate for Payer: Aetna Commercial |
$561.82
|
| Rate for Payer: ASR ASR |
$605.51
|
| Rate for Payer: ASR Commercial |
$605.51
|
| Rate for Payer: BCBS Trust/PPO |
$508.69
|
| Rate for Payer: BCN Commercial |
$483.97
|
| Rate for Payer: Cash Price |
$499.39
|
| Rate for Payer: Cofinity Commercial |
$586.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$499.39
|
| Rate for Payer: Healthscope Commercial |
$624.24
|
| Rate for Payer: Healthscope Whirlpool |
$605.51
|
| Rate for Payer: Mclaren Commercial |
$561.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$530.60
|
| Rate for Payer: Nomi Health Commercial |
$511.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$405.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$549.33
|
|
|
HC CULTURE OTHER SOURCE
|
Facility
|
IP
|
$46.82
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
30600075
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$30.43 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$42.14
|
| Rate for Payer: ASR ASR |
$45.42
|
| Rate for Payer: ASR Commercial |
$45.42
|
| Rate for Payer: BCBS Trust/PPO |
$38.15
|
| Rate for Payer: BCN Commercial |
$36.30
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Commercial |
$44.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Healthscope Whirlpool |
$45.42
|
| Rate for Payer: Mclaren Commercial |
$42.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.80
|
| Rate for Payer: Nomi Health Commercial |
$38.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$41.20
|
|
|
HC CULTURE OTHER SOURCE
|
Facility
|
OP
|
$46.82
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
30600075
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.62 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$42.14
|
| Rate for Payer: Aetna Medicare |
$8.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.78
|
| Rate for Payer: ASR ASR |
$45.42
|
| Rate for Payer: ASR Commercial |
$45.42
|
| Rate for Payer: BCBS Complete |
$4.85
|
| Rate for Payer: BCBS MAPPO |
$8.62
|
| Rate for Payer: BCBS Trust/PPO |
$38.34
|
| Rate for Payer: BCN Commercial |
$36.30
|
| Rate for Payer: BCN Medicare Advantage |
$8.62
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Commercial |
$44.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.62
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Healthscope Whirlpool |
$45.42
|
| Rate for Payer: Humana Choice PPO Medicare |
$8.62
|
| Rate for Payer: Mclaren Commercial |
$42.14
|
| Rate for Payer: Mclaren Medicaid |
$4.62
|
| Rate for Payer: Mclaren Medicare |
$8.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.05
|
| Rate for Payer: Meridian Medicaid |
$4.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.80
|
| Rate for Payer: Nomi Health Commercial |
$38.39
|
| Rate for Payer: PACE Medicare |
$8.19
|
| Rate for Payer: PACE SWMI |
$8.62
|
| Rate for Payer: PHP Commercial |
$9.48
|
| Rate for Payer: PHP Medicaid |
$4.62
|
| Rate for Payer: PHP Medicare Advantage |
$8.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$41.02
|
| Rate for Payer: Priority Health Medicare |
$8.62
|
| Rate for Payer: Priority Health Narrow Network |
$32.82
|
| Rate for Payer: Railroad Medicare Medicare |
$8.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$41.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.62
|
| Rate for Payer: UHC Exchange |
$13.36
|
| Rate for Payer: UHC Medicare Advantage |
$8.62
|
| Rate for Payer: UHCCP DNSP |
$8.62
|
| Rate for Payer: UHCCP Medicaid |
$4.62
|
| Rate for Payer: VA VA |
$8.62
|
|
|
HC CULTURE SCREENING
|
Facility
|
IP
|
$26.01
|
|
|
Service Code
|
CPT 87081
|
| Hospital Charge Code |
30600079
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$16.91 |
| Max. Negotiated Rate |
$26.01 |
| Rate for Payer: Aetna Commercial |
$23.41
|
| Rate for Payer: ASR ASR |
$25.23
|
| Rate for Payer: ASR Commercial |
$25.23
|
| Rate for Payer: BCBS Trust/PPO |
$21.20
|
| Rate for Payer: BCN Commercial |
$20.17
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$24.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$26.01
|
| Rate for Payer: Healthscope Whirlpool |
$25.23
|
| Rate for Payer: Mclaren Commercial |
$23.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: Nomi Health Commercial |
$21.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.89
|
|
|
HC CULTURE SCREENING
|
Facility
|
OP
|
$26.01
|
|
|
Service Code
|
CPT 87081
|
| Hospital Charge Code |
30600079
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$3.55 |
| Max. Negotiated Rate |
$26.01 |
| Rate for Payer: Aetna Commercial |
$23.41
|
| Rate for Payer: Aetna Medicare |
$6.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.29
|
| Rate for Payer: ASR ASR |
$25.23
|
| Rate for Payer: ASR Commercial |
$25.23
|
| Rate for Payer: BCBS Complete |
$3.73
|
| Rate for Payer: BCBS MAPPO |
$6.63
|
| Rate for Payer: BCBS Trust/PPO |
$21.30
|
| Rate for Payer: BCN Commercial |
$20.17
|
| Rate for Payer: BCN Medicare Advantage |
$6.63
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$24.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.63
|
| Rate for Payer: Healthscope Commercial |
$26.01
|
| Rate for Payer: Healthscope Whirlpool |
$25.23
|
| Rate for Payer: Humana Choice PPO Medicare |
$6.63
|
| Rate for Payer: Mclaren Commercial |
$23.41
|
| Rate for Payer: Mclaren Medicaid |
$3.55
|
| Rate for Payer: Mclaren Medicare |
$6.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.96
|
| Rate for Payer: Meridian Medicaid |
$3.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: Nomi Health Commercial |
$21.33
|
| Rate for Payer: PACE Medicare |
$6.30
|
| Rate for Payer: PACE SWMI |
$6.63
|
| Rate for Payer: PHP Commercial |
$7.29
|
| Rate for Payer: PHP Medicaid |
$3.55
|
| Rate for Payer: PHP Medicare Advantage |
$6.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.79
|
| Rate for Payer: Priority Health Medicare |
$6.63
|
| Rate for Payer: Priority Health Narrow Network |
$18.23
|
| Rate for Payer: Railroad Medicare Medicare |
$6.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.63
|
| Rate for Payer: UHC Exchange |
$10.28
|
| Rate for Payer: UHC Medicare Advantage |
$6.63
|
| Rate for Payer: UHCCP DNSP |
$6.63
|
| Rate for Payer: UHCCP Medicaid |
$3.55
|
| Rate for Payer: VA VA |
$6.63
|
|
|
HC CUVETTE HEMOCHRON JR ACT+
|
Facility
|
OP
|
$13.01
|
|
| Hospital Charge Code |
27000657
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$5.20 |
| Max. Negotiated Rate |
$13.01 |
| Rate for Payer: Aetna Commercial |
$11.71
|
| Rate for Payer: Aetna Medicare |
$6.50
|
| Rate for Payer: ASR ASR |
$12.62
|
| Rate for Payer: ASR Commercial |
$12.62
|
| Rate for Payer: BCBS Complete |
$5.20
|
| Rate for Payer: BCBS Trust/PPO |
$10.65
|
| Rate for Payer: BCN Commercial |
$10.09
|
| Rate for Payer: Cash Price |
$10.41
|
| Rate for Payer: Cofinity Commercial |
$12.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.41
|
| Rate for Payer: Healthscope Commercial |
$13.01
|
| Rate for Payer: Healthscope Whirlpool |
$12.62
|
| Rate for Payer: Mclaren Commercial |
$11.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.06
|
| Rate for Payer: Nomi Health Commercial |
$10.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11.40
|
| Rate for Payer: Priority Health Narrow Network |
$9.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11.45
|
|
|
HC CUVETTE HEMOCHRON JR ACT+
|
Facility
|
IP
|
$13.01
|
|
| Hospital Charge Code |
27000657
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$8.46 |
| Max. Negotiated Rate |
$13.01 |
| Rate for Payer: Aetna Commercial |
$11.71
|
| Rate for Payer: ASR ASR |
$12.62
|
| Rate for Payer: ASR Commercial |
$12.62
|
| Rate for Payer: BCBS Trust/PPO |
$10.60
|
| Rate for Payer: BCN Commercial |
$10.09
|
| Rate for Payer: Cash Price |
$10.41
|
| Rate for Payer: Cofinity Commercial |
$12.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.41
|
| Rate for Payer: Healthscope Commercial |
$13.01
|
| Rate for Payer: Healthscope Whirlpool |
$12.62
|
| Rate for Payer: Mclaren Commercial |
$11.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.06
|
| Rate for Payer: Nomi Health Commercial |
$10.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11.45
|
|
|
HC CVC ACCESS TRAY
|
Facility
|
IP
|
$134.58
|
|
| Hospital Charge Code |
27000052
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$87.48 |
| Max. Negotiated Rate |
$134.58 |
| Rate for Payer: Aetna Commercial |
$121.12
|
| Rate for Payer: ASR ASR |
$130.54
|
| Rate for Payer: ASR Commercial |
$130.54
|
| Rate for Payer: BCBS Trust/PPO |
$109.67
|
| Rate for Payer: BCN Commercial |
$104.34
|
| Rate for Payer: Cash Price |
$107.66
|
| Rate for Payer: Cofinity Commercial |
$126.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.66
|
| Rate for Payer: Healthscope Commercial |
$134.58
|
| Rate for Payer: Healthscope Whirlpool |
$130.54
|
| Rate for Payer: Mclaren Commercial |
$121.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$114.39
|
| Rate for Payer: Nomi Health Commercial |
$110.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$87.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$118.43
|
|
|
HC CVC ACCESS TRAY
|
Facility
|
OP
|
$134.58
|
|
| Hospital Charge Code |
27000052
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$53.83 |
| Max. Negotiated Rate |
$134.58 |
| Rate for Payer: Aetna Commercial |
$121.12
|
| Rate for Payer: Aetna Medicare |
$67.29
|
| Rate for Payer: ASR ASR |
$130.54
|
| Rate for Payer: ASR Commercial |
$130.54
|
| Rate for Payer: BCBS Complete |
$53.83
|
| Rate for Payer: BCBS Trust/PPO |
$110.21
|
| Rate for Payer: BCN Commercial |
$104.34
|
| Rate for Payer: Cash Price |
$107.66
|
| Rate for Payer: Cofinity Commercial |
$126.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.66
|
| Rate for Payer: Healthscope Commercial |
$134.58
|
| Rate for Payer: Healthscope Whirlpool |
$130.54
|
| Rate for Payer: Mclaren Commercial |
$121.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$114.39
|
| Rate for Payer: Nomi Health Commercial |
$110.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$87.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$117.92
|
| Rate for Payer: Priority Health Narrow Network |
$94.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$118.43
|
|
|
HC CVC INSERT
|
Facility
|
OP
|
$2,545.54
|
|
| Hospital Charge Code |
45000036
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,018.22 |
| Max. Negotiated Rate |
$2,545.54 |
| Rate for Payer: Aetna Commercial |
$2,290.99
|
| Rate for Payer: Aetna Medicare |
$1,272.77
|
| Rate for Payer: ASR ASR |
$2,469.17
|
| Rate for Payer: ASR Commercial |
$2,469.17
|
| Rate for Payer: BCBS Complete |
$1,018.22
|
| Rate for Payer: BCBS Trust/PPO |
$2,084.54
|
| Rate for Payer: BCN Commercial |
$1,973.56
|
| Rate for Payer: Cash Price |
$2,036.43
|
| Rate for Payer: Cofinity Commercial |
$2,392.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,036.43
|
| Rate for Payer: Healthscope Commercial |
$2,545.54
|
| Rate for Payer: Healthscope Whirlpool |
$2,469.17
|
| Rate for Payer: Mclaren Commercial |
$2,290.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,163.71
|
| Rate for Payer: Nomi Health Commercial |
$2,087.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,654.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,230.40
|
| Rate for Payer: Priority Health Narrow Network |
$1,784.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,240.08
|
|
|
HC CVC INSERT
|
Facility
|
IP
|
$2,545.54
|
|
| Hospital Charge Code |
45000036
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,654.60 |
| Max. Negotiated Rate |
$2,545.54 |
| Rate for Payer: Aetna Commercial |
$2,290.99
|
| Rate for Payer: ASR ASR |
$2,469.17
|
| Rate for Payer: ASR Commercial |
$2,469.17
|
| Rate for Payer: BCBS Trust/PPO |
$2,074.36
|
| Rate for Payer: BCN Commercial |
$1,973.56
|
| Rate for Payer: Cash Price |
$2,036.43
|
| Rate for Payer: Cofinity Commercial |
$2,392.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,036.43
|
| Rate for Payer: Healthscope Commercial |
$2,545.54
|
| Rate for Payer: Healthscope Whirlpool |
$2,469.17
|
| Rate for Payer: Mclaren Commercial |
$2,290.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,163.71
|
| Rate for Payer: Nomi Health Commercial |
$2,087.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,654.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,240.08
|
|
|
HC CVS PSEUDOANEURYSM COMPRESSION
|
Facility
|
IP
|
$816.54
|
|
|
Service Code
|
CPT 76936
|
| Hospital Charge Code |
40200042
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$530.75 |
| Max. Negotiated Rate |
$816.54 |
| Rate for Payer: Aetna Commercial |
$734.89
|
| Rate for Payer: ASR ASR |
$792.04
|
| Rate for Payer: ASR Commercial |
$792.04
|
| Rate for Payer: BCBS Trust/PPO |
$665.40
|
| Rate for Payer: BCN Commercial |
$633.06
|
| Rate for Payer: Cash Price |
$653.23
|
| Rate for Payer: Cofinity Commercial |
$767.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$653.23
|
| Rate for Payer: Healthscope Commercial |
$816.54
|
| Rate for Payer: Healthscope Whirlpool |
$792.04
|
| Rate for Payer: Mclaren Commercial |
$734.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$694.06
|
| Rate for Payer: Nomi Health Commercial |
$669.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$530.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$718.56
|
|
