|
HC CYTOPATH CELL ENHANCE TECHNIQU
|
Facility
|
OP
|
$134.42
|
|
|
Service Code
|
CPT 88112
|
| Hospital Charge Code |
31100003
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$28.06 |
| Max. Negotiated Rate |
$186.66 |
| Rate for Payer: Aetna Commercial |
$120.98
|
| Rate for Payer: Aetna Medicare |
$52.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$65.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$65.44
|
| Rate for Payer: ASR ASR |
$130.39
|
| Rate for Payer: ASR Commercial |
$130.39
|
| Rate for Payer: BCBS Complete |
$29.46
|
| Rate for Payer: BCBS MAPPO |
$52.35
|
| Rate for Payer: BCBS Trust/PPO |
$110.08
|
| Rate for Payer: BCN Commercial |
$104.22
|
| Rate for Payer: BCN Medicare Advantage |
$52.35
|
| Rate for Payer: Cash Price |
$107.54
|
| Rate for Payer: Cash Price |
$107.54
|
| Rate for Payer: Cofinity Commercial |
$126.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.35
|
| Rate for Payer: Healthscope Commercial |
$134.42
|
| Rate for Payer: Healthscope Whirlpool |
$130.39
|
| Rate for Payer: Humana Choice PPO Medicare |
$52.35
|
| Rate for Payer: Mclaren Commercial |
$120.98
|
| Rate for Payer: Mclaren Medicaid |
$28.06
|
| Rate for Payer: Mclaren Medicare |
$52.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$54.97
|
| Rate for Payer: Meridian Medicaid |
$29.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$60.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$114.26
|
| Rate for Payer: Nomi Health Commercial |
$110.22
|
| Rate for Payer: PACE Medicare |
$49.73
|
| Rate for Payer: PACE SWMI |
$52.35
|
| Rate for Payer: PHP Commercial |
$57.58
|
| Rate for Payer: PHP Medicaid |
$28.06
|
| Rate for Payer: PHP Medicare Advantage |
$52.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$87.37
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$186.66
|
| Rate for Payer: Priority Health Medicare |
$52.35
|
| Rate for Payer: Priority Health Narrow Network |
$149.33
|
| Rate for Payer: Railroad Medicare Medicare |
$52.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$118.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$52.35
|
| Rate for Payer: UHC Exchange |
$81.14
|
| Rate for Payer: UHC Medicare Advantage |
$52.35
|
| Rate for Payer: UHCCP DNSP |
$52.35
|
| Rate for Payer: UHCCP Medicaid |
$28.06
|
| Rate for Payer: VA VA |
$52.35
|
|
|
HC CYTOPATH CELL ENHANCE TECHNIQU
|
Facility
|
IP
|
$134.42
|
|
|
Service Code
|
CPT 88112
|
| Hospital Charge Code |
31100003
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$87.37 |
| Max. Negotiated Rate |
$134.42 |
| Rate for Payer: Aetna Commercial |
$120.98
|
| Rate for Payer: ASR ASR |
$130.39
|
| Rate for Payer: ASR Commercial |
$130.39
|
| Rate for Payer: BCBS Trust/PPO |
$109.54
|
| Rate for Payer: BCN Commercial |
$104.22
|
| Rate for Payer: Cash Price |
$107.54
|
| Rate for Payer: Cofinity Commercial |
$126.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.54
|
| Rate for Payer: Healthscope Commercial |
$134.42
|
| Rate for Payer: Healthscope Whirlpool |
$130.39
|
| Rate for Payer: Mclaren Commercial |
$120.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$114.26
|
| Rate for Payer: Nomi Health Commercial |
$110.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$87.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$118.29
|
|
|
HC CYTOPATH SCREEN & INTERPRETATION
|
Facility
|
IP
|
$102.41
|
|
|
Service Code
|
CPT 88160
|
| Hospital Charge Code |
31100005
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$66.57 |
| Max. Negotiated Rate |
$102.41 |
| Rate for Payer: Aetna Commercial |
$92.17
|
| Rate for Payer: ASR ASR |
$99.34
|
| Rate for Payer: ASR Commercial |
$99.34
|
| Rate for Payer: BCBS Trust/PPO |
$83.45
|
| Rate for Payer: BCN Commercial |
$79.40
|
| Rate for Payer: Cash Price |
$81.93
|
| Rate for Payer: Cofinity Commercial |
$96.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.93
|
| Rate for Payer: Healthscope Commercial |
$102.41
|
| Rate for Payer: Healthscope Whirlpool |
$99.34
|
| Rate for Payer: Mclaren Commercial |
$92.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.05
|
| Rate for Payer: Nomi Health Commercial |
$83.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$90.12
|
|
|
HC CYTOPATH SCREEN & INTERPRETATION
|
Facility
|
OP
|
$102.41
|
|
|
Service Code
|
CPT 88160
|
| Hospital Charge Code |
31100005
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$12.86 |
| Max. Negotiated Rate |
$102.41 |
| Rate for Payer: Aetna Commercial |
$92.17
|
| Rate for Payer: Aetna Medicare |
$23.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.99
|
| Rate for Payer: ASR ASR |
$99.34
|
| Rate for Payer: ASR Commercial |
$99.34
|
| Rate for Payer: BCBS Complete |
$13.50
|
| Rate for Payer: BCBS MAPPO |
$23.99
|
| Rate for Payer: BCBS Trust/PPO |
$83.86
|
| Rate for Payer: BCN Commercial |
$79.40
|
| Rate for Payer: BCN Medicare Advantage |
$23.99
|
| Rate for Payer: Cash Price |
$81.93
|
| Rate for Payer: Cash Price |
$81.93
|
| Rate for Payer: Cofinity Commercial |
$96.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.99
|
| Rate for Payer: Healthscope Commercial |
$102.41
|
| Rate for Payer: Healthscope Whirlpool |
$99.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$23.99
|
| Rate for Payer: Mclaren Commercial |
$92.17
|
| Rate for Payer: Mclaren Medicaid |
$12.86
|
| Rate for Payer: Mclaren Medicare |
$23.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.19
|
| Rate for Payer: Meridian Medicaid |
$13.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.05
|
| Rate for Payer: Nomi Health Commercial |
$83.98
|
| Rate for Payer: PACE Medicare |
$22.79
|
| Rate for Payer: PACE SWMI |
$23.99
|
| Rate for Payer: PHP Commercial |
$26.39
|
| Rate for Payer: PHP Medicaid |
$12.86
|
| Rate for Payer: PHP Medicare Advantage |
$23.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$89.73
|
| Rate for Payer: Priority Health Medicare |
$23.99
|
| Rate for Payer: Priority Health Narrow Network |
$71.79
|
| Rate for Payer: Railroad Medicare Medicare |
$23.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$90.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.99
|
| Rate for Payer: UHC Exchange |
$37.18
|
| Rate for Payer: UHC Medicare Advantage |
$23.99
|
| Rate for Payer: UHCCP DNSP |
$23.99
|
| Rate for Payer: UHCCP Medicaid |
$12.86
|
| Rate for Payer: VA VA |
$23.99
|
|
|
HC CYTOPLASMIC NEUTROPHIL ANCA AB
|
Facility
|
OP
|
$74.46
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200173
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.46 |
| Max. Negotiated Rate |
$227.29 |
| Rate for Payer: Aetna Commercial |
$67.01
|
| Rate for Payer: Aetna Medicare |
$12.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.06
|
| Rate for Payer: ASR ASR |
$72.23
|
| Rate for Payer: ASR Commercial |
$72.23
|
| Rate for Payer: BCBS Complete |
$6.78
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCBS Trust/PPO |
$60.98
|
| Rate for Payer: BCN Commercial |
$57.73
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$59.57
|
| Rate for Payer: Cash Price |
$59.57
|
| Rate for Payer: Cofinity Commercial |
$69.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$74.46
|
| Rate for Payer: Healthscope Whirlpool |
$72.23
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.05
|
| Rate for Payer: Mclaren Commercial |
$67.01
|
| Rate for Payer: Mclaren Medicaid |
$6.46
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: Meridian Medicaid |
$6.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.29
|
| Rate for Payer: Nomi Health Commercial |
$61.06
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$13.26
|
| Rate for Payer: PHP Medicaid |
$6.46
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$227.29
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health Narrow Network |
$181.83
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$65.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.05
|
| Rate for Payer: UHC Exchange |
$18.68
|
| Rate for Payer: UHC Medicare Advantage |
$12.05
|
| Rate for Payer: UHCCP DNSP |
$12.05
|
| Rate for Payer: UHCCP Medicaid |
$6.46
|
| Rate for Payer: VA VA |
$12.05
|
|
|
HC CYTOPLASMIC NEUTROPHIL ANCA AB
|
Facility
|
IP
|
$74.46
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200173
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$48.40 |
| Max. Negotiated Rate |
$74.46 |
| Rate for Payer: Aetna Commercial |
$67.01
|
| Rate for Payer: ASR ASR |
$72.23
|
| Rate for Payer: ASR Commercial |
$72.23
|
| Rate for Payer: BCBS Trust/PPO |
$60.68
|
| Rate for Payer: BCN Commercial |
$57.73
|
| Rate for Payer: Cash Price |
$59.57
|
| Rate for Payer: Cofinity Commercial |
$69.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.57
|
| Rate for Payer: Healthscope Commercial |
$74.46
|
| Rate for Payer: Healthscope Whirlpool |
$72.23
|
| Rate for Payer: Mclaren Commercial |
$67.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.29
|
| Rate for Payer: Nomi Health Commercial |
$61.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$65.52
|
|
|
HC DAMAGED WATCH PAT DEVICE
|
Facility
|
IP
|
$100.00
|
|
| Hospital Charge Code |
27000706
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$65.00 |
| Max. Negotiated Rate |
$100.00 |
| Rate for Payer: Aetna Commercial |
$90.00
|
| Rate for Payer: ASR ASR |
$97.00
|
| Rate for Payer: ASR Commercial |
$97.00
|
| Rate for Payer: BCBS Trust/PPO |
$81.49
|
| Rate for Payer: BCN Commercial |
$77.53
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cofinity Commercial |
$94.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.00
|
| Rate for Payer: Healthscope Commercial |
$100.00
|
| Rate for Payer: Healthscope Whirlpool |
$97.00
|
| Rate for Payer: Mclaren Commercial |
$90.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.00
|
| Rate for Payer: Nomi Health Commercial |
$82.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$65.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$88.00
|
|
|
HC DAMAGED WATCH PAT DEVICE
|
Facility
|
OP
|
$100.00
|
|
| Hospital Charge Code |
27000706
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$40.00 |
| Max. Negotiated Rate |
$100.00 |
| Rate for Payer: Aetna Commercial |
$90.00
|
| Rate for Payer: Aetna Medicare |
$50.00
|
| Rate for Payer: ASR ASR |
$97.00
|
| Rate for Payer: ASR Commercial |
$97.00
|
| Rate for Payer: BCBS Complete |
$40.00
|
| Rate for Payer: BCBS Trust/PPO |
$81.89
|
| Rate for Payer: BCN Commercial |
$77.53
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cofinity Commercial |
$94.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.00
|
| Rate for Payer: Healthscope Commercial |
$100.00
|
| Rate for Payer: Healthscope Whirlpool |
$97.00
|
| Rate for Payer: Mclaren Commercial |
$90.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.00
|
| Rate for Payer: Nomi Health Commercial |
$82.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$65.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$87.62
|
| Rate for Payer: Priority Health Narrow Network |
$70.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$88.00
|
|
|
HC DAVITA IP HEMODIALYSIS SGL
|
Facility
|
OP
|
$798.66
|
|
|
Service Code
|
CPT 90935
|
| Hospital Charge Code |
80100003
|
|
Hospital Revenue Code
|
801
|
| Min. Negotiated Rate |
$367.47 |
| Max. Negotiated Rate |
$1,062.63 |
| Rate for Payer: Aetna Commercial |
$718.79
|
| Rate for Payer: Aetna Medicare |
$685.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$856.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$856.96
|
| Rate for Payer: ASR ASR |
$774.70
|
| Rate for Payer: ASR Commercial |
$774.70
|
| Rate for Payer: BCBS Complete |
$385.84
|
| Rate for Payer: BCBS MAPPO |
$685.57
|
| Rate for Payer: BCBS Trust/PPO |
$654.02
|
| Rate for Payer: BCN Commercial |
$619.20
|
| Rate for Payer: BCN Medicare Advantage |
$685.57
|
| Rate for Payer: Cash Price |
$638.93
|
| Rate for Payer: Cash Price |
$638.93
|
| Rate for Payer: Cofinity Commercial |
$750.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$638.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$685.57
|
| Rate for Payer: Healthscope Commercial |
$798.66
|
| Rate for Payer: Healthscope Whirlpool |
$774.70
|
| Rate for Payer: Humana Choice PPO Medicare |
$685.57
|
| Rate for Payer: Mclaren Commercial |
$718.79
|
| Rate for Payer: Mclaren Medicaid |
$367.47
|
| Rate for Payer: Mclaren Medicare |
$685.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$719.85
|
| Rate for Payer: Meridian Medicaid |
$385.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$788.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$678.86
|
| Rate for Payer: Nomi Health Commercial |
$654.90
|
| Rate for Payer: PACE Medicare |
$651.29
|
| Rate for Payer: PACE SWMI |
$685.57
|
| Rate for Payer: PHP Commercial |
$754.13
|
| Rate for Payer: PHP Medicaid |
$367.47
|
| Rate for Payer: PHP Medicare Advantage |
$685.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$519.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$699.79
|
| Rate for Payer: Priority Health Medicare |
$685.57
|
| Rate for Payer: Priority Health Narrow Network |
$559.86
|
| Rate for Payer: Railroad Medicare Medicare |
$685.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$702.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$685.57
|
| Rate for Payer: UHC Exchange |
$1,062.63
|
| Rate for Payer: UHC Medicare Advantage |
$685.57
|
| Rate for Payer: UHCCP DNSP |
$685.57
|
| Rate for Payer: UHCCP Medicaid |
$367.47
|
| Rate for Payer: VA VA |
$685.57
|
|
|
HC DAVITA IP HEMODIALYSIS SGL
|
Facility
|
IP
|
$798.66
|
|
|
Service Code
|
CPT 90935
|
| Hospital Charge Code |
80100003
|
|
Hospital Revenue Code
|
801
|
| Min. Negotiated Rate |
$519.13 |
| Max. Negotiated Rate |
$798.66 |
| Rate for Payer: Aetna Commercial |
$718.79
|
| Rate for Payer: ASR ASR |
$774.70
|
| Rate for Payer: ASR Commercial |
$774.70
|
| Rate for Payer: BCBS Trust/PPO |
$650.83
|
| Rate for Payer: BCN Commercial |
$619.20
|
| Rate for Payer: Cash Price |
$638.93
|
| Rate for Payer: Cofinity Commercial |
$750.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$638.93
|
| Rate for Payer: Healthscope Commercial |
$798.66
|
| Rate for Payer: Healthscope Whirlpool |
$774.70
|
| Rate for Payer: Mclaren Commercial |
$718.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$678.86
|
| Rate for Payer: Nomi Health Commercial |
$654.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$519.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$702.82
|
|
|
HC DAVITA OP HEMODIALYSIS
|
Facility
|
OP
|
$855.04
|
|
|
Service Code
|
HCPCS G0257
|
| Hospital Charge Code |
88100002
|
|
Hospital Revenue Code
|
820
|
| Min. Negotiated Rate |
$367.47 |
| Max. Negotiated Rate |
$1,062.63 |
| Rate for Payer: Aetna Commercial |
$769.54
|
| Rate for Payer: Aetna Medicare |
$685.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$856.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$856.96
|
| Rate for Payer: ASR ASR |
$829.39
|
| Rate for Payer: ASR Commercial |
$829.39
|
| Rate for Payer: BCBS Complete |
$385.84
|
| Rate for Payer: BCBS MAPPO |
$685.57
|
| Rate for Payer: BCBS Trust/PPO |
$700.19
|
| Rate for Payer: BCN Commercial |
$662.91
|
| Rate for Payer: BCN Medicare Advantage |
$685.57
|
| Rate for Payer: Cash Price |
$684.03
|
| Rate for Payer: Cash Price |
$684.03
|
| Rate for Payer: Cofinity Commercial |
$803.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$684.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$685.57
|
| Rate for Payer: Healthscope Commercial |
$855.04
|
| Rate for Payer: Healthscope Whirlpool |
$829.39
|
| Rate for Payer: Humana Choice PPO Medicare |
$685.57
|
| Rate for Payer: Mclaren Commercial |
$769.54
|
| Rate for Payer: Mclaren Medicaid |
$367.47
|
| Rate for Payer: Mclaren Medicare |
$685.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$719.85
|
| Rate for Payer: Meridian Medicaid |
$385.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$788.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$726.78
|
| Rate for Payer: Nomi Health Commercial |
$701.13
|
| Rate for Payer: PACE Medicare |
$651.29
|
| Rate for Payer: PACE SWMI |
$685.57
|
| Rate for Payer: PHP Commercial |
$754.13
|
| Rate for Payer: PHP Medicaid |
$367.47
|
| Rate for Payer: PHP Medicare Advantage |
$685.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$555.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$749.19
|
| Rate for Payer: Priority Health Medicare |
$685.57
|
| Rate for Payer: Priority Health Narrow Network |
$599.38
|
| Rate for Payer: Railroad Medicare Medicare |
$685.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$752.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$685.57
|
| Rate for Payer: UHC Exchange |
$1,062.63
|
| Rate for Payer: UHC Medicare Advantage |
$685.57
|
| Rate for Payer: UHCCP DNSP |
$685.57
|
| Rate for Payer: UHCCP Medicaid |
$367.47
|
| Rate for Payer: VA VA |
$685.57
|
|
|
HC DAVITA OP HEMODIALYSIS
|
Facility
|
IP
|
$855.04
|
|
|
Service Code
|
HCPCS G0257
|
| Hospital Charge Code |
88100002
|
|
Hospital Revenue Code
|
820
|
| Min. Negotiated Rate |
$555.78 |
| Max. Negotiated Rate |
$855.04 |
| Rate for Payer: Aetna Commercial |
$769.54
|
| Rate for Payer: ASR ASR |
$829.39
|
| Rate for Payer: ASR Commercial |
$829.39
|
| Rate for Payer: BCBS Trust/PPO |
$696.77
|
| Rate for Payer: BCN Commercial |
$662.91
|
| Rate for Payer: Cash Price |
$684.03
|
| Rate for Payer: Cofinity Commercial |
$803.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$684.03
|
| Rate for Payer: Healthscope Commercial |
$855.04
|
| Rate for Payer: Healthscope Whirlpool |
$829.39
|
| Rate for Payer: Mclaren Commercial |
$769.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$726.78
|
| Rate for Payer: Nomi Health Commercial |
$701.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$555.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$752.44
|
|
|
HC DBL PIGTAIL BILIARY STENT
|
Facility
|
OP
|
$783.42
|
|
|
Service Code
|
HCPCS C2617
|
| Hospital Charge Code |
27800064
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$313.37 |
| Max. Negotiated Rate |
$783.42 |
| Rate for Payer: Aetna Commercial |
$705.08
|
| Rate for Payer: Aetna Medicare |
$391.71
|
| Rate for Payer: ASR ASR |
$759.92
|
| Rate for Payer: ASR Commercial |
$759.92
|
| Rate for Payer: BCBS Complete |
$313.37
|
| Rate for Payer: BCBS Trust/PPO |
$641.54
|
| Rate for Payer: BCN Commercial |
$607.39
|
| Rate for Payer: Cash Price |
$626.74
|
| Rate for Payer: Cofinity Commercial |
$736.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$626.74
|
| Rate for Payer: Healthscope Commercial |
$783.42
|
| Rate for Payer: Healthscope Whirlpool |
$759.92
|
| Rate for Payer: Mclaren Commercial |
$705.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$665.91
|
| Rate for Payer: Nomi Health Commercial |
$642.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$509.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$686.43
|
| Rate for Payer: Priority Health Narrow Network |
$549.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$689.41
|
|
|
HC DBL PIGTAIL BILIARY STENT
|
Facility
|
IP
|
$783.42
|
|
|
Service Code
|
HCPCS C2617
|
| Hospital Charge Code |
27800064
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$509.22 |
| Max. Negotiated Rate |
$783.42 |
| Rate for Payer: Aetna Commercial |
$705.08
|
| Rate for Payer: ASR ASR |
$759.92
|
| Rate for Payer: ASR Commercial |
$759.92
|
| Rate for Payer: BCBS Trust/PPO |
$638.41
|
| Rate for Payer: BCN Commercial |
$607.39
|
| Rate for Payer: Cash Price |
$626.74
|
| Rate for Payer: Cofinity Commercial |
$736.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$626.74
|
| Rate for Payer: Healthscope Commercial |
$783.42
|
| Rate for Payer: Healthscope Whirlpool |
$759.92
|
| Rate for Payer: Mclaren Commercial |
$705.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$665.91
|
| Rate for Payer: Nomi Health Commercial |
$642.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$509.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$689.41
|
|
|
HC D & C
|
Facility
|
OP
|
$2,041.41
|
|
| Hospital Charge Code |
45000037
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$816.56 |
| Max. Negotiated Rate |
$2,041.41 |
| Rate for Payer: Aetna Commercial |
$1,837.27
|
| Rate for Payer: Aetna Medicare |
$1,020.70
|
| Rate for Payer: ASR ASR |
$1,980.17
|
| Rate for Payer: ASR Commercial |
$1,980.17
|
| Rate for Payer: BCBS Complete |
$816.56
|
| Rate for Payer: BCBS Trust/PPO |
$1,671.71
|
| Rate for Payer: BCN Commercial |
$1,582.71
|
| Rate for Payer: Cash Price |
$1,633.13
|
| Rate for Payer: Cofinity Commercial |
$1,918.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,633.13
|
| Rate for Payer: Healthscope Commercial |
$2,041.41
|
| Rate for Payer: Healthscope Whirlpool |
$1,980.17
|
| Rate for Payer: Mclaren Commercial |
$1,837.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,735.20
|
| Rate for Payer: Nomi Health Commercial |
$1,673.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,326.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,788.68
|
| Rate for Payer: Priority Health Narrow Network |
$1,431.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,796.44
|
|
|
HC D & C
|
Facility
|
IP
|
$2,041.41
|
|
| Hospital Charge Code |
45000037
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,326.92 |
| Max. Negotiated Rate |
$2,041.41 |
| Rate for Payer: Aetna Commercial |
$1,837.27
|
| Rate for Payer: ASR ASR |
$1,980.17
|
| Rate for Payer: ASR Commercial |
$1,980.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,663.55
|
| Rate for Payer: BCN Commercial |
$1,582.71
|
| Rate for Payer: Cash Price |
$1,633.13
|
| Rate for Payer: Cofinity Commercial |
$1,918.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,633.13
|
| Rate for Payer: Healthscope Commercial |
$2,041.41
|
| Rate for Payer: Healthscope Whirlpool |
$1,980.17
|
| Rate for Payer: Mclaren Commercial |
$1,837.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,735.20
|
| Rate for Payer: Nomi Health Commercial |
$1,673.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,326.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,796.44
|
|
|
HC D&C (OB SURGERY)
|
Facility
|
IP
|
$1,051.40
|
|
| Hospital Charge Code |
36000026
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$683.41 |
| Max. Negotiated Rate |
$1,051.40 |
| Rate for Payer: Aetna Commercial |
$946.26
|
| Rate for Payer: ASR ASR |
$1,019.86
|
| Rate for Payer: ASR Commercial |
$1,019.86
|
| Rate for Payer: BCBS Trust/PPO |
$856.79
|
| Rate for Payer: BCN Commercial |
$815.15
|
| Rate for Payer: Cash Price |
$841.12
|
| Rate for Payer: Cofinity Commercial |
$988.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$841.12
|
| Rate for Payer: Healthscope Commercial |
$1,051.40
|
| Rate for Payer: Healthscope Whirlpool |
$1,019.86
|
| Rate for Payer: Mclaren Commercial |
$946.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$893.69
|
| Rate for Payer: Nomi Health Commercial |
$862.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$683.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$925.23
|
|
|
HC D&C (OB SURGERY)
|
Facility
|
OP
|
$1,051.40
|
|
| Hospital Charge Code |
36000026
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$420.56 |
| Max. Negotiated Rate |
$1,051.40 |
| Rate for Payer: Aetna Commercial |
$946.26
|
| Rate for Payer: Aetna Medicare |
$525.70
|
| Rate for Payer: ASR ASR |
$1,019.86
|
| Rate for Payer: ASR Commercial |
$1,019.86
|
| Rate for Payer: BCBS Complete |
$420.56
|
| Rate for Payer: BCBS Trust/PPO |
$860.99
|
| Rate for Payer: BCN Commercial |
$815.15
|
| Rate for Payer: Cash Price |
$841.12
|
| Rate for Payer: Cofinity Commercial |
$988.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$841.12
|
| Rate for Payer: Healthscope Commercial |
$1,051.40
|
| Rate for Payer: Healthscope Whirlpool |
$1,019.86
|
| Rate for Payer: Mclaren Commercial |
$946.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$893.69
|
| Rate for Payer: Nomi Health Commercial |
$862.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$683.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$921.24
|
| Rate for Payer: Priority Health Narrow Network |
$737.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$925.23
|
|
|
HC D & C POSTPARTUM
|
Facility
|
OP
|
$7,945.53
|
|
|
Service Code
|
CPT 59160
|
| Hospital Charge Code |
76100341
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,669.77 |
| Max. Negotiated Rate |
$7,945.53 |
| Rate for Payer: Aetna Commercial |
$7,150.98
|
| Rate for Payer: Aetna Medicare |
$3,115.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,894.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,894.05
|
| Rate for Payer: ASR ASR |
$7,707.16
|
| Rate for Payer: ASR Commercial |
$7,707.16
|
| Rate for Payer: BCBS Complete |
$1,753.26
|
| Rate for Payer: BCBS MAPPO |
$3,115.24
|
| Rate for Payer: BCBS Trust/PPO |
$6,506.59
|
| Rate for Payer: BCN Commercial |
$6,160.17
|
| Rate for Payer: BCN Medicare Advantage |
$3,115.24
|
| Rate for Payer: Cash Price |
$6,356.42
|
| Rate for Payer: Cash Price |
$6,356.42
|
| Rate for Payer: Cofinity Commercial |
$7,468.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,356.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,115.24
|
| Rate for Payer: Healthscope Commercial |
$7,945.53
|
| Rate for Payer: Healthscope Whirlpool |
$7,707.16
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,115.24
|
| Rate for Payer: Mclaren Commercial |
$7,150.98
|
| Rate for Payer: Mclaren Medicaid |
$1,669.77
|
| Rate for Payer: Mclaren Medicare |
$3,115.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,271.00
|
| Rate for Payer: Meridian Medicaid |
$1,753.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,582.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,753.70
|
| Rate for Payer: Nomi Health Commercial |
$6,515.33
|
| Rate for Payer: PACE Medicare |
$2,959.48
|
| Rate for Payer: PACE SWMI |
$3,115.24
|
| Rate for Payer: PHP Commercial |
$3,426.76
|
| Rate for Payer: PHP Medicaid |
$1,669.77
|
| Rate for Payer: PHP Medicare Advantage |
$3,115.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,669.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,164.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,961.87
|
| Rate for Payer: Priority Health Medicare |
$3,115.24
|
| Rate for Payer: Priority Health Narrow Network |
$5,569.82
|
| Rate for Payer: Railroad Medicare Medicare |
$3,115.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,992.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,115.24
|
| Rate for Payer: UHC Exchange |
$4,828.62
|
| Rate for Payer: UHC Medicare Advantage |
$3,115.24
|
| Rate for Payer: UHCCP DNSP |
$3,115.24
|
| Rate for Payer: UHCCP Medicaid |
$1,669.77
|
| Rate for Payer: VA VA |
$3,115.24
|
|
|
HC D & C POSTPARTUM
|
Facility
|
IP
|
$7,945.53
|
|
|
Service Code
|
CPT 59160
|
| Hospital Charge Code |
76100341
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,164.59 |
| Max. Negotiated Rate |
$7,945.53 |
| Rate for Payer: Aetna Commercial |
$7,150.98
|
| Rate for Payer: ASR ASR |
$7,707.16
|
| Rate for Payer: ASR Commercial |
$7,707.16
|
| Rate for Payer: BCBS Trust/PPO |
$6,474.81
|
| Rate for Payer: BCN Commercial |
$6,160.17
|
| Rate for Payer: Cash Price |
$6,356.42
|
| Rate for Payer: Cofinity Commercial |
$7,468.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,356.42
|
| Rate for Payer: Healthscope Commercial |
$7,945.53
|
| Rate for Payer: Healthscope Whirlpool |
$7,707.16
|
| Rate for Payer: Mclaren Commercial |
$7,150.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,753.70
|
| Rate for Payer: Nomi Health Commercial |
$6,515.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,164.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,992.07
|
|
|
HC DDAVP CMPT1
|
Facility
|
IP
|
$38.49
|
|
|
Service Code
|
CPT 85245
|
| Hospital Charge Code |
30500024
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$25.02 |
| Max. Negotiated Rate |
$38.49 |
| Rate for Payer: Aetna Commercial |
$34.64
|
| Rate for Payer: ASR ASR |
$37.34
|
| Rate for Payer: ASR Commercial |
$37.34
|
| Rate for Payer: BCBS Trust/PPO |
$31.37
|
| Rate for Payer: BCN Commercial |
$29.84
|
| Rate for Payer: Cash Price |
$30.79
|
| Rate for Payer: Cofinity Commercial |
$36.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.79
|
| Rate for Payer: Healthscope Commercial |
$38.49
|
| Rate for Payer: Healthscope Whirlpool |
$37.34
|
| Rate for Payer: Mclaren Commercial |
$34.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.72
|
| Rate for Payer: Nomi Health Commercial |
$31.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$33.87
|
|
|
HC DDAVP CMPT1
|
Facility
|
OP
|
$38.49
|
|
|
Service Code
|
CPT 85245
|
| Hospital Charge Code |
30500024
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$12.30 |
| Max. Negotiated Rate |
$38.49 |
| Rate for Payer: Aetna Commercial |
$34.64
|
| Rate for Payer: Aetna Medicare |
$22.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.68
|
| Rate for Payer: ASR ASR |
$37.34
|
| Rate for Payer: ASR Commercial |
$37.34
|
| Rate for Payer: BCBS Complete |
$12.91
|
| Rate for Payer: BCBS MAPPO |
$22.94
|
| Rate for Payer: BCBS Trust/PPO |
$31.52
|
| Rate for Payer: BCN Commercial |
$29.84
|
| Rate for Payer: BCN Medicare Advantage |
$22.94
|
| Rate for Payer: Cash Price |
$30.79
|
| Rate for Payer: Cash Price |
$30.79
|
| Rate for Payer: Cofinity Commercial |
$36.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.94
|
| Rate for Payer: Healthscope Commercial |
$38.49
|
| Rate for Payer: Healthscope Whirlpool |
$37.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$22.94
|
| Rate for Payer: Mclaren Commercial |
$34.64
|
| Rate for Payer: Mclaren Medicaid |
$12.30
|
| Rate for Payer: Mclaren Medicare |
$22.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.09
|
| Rate for Payer: Meridian Medicaid |
$12.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.72
|
| Rate for Payer: Nomi Health Commercial |
$31.56
|
| Rate for Payer: PACE Medicare |
$21.79
|
| Rate for Payer: PACE SWMI |
$22.94
|
| Rate for Payer: PHP Commercial |
$25.23
|
| Rate for Payer: PHP Medicaid |
$12.30
|
| Rate for Payer: PHP Medicare Advantage |
$22.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$33.72
|
| Rate for Payer: Priority Health Medicare |
$22.94
|
| Rate for Payer: Priority Health Narrow Network |
$26.98
|
| Rate for Payer: Railroad Medicare Medicare |
$22.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$33.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.94
|
| Rate for Payer: UHC Exchange |
$35.56
|
| Rate for Payer: UHC Medicare Advantage |
$22.94
|
| Rate for Payer: UHCCP DNSP |
$22.94
|
| Rate for Payer: UHCCP Medicaid |
$12.30
|
| Rate for Payer: VA VA |
$22.94
|
|
|
HC DDAVP CMPT2
|
Facility
|
IP
|
$38.49
|
|
|
Service Code
|
CPT 85246
|
| Hospital Charge Code |
30500027
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$25.02 |
| Max. Negotiated Rate |
$38.49 |
| Rate for Payer: Aetna Commercial |
$34.64
|
| Rate for Payer: ASR ASR |
$37.34
|
| Rate for Payer: ASR Commercial |
$37.34
|
| Rate for Payer: BCBS Trust/PPO |
$31.37
|
| Rate for Payer: BCN Commercial |
$29.84
|
| Rate for Payer: Cash Price |
$30.79
|
| Rate for Payer: Cofinity Commercial |
$36.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.79
|
| Rate for Payer: Healthscope Commercial |
$38.49
|
| Rate for Payer: Healthscope Whirlpool |
$37.34
|
| Rate for Payer: Mclaren Commercial |
$34.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.72
|
| Rate for Payer: Nomi Health Commercial |
$31.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$33.87
|
|
|
HC DDAVP CMPT2
|
Facility
|
OP
|
$38.49
|
|
|
Service Code
|
CPT 85246
|
| Hospital Charge Code |
30500027
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$12.30 |
| Max. Negotiated Rate |
$197.64 |
| Rate for Payer: Aetna Commercial |
$34.64
|
| Rate for Payer: Aetna Medicare |
$22.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.68
|
| Rate for Payer: ASR ASR |
$37.34
|
| Rate for Payer: ASR Commercial |
$37.34
|
| Rate for Payer: BCBS Complete |
$12.91
|
| Rate for Payer: BCBS MAPPO |
$22.94
|
| Rate for Payer: BCBS Trust/PPO |
$31.52
|
| Rate for Payer: BCN Commercial |
$29.84
|
| Rate for Payer: BCN Medicare Advantage |
$22.94
|
| Rate for Payer: Cash Price |
$30.79
|
| Rate for Payer: Cash Price |
$30.79
|
| Rate for Payer: Cofinity Commercial |
$36.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.94
|
| Rate for Payer: Healthscope Commercial |
$38.49
|
| Rate for Payer: Healthscope Whirlpool |
$37.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$22.94
|
| Rate for Payer: Mclaren Commercial |
$34.64
|
| Rate for Payer: Mclaren Medicaid |
$12.30
|
| Rate for Payer: Mclaren Medicare |
$22.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.09
|
| Rate for Payer: Meridian Medicaid |
$12.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.72
|
| Rate for Payer: Nomi Health Commercial |
$31.56
|
| Rate for Payer: PACE Medicare |
$21.79
|
| Rate for Payer: PACE SWMI |
$22.94
|
| Rate for Payer: PHP Commercial |
$25.23
|
| Rate for Payer: PHP Medicaid |
$12.30
|
| Rate for Payer: PHP Medicare Advantage |
$22.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$197.64
|
| Rate for Payer: Priority Health Medicare |
$22.94
|
| Rate for Payer: Priority Health Narrow Network |
$158.11
|
| Rate for Payer: Railroad Medicare Medicare |
$22.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$33.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.94
|
| Rate for Payer: UHC Exchange |
$35.56
|
| Rate for Payer: UHC Medicare Advantage |
$22.94
|
| Rate for Payer: UHCCP DNSP |
$22.94
|
| Rate for Payer: UHCCP Medicaid |
$12.30
|
| Rate for Payer: VA VA |
$22.94
|
|
|
HC DDAVP FACTOR VIII RISTOCETIN V
|
Facility
|
IP
|
$38.49
|
|
|
Service Code
|
CPT 85240
|
| Hospital Charge Code |
30500021
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$25.02 |
| Max. Negotiated Rate |
$38.49 |
| Rate for Payer: Aetna Commercial |
$34.64
|
| Rate for Payer: ASR ASR |
$37.34
|
| Rate for Payer: ASR Commercial |
$37.34
|
| Rate for Payer: BCBS Trust/PPO |
$31.37
|
| Rate for Payer: BCN Commercial |
$29.84
|
| Rate for Payer: Cash Price |
$30.79
|
| Rate for Payer: Cofinity Commercial |
$36.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.79
|
| Rate for Payer: Healthscope Commercial |
$38.49
|
| Rate for Payer: Healthscope Whirlpool |
$37.34
|
| Rate for Payer: Mclaren Commercial |
$34.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.72
|
| Rate for Payer: Nomi Health Commercial |
$31.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$33.87
|
|
