|
HC DNA DOUBLE STRANDED AB
|
Facility
|
OP
|
$28.41
|
|
|
Service Code
|
CPT 86225
|
| Hospital Charge Code |
30200158
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.36 |
| Max. Negotiated Rate |
$36.24 |
| Rate for Payer: Aetna Commercial |
$25.57
|
| Rate for Payer: Aetna Medicare |
$13.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.18
|
| Rate for Payer: ASR ASR |
$27.56
|
| Rate for Payer: ASR Commercial |
$27.56
|
| Rate for Payer: BCBS Complete |
$7.73
|
| Rate for Payer: BCBS MAPPO |
$13.74
|
| Rate for Payer: BCBS Trust/PPO |
$23.26
|
| Rate for Payer: BCN Commercial |
$22.03
|
| Rate for Payer: BCN Medicare Advantage |
$13.74
|
| Rate for Payer: Cash Price |
$22.73
|
| Rate for Payer: Cash Price |
$22.73
|
| Rate for Payer: Cofinity Commercial |
$26.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.74
|
| Rate for Payer: Healthscope Commercial |
$28.41
|
| Rate for Payer: Healthscope Whirlpool |
$27.56
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.74
|
| Rate for Payer: Mclaren Commercial |
$25.57
|
| Rate for Payer: Mclaren Medicaid |
$7.36
|
| Rate for Payer: Mclaren Medicare |
$13.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.43
|
| Rate for Payer: Meridian Medicaid |
$7.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.15
|
| Rate for Payer: Nomi Health Commercial |
$23.30
|
| Rate for Payer: PACE Medicare |
$13.05
|
| Rate for Payer: PACE SWMI |
$13.74
|
| Rate for Payer: PHP Commercial |
$15.11
|
| Rate for Payer: PHP Medicaid |
$7.36
|
| Rate for Payer: PHP Medicare Advantage |
$13.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$36.24
|
| Rate for Payer: Priority Health Medicare |
$13.74
|
| Rate for Payer: Priority Health Narrow Network |
$28.99
|
| Rate for Payer: Railroad Medicare Medicare |
$13.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.74
|
| Rate for Payer: UHC Exchange |
$21.30
|
| Rate for Payer: UHC Medicare Advantage |
$13.74
|
| Rate for Payer: UHCCP DNSP |
$13.74
|
| Rate for Payer: UHCCP Medicaid |
$7.36
|
| Rate for Payer: VA VA |
$13.74
|
|
|
HC DNA PROBES CMPT2
|
Facility
|
IP
|
$77.87
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000043
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$50.62 |
| Max. Negotiated Rate |
$77.87 |
| Rate for Payer: Aetna Commercial |
$70.08
|
| Rate for Payer: ASR ASR |
$75.53
|
| Rate for Payer: ASR Commercial |
$75.53
|
| Rate for Payer: BCBS Trust/PPO |
$63.46
|
| Rate for Payer: BCN Commercial |
$60.37
|
| Rate for Payer: Cash Price |
$62.30
|
| Rate for Payer: Cofinity Commercial |
$73.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.30
|
| Rate for Payer: Healthscope Commercial |
$77.87
|
| Rate for Payer: Healthscope Whirlpool |
$75.53
|
| Rate for Payer: Mclaren Commercial |
$70.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.19
|
| Rate for Payer: Nomi Health Commercial |
$63.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$68.53
|
|
|
HC DNA PROBES CMPT2
|
Facility
|
OP
|
$77.87
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000043
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$27.44 |
| Max. Negotiated Rate |
$79.34 |
| Rate for Payer: Aetna Commercial |
$70.08
|
| Rate for Payer: Aetna Medicare |
$51.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$63.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$63.99
|
| Rate for Payer: ASR ASR |
$75.53
|
| Rate for Payer: ASR Commercial |
$75.53
|
| Rate for Payer: BCBS Complete |
$28.81
|
| Rate for Payer: BCBS MAPPO |
$51.19
|
| Rate for Payer: BCBS Trust/PPO |
$63.77
|
| Rate for Payer: BCN Commercial |
$60.37
|
| Rate for Payer: BCN Medicare Advantage |
$51.19
|
| Rate for Payer: Cash Price |
$62.30
|
| Rate for Payer: Cash Price |
$62.30
|
| Rate for Payer: Cofinity Commercial |
$73.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.19
|
| Rate for Payer: Healthscope Commercial |
$77.87
|
| Rate for Payer: Healthscope Whirlpool |
$75.53
|
| Rate for Payer: Humana Choice PPO Medicare |
$51.19
|
| Rate for Payer: Mclaren Commercial |
$70.08
|
| Rate for Payer: Mclaren Medicaid |
$27.44
|
| Rate for Payer: Mclaren Medicare |
$51.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.75
|
| Rate for Payer: Meridian Medicaid |
$28.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.19
|
| Rate for Payer: Nomi Health Commercial |
$63.85
|
| Rate for Payer: PACE Medicare |
$48.63
|
| Rate for Payer: PACE SWMI |
$51.19
|
| Rate for Payer: PHP Commercial |
$56.31
|
| Rate for Payer: PHP Medicaid |
$27.44
|
| Rate for Payer: PHP Medicare Advantage |
$51.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$68.23
|
| Rate for Payer: Priority Health Medicare |
$51.19
|
| Rate for Payer: Priority Health Narrow Network |
$54.59
|
| Rate for Payer: Railroad Medicare Medicare |
$51.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$68.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$51.19
|
| Rate for Payer: UHC Exchange |
$79.34
|
| Rate for Payer: UHC Medicare Advantage |
$51.19
|
| Rate for Payer: UHCCP DNSP |
$51.19
|
| Rate for Payer: UHCCP Medicaid |
$27.44
|
| Rate for Payer: VA VA |
$51.19
|
|
|
HC DOG IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200038
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$25.39 |
| Rate for Payer: Aetna Commercial |
$22.85
|
| Rate for Payer: ASR ASR |
$24.63
|
| Rate for Payer: ASR Commercial |
$24.63
|
| Rate for Payer: BCBS Trust/PPO |
$20.69
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$23.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$25.39
|
| Rate for Payer: Healthscope Whirlpool |
$24.63
|
| Rate for Payer: Mclaren Commercial |
$22.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.34
|
|
|
HC DOG IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200038
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$25.39 |
| Rate for Payer: Aetna Commercial |
$22.85
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: ASR ASR |
$24.63
|
| Rate for Payer: ASR Commercial |
$24.63
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$20.79
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$23.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$25.39
|
| Rate for Payer: Healthscope Whirlpool |
$24.63
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$22.85
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$5.74
|
| Rate for Payer: PHP Medicaid |
$2.80
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.25
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$17.80
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP DNSP |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.80
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC DOPPLER COLOR FLOW
|
Facility
|
IP
|
$440.60
|
|
|
Service Code
|
CPT 93325
|
| Hospital Charge Code |
48000007
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$286.39 |
| Max. Negotiated Rate |
$440.60 |
| Rate for Payer: Aetna Commercial |
$396.54
|
| Rate for Payer: ASR ASR |
$427.38
|
| Rate for Payer: ASR Commercial |
$427.38
|
| Rate for Payer: BCBS Trust/PPO |
$359.04
|
| Rate for Payer: BCN Commercial |
$341.60
|
| Rate for Payer: Cash Price |
$352.48
|
| Rate for Payer: Cofinity Commercial |
$414.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$352.48
|
| Rate for Payer: Healthscope Commercial |
$440.60
|
| Rate for Payer: Healthscope Whirlpool |
$427.38
|
| Rate for Payer: Mclaren Commercial |
$396.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$374.51
|
| Rate for Payer: Nomi Health Commercial |
$361.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$286.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$387.73
|
|
|
HC DOPPLER COLOR FLOW
|
Facility
|
OP
|
$440.60
|
|
|
Service Code
|
CPT 93325
|
| Hospital Charge Code |
48000007
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$176.24 |
| Max. Negotiated Rate |
$440.60 |
| Rate for Payer: Aetna Commercial |
$396.54
|
| Rate for Payer: Aetna Medicare |
$220.30
|
| Rate for Payer: ASR ASR |
$427.38
|
| Rate for Payer: ASR Commercial |
$427.38
|
| Rate for Payer: BCBS Complete |
$176.24
|
| Rate for Payer: BCBS Trust/PPO |
$360.81
|
| Rate for Payer: BCN Commercial |
$341.60
|
| Rate for Payer: Cash Price |
$352.48
|
| Rate for Payer: Cash Price |
$352.48
|
| Rate for Payer: Cofinity Commercial |
$414.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$352.48
|
| Rate for Payer: Healthscope Commercial |
$440.60
|
| Rate for Payer: Healthscope Whirlpool |
$427.38
|
| Rate for Payer: Mclaren Commercial |
$396.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$374.51
|
| Rate for Payer: Nomi Health Commercial |
$361.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$286.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$390.35
|
| Rate for Payer: Priority Health Narrow Network |
$312.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$387.73
|
|
|
HC DOXYCYCLINE HYCLATE 100 MG
|
Facility
|
IP
|
$225.72
|
|
|
Service Code
|
HCPCS J3490
|
| Hospital Charge Code |
63600189
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$146.72 |
| Max. Negotiated Rate |
$225.72 |
| Rate for Payer: Aetna Commercial |
$203.15
|
| Rate for Payer: ASR ASR |
$218.95
|
| Rate for Payer: ASR Commercial |
$218.95
|
| Rate for Payer: BCBS Trust/PPO |
$183.94
|
| Rate for Payer: BCN Commercial |
$175.00
|
| Rate for Payer: Cash Price |
$180.58
|
| Rate for Payer: Cofinity Commercial |
$212.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$180.58
|
| Rate for Payer: Healthscope Commercial |
$225.72
|
| Rate for Payer: Healthscope Whirlpool |
$218.95
|
| Rate for Payer: Mclaren Commercial |
$203.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$191.86
|
| Rate for Payer: Nomi Health Commercial |
$185.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$198.63
|
|
|
HC DOXYCYCLINE HYCLATE 100 MG
|
Facility
|
OP
|
$225.72
|
|
|
Service Code
|
HCPCS J3490
|
| Hospital Charge Code |
63600189
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$90.29 |
| Max. Negotiated Rate |
$225.72 |
| Rate for Payer: Aetna Commercial |
$203.15
|
| Rate for Payer: Aetna Medicare |
$112.86
|
| Rate for Payer: ASR ASR |
$218.95
|
| Rate for Payer: ASR Commercial |
$218.95
|
| Rate for Payer: BCBS Complete |
$90.29
|
| Rate for Payer: BCBS Trust/PPO |
$184.84
|
| Rate for Payer: BCN Commercial |
$175.00
|
| Rate for Payer: Cash Price |
$180.58
|
| Rate for Payer: Cofinity Commercial |
$212.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$180.58
|
| Rate for Payer: Healthscope Commercial |
$225.72
|
| Rate for Payer: Healthscope Whirlpool |
$218.95
|
| Rate for Payer: Mclaren Commercial |
$203.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$191.86
|
| Rate for Payer: Nomi Health Commercial |
$185.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$197.78
|
| Rate for Payer: Priority Health Narrow Network |
$158.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$198.63
|
|
|
HC DPPX AB CBA, S
|
Facility
|
OP
|
$255.00
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200462
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.46 |
| Max. Negotiated Rate |
$255.00 |
| Rate for Payer: Aetna Commercial |
$229.50
|
| 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 |
$247.35
|
| Rate for Payer: ASR Commercial |
$247.35
|
| Rate for Payer: BCBS Complete |
$6.78
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCBS Trust/PPO |
$208.82
|
| Rate for Payer: BCN Commercial |
$197.70
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Cofinity Commercial |
$239.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$204.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$255.00
|
| Rate for Payer: Healthscope Whirlpool |
$247.35
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.05
|
| Rate for Payer: Mclaren Commercial |
$229.50
|
| 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 |
$216.75
|
| Rate for Payer: Nomi Health Commercial |
$209.10
|
| 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 |
$165.75
|
| 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 |
$224.40
|
| 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 DPPX AB CBA, S
|
Facility
|
IP
|
$255.00
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200462
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$165.75 |
| Max. Negotiated Rate |
$255.00 |
| Rate for Payer: Aetna Commercial |
$229.50
|
| Rate for Payer: ASR ASR |
$247.35
|
| Rate for Payer: ASR Commercial |
$247.35
|
| Rate for Payer: BCBS Trust/PPO |
$207.80
|
| Rate for Payer: BCN Commercial |
$197.70
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Cofinity Commercial |
$239.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$204.00
|
| Rate for Payer: Healthscope Commercial |
$255.00
|
| Rate for Payer: Healthscope Whirlpool |
$247.35
|
| Rate for Payer: Mclaren Commercial |
$229.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$216.75
|
| Rate for Payer: Nomi Health Commercial |
$209.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$224.40
|
|
|
HC DPPX AB IFA, S
|
Facility
|
IP
|
$78.03
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200463
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$50.72 |
| Max. Negotiated Rate |
$78.03 |
| Rate for Payer: Aetna Commercial |
$70.23
|
| Rate for Payer: ASR ASR |
$75.69
|
| Rate for Payer: ASR Commercial |
$75.69
|
| Rate for Payer: BCBS Trust/PPO |
$63.59
|
| Rate for Payer: BCN Commercial |
$60.50
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Commercial |
$73.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Healthscope Commercial |
$78.03
|
| Rate for Payer: Healthscope Whirlpool |
$75.69
|
| Rate for Payer: Mclaren Commercial |
$70.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Nomi Health Commercial |
$63.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$68.67
|
|
|
HC DPPX AB IFA, S
|
Facility
|
OP
|
$78.03
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200463
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.46 |
| Max. Negotiated Rate |
$227.29 |
| Rate for Payer: Aetna Commercial |
$70.23
|
| 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 |
$75.69
|
| Rate for Payer: ASR Commercial |
$75.69
|
| Rate for Payer: BCBS Complete |
$6.78
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCBS Trust/PPO |
$63.90
|
| Rate for Payer: BCN Commercial |
$60.50
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Commercial |
$73.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$78.03
|
| Rate for Payer: Healthscope Whirlpool |
$75.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.05
|
| Rate for Payer: Mclaren Commercial |
$70.23
|
| 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 |
$66.33
|
| Rate for Payer: Nomi Health Commercial |
$63.98
|
| 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 |
$50.72
|
| 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 |
$68.67
|
| 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 DPPX AB IFA TITER, S
|
Facility
|
IP
|
$78.03
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200461
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$50.72 |
| Max. Negotiated Rate |
$78.03 |
| Rate for Payer: Aetna Commercial |
$70.23
|
| Rate for Payer: ASR ASR |
$75.69
|
| Rate for Payer: ASR Commercial |
$75.69
|
| Rate for Payer: BCBS Trust/PPO |
$63.59
|
| Rate for Payer: BCN Commercial |
$60.50
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Commercial |
$73.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Healthscope Commercial |
$78.03
|
| Rate for Payer: Healthscope Whirlpool |
$75.69
|
| Rate for Payer: Mclaren Commercial |
$70.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Nomi Health Commercial |
$63.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$68.67
|
|
|
HC DPPX AB IFA TITER, S
|
Facility
|
OP
|
$78.03
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200461
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.46 |
| Max. Negotiated Rate |
$227.29 |
| Rate for Payer: Aetna Commercial |
$70.23
|
| 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 |
$75.69
|
| Rate for Payer: ASR Commercial |
$75.69
|
| Rate for Payer: BCBS Complete |
$6.78
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCBS Trust/PPO |
$63.90
|
| Rate for Payer: BCN Commercial |
$60.50
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Commercial |
$73.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$78.03
|
| Rate for Payer: Healthscope Whirlpool |
$75.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.05
|
| Rate for Payer: Mclaren Commercial |
$70.23
|
| 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 |
$66.33
|
| Rate for Payer: Nomi Health Commercial |
$63.98
|
| 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 |
$50.72
|
| 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 |
$68.67
|
| 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 DRAINAGE ABSC CST HEMAT DENTOALVEOLAR STRUX
|
Facility
|
OP
|
$371.00
|
|
|
Service Code
|
CPT 41800
|
| Hospital Charge Code |
76100529
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$67.69 |
| Max. Negotiated Rate |
$371.00 |
| Rate for Payer: Aetna Commercial |
$333.90
|
| Rate for Payer: Aetna Medicare |
$126.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.86
|
| Rate for Payer: ASR ASR |
$359.87
|
| Rate for Payer: ASR Commercial |
$359.87
|
| Rate for Payer: BCBS Complete |
$71.08
|
| Rate for Payer: BCBS MAPPO |
$126.29
|
| Rate for Payer: BCBS Trust/PPO |
$303.81
|
| Rate for Payer: BCN Commercial |
$287.64
|
| Rate for Payer: BCN Medicare Advantage |
$126.29
|
| Rate for Payer: Cash Price |
$296.80
|
| Rate for Payer: Cash Price |
$296.80
|
| Rate for Payer: Cofinity Commercial |
$348.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$296.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.29
|
| Rate for Payer: Healthscope Commercial |
$371.00
|
| Rate for Payer: Healthscope Whirlpool |
$359.87
|
| Rate for Payer: Humana Choice PPO Medicare |
$126.29
|
| Rate for Payer: Mclaren Commercial |
$333.90
|
| Rate for Payer: Mclaren Medicaid |
$67.69
|
| Rate for Payer: Mclaren Medicare |
$126.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.60
|
| Rate for Payer: Meridian Medicaid |
$71.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$145.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$315.35
|
| Rate for Payer: Nomi Health Commercial |
$304.22
|
| Rate for Payer: PACE Medicare |
$119.98
|
| Rate for Payer: PACE SWMI |
$126.29
|
| Rate for Payer: PHP Commercial |
$138.92
|
| Rate for Payer: PHP Medicaid |
$67.69
|
| Rate for Payer: PHP Medicare Advantage |
$126.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$233.11
|
| Rate for Payer: Priority Health Medicare |
$126.29
|
| Rate for Payer: Priority Health Narrow Network |
$186.49
|
| Rate for Payer: Railroad Medicare Medicare |
$126.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$326.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$126.29
|
| Rate for Payer: UHC Exchange |
$195.75
|
| Rate for Payer: UHC Medicare Advantage |
$126.29
|
| Rate for Payer: UHCCP DNSP |
$126.29
|
| Rate for Payer: UHCCP Medicaid |
$67.69
|
| Rate for Payer: VA VA |
$126.29
|
|
|
HC DRAINAGE ABSC CST HEMAT DENTOALVEOLAR STRUX
|
Facility
|
IP
|
$371.00
|
|
|
Service Code
|
CPT 41800
|
| Hospital Charge Code |
76100529
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$241.15 |
| Max. Negotiated Rate |
$371.00 |
| Rate for Payer: Aetna Commercial |
$333.90
|
| Rate for Payer: ASR ASR |
$359.87
|
| Rate for Payer: ASR Commercial |
$359.87
|
| Rate for Payer: BCBS Trust/PPO |
$302.33
|
| Rate for Payer: BCN Commercial |
$287.64
|
| Rate for Payer: Cash Price |
$296.80
|
| Rate for Payer: Cofinity Commercial |
$348.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$296.80
|
| Rate for Payer: Healthscope Commercial |
$371.00
|
| Rate for Payer: Healthscope Whirlpool |
$359.87
|
| Rate for Payer: Mclaren Commercial |
$333.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$315.35
|
| Rate for Payer: Nomi Health Commercial |
$304.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$326.48
|
|
|
HC DRAINAGE CATHETER LVL 1
|
Facility
|
OP
|
$21.42
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200354
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.57 |
| Max. Negotiated Rate |
$21.42 |
| Rate for Payer: Aetna Commercial |
$19.28
|
| Rate for Payer: Aetna Medicare |
$10.71
|
| Rate for Payer: ASR ASR |
$20.78
|
| Rate for Payer: ASR Commercial |
$20.78
|
| Rate for Payer: BCBS Complete |
$8.57
|
| Rate for Payer: BCBS Trust/PPO |
$17.54
|
| Rate for Payer: BCN Commercial |
$16.61
|
| Rate for Payer: Cash Price |
$17.14
|
| Rate for Payer: Cofinity Commercial |
$20.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.14
|
| Rate for Payer: Healthscope Commercial |
$21.42
|
| Rate for Payer: Healthscope Whirlpool |
$20.78
|
| Rate for Payer: Mclaren Commercial |
$19.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.21
|
| Rate for Payer: Nomi Health Commercial |
$17.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.77
|
| Rate for Payer: Priority Health Narrow Network |
$15.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.85
|
|
|
HC DRAINAGE CATHETER LVL 1
|
Facility
|
IP
|
$21.42
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200354
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.92 |
| Max. Negotiated Rate |
$21.42 |
| Rate for Payer: Aetna Commercial |
$19.28
|
| Rate for Payer: ASR ASR |
$20.78
|
| Rate for Payer: ASR Commercial |
$20.78
|
| Rate for Payer: BCBS Trust/PPO |
$17.46
|
| Rate for Payer: BCN Commercial |
$16.61
|
| Rate for Payer: Cash Price |
$17.14
|
| Rate for Payer: Cofinity Commercial |
$20.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.14
|
| Rate for Payer: Healthscope Commercial |
$21.42
|
| Rate for Payer: Healthscope Whirlpool |
$20.78
|
| Rate for Payer: Mclaren Commercial |
$19.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.21
|
| Rate for Payer: Nomi Health Commercial |
$17.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.85
|
|
|
HC DRAINAGE CATHETER LVL 15
|
Facility
|
OP
|
$1,590.00
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200348
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$636.00 |
| Max. Negotiated Rate |
$1,590.00 |
| Rate for Payer: Aetna Commercial |
$1,431.00
|
| Rate for Payer: Aetna Medicare |
$795.00
|
| Rate for Payer: ASR ASR |
$1,542.30
|
| Rate for Payer: ASR Commercial |
$1,542.30
|
| Rate for Payer: BCBS Complete |
$636.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,302.05
|
| Rate for Payer: BCN Commercial |
$1,232.73
|
| Rate for Payer: Cash Price |
$1,272.00
|
| Rate for Payer: Cofinity Commercial |
$1,494.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,272.00
|
| Rate for Payer: Healthscope Commercial |
$1,590.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,542.30
|
| Rate for Payer: Mclaren Commercial |
$1,431.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,351.50
|
| Rate for Payer: Nomi Health Commercial |
$1,303.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,033.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,393.16
|
| Rate for Payer: Priority Health Narrow Network |
$1,114.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,399.20
|
|
|
HC DRAINAGE CATHETER LVL 15
|
Facility
|
IP
|
$1,590.00
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200348
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,033.50 |
| Max. Negotiated Rate |
$1,590.00 |
| Rate for Payer: Aetna Commercial |
$1,431.00
|
| Rate for Payer: ASR ASR |
$1,542.30
|
| Rate for Payer: ASR Commercial |
$1,542.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,295.69
|
| Rate for Payer: BCN Commercial |
$1,232.73
|
| Rate for Payer: Cash Price |
$1,272.00
|
| Rate for Payer: Cofinity Commercial |
$1,494.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,272.00
|
| Rate for Payer: Healthscope Commercial |
$1,590.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,542.30
|
| Rate for Payer: Mclaren Commercial |
$1,431.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,351.50
|
| Rate for Payer: Nomi Health Commercial |
$1,303.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,033.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,399.20
|
|
|
HC DRAINAGE CATHETER LVL 2
|
Facility
|
OP
|
$232.56
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200084
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$93.02 |
| Max. Negotiated Rate |
$232.56 |
| Rate for Payer: Aetna Commercial |
$209.30
|
| Rate for Payer: Aetna Medicare |
$116.28
|
| Rate for Payer: ASR ASR |
$225.58
|
| Rate for Payer: ASR Commercial |
$225.58
|
| Rate for Payer: BCBS Complete |
$93.02
|
| Rate for Payer: BCBS Trust/PPO |
$190.44
|
| Rate for Payer: BCN Commercial |
$180.30
|
| Rate for Payer: Cash Price |
$186.05
|
| Rate for Payer: Cofinity Commercial |
$218.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$186.05
|
| Rate for Payer: Healthscope Commercial |
$232.56
|
| Rate for Payer: Healthscope Whirlpool |
$225.58
|
| Rate for Payer: Mclaren Commercial |
$209.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$197.68
|
| Rate for Payer: Nomi Health Commercial |
$190.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$151.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$203.77
|
| Rate for Payer: Priority Health Narrow Network |
$163.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$204.65
|
|
|
HC DRAINAGE CATHETER LVL 2
|
Facility
|
IP
|
$232.56
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200084
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$151.16 |
| Max. Negotiated Rate |
$232.56 |
| Rate for Payer: Aetna Commercial |
$209.30
|
| Rate for Payer: ASR ASR |
$225.58
|
| Rate for Payer: ASR Commercial |
$225.58
|
| Rate for Payer: BCBS Trust/PPO |
$189.51
|
| Rate for Payer: BCN Commercial |
$180.30
|
| Rate for Payer: Cash Price |
$186.05
|
| Rate for Payer: Cofinity Commercial |
$218.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$186.05
|
| Rate for Payer: Healthscope Commercial |
$232.56
|
| Rate for Payer: Healthscope Whirlpool |
$225.58
|
| Rate for Payer: Mclaren Commercial |
$209.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$197.68
|
| Rate for Payer: Nomi Health Commercial |
$190.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$151.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$204.65
|
|
|
HC DRAINAGE CATHETER LVL 3
|
Facility
|
OP
|
$385.56
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200270
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$154.22 |
| Max. Negotiated Rate |
$385.56 |
| Rate for Payer: Aetna Commercial |
$347.00
|
| Rate for Payer: Aetna Medicare |
$192.78
|
| Rate for Payer: ASR ASR |
$373.99
|
| Rate for Payer: ASR Commercial |
$373.99
|
| Rate for Payer: BCBS Complete |
$154.22
|
| Rate for Payer: BCBS Trust/PPO |
$315.74
|
| Rate for Payer: BCN Commercial |
$298.92
|
| Rate for Payer: Cash Price |
$308.45
|
| Rate for Payer: Cofinity Commercial |
$362.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$308.45
|
| Rate for Payer: Healthscope Commercial |
$385.56
|
| Rate for Payer: Healthscope Whirlpool |
$373.99
|
| Rate for Payer: Mclaren Commercial |
$347.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$327.73
|
| Rate for Payer: Nomi Health Commercial |
$316.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$250.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$337.83
|
| Rate for Payer: Priority Health Narrow Network |
$270.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$339.29
|
|
|
HC DRAINAGE CATHETER LVL 3
|
Facility
|
IP
|
$385.56
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200270
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$250.61 |
| Max. Negotiated Rate |
$385.56 |
| Rate for Payer: Aetna Commercial |
$347.00
|
| Rate for Payer: ASR ASR |
$373.99
|
| Rate for Payer: ASR Commercial |
$373.99
|
| Rate for Payer: BCBS Trust/PPO |
$314.19
|
| Rate for Payer: BCN Commercial |
$298.92
|
| Rate for Payer: Cash Price |
$308.45
|
| Rate for Payer: Cofinity Commercial |
$362.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$308.45
|
| Rate for Payer: Healthscope Commercial |
$385.56
|
| Rate for Payer: Healthscope Whirlpool |
$373.99
|
| Rate for Payer: Mclaren Commercial |
$347.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$327.73
|
| Rate for Payer: Nomi Health Commercial |
$316.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$250.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$339.29
|
|
