|
HC EMBOLIZATION URETER
|
Facility
|
IP
|
$428.76
|
|
|
Service Code
|
CPT 50705
|
| Hospital Charge Code |
36100511
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$278.69 |
| Max. Negotiated Rate |
$428.76 |
| Rate for Payer: Aetna Commercial |
$385.88
|
| Rate for Payer: ASR ASR |
$415.90
|
| Rate for Payer: ASR Commercial |
$415.90
|
| Rate for Payer: BCBS Trust/PPO |
$349.40
|
| Rate for Payer: BCN Commercial |
$332.42
|
| Rate for Payer: Cash Price |
$343.01
|
| Rate for Payer: Cofinity Commercial |
$403.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$343.01
|
| Rate for Payer: Healthscope Commercial |
$428.76
|
| Rate for Payer: Healthscope Whirlpool |
$415.90
|
| Rate for Payer: Mclaren Commercial |
$385.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$364.45
|
| Rate for Payer: Nomi Health Commercial |
$351.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$278.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$377.31
|
|
|
HC EMBOLIZATION VENOUS OTHER THAN HEMORRHAGE
|
Facility
|
OP
|
$21,556.74
|
|
|
Service Code
|
CPT 37241
|
| Hospital Charge Code |
36100428
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,928.28 |
| Max. Negotiated Rate |
$21,556.74 |
| Rate for Payer: Aetna Commercial |
$19,401.07
|
| Rate for Payer: Aetna Medicare |
$11,060.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,825.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,825.29
|
| Rate for Payer: ASR ASR |
$20,910.04
|
| Rate for Payer: ASR Commercial |
$20,910.04
|
| Rate for Payer: BCBS Complete |
$6,224.70
|
| Rate for Payer: BCBS MAPPO |
$11,060.23
|
| Rate for Payer: BCBS Trust/PPO |
$17,652.81
|
| Rate for Payer: BCN Commercial |
$16,712.94
|
| Rate for Payer: BCN Medicare Advantage |
$11,060.23
|
| Rate for Payer: Cash Price |
$17,245.39
|
| Rate for Payer: Cash Price |
$17,245.39
|
| Rate for Payer: Cofinity Commercial |
$20,263.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17,245.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,060.23
|
| Rate for Payer: Healthscope Commercial |
$21,556.74
|
| Rate for Payer: Healthscope Whirlpool |
$20,910.04
|
| Rate for Payer: Humana Choice PPO Medicare |
$11,060.23
|
| Rate for Payer: Mclaren Commercial |
$19,401.07
|
| Rate for Payer: Mclaren Medicaid |
$5,928.28
|
| Rate for Payer: Mclaren Medicare |
$11,060.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,613.24
|
| Rate for Payer: Meridian Medicaid |
$6,224.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,719.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18,323.23
|
| Rate for Payer: Nomi Health Commercial |
$17,676.53
|
| Rate for Payer: PACE Medicare |
$10,507.22
|
| Rate for Payer: PACE SWMI |
$11,060.23
|
| Rate for Payer: PHP Commercial |
$12,166.25
|
| Rate for Payer: PHP Medicaid |
$5,928.28
|
| Rate for Payer: PHP Medicare Advantage |
$11,060.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,928.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14,011.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18,888.02
|
| Rate for Payer: Priority Health Medicare |
$11,060.23
|
| Rate for Payer: Priority Health Narrow Network |
$15,111.27
|
| Rate for Payer: Railroad Medicare Medicare |
$11,060.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18,969.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,060.23
|
| Rate for Payer: UHC Exchange |
$17,143.36
|
| Rate for Payer: UHC Medicare Advantage |
$11,060.23
|
| Rate for Payer: UHCCP DNSP |
$11,060.23
|
| Rate for Payer: UHCCP Medicaid |
$5,928.28
|
| Rate for Payer: VA VA |
$11,060.23
|
|
|
HC EMBOLIZATION VENOUS OTHER THAN HEMORRHAGE
|
Facility
|
IP
|
$21,556.74
|
|
|
Service Code
|
CPT 37241
|
| Hospital Charge Code |
36100428
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$14,011.88 |
| Max. Negotiated Rate |
$21,556.74 |
| Rate for Payer: Aetna Commercial |
$19,401.07
|
| Rate for Payer: ASR ASR |
$20,910.04
|
| Rate for Payer: ASR Commercial |
$20,910.04
|
| Rate for Payer: BCBS Trust/PPO |
$17,566.59
|
| Rate for Payer: BCN Commercial |
$16,712.94
|
| Rate for Payer: Cash Price |
$17,245.39
|
| Rate for Payer: Cofinity Commercial |
$20,263.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17,245.39
|
| Rate for Payer: Healthscope Commercial |
$21,556.74
|
| Rate for Payer: Healthscope Whirlpool |
$20,910.04
|
| Rate for Payer: Mclaren Commercial |
$19,401.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18,323.23
|
| Rate for Payer: Nomi Health Commercial |
$17,676.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14,011.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18,969.93
|
|
|
HC EMBOSHIELD SYSTEM
|
Facility
|
IP
|
$5,902.41
|
|
|
Service Code
|
HCPCS C1884
|
| Hospital Charge Code |
27800010
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,836.57 |
| Max. Negotiated Rate |
$5,902.41 |
| Rate for Payer: Aetna Commercial |
$5,312.17
|
| Rate for Payer: ASR ASR |
$5,725.34
|
| Rate for Payer: ASR Commercial |
$5,725.34
|
| Rate for Payer: BCBS Trust/PPO |
$4,809.87
|
| Rate for Payer: BCN Commercial |
$4,576.14
|
| Rate for Payer: Cash Price |
$4,721.93
|
| Rate for Payer: Cofinity Commercial |
$5,548.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,721.93
|
| Rate for Payer: Healthscope Commercial |
$5,902.41
|
| Rate for Payer: Healthscope Whirlpool |
$5,725.34
|
| Rate for Payer: Mclaren Commercial |
$5,312.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,017.05
|
| Rate for Payer: Nomi Health Commercial |
$4,839.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,836.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,194.12
|
|
|
HC EMBOSHIELD SYSTEM
|
Facility
|
OP
|
$5,902.41
|
|
|
Service Code
|
HCPCS C1884
|
| Hospital Charge Code |
27800010
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,360.96 |
| Max. Negotiated Rate |
$5,902.41 |
| Rate for Payer: Aetna Commercial |
$5,312.17
|
| Rate for Payer: Aetna Medicare |
$2,951.20
|
| Rate for Payer: ASR ASR |
$5,725.34
|
| Rate for Payer: ASR Commercial |
$5,725.34
|
| Rate for Payer: BCBS Complete |
$2,360.96
|
| Rate for Payer: BCBS Trust/PPO |
$4,833.48
|
| Rate for Payer: BCN Commercial |
$4,576.14
|
| Rate for Payer: Cash Price |
$4,721.93
|
| Rate for Payer: Cofinity Commercial |
$5,548.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,721.93
|
| Rate for Payer: Healthscope Commercial |
$5,902.41
|
| Rate for Payer: Healthscope Whirlpool |
$5,725.34
|
| Rate for Payer: Mclaren Commercial |
$5,312.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,017.05
|
| Rate for Payer: Nomi Health Commercial |
$4,839.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,836.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,171.69
|
| Rate for Payer: Priority Health Narrow Network |
$4,137.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,194.12
|
|
|
HC EMCU OBSERVATION PER HOUR
|
Facility
|
OP
|
$140.97
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200022
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$56.39 |
| Max. Negotiated Rate |
$140.97 |
| Rate for Payer: Aetna Commercial |
$126.87
|
| Rate for Payer: Aetna Medicare |
$70.48
|
| Rate for Payer: ASR ASR |
$136.74
|
| Rate for Payer: ASR Commercial |
$136.74
|
| Rate for Payer: BCBS Complete |
$56.39
|
| Rate for Payer: BCBS Trust/PPO |
$115.44
|
| Rate for Payer: BCN Commercial |
$109.29
|
| Rate for Payer: Cash Price |
$112.78
|
| Rate for Payer: Cofinity Commercial |
$132.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.78
|
| Rate for Payer: Healthscope Commercial |
$140.97
|
| Rate for Payer: Healthscope Whirlpool |
$136.74
|
| Rate for Payer: Mclaren Commercial |
$126.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$119.82
|
| Rate for Payer: Nomi Health Commercial |
$115.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$91.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$123.52
|
| Rate for Payer: Priority Health Narrow Network |
$98.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$124.05
|
|
|
HC EMCU OBSERVATION PER HOUR
|
Facility
|
IP
|
$140.97
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200022
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$91.63 |
| Max. Negotiated Rate |
$140.97 |
| Rate for Payer: Aetna Commercial |
$126.87
|
| Rate for Payer: ASR ASR |
$136.74
|
| Rate for Payer: ASR Commercial |
$136.74
|
| Rate for Payer: BCBS Trust/PPO |
$114.88
|
| Rate for Payer: BCN Commercial |
$109.29
|
| Rate for Payer: Cash Price |
$112.78
|
| Rate for Payer: Cofinity Commercial |
$132.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.78
|
| Rate for Payer: Healthscope Commercial |
$140.97
|
| Rate for Payer: Healthscope Whirlpool |
$136.74
|
| Rate for Payer: Mclaren Commercial |
$126.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$119.82
|
| Rate for Payer: Nomi Health Commercial |
$115.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$91.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$124.05
|
|
|
HC EMG ANAL SPHINCTER
|
Facility
|
OP
|
$351.04
|
|
|
Service Code
|
CPT 51785
|
| Hospital Charge Code |
92000002
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$127.14 |
| Max. Negotiated Rate |
$367.66 |
| Rate for Payer: Aetna Commercial |
$315.94
|
| Rate for Payer: Aetna Medicare |
$237.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$296.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$296.50
|
| Rate for Payer: ASR ASR |
$340.51
|
| Rate for Payer: ASR Commercial |
$340.51
|
| Rate for Payer: BCBS Complete |
$133.50
|
| Rate for Payer: BCBS MAPPO |
$237.20
|
| Rate for Payer: BCBS Trust/PPO |
$287.47
|
| Rate for Payer: BCN Commercial |
$272.16
|
| Rate for Payer: BCN Medicare Advantage |
$237.20
|
| Rate for Payer: Cash Price |
$280.83
|
| Rate for Payer: Cash Price |
$280.83
|
| Rate for Payer: Cofinity Commercial |
$329.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.20
|
| Rate for Payer: Healthscope Commercial |
$351.04
|
| Rate for Payer: Healthscope Whirlpool |
$340.51
|
| Rate for Payer: Humana Choice PPO Medicare |
$237.20
|
| Rate for Payer: Mclaren Commercial |
$315.94
|
| Rate for Payer: Mclaren Medicaid |
$127.14
|
| Rate for Payer: Mclaren Medicare |
$237.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.06
|
| Rate for Payer: Meridian Medicaid |
$133.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$272.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$298.38
|
| Rate for Payer: Nomi Health Commercial |
$287.85
|
| Rate for Payer: PACE Medicare |
$225.34
|
| Rate for Payer: PACE SWMI |
$237.20
|
| Rate for Payer: PHP Commercial |
$260.92
|
| Rate for Payer: PHP Medicaid |
$127.14
|
| Rate for Payer: PHP Medicare Advantage |
$237.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$127.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$228.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$307.58
|
| Rate for Payer: Priority Health Medicare |
$237.20
|
| Rate for Payer: Priority Health Narrow Network |
$246.08
|
| Rate for Payer: Railroad Medicare Medicare |
$237.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$308.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$237.20
|
| Rate for Payer: UHC Exchange |
$367.66
|
| Rate for Payer: UHC Medicare Advantage |
$237.20
|
| Rate for Payer: UHCCP DNSP |
$237.20
|
| Rate for Payer: UHCCP Medicaid |
$127.14
|
| Rate for Payer: VA VA |
$237.20
|
|
|
HC EMG ANAL SPHINCTER
|
Facility
|
IP
|
$351.04
|
|
|
Service Code
|
CPT 51785
|
| Hospital Charge Code |
92000002
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$228.18 |
| Max. Negotiated Rate |
$351.04 |
| Rate for Payer: Aetna Commercial |
$315.94
|
| Rate for Payer: ASR ASR |
$340.51
|
| Rate for Payer: ASR Commercial |
$340.51
|
| Rate for Payer: BCBS Trust/PPO |
$286.06
|
| Rate for Payer: BCN Commercial |
$272.16
|
| Rate for Payer: Cash Price |
$280.83
|
| Rate for Payer: Cofinity Commercial |
$329.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.83
|
| Rate for Payer: Healthscope Commercial |
$351.04
|
| Rate for Payer: Healthscope Whirlpool |
$340.51
|
| Rate for Payer: Mclaren Commercial |
$315.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$298.38
|
| Rate for Payer: Nomi Health Commercial |
$287.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$228.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$308.92
|
|
|
HC EMG BLADDER
|
Facility
|
OP
|
$365.12
|
|
|
Service Code
|
CPT 51784
|
| Hospital Charge Code |
92000001
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$81.79 |
| Max. Negotiated Rate |
$365.12 |
| Rate for Payer: Aetna Commercial |
$328.61
|
| Rate for Payer: Aetna Medicare |
$152.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$190.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$190.74
|
| Rate for Payer: ASR ASR |
$354.17
|
| Rate for Payer: ASR Commercial |
$354.17
|
| Rate for Payer: BCBS Complete |
$85.88
|
| Rate for Payer: BCBS MAPPO |
$152.59
|
| Rate for Payer: BCBS Trust/PPO |
$299.00
|
| Rate for Payer: BCN Commercial |
$283.08
|
| Rate for Payer: BCN Medicare Advantage |
$152.59
|
| Rate for Payer: Cash Price |
$292.10
|
| Rate for Payer: Cash Price |
$292.10
|
| Rate for Payer: Cofinity Commercial |
$343.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$292.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$152.59
|
| Rate for Payer: Healthscope Commercial |
$365.12
|
| Rate for Payer: Healthscope Whirlpool |
$354.17
|
| Rate for Payer: Humana Choice PPO Medicare |
$152.59
|
| Rate for Payer: Mclaren Commercial |
$328.61
|
| Rate for Payer: Mclaren Medicaid |
$81.79
|
| Rate for Payer: Mclaren Medicare |
$152.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.22
|
| Rate for Payer: Meridian Medicaid |
$85.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$175.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$310.35
|
| Rate for Payer: Nomi Health Commercial |
$299.40
|
| Rate for Payer: PACE Medicare |
$144.96
|
| Rate for Payer: PACE SWMI |
$152.59
|
| Rate for Payer: PHP Commercial |
$167.85
|
| Rate for Payer: PHP Medicaid |
$81.79
|
| Rate for Payer: PHP Medicare Advantage |
$152.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$81.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$237.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$319.92
|
| Rate for Payer: Priority Health Medicare |
$152.59
|
| Rate for Payer: Priority Health Narrow Network |
$255.95
|
| Rate for Payer: Railroad Medicare Medicare |
$152.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$321.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$152.59
|
| Rate for Payer: UHC Exchange |
$236.51
|
| Rate for Payer: UHC Medicare Advantage |
$152.59
|
| Rate for Payer: UHCCP DNSP |
$152.59
|
| Rate for Payer: UHCCP Medicaid |
$81.79
|
| Rate for Payer: VA VA |
$152.59
|
|
|
HC EMG BLADDER
|
Facility
|
IP
|
$365.12
|
|
|
Service Code
|
CPT 51784
|
| Hospital Charge Code |
92000001
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$237.33 |
| Max. Negotiated Rate |
$365.12 |
| Rate for Payer: Aetna Commercial |
$328.61
|
| Rate for Payer: ASR ASR |
$354.17
|
| Rate for Payer: ASR Commercial |
$354.17
|
| Rate for Payer: BCBS Trust/PPO |
$297.54
|
| Rate for Payer: BCN Commercial |
$283.08
|
| Rate for Payer: Cash Price |
$292.10
|
| Rate for Payer: Cofinity Commercial |
$343.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$292.10
|
| Rate for Payer: Healthscope Commercial |
$365.12
|
| Rate for Payer: Healthscope Whirlpool |
$354.17
|
| Rate for Payer: Mclaren Commercial |
$328.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$310.35
|
| Rate for Payer: Nomi Health Commercial |
$299.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$237.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$321.31
|
|
|
HC EMG BLINK REFLEX
|
Facility
|
OP
|
$246.37
|
|
|
Service Code
|
CPT 95933
|
| Hospital Charge Code |
92200019
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$31.05 |
| Max. Negotiated Rate |
$246.37 |
| Rate for Payer: Aetna Commercial |
$221.73
|
| Rate for Payer: Aetna Medicare |
$57.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$72.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$72.41
|
| Rate for Payer: ASR ASR |
$238.98
|
| Rate for Payer: ASR Commercial |
$238.98
|
| Rate for Payer: BCBS Complete |
$32.60
|
| Rate for Payer: BCBS MAPPO |
$57.93
|
| Rate for Payer: BCBS Trust/PPO |
$201.75
|
| Rate for Payer: BCN Commercial |
$191.01
|
| Rate for Payer: BCN Medicare Advantage |
$57.93
|
| Rate for Payer: Cash Price |
$197.10
|
| Rate for Payer: Cash Price |
$197.10
|
| Rate for Payer: Cofinity Commercial |
$231.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$197.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.93
|
| Rate for Payer: Healthscope Commercial |
$246.37
|
| Rate for Payer: Healthscope Whirlpool |
$238.98
|
| Rate for Payer: Humana Choice PPO Medicare |
$57.93
|
| Rate for Payer: Mclaren Commercial |
$221.73
|
| Rate for Payer: Mclaren Medicaid |
$31.05
|
| Rate for Payer: Mclaren Medicare |
$57.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$60.83
|
| Rate for Payer: Meridian Medicaid |
$32.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$66.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$209.41
|
| Rate for Payer: Nomi Health Commercial |
$202.02
|
| Rate for Payer: PACE Medicare |
$55.03
|
| Rate for Payer: PACE SWMI |
$57.93
|
| Rate for Payer: PHP Commercial |
$63.72
|
| Rate for Payer: PHP Medicaid |
$31.05
|
| Rate for Payer: PHP Medicare Advantage |
$57.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$160.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$215.87
|
| Rate for Payer: Priority Health Medicare |
$57.93
|
| Rate for Payer: Priority Health Narrow Network |
$172.71
|
| Rate for Payer: Railroad Medicare Medicare |
$57.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$216.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$57.93
|
| Rate for Payer: UHC Exchange |
$89.79
|
| Rate for Payer: UHC Medicare Advantage |
$57.93
|
| Rate for Payer: UHCCP DNSP |
$57.93
|
| Rate for Payer: UHCCP Medicaid |
$31.05
|
| Rate for Payer: VA VA |
$57.93
|
|
|
HC EMG BLINK REFLEX
|
Facility
|
IP
|
$246.37
|
|
|
Service Code
|
CPT 95933
|
| Hospital Charge Code |
92200019
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$160.14 |
| Max. Negotiated Rate |
$246.37 |
| Rate for Payer: Aetna Commercial |
$221.73
|
| Rate for Payer: ASR ASR |
$238.98
|
| Rate for Payer: ASR Commercial |
$238.98
|
| Rate for Payer: BCBS Trust/PPO |
$200.77
|
| Rate for Payer: BCN Commercial |
$191.01
|
| Rate for Payer: Cash Price |
$197.10
|
| Rate for Payer: Cofinity Commercial |
$231.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$197.10
|
| Rate for Payer: Healthscope Commercial |
$246.37
|
| Rate for Payer: Healthscope Whirlpool |
$238.98
|
| Rate for Payer: Mclaren Commercial |
$221.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$209.41
|
| Rate for Payer: Nomi Health Commercial |
$202.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$160.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$216.81
|
|
|
HC EMG CRANIAL CERV THOR LUMB PARASPINE NDL EXAM W NCS UNI
|
Facility
|
OP
|
$612.05
|
|
|
Service Code
|
CPT 95887
|
| Hospital Charge Code |
92200024
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$244.82 |
| Max. Negotiated Rate |
$612.05 |
| Rate for Payer: Aetna Commercial |
$550.85
|
| Rate for Payer: Aetna Medicare |
$306.02
|
| Rate for Payer: ASR ASR |
$593.69
|
| Rate for Payer: ASR Commercial |
$593.69
|
| Rate for Payer: BCBS Complete |
$244.82
|
| Rate for Payer: BCBS Trust/PPO |
$501.21
|
| Rate for Payer: BCN Commercial |
$474.52
|
| Rate for Payer: Cash Price |
$489.64
|
| Rate for Payer: Cofinity Commercial |
$575.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$489.64
|
| Rate for Payer: Healthscope Commercial |
$612.05
|
| Rate for Payer: Healthscope Whirlpool |
$593.69
|
| Rate for Payer: Mclaren Commercial |
$550.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$520.24
|
| Rate for Payer: Nomi Health Commercial |
$501.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$397.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$536.28
|
| Rate for Payer: Priority Health Narrow Network |
$429.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$538.60
|
|
|
HC EMG CRANIAL CERV THOR LUMB PARASPINE NDL EXAM W NCS UNI
|
Facility
|
IP
|
$612.05
|
|
|
Service Code
|
CPT 95887
|
| Hospital Charge Code |
92200024
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$397.83 |
| Max. Negotiated Rate |
$612.05 |
| Rate for Payer: Aetna Commercial |
$550.85
|
| Rate for Payer: ASR ASR |
$593.69
|
| Rate for Payer: ASR Commercial |
$593.69
|
| Rate for Payer: BCBS Trust/PPO |
$498.76
|
| Rate for Payer: BCN Commercial |
$474.52
|
| Rate for Payer: Cash Price |
$489.64
|
| Rate for Payer: Cofinity Commercial |
$575.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$489.64
|
| Rate for Payer: Healthscope Commercial |
$612.05
|
| Rate for Payer: Healthscope Whirlpool |
$593.69
|
| Rate for Payer: Mclaren Commercial |
$550.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$520.24
|
| Rate for Payer: Nomi Health Commercial |
$501.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$397.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$538.60
|
|
|
HC EMG NDL GUIDANCE NERVE DEST WITH CHEMODENERVATION
|
Facility
|
OP
|
$187.38
|
|
|
Service Code
|
CPT 95874
|
| Hospital Charge Code |
92200034
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$74.95 |
| Max. Negotiated Rate |
$187.38 |
| Rate for Payer: Aetna Commercial |
$168.64
|
| Rate for Payer: Aetna Medicare |
$93.69
|
| Rate for Payer: ASR ASR |
$181.76
|
| Rate for Payer: ASR Commercial |
$181.76
|
| Rate for Payer: BCBS Complete |
$74.95
|
| Rate for Payer: BCBS Trust/PPO |
$153.45
|
| Rate for Payer: BCN Commercial |
$145.28
|
| Rate for Payer: Cash Price |
$149.90
|
| Rate for Payer: Cofinity Commercial |
$176.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$149.90
|
| Rate for Payer: Healthscope Commercial |
$187.38
|
| Rate for Payer: Healthscope Whirlpool |
$181.76
|
| Rate for Payer: Mclaren Commercial |
$168.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$159.27
|
| Rate for Payer: Nomi Health Commercial |
$153.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$164.18
|
| Rate for Payer: Priority Health Narrow Network |
$131.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$164.89
|
|
|
HC EMG NDL GUIDANCE NERVE DEST WITH CHEMODENERVATION
|
Facility
|
IP
|
$187.38
|
|
|
Service Code
|
CPT 95874
|
| Hospital Charge Code |
92200034
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$121.80 |
| Max. Negotiated Rate |
$187.38 |
| Rate for Payer: Aetna Commercial |
$168.64
|
| Rate for Payer: ASR ASR |
$181.76
|
| Rate for Payer: ASR Commercial |
$181.76
|
| Rate for Payer: BCBS Trust/PPO |
$152.70
|
| Rate for Payer: BCN Commercial |
$145.28
|
| Rate for Payer: Cash Price |
$149.90
|
| Rate for Payer: Cofinity Commercial |
$176.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$149.90
|
| Rate for Payer: Healthscope Commercial |
$187.38
|
| Rate for Payer: Healthscope Whirlpool |
$181.76
|
| Rate for Payer: Mclaren Commercial |
$168.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$159.27
|
| Rate for Payer: Nomi Health Commercial |
$153.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$164.89
|
|
|
HC EMG NEEDLE EXAM-1 EXT.
|
Facility
|
IP
|
$597.18
|
|
|
Service Code
|
CPT 95860
|
| Hospital Charge Code |
92200001
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$388.17 |
| Max. Negotiated Rate |
$597.18 |
| Rate for Payer: Aetna Commercial |
$537.46
|
| Rate for Payer: ASR ASR |
$579.26
|
| Rate for Payer: ASR Commercial |
$579.26
|
| Rate for Payer: BCBS Trust/PPO |
$486.64
|
| Rate for Payer: BCN Commercial |
$462.99
|
| Rate for Payer: Cash Price |
$477.74
|
| Rate for Payer: Cofinity Commercial |
$561.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$477.74
|
| Rate for Payer: Healthscope Commercial |
$597.18
|
| Rate for Payer: Healthscope Whirlpool |
$579.26
|
| Rate for Payer: Mclaren Commercial |
$537.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$507.60
|
| Rate for Payer: Nomi Health Commercial |
$489.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$388.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$525.52
|
|
|
HC EMG NEEDLE EXAM-1 EXT.
|
Facility
|
OP
|
$597.18
|
|
|
Service Code
|
CPT 95860
|
| Hospital Charge Code |
92200001
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$67.38 |
| Max. Negotiated Rate |
$597.18 |
| Rate for Payer: Aetna Commercial |
$537.46
|
| Rate for Payer: Aetna Medicare |
$125.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.14
|
| Rate for Payer: ASR ASR |
$579.26
|
| Rate for Payer: ASR Commercial |
$579.26
|
| Rate for Payer: BCBS Complete |
$70.75
|
| Rate for Payer: BCBS MAPPO |
$125.71
|
| Rate for Payer: BCBS Trust/PPO |
$489.03
|
| Rate for Payer: BCN Commercial |
$462.99
|
| Rate for Payer: BCN Medicare Advantage |
$125.71
|
| Rate for Payer: Cash Price |
$477.74
|
| Rate for Payer: Cash Price |
$477.74
|
| Rate for Payer: Cofinity Commercial |
$561.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$477.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.71
|
| Rate for Payer: Healthscope Commercial |
$597.18
|
| Rate for Payer: Healthscope Whirlpool |
$579.26
|
| Rate for Payer: Humana Choice PPO Medicare |
$125.71
|
| Rate for Payer: Mclaren Commercial |
$537.46
|
| Rate for Payer: Mclaren Medicaid |
$67.38
|
| Rate for Payer: Mclaren Medicare |
$125.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.00
|
| Rate for Payer: Meridian Medicaid |
$70.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$144.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$507.60
|
| Rate for Payer: Nomi Health Commercial |
$489.69
|
| Rate for Payer: PACE Medicare |
$119.42
|
| Rate for Payer: PACE SWMI |
$125.71
|
| Rate for Payer: PHP Commercial |
$138.28
|
| Rate for Payer: PHP Medicaid |
$67.38
|
| Rate for Payer: PHP Medicare Advantage |
$125.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$388.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$523.25
|
| Rate for Payer: Priority Health Medicare |
$125.71
|
| Rate for Payer: Priority Health Narrow Network |
$418.62
|
| Rate for Payer: Railroad Medicare Medicare |
$125.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$525.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.71
|
| Rate for Payer: UHC Exchange |
$194.85
|
| Rate for Payer: UHC Medicare Advantage |
$125.71
|
| Rate for Payer: UHCCP DNSP |
$125.71
|
| Rate for Payer: UHCCP Medicaid |
$67.38
|
| Rate for Payer: VA VA |
$125.71
|
|
|
HC EMG NEEDLE EXAM 2 EXT
|
Facility
|
OP
|
$704.60
|
|
|
Service Code
|
CPT 95861
|
| Hospital Charge Code |
92200002
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$67.38 |
| Max. Negotiated Rate |
$704.60 |
| Rate for Payer: Aetna Commercial |
$634.14
|
| Rate for Payer: Aetna Medicare |
$125.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.14
|
| Rate for Payer: ASR ASR |
$683.46
|
| Rate for Payer: ASR Commercial |
$683.46
|
| Rate for Payer: BCBS Complete |
$70.75
|
| Rate for Payer: BCBS MAPPO |
$125.71
|
| Rate for Payer: BCBS Trust/PPO |
$577.00
|
| Rate for Payer: BCN Commercial |
$546.28
|
| Rate for Payer: BCN Medicare Advantage |
$125.71
|
| Rate for Payer: Cash Price |
$563.68
|
| Rate for Payer: Cash Price |
$563.68
|
| Rate for Payer: Cofinity Commercial |
$662.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$563.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.71
|
| Rate for Payer: Healthscope Commercial |
$704.60
|
| Rate for Payer: Healthscope Whirlpool |
$683.46
|
| Rate for Payer: Humana Choice PPO Medicare |
$125.71
|
| Rate for Payer: Mclaren Commercial |
$634.14
|
| Rate for Payer: Mclaren Medicaid |
$67.38
|
| Rate for Payer: Mclaren Medicare |
$125.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.00
|
| Rate for Payer: Meridian Medicaid |
$70.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$144.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$598.91
|
| Rate for Payer: Nomi Health Commercial |
$577.77
|
| Rate for Payer: PACE Medicare |
$119.42
|
| Rate for Payer: PACE SWMI |
$125.71
|
| Rate for Payer: PHP Commercial |
$138.28
|
| Rate for Payer: PHP Medicaid |
$67.38
|
| Rate for Payer: PHP Medicare Advantage |
$125.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$457.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$617.37
|
| Rate for Payer: Priority Health Medicare |
$125.71
|
| Rate for Payer: Priority Health Narrow Network |
$493.92
|
| Rate for Payer: Railroad Medicare Medicare |
$125.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$620.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.71
|
| Rate for Payer: UHC Exchange |
$194.85
|
| Rate for Payer: UHC Medicare Advantage |
$125.71
|
| Rate for Payer: UHCCP DNSP |
$125.71
|
| Rate for Payer: UHCCP Medicaid |
$67.38
|
| Rate for Payer: VA VA |
$125.71
|
|
|
HC EMG NEEDLE EXAM 2 EXT
|
Facility
|
IP
|
$704.60
|
|
|
Service Code
|
CPT 95861
|
| Hospital Charge Code |
92200002
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$457.99 |
| Max. Negotiated Rate |
$704.60 |
| Rate for Payer: Aetna Commercial |
$634.14
|
| Rate for Payer: ASR ASR |
$683.46
|
| Rate for Payer: ASR Commercial |
$683.46
|
| Rate for Payer: BCBS Trust/PPO |
$574.18
|
| Rate for Payer: BCN Commercial |
$546.28
|
| Rate for Payer: Cash Price |
$563.68
|
| Rate for Payer: Cofinity Commercial |
$662.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$563.68
|
| Rate for Payer: Healthscope Commercial |
$704.60
|
| Rate for Payer: Healthscope Whirlpool |
$683.46
|
| Rate for Payer: Mclaren Commercial |
$634.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$598.91
|
| Rate for Payer: Nomi Health Commercial |
$577.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$457.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$620.05
|
|
|
HC EMG NEEDLE EXAM 3 EXT
|
Facility
|
OP
|
$651.13
|
|
|
Service Code
|
CPT 95863
|
| Hospital Charge Code |
92200003
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$81.79 |
| Max. Negotiated Rate |
$651.13 |
| Rate for Payer: Aetna Commercial |
$586.02
|
| Rate for Payer: Aetna Medicare |
$152.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$190.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$190.74
|
| Rate for Payer: ASR ASR |
$631.60
|
| Rate for Payer: ASR Commercial |
$631.60
|
| Rate for Payer: BCBS Complete |
$85.88
|
| Rate for Payer: BCBS MAPPO |
$152.59
|
| Rate for Payer: BCBS Trust/PPO |
$533.21
|
| Rate for Payer: BCN Commercial |
$504.82
|
| Rate for Payer: BCN Medicare Advantage |
$152.59
|
| Rate for Payer: Cash Price |
$520.90
|
| Rate for Payer: Cash Price |
$520.90
|
| Rate for Payer: Cofinity Commercial |
$612.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$520.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$152.59
|
| Rate for Payer: Healthscope Commercial |
$651.13
|
| Rate for Payer: Healthscope Whirlpool |
$631.60
|
| Rate for Payer: Humana Choice PPO Medicare |
$152.59
|
| Rate for Payer: Mclaren Commercial |
$586.02
|
| Rate for Payer: Mclaren Medicaid |
$81.79
|
| Rate for Payer: Mclaren Medicare |
$152.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.22
|
| Rate for Payer: Meridian Medicaid |
$85.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$175.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$553.46
|
| Rate for Payer: Nomi Health Commercial |
$533.93
|
| Rate for Payer: PACE Medicare |
$144.96
|
| Rate for Payer: PACE SWMI |
$152.59
|
| Rate for Payer: PHP Commercial |
$167.85
|
| Rate for Payer: PHP Medicaid |
$81.79
|
| Rate for Payer: PHP Medicare Advantage |
$152.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$81.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$423.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$570.52
|
| Rate for Payer: Priority Health Medicare |
$152.59
|
| Rate for Payer: Priority Health Narrow Network |
$456.44
|
| Rate for Payer: Railroad Medicare Medicare |
$152.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$572.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$152.59
|
| Rate for Payer: UHC Exchange |
$236.51
|
| Rate for Payer: UHC Medicare Advantage |
$152.59
|
| Rate for Payer: UHCCP DNSP |
$152.59
|
| Rate for Payer: UHCCP Medicaid |
$81.79
|
| Rate for Payer: VA VA |
$152.59
|
|
|
HC EMG NEEDLE EXAM 3 EXT
|
Facility
|
IP
|
$651.13
|
|
|
Service Code
|
CPT 95863
|
| Hospital Charge Code |
92200003
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$423.23 |
| Max. Negotiated Rate |
$651.13 |
| Rate for Payer: Aetna Commercial |
$586.02
|
| Rate for Payer: ASR ASR |
$631.60
|
| Rate for Payer: ASR Commercial |
$631.60
|
| Rate for Payer: BCBS Trust/PPO |
$530.61
|
| Rate for Payer: BCN Commercial |
$504.82
|
| Rate for Payer: Cash Price |
$520.90
|
| Rate for Payer: Cofinity Commercial |
$612.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$520.90
|
| Rate for Payer: Healthscope Commercial |
$651.13
|
| Rate for Payer: Healthscope Whirlpool |
$631.60
|
| Rate for Payer: Mclaren Commercial |
$586.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$553.46
|
| Rate for Payer: Nomi Health Commercial |
$533.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$423.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$572.99
|
|
|
HC EMG NEEDLE EXAM 4 EXT
|
Facility
|
IP
|
$816.54
|
|
|
Service Code
|
CPT 95864
|
| Hospital Charge Code |
92200004
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$530.75 |
| Max. Negotiated Rate |
$816.54 |
| Rate for Payer: Aetna Commercial |
$734.89
|
| Rate for Payer: ASR ASR |
$792.04
|
| Rate for Payer: ASR Commercial |
$792.04
|
| Rate for Payer: BCBS Trust/PPO |
$665.40
|
| Rate for Payer: BCN Commercial |
$633.06
|
| Rate for Payer: Cash Price |
$653.23
|
| Rate for Payer: Cofinity Commercial |
$767.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$653.23
|
| Rate for Payer: Healthscope Commercial |
$816.54
|
| Rate for Payer: Healthscope Whirlpool |
$792.04
|
| Rate for Payer: Mclaren Commercial |
$734.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$694.06
|
| Rate for Payer: Nomi Health Commercial |
$669.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$530.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$718.56
|
|
|
HC EMG NEEDLE EXAM 4 EXT
|
Facility
|
OP
|
$816.54
|
|
|
Service Code
|
CPT 95864
|
| Hospital Charge Code |
92200004
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$81.79 |
| Max. Negotiated Rate |
$816.54 |
| Rate for Payer: Aetna Commercial |
$734.89
|
| Rate for Payer: Aetna Medicare |
$152.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$190.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$190.74
|
| Rate for Payer: ASR ASR |
$792.04
|
| Rate for Payer: ASR Commercial |
$792.04
|
| Rate for Payer: BCBS Complete |
$85.88
|
| Rate for Payer: BCBS MAPPO |
$152.59
|
| Rate for Payer: BCBS Trust/PPO |
$668.66
|
| Rate for Payer: BCN Commercial |
$633.06
|
| Rate for Payer: BCN Medicare Advantage |
$152.59
|
| Rate for Payer: Cash Price |
$653.23
|
| Rate for Payer: Cash Price |
$653.23
|
| Rate for Payer: Cofinity Commercial |
$767.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$653.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$152.59
|
| Rate for Payer: Healthscope Commercial |
$816.54
|
| Rate for Payer: Healthscope Whirlpool |
$792.04
|
| Rate for Payer: Humana Choice PPO Medicare |
$152.59
|
| Rate for Payer: Mclaren Commercial |
$734.89
|
| Rate for Payer: Mclaren Medicaid |
$81.79
|
| Rate for Payer: Mclaren Medicare |
$152.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.22
|
| Rate for Payer: Meridian Medicaid |
$85.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$175.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$694.06
|
| Rate for Payer: Nomi Health Commercial |
$669.56
|
| Rate for Payer: PACE Medicare |
$144.96
|
| Rate for Payer: PACE SWMI |
$152.59
|
| Rate for Payer: PHP Commercial |
$167.85
|
| Rate for Payer: PHP Medicaid |
$81.79
|
| Rate for Payer: PHP Medicare Advantage |
$152.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$81.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$530.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$715.45
|
| Rate for Payer: Priority Health Medicare |
$152.59
|
| Rate for Payer: Priority Health Narrow Network |
$572.39
|
| Rate for Payer: Railroad Medicare Medicare |
$152.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$718.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$152.59
|
| Rate for Payer: UHC Exchange |
$236.51
|
| Rate for Payer: UHC Medicare Advantage |
$152.59
|
| Rate for Payer: UHCCP DNSP |
$152.59
|
| Rate for Payer: UHCCP Medicaid |
$81.79
|
| Rate for Payer: VA VA |
$152.59
|
|
