|
HC EMCU OBSERVATION PER HOUR
|
Facility
|
OP
|
$160.00
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200022
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$54.44 |
| Max. Negotiated Rate |
$1,608.00 |
| Rate for Payer: Aetna Commercial |
$144.00
|
| Rate for Payer: Aetna Medicare |
$59.20
|
| Rate for Payer: ASR ASR |
$155.20
|
| Rate for Payer: BCBS Complete |
$64.00
|
| Rate for Payer: BCBS Trust/PPO |
$131.92
|
| Rate for Payer: BCN Commercial |
$131.92
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cofinity Commercial |
$150.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.00
|
| Rate for Payer: Healthscope Commercial |
$155.20
|
| Rate for Payer: Healthscope Whirlpool |
$160.00
|
| Rate for Payer: Mclaren Commercial |
$144.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$128.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.00
|
| Rate for Payer: Nomi Health Commercial |
$131.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$120.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$68.05
|
| Rate for Payer: Priority Health Narrow Network |
$54.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$140.80
|
| Rate for Payer: UHC Medicaid |
$1,608.00
|
|
|
HC EMCU OBSERVATION PER HOUR
|
Facility
|
IP
|
$160.00
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200022
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$120.00 |
| Max. Negotiated Rate |
$160.00 |
| Rate for Payer: Aetna Commercial |
$144.00
|
| Rate for Payer: ASR ASR |
$155.20
|
| Rate for Payer: BCBS Trust/PPO |
$131.39
|
| Rate for Payer: BCN Commercial |
$131.39
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cofinity Commercial |
$150.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.00
|
| Rate for Payer: Healthscope Commercial |
$155.20
|
| Rate for Payer: Healthscope Whirlpool |
$160.00
|
| Rate for Payer: Mclaren Commercial |
$144.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.00
|
| Rate for Payer: Nomi Health Commercial |
$131.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$120.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$140.80
|
|
|
HC EMG ANAL SPHINCTER
|
Facility
|
OP
|
$358.06
|
|
|
Service Code
|
CPT 51785
|
| Hospital Charge Code |
92000002
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$130.20 |
| Max. Negotiated Rate |
$385.87 |
| Rate for Payer: Aetna Commercial |
$322.25
|
| Rate for Payer: Aetna Medicare |
$248.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$311.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$311.19
|
| Rate for Payer: ASR ASR |
$347.32
|
| Rate for Payer: BCBS Complete |
$136.72
|
| Rate for Payer: BCBS MAPPO |
$248.95
|
| Rate for Payer: BCBS Trust/PPO |
$295.22
|
| Rate for Payer: BCN Commercial |
$295.22
|
| Rate for Payer: BCN Medicare Advantage |
$248.95
|
| Rate for Payer: Cash Price |
$286.45
|
| Rate for Payer: Cash Price |
$286.45
|
| Rate for Payer: Cofinity Commercial |
$336.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$286.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$248.95
|
| Rate for Payer: Healthscope Commercial |
$347.32
|
| Rate for Payer: Healthscope Whirlpool |
$358.06
|
| Rate for Payer: Humana Choice PPO Medicare |
$248.95
|
| Rate for Payer: Mclaren Commercial |
$322.25
|
| Rate for Payer: Mclaren Medicaid |
$248.95
|
| Rate for Payer: Mclaren Medicare |
$248.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$261.40
|
| Rate for Payer: Meridian Medicaid |
$136.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$286.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$273.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$304.35
|
| Rate for Payer: Nomi Health Commercial |
$293.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$268.55
|
| Rate for Payer: PACE Medicare |
$236.50
|
| Rate for Payer: PACE SWMI |
$248.95
|
| Rate for Payer: PHP Commercial |
$273.85
|
| Rate for Payer: PHP Medicaid |
$133.44
|
| Rate for Payer: PHP Medicare Advantage |
$248.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$130.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$313.73
|
| Rate for Payer: Priority Health Medicare |
$248.95
|
| Rate for Payer: Priority Health Narrow Network |
$251.00
|
| Rate for Payer: Railroad Medicare Medicare |
$248.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$315.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$248.95
|
| Rate for Payer: UHC Exchange |
$385.87
|
| Rate for Payer: UHC Medicaid |
$130.20
|
| Rate for Payer: UHCCP DNSP |
$248.95
|
| Rate for Payer: UHCCP Medicaid |
$130.20
|
| Rate for Payer: VA VA |
$248.95
|
|
|
HC EMG ANAL SPHINCTER
|
Facility
|
IP
|
$358.06
|
|
|
Service Code
|
CPT 51785
|
| Hospital Charge Code |
92000002
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$268.55 |
| Max. Negotiated Rate |
$358.06 |
| Rate for Payer: Aetna Commercial |
$322.25
|
| Rate for Payer: ASR ASR |
$347.32
|
| Rate for Payer: BCBS Trust/PPO |
$294.04
|
| Rate for Payer: BCN Commercial |
$294.04
|
| Rate for Payer: Cash Price |
$286.45
|
| Rate for Payer: Cofinity Commercial |
$336.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$286.45
|
| Rate for Payer: Healthscope Commercial |
$347.32
|
| Rate for Payer: Healthscope Whirlpool |
$358.06
|
| Rate for Payer: Mclaren Commercial |
$322.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$304.35
|
| Rate for Payer: Nomi Health Commercial |
$293.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$268.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$315.09
|
|
|
HC EMG BLADDER
|
Facility
|
IP
|
$372.42
|
|
|
Service Code
|
CPT 51784
|
| Hospital Charge Code |
92000001
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$279.31 |
| Max. Negotiated Rate |
$372.42 |
| Rate for Payer: Aetna Commercial |
$335.18
|
| Rate for Payer: ASR ASR |
$361.25
|
| Rate for Payer: BCBS Trust/PPO |
$305.83
|
| Rate for Payer: BCN Commercial |
$305.83
|
| Rate for Payer: Cash Price |
$297.94
|
| Rate for Payer: Cofinity Commercial |
$350.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$297.94
|
| Rate for Payer: Healthscope Commercial |
$361.25
|
| Rate for Payer: Healthscope Whirlpool |
$372.42
|
| Rate for Payer: Mclaren Commercial |
$335.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$316.56
|
| Rate for Payer: Nomi Health Commercial |
$305.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$279.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$327.73
|
|
|
HC EMG BLADDER
|
Facility
|
OP
|
$372.42
|
|
|
Service Code
|
CPT 51784
|
| Hospital Charge Code |
92000001
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$67.05 |
| Max. Negotiated Rate |
$372.42 |
| Rate for Payer: Aetna Commercial |
$335.18
|
| Rate for Payer: Aetna Medicare |
$128.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$160.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$160.26
|
| Rate for Payer: ASR ASR |
$361.25
|
| Rate for Payer: BCBS Complete |
$70.41
|
| Rate for Payer: BCBS MAPPO |
$128.21
|
| Rate for Payer: BCBS Trust/PPO |
$307.06
|
| Rate for Payer: BCN Commercial |
$307.06
|
| Rate for Payer: BCN Medicare Advantage |
$128.21
|
| Rate for Payer: Cash Price |
$297.94
|
| Rate for Payer: Cash Price |
$297.94
|
| Rate for Payer: Cofinity Commercial |
$350.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$297.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.21
|
| Rate for Payer: Healthscope Commercial |
$361.25
|
| Rate for Payer: Healthscope Whirlpool |
$372.42
|
| Rate for Payer: Humana Choice PPO Medicare |
$128.21
|
| Rate for Payer: Mclaren Commercial |
$335.18
|
| Rate for Payer: Mclaren Medicaid |
$128.21
|
| Rate for Payer: Mclaren Medicare |
$128.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$134.62
|
| Rate for Payer: Meridian Medicaid |
$70.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$147.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$141.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$316.56
|
| Rate for Payer: Nomi Health Commercial |
$305.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$279.31
|
| Rate for Payer: PACE Medicare |
$121.80
|
| Rate for Payer: PACE SWMI |
$128.21
|
| Rate for Payer: PHP Commercial |
$141.03
|
| Rate for Payer: PHP Medicaid |
$68.72
|
| Rate for Payer: PHP Medicare Advantage |
$128.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$326.31
|
| Rate for Payer: Priority Health Medicare |
$128.21
|
| Rate for Payer: Priority Health Narrow Network |
$261.07
|
| Rate for Payer: Railroad Medicare Medicare |
$128.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$327.73
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$128.21
|
| Rate for Payer: UHC Exchange |
$198.73
|
| Rate for Payer: UHC Medicaid |
$67.05
|
| Rate for Payer: UHCCP DNSP |
$128.21
|
| Rate for Payer: UHCCP Medicaid |
$67.05
|
| Rate for Payer: VA VA |
$128.21
|
|
|
HC EMG BLINK REFLEX
|
Facility
|
IP
|
$251.30
|
|
|
Service Code
|
CPT 95933
|
| Hospital Charge Code |
92200019
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$188.47 |
| Max. Negotiated Rate |
$251.30 |
| Rate for Payer: Aetna Commercial |
$226.17
|
| Rate for Payer: ASR ASR |
$243.76
|
| Rate for Payer: BCBS Trust/PPO |
$206.37
|
| Rate for Payer: BCN Commercial |
$206.37
|
| Rate for Payer: Cash Price |
$201.04
|
| Rate for Payer: Cofinity Commercial |
$236.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$201.04
|
| Rate for Payer: Healthscope Commercial |
$243.76
|
| Rate for Payer: Healthscope Whirlpool |
$251.30
|
| Rate for Payer: Mclaren Commercial |
$226.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$213.60
|
| Rate for Payer: Nomi Health Commercial |
$206.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$188.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$221.14
|
|
|
HC EMG BLINK REFLEX
|
Facility
|
OP
|
$251.30
|
|
|
Service Code
|
CPT 95933
|
| Hospital Charge Code |
92200019
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$30.74 |
| Max. Negotiated Rate |
$251.30 |
| Rate for Payer: Aetna Commercial |
$226.17
|
| Rate for Payer: Aetna Medicare |
$58.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$73.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$73.47
|
| Rate for Payer: ASR ASR |
$243.76
|
| Rate for Payer: BCBS Complete |
$32.28
|
| Rate for Payer: BCBS MAPPO |
$58.78
|
| Rate for Payer: BCBS Trust/PPO |
$207.20
|
| Rate for Payer: BCN Commercial |
$207.20
|
| Rate for Payer: BCN Medicare Advantage |
$58.78
|
| Rate for Payer: Cash Price |
$201.04
|
| Rate for Payer: Cash Price |
$201.04
|
| Rate for Payer: Cofinity Commercial |
$236.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$201.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.78
|
| Rate for Payer: Healthscope Commercial |
$243.76
|
| Rate for Payer: Healthscope Whirlpool |
$251.30
|
| Rate for Payer: Humana Choice PPO Medicare |
$58.78
|
| Rate for Payer: Mclaren Commercial |
$226.17
|
| Rate for Payer: Mclaren Medicaid |
$58.78
|
| Rate for Payer: Mclaren Medicare |
$58.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.72
|
| Rate for Payer: Meridian Medicaid |
$32.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$67.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$64.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$213.60
|
| Rate for Payer: Nomi Health Commercial |
$206.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$188.47
|
| Rate for Payer: PACE Medicare |
$55.84
|
| Rate for Payer: PACE SWMI |
$58.78
|
| Rate for Payer: PHP Commercial |
$64.66
|
| Rate for Payer: PHP Medicaid |
$31.51
|
| Rate for Payer: PHP Medicare Advantage |
$58.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$220.19
|
| Rate for Payer: Priority Health Medicare |
$58.78
|
| Rate for Payer: Priority Health Narrow Network |
$176.16
|
| Rate for Payer: Railroad Medicare Medicare |
$58.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$221.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$58.78
|
| Rate for Payer: UHC Exchange |
$91.11
|
| Rate for Payer: UHC Medicaid |
$30.74
|
| Rate for Payer: UHCCP DNSP |
$58.78
|
| Rate for Payer: UHCCP Medicaid |
$30.74
|
| Rate for Payer: VA VA |
$58.78
|
|
|
HC EMG CRANIAL CERV THOR LUMB PARASPINE NDL EXAM W NCS UNI
|
Facility
|
IP
|
$624.29
|
|
|
Service Code
|
CPT 95887
|
| Hospital Charge Code |
92200024
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$468.22 |
| Max. Negotiated Rate |
$624.29 |
| Rate for Payer: Aetna Commercial |
$561.86
|
| Rate for Payer: ASR ASR |
$605.56
|
| Rate for Payer: BCBS Trust/PPO |
$512.67
|
| Rate for Payer: BCN Commercial |
$512.67
|
| Rate for Payer: Cash Price |
$499.43
|
| Rate for Payer: Cofinity Commercial |
$586.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$499.43
|
| Rate for Payer: Healthscope Commercial |
$605.56
|
| Rate for Payer: Healthscope Whirlpool |
$624.29
|
| Rate for Payer: Mclaren Commercial |
$561.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$530.65
|
| Rate for Payer: Nomi Health Commercial |
$511.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$468.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$549.38
|
|
|
HC EMG CRANIAL CERV THOR LUMB PARASPINE NDL EXAM W NCS UNI
|
Facility
|
OP
|
$624.29
|
|
|
Service Code
|
CPT 95887
|
| Hospital Charge Code |
92200024
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$230.99 |
| Max. Negotiated Rate |
$624.29 |
| Rate for Payer: Aetna Commercial |
$561.86
|
| Rate for Payer: Aetna Medicare |
$230.99
|
| Rate for Payer: ASR ASR |
$605.56
|
| Rate for Payer: BCBS Complete |
$249.72
|
| Rate for Payer: BCBS Trust/PPO |
$514.73
|
| Rate for Payer: BCN Commercial |
$514.73
|
| Rate for Payer: Cash Price |
$499.43
|
| Rate for Payer: Cofinity Commercial |
$586.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$499.43
|
| Rate for Payer: Healthscope Commercial |
$605.56
|
| Rate for Payer: Healthscope Whirlpool |
$624.29
|
| Rate for Payer: Mclaren Commercial |
$561.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$499.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$530.65
|
| Rate for Payer: Nomi Health Commercial |
$511.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$468.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$547.00
|
| Rate for Payer: Priority Health Narrow Network |
$437.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$549.38
|
|
|
HC EMG NDL GUIDANCE NERVE DEST WITH CHEMODENERVATION
|
Facility
|
IP
|
$224.86
|
|
|
Service Code
|
CPT 95874
|
| Hospital Charge Code |
92200034
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$168.65 |
| Max. Negotiated Rate |
$224.86 |
| Rate for Payer: Aetna Commercial |
$202.37
|
| Rate for Payer: ASR ASR |
$218.11
|
| Rate for Payer: BCBS Trust/PPO |
$184.66
|
| Rate for Payer: BCN Commercial |
$184.66
|
| Rate for Payer: Cash Price |
$179.89
|
| Rate for Payer: Cofinity Commercial |
$211.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$179.89
|
| Rate for Payer: Healthscope Commercial |
$218.11
|
| Rate for Payer: Healthscope Whirlpool |
$224.86
|
| Rate for Payer: Mclaren Commercial |
$202.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$191.13
|
| Rate for Payer: Nomi Health Commercial |
$184.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$168.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$197.88
|
|
|
HC EMG NDL GUIDANCE NERVE DEST WITH CHEMODENERVATION
|
Facility
|
OP
|
$224.86
|
|
|
Service Code
|
CPT 95874
|
| Hospital Charge Code |
92200034
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$83.20 |
| Max. Negotiated Rate |
$224.86 |
| Rate for Payer: Aetna Commercial |
$202.37
|
| Rate for Payer: Aetna Medicare |
$83.20
|
| Rate for Payer: ASR ASR |
$218.11
|
| Rate for Payer: BCBS Complete |
$89.94
|
| Rate for Payer: BCBS Trust/PPO |
$185.40
|
| Rate for Payer: BCN Commercial |
$185.40
|
| Rate for Payer: Cash Price |
$179.89
|
| Rate for Payer: Cofinity Commercial |
$211.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$179.89
|
| Rate for Payer: Healthscope Commercial |
$218.11
|
| Rate for Payer: Healthscope Whirlpool |
$224.86
|
| Rate for Payer: Mclaren Commercial |
$202.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$179.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$191.13
|
| Rate for Payer: Nomi Health Commercial |
$184.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$168.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$197.02
|
| Rate for Payer: Priority Health Narrow Network |
$157.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$197.88
|
|
|
HC EMG NEEDLE EXAM-1 EXT.
|
Facility
|
IP
|
$609.12
|
|
|
Service Code
|
CPT 95860
|
| Hospital Charge Code |
92200001
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$456.84 |
| Max. Negotiated Rate |
$609.12 |
| Rate for Payer: Aetna Commercial |
$548.21
|
| Rate for Payer: ASR ASR |
$590.85
|
| Rate for Payer: BCBS Trust/PPO |
$500.21
|
| Rate for Payer: BCN Commercial |
$500.21
|
| Rate for Payer: Cash Price |
$487.30
|
| Rate for Payer: Cofinity Commercial |
$572.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$487.30
|
| Rate for Payer: Healthscope Commercial |
$590.85
|
| Rate for Payer: Healthscope Whirlpool |
$609.12
|
| Rate for Payer: Mclaren Commercial |
$548.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$517.75
|
| Rate for Payer: Nomi Health Commercial |
$499.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$456.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$536.03
|
|
|
HC EMG NEEDLE EXAM-1 EXT.
|
Facility
|
OP
|
$609.12
|
|
|
Service Code
|
CPT 95860
|
| Hospital Charge Code |
92200001
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$69.33 |
| Max. Negotiated Rate |
$609.12 |
| Rate for Payer: Aetna Commercial |
$548.21
|
| Rate for Payer: Aetna Medicare |
$132.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$165.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$165.71
|
| Rate for Payer: ASR ASR |
$590.85
|
| Rate for Payer: BCBS Complete |
$72.81
|
| Rate for Payer: BCBS MAPPO |
$132.57
|
| Rate for Payer: BCBS Trust/PPO |
$502.22
|
| Rate for Payer: BCN Commercial |
$502.22
|
| Rate for Payer: BCN Medicare Advantage |
$132.57
|
| Rate for Payer: Cash Price |
$487.30
|
| Rate for Payer: Cash Price |
$487.30
|
| Rate for Payer: Cofinity Commercial |
$572.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$487.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.57
|
| Rate for Payer: Healthscope Commercial |
$590.85
|
| Rate for Payer: Healthscope Whirlpool |
$609.12
|
| Rate for Payer: Humana Choice PPO Medicare |
$132.57
|
| Rate for Payer: Mclaren Commercial |
$548.21
|
| Rate for Payer: Mclaren Medicaid |
$132.57
|
| Rate for Payer: Mclaren Medicare |
$132.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$139.20
|
| Rate for Payer: Meridian Medicaid |
$72.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$145.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$517.75
|
| Rate for Payer: Nomi Health Commercial |
$499.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$456.84
|
| Rate for Payer: PACE Medicare |
$125.94
|
| Rate for Payer: PACE SWMI |
$132.57
|
| Rate for Payer: PHP Commercial |
$145.83
|
| Rate for Payer: PHP Medicaid |
$71.06
|
| Rate for Payer: PHP Medicare Advantage |
$132.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$533.71
|
| Rate for Payer: Priority Health Medicare |
$132.57
|
| Rate for Payer: Priority Health Narrow Network |
$426.99
|
| Rate for Payer: Railroad Medicare Medicare |
$132.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$536.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$132.57
|
| Rate for Payer: UHC Exchange |
$205.48
|
| Rate for Payer: UHC Medicaid |
$69.33
|
| Rate for Payer: UHCCP DNSP |
$132.57
|
| Rate for Payer: UHCCP Medicaid |
$69.33
|
| Rate for Payer: VA VA |
$132.57
|
|
|
HC EMG NEEDLE EXAM 2 EXT
|
Facility
|
IP
|
$718.69
|
|
|
Service Code
|
CPT 95861
|
| Hospital Charge Code |
92200002
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$539.02 |
| Max. Negotiated Rate |
$718.69 |
| Rate for Payer: Aetna Commercial |
$646.82
|
| Rate for Payer: ASR ASR |
$697.13
|
| Rate for Payer: BCBS Trust/PPO |
$590.19
|
| Rate for Payer: BCN Commercial |
$590.19
|
| Rate for Payer: Cash Price |
$574.95
|
| Rate for Payer: Cofinity Commercial |
$675.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$574.95
|
| Rate for Payer: Healthscope Commercial |
$697.13
|
| Rate for Payer: Healthscope Whirlpool |
$718.69
|
| Rate for Payer: Mclaren Commercial |
$646.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$610.89
|
| Rate for Payer: Nomi Health Commercial |
$589.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$539.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$632.45
|
|
|
HC EMG NEEDLE EXAM 2 EXT
|
Facility
|
OP
|
$718.69
|
|
|
Service Code
|
CPT 95861
|
| Hospital Charge Code |
92200002
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$69.33 |
| Max. Negotiated Rate |
$718.69 |
| Rate for Payer: Aetna Commercial |
$646.82
|
| Rate for Payer: Aetna Medicare |
$132.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$165.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$165.71
|
| Rate for Payer: ASR ASR |
$697.13
|
| Rate for Payer: BCBS Complete |
$72.81
|
| Rate for Payer: BCBS MAPPO |
$132.57
|
| Rate for Payer: BCBS Trust/PPO |
$592.56
|
| Rate for Payer: BCN Commercial |
$592.56
|
| Rate for Payer: BCN Medicare Advantage |
$132.57
|
| Rate for Payer: Cash Price |
$574.95
|
| Rate for Payer: Cash Price |
$574.95
|
| Rate for Payer: Cofinity Commercial |
$675.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$574.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.57
|
| Rate for Payer: Healthscope Commercial |
$697.13
|
| Rate for Payer: Healthscope Whirlpool |
$718.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$132.57
|
| Rate for Payer: Mclaren Commercial |
$646.82
|
| Rate for Payer: Mclaren Medicaid |
$132.57
|
| Rate for Payer: Mclaren Medicare |
$132.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$139.20
|
| Rate for Payer: Meridian Medicaid |
$72.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$145.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$610.89
|
| Rate for Payer: Nomi Health Commercial |
$589.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$539.02
|
| Rate for Payer: PACE Medicare |
$125.94
|
| Rate for Payer: PACE SWMI |
$132.57
|
| Rate for Payer: PHP Commercial |
$145.83
|
| Rate for Payer: PHP Medicaid |
$71.06
|
| Rate for Payer: PHP Medicare Advantage |
$132.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$629.72
|
| Rate for Payer: Priority Health Medicare |
$132.57
|
| Rate for Payer: Priority Health Narrow Network |
$503.80
|
| Rate for Payer: Railroad Medicare Medicare |
$132.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$632.45
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$132.57
|
| Rate for Payer: UHC Exchange |
$205.48
|
| Rate for Payer: UHC Medicaid |
$69.33
|
| Rate for Payer: UHCCP DNSP |
$132.57
|
| Rate for Payer: UHCCP Medicaid |
$69.33
|
| Rate for Payer: VA VA |
$132.57
|
|
|
HC EMG NEEDLE EXAM 3 EXT
|
Facility
|
IP
|
$664.15
|
|
|
Service Code
|
CPT 95863
|
| Hospital Charge Code |
92200003
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$498.11 |
| Max. Negotiated Rate |
$664.15 |
| Rate for Payer: Aetna Commercial |
$597.74
|
| Rate for Payer: ASR ASR |
$644.23
|
| Rate for Payer: BCBS Trust/PPO |
$545.40
|
| Rate for Payer: BCN Commercial |
$545.40
|
| Rate for Payer: Cash Price |
$531.32
|
| Rate for Payer: Cofinity Commercial |
$624.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$531.32
|
| Rate for Payer: Healthscope Commercial |
$644.23
|
| Rate for Payer: Healthscope Whirlpool |
$664.15
|
| Rate for Payer: Mclaren Commercial |
$597.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$564.53
|
| Rate for Payer: Nomi Health Commercial |
$544.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$498.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$584.45
|
|
|
HC EMG NEEDLE EXAM 3 EXT
|
Facility
|
OP
|
$664.15
|
|
|
Service Code
|
CPT 95863
|
| Hospital Charge Code |
92200003
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$67.05 |
| Max. Negotiated Rate |
$664.15 |
| Rate for Payer: Aetna Commercial |
$597.74
|
| Rate for Payer: Aetna Medicare |
$128.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$160.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$160.26
|
| Rate for Payer: ASR ASR |
$644.23
|
| Rate for Payer: BCBS Complete |
$70.41
|
| Rate for Payer: BCBS MAPPO |
$128.21
|
| Rate for Payer: BCBS Trust/PPO |
$547.59
|
| Rate for Payer: BCN Commercial |
$547.59
|
| Rate for Payer: BCN Medicare Advantage |
$128.21
|
| Rate for Payer: Cash Price |
$531.32
|
| Rate for Payer: Cash Price |
$531.32
|
| Rate for Payer: Cofinity Commercial |
$624.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$531.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.21
|
| Rate for Payer: Healthscope Commercial |
$644.23
|
| Rate for Payer: Healthscope Whirlpool |
$664.15
|
| Rate for Payer: Humana Choice PPO Medicare |
$128.21
|
| Rate for Payer: Mclaren Commercial |
$597.74
|
| Rate for Payer: Mclaren Medicaid |
$128.21
|
| Rate for Payer: Mclaren Medicare |
$128.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$134.62
|
| Rate for Payer: Meridian Medicaid |
$70.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$147.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$141.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$564.53
|
| Rate for Payer: Nomi Health Commercial |
$544.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$498.11
|
| Rate for Payer: PACE Medicare |
$121.80
|
| Rate for Payer: PACE SWMI |
$128.21
|
| Rate for Payer: PHP Commercial |
$141.03
|
| Rate for Payer: PHP Medicaid |
$68.72
|
| Rate for Payer: PHP Medicare Advantage |
$128.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$581.93
|
| Rate for Payer: Priority Health Medicare |
$128.21
|
| Rate for Payer: Priority Health Narrow Network |
$465.57
|
| Rate for Payer: Railroad Medicare Medicare |
$128.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$584.45
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$128.21
|
| Rate for Payer: UHC Exchange |
$198.73
|
| Rate for Payer: UHC Medicaid |
$67.05
|
| Rate for Payer: UHCCP DNSP |
$128.21
|
| Rate for Payer: UHCCP Medicaid |
$67.05
|
| Rate for Payer: VA VA |
$128.21
|
|
|
HC EMG NEEDLE EXAM 4 EXT
|
Facility
|
OP
|
$832.87
|
|
|
Service Code
|
CPT 95864
|
| Hospital Charge Code |
92200004
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$67.05 |
| Max. Negotiated Rate |
$832.87 |
| Rate for Payer: Aetna Commercial |
$749.58
|
| Rate for Payer: Aetna Medicare |
$128.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$160.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$160.26
|
| Rate for Payer: ASR ASR |
$807.88
|
| Rate for Payer: BCBS Complete |
$70.41
|
| Rate for Payer: BCBS MAPPO |
$128.21
|
| Rate for Payer: BCBS Trust/PPO |
$686.70
|
| Rate for Payer: BCN Commercial |
$686.70
|
| Rate for Payer: BCN Medicare Advantage |
$128.21
|
| Rate for Payer: Cash Price |
$666.30
|
| Rate for Payer: Cash Price |
$666.30
|
| Rate for Payer: Cofinity Commercial |
$782.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$666.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.21
|
| Rate for Payer: Healthscope Commercial |
$807.88
|
| Rate for Payer: Healthscope Whirlpool |
$832.87
|
| Rate for Payer: Humana Choice PPO Medicare |
$128.21
|
| Rate for Payer: Mclaren Commercial |
$749.58
|
| Rate for Payer: Mclaren Medicaid |
$128.21
|
| Rate for Payer: Mclaren Medicare |
$128.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$134.62
|
| Rate for Payer: Meridian Medicaid |
$70.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$147.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$141.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$707.94
|
| Rate for Payer: Nomi Health Commercial |
$682.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$624.65
|
| Rate for Payer: PACE Medicare |
$121.80
|
| Rate for Payer: PACE SWMI |
$128.21
|
| Rate for Payer: PHP Commercial |
$141.03
|
| Rate for Payer: PHP Medicaid |
$68.72
|
| Rate for Payer: PHP Medicare Advantage |
$128.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$729.76
|
| Rate for Payer: Priority Health Medicare |
$128.21
|
| Rate for Payer: Priority Health Narrow Network |
$583.84
|
| Rate for Payer: Railroad Medicare Medicare |
$128.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$732.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$128.21
|
| Rate for Payer: UHC Exchange |
$198.73
|
| Rate for Payer: UHC Medicaid |
$67.05
|
| Rate for Payer: UHCCP DNSP |
$128.21
|
| Rate for Payer: UHCCP Medicaid |
$67.05
|
| Rate for Payer: VA VA |
$128.21
|
|
|
HC EMG NEEDLE EXAM 4 EXT
|
Facility
|
IP
|
$832.87
|
|
|
Service Code
|
CPT 95864
|
| Hospital Charge Code |
92200004
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$624.65 |
| Max. Negotiated Rate |
$832.87 |
| Rate for Payer: Aetna Commercial |
$749.58
|
| Rate for Payer: ASR ASR |
$807.88
|
| Rate for Payer: BCBS Trust/PPO |
$683.95
|
| Rate for Payer: BCN Commercial |
$683.95
|
| Rate for Payer: Cash Price |
$666.30
|
| Rate for Payer: Cofinity Commercial |
$782.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$666.30
|
| Rate for Payer: Healthscope Commercial |
$807.88
|
| Rate for Payer: Healthscope Whirlpool |
$832.87
|
| Rate for Payer: Mclaren Commercial |
$749.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$707.94
|
| Rate for Payer: Nomi Health Commercial |
$682.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$624.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$732.93
|
|
|
HC EMG NEEDLE EXAM CRANIAL BILAT NCS
|
Facility
|
OP
|
$832.87
|
|
|
Service Code
|
CPT 95868
|
| Hospital Charge Code |
92200007
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$112.52 |
| Max. Negotiated Rate |
$832.87 |
| Rate for Payer: Aetna Commercial |
$749.58
|
| Rate for Payer: Aetna Medicare |
$215.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$268.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$268.94
|
| Rate for Payer: ASR ASR |
$807.88
|
| Rate for Payer: BCBS Complete |
$118.16
|
| Rate for Payer: BCBS MAPPO |
$215.15
|
| Rate for Payer: BCBS Trust/PPO |
$686.70
|
| Rate for Payer: BCN Commercial |
$686.70
|
| Rate for Payer: BCN Medicare Advantage |
$215.15
|
| Rate for Payer: Cash Price |
$666.30
|
| Rate for Payer: Cash Price |
$666.30
|
| Rate for Payer: Cofinity Commercial |
$782.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$666.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$215.15
|
| Rate for Payer: Healthscope Commercial |
$807.88
|
| Rate for Payer: Healthscope Whirlpool |
$832.87
|
| Rate for Payer: Humana Choice PPO Medicare |
$215.15
|
| Rate for Payer: Mclaren Commercial |
$749.58
|
| Rate for Payer: Mclaren Medicaid |
$215.15
|
| Rate for Payer: Mclaren Medicare |
$215.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$225.91
|
| Rate for Payer: Meridian Medicaid |
$118.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$247.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$236.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$707.94
|
| Rate for Payer: Nomi Health Commercial |
$682.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$624.65
|
| Rate for Payer: PACE Medicare |
$204.39
|
| Rate for Payer: PACE SWMI |
$215.15
|
| Rate for Payer: PHP Commercial |
$236.66
|
| Rate for Payer: PHP Medicaid |
$115.32
|
| Rate for Payer: PHP Medicare Advantage |
$215.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$729.76
|
| Rate for Payer: Priority Health Medicare |
$215.15
|
| Rate for Payer: Priority Health Narrow Network |
$583.84
|
| Rate for Payer: Railroad Medicare Medicare |
$215.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$732.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$215.15
|
| Rate for Payer: UHC Exchange |
$333.48
|
| Rate for Payer: UHC Medicaid |
$112.52
|
| Rate for Payer: UHCCP DNSP |
$215.15
|
| Rate for Payer: UHCCP Medicaid |
$112.52
|
| Rate for Payer: VA VA |
$215.15
|
|
|
HC EMG NEEDLE EXAM CRANIAL BILAT NCS
|
Facility
|
IP
|
$832.87
|
|
|
Service Code
|
CPT 95868
|
| Hospital Charge Code |
92200007
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$624.65 |
| Max. Negotiated Rate |
$832.87 |
| Rate for Payer: Aetna Commercial |
$749.58
|
| Rate for Payer: ASR ASR |
$807.88
|
| Rate for Payer: BCBS Trust/PPO |
$683.95
|
| Rate for Payer: BCN Commercial |
$683.95
|
| Rate for Payer: Cash Price |
$666.30
|
| Rate for Payer: Cofinity Commercial |
$782.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$666.30
|
| Rate for Payer: Healthscope Commercial |
$807.88
|
| Rate for Payer: Healthscope Whirlpool |
$832.87
|
| Rate for Payer: Mclaren Commercial |
$749.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$707.94
|
| Rate for Payer: Nomi Health Commercial |
$682.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$624.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$732.93
|
|
|
HC EMG NEEDLE EXAM CRANIAL UNILAT WO NCS
|
Facility
|
IP
|
$749.63
|
|
|
Service Code
|
CPT 95867
|
| Hospital Charge Code |
92200006
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$562.22 |
| Max. Negotiated Rate |
$749.63 |
| Rate for Payer: Aetna Commercial |
$674.67
|
| Rate for Payer: ASR ASR |
$727.14
|
| Rate for Payer: BCBS Trust/PPO |
$615.60
|
| Rate for Payer: BCN Commercial |
$615.60
|
| Rate for Payer: Cash Price |
$599.70
|
| Rate for Payer: Cofinity Commercial |
$704.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$599.70
|
| Rate for Payer: Healthscope Commercial |
$727.14
|
| Rate for Payer: Healthscope Whirlpool |
$749.63
|
| Rate for Payer: Mclaren Commercial |
$674.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$637.19
|
| Rate for Payer: Nomi Health Commercial |
$614.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$562.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$659.67
|
|
|
HC EMG NEEDLE EXAM CRANIAL UNILAT WO NCS
|
Facility
|
OP
|
$749.63
|
|
|
Service Code
|
CPT 95867
|
| Hospital Charge Code |
92200006
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$112.52 |
| Max. Negotiated Rate |
$749.63 |
| Rate for Payer: Aetna Commercial |
$674.67
|
| Rate for Payer: Aetna Medicare |
$215.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$268.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$268.94
|
| Rate for Payer: ASR ASR |
$727.14
|
| Rate for Payer: BCBS Complete |
$118.16
|
| Rate for Payer: BCBS MAPPO |
$215.15
|
| Rate for Payer: BCBS Trust/PPO |
$618.07
|
| Rate for Payer: BCN Commercial |
$618.07
|
| Rate for Payer: BCN Medicare Advantage |
$215.15
|
| Rate for Payer: Cash Price |
$599.70
|
| Rate for Payer: Cash Price |
$599.70
|
| Rate for Payer: Cofinity Commercial |
$704.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$599.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$215.15
|
| Rate for Payer: Healthscope Commercial |
$727.14
|
| Rate for Payer: Healthscope Whirlpool |
$749.63
|
| Rate for Payer: Humana Choice PPO Medicare |
$215.15
|
| Rate for Payer: Mclaren Commercial |
$674.67
|
| Rate for Payer: Mclaren Medicaid |
$215.15
|
| Rate for Payer: Mclaren Medicare |
$215.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$225.91
|
| Rate for Payer: Meridian Medicaid |
$118.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$247.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$236.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$637.19
|
| Rate for Payer: Nomi Health Commercial |
$614.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$562.22
|
| Rate for Payer: PACE Medicare |
$204.39
|
| Rate for Payer: PACE SWMI |
$215.15
|
| Rate for Payer: PHP Commercial |
$236.66
|
| Rate for Payer: PHP Medicaid |
$115.32
|
| Rate for Payer: PHP Medicare Advantage |
$215.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$656.83
|
| Rate for Payer: Priority Health Medicare |
$215.15
|
| Rate for Payer: Priority Health Narrow Network |
$525.49
|
| Rate for Payer: Railroad Medicare Medicare |
$215.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$659.67
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$215.15
|
| Rate for Payer: UHC Exchange |
$333.48
|
| Rate for Payer: UHC Medicaid |
$112.52
|
| Rate for Payer: UHCCP DNSP |
$215.15
|
| Rate for Payer: UHCCP Medicaid |
$112.52
|
| Rate for Payer: VA VA |
$215.15
|
|
|
HC EMG NEEDLE EXAM WITH NCS LIMITED
|
Facility
|
OP
|
$382.48
|
|
|
Service Code
|
CPT 95885
|
| Hospital Charge Code |
92200022
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$141.52 |
| Max. Negotiated Rate |
$382.48 |
| Rate for Payer: Aetna Commercial |
$344.23
|
| Rate for Payer: Aetna Medicare |
$141.52
|
| Rate for Payer: ASR ASR |
$371.01
|
| Rate for Payer: BCBS Complete |
$152.99
|
| Rate for Payer: BCBS Trust/PPO |
$315.35
|
| Rate for Payer: BCN Commercial |
$315.35
|
| Rate for Payer: Cash Price |
$305.98
|
| Rate for Payer: Cofinity Commercial |
$359.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$305.98
|
| Rate for Payer: Healthscope Commercial |
$371.01
|
| Rate for Payer: Healthscope Whirlpool |
$382.48
|
| Rate for Payer: Mclaren Commercial |
$344.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$305.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$325.11
|
| Rate for Payer: Nomi Health Commercial |
$313.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$286.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$335.13
|
| Rate for Payer: Priority Health Narrow Network |
$268.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$336.58
|
|
