|
HC EMG NEEDLE EXAM CRANIAL BILAT NCS
|
Facility
|
OP
|
$816.54
|
|
|
Service Code
|
CPT 95868
|
| Hospital Charge Code |
92200007
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$162.78 |
| Max. Negotiated Rate |
$816.54 |
| Rate for Payer: Aetna Commercial |
$734.89
|
| Rate for Payer: Aetna Medicare |
$303.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$379.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$379.62
|
| Rate for Payer: ASR ASR |
$792.04
|
| Rate for Payer: ASR Commercial |
$792.04
|
| Rate for Payer: BCBS Complete |
$170.92
|
| Rate for Payer: BCBS MAPPO |
$303.70
|
| Rate for Payer: BCBS Trust/PPO |
$668.66
|
| Rate for Payer: BCN Commercial |
$633.06
|
| Rate for Payer: BCN Medicare Advantage |
$303.70
|
| 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 |
$303.70
|
| Rate for Payer: Healthscope Commercial |
$816.54
|
| Rate for Payer: Healthscope Whirlpool |
$792.04
|
| Rate for Payer: Humana Choice PPO Medicare |
$303.70
|
| Rate for Payer: Mclaren Commercial |
$734.89
|
| Rate for Payer: Mclaren Medicaid |
$162.78
|
| Rate for Payer: Mclaren Medicare |
$303.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$318.88
|
| Rate for Payer: Meridian Medicaid |
$170.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$349.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$694.06
|
| Rate for Payer: Nomi Health Commercial |
$669.56
|
| Rate for Payer: PACE Medicare |
$288.51
|
| Rate for Payer: PACE SWMI |
$303.70
|
| Rate for Payer: PHP Commercial |
$334.07
|
| Rate for Payer: PHP Medicaid |
$162.78
|
| Rate for Payer: PHP Medicare Advantage |
$303.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$162.78
|
| 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 |
$303.70
|
| Rate for Payer: Priority Health Narrow Network |
$572.39
|
| Rate for Payer: Railroad Medicare Medicare |
$303.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$718.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$303.70
|
| Rate for Payer: UHC Exchange |
$470.74
|
| Rate for Payer: UHC Medicare Advantage |
$303.70
|
| Rate for Payer: UHCCP DNSP |
$303.70
|
| Rate for Payer: UHCCP Medicaid |
$162.78
|
| Rate for Payer: VA VA |
$303.70
|
|
|
HC EMG NEEDLE EXAM CRANIAL BILAT NCS
|
Facility
|
IP
|
$816.54
|
|
|
Service Code
|
CPT 95868
|
| Hospital Charge Code |
92200007
|
|
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 CRANIAL UNILAT WO NCS
|
Facility
|
OP
|
$734.93
|
|
|
Service Code
|
CPT 95867
|
| Hospital Charge Code |
92200006
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$162.78 |
| Max. Negotiated Rate |
$734.93 |
| Rate for Payer: Aetna Commercial |
$661.44
|
| Rate for Payer: Aetna Medicare |
$303.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$379.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$379.62
|
| Rate for Payer: ASR ASR |
$712.88
|
| Rate for Payer: ASR Commercial |
$712.88
|
| Rate for Payer: BCBS Complete |
$170.92
|
| Rate for Payer: BCBS MAPPO |
$303.70
|
| Rate for Payer: BCBS Trust/PPO |
$601.83
|
| Rate for Payer: BCN Commercial |
$569.79
|
| Rate for Payer: BCN Medicare Advantage |
$303.70
|
| Rate for Payer: Cash Price |
$587.94
|
| Rate for Payer: Cash Price |
$587.94
|
| Rate for Payer: Cofinity Commercial |
$690.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$587.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$303.70
|
| Rate for Payer: Healthscope Commercial |
$734.93
|
| Rate for Payer: Healthscope Whirlpool |
$712.88
|
| Rate for Payer: Humana Choice PPO Medicare |
$303.70
|
| Rate for Payer: Mclaren Commercial |
$661.44
|
| Rate for Payer: Mclaren Medicaid |
$162.78
|
| Rate for Payer: Mclaren Medicare |
$303.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$318.88
|
| Rate for Payer: Meridian Medicaid |
$170.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$349.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$624.69
|
| Rate for Payer: Nomi Health Commercial |
$602.64
|
| Rate for Payer: PACE Medicare |
$288.51
|
| Rate for Payer: PACE SWMI |
$303.70
|
| Rate for Payer: PHP Commercial |
$334.07
|
| Rate for Payer: PHP Medicaid |
$162.78
|
| Rate for Payer: PHP Medicare Advantage |
$303.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$162.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$477.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$643.95
|
| Rate for Payer: Priority Health Medicare |
$303.70
|
| Rate for Payer: Priority Health Narrow Network |
$515.19
|
| Rate for Payer: Railroad Medicare Medicare |
$303.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$646.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$303.70
|
| Rate for Payer: UHC Exchange |
$470.74
|
| Rate for Payer: UHC Medicare Advantage |
$303.70
|
| Rate for Payer: UHCCP DNSP |
$303.70
|
| Rate for Payer: UHCCP Medicaid |
$162.78
|
| Rate for Payer: VA VA |
$303.70
|
|
|
HC EMG NEEDLE EXAM CRANIAL UNILAT WO NCS
|
Facility
|
IP
|
$734.93
|
|
|
Service Code
|
CPT 95867
|
| Hospital Charge Code |
92200006
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$477.70 |
| Max. Negotiated Rate |
$734.93 |
| Rate for Payer: Aetna Commercial |
$661.44
|
| Rate for Payer: ASR ASR |
$712.88
|
| Rate for Payer: ASR Commercial |
$712.88
|
| Rate for Payer: BCBS Trust/PPO |
$598.89
|
| Rate for Payer: BCN Commercial |
$569.79
|
| Rate for Payer: Cash Price |
$587.94
|
| Rate for Payer: Cofinity Commercial |
$690.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$587.94
|
| Rate for Payer: Healthscope Commercial |
$734.93
|
| Rate for Payer: Healthscope Whirlpool |
$712.88
|
| Rate for Payer: Mclaren Commercial |
$661.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$624.69
|
| Rate for Payer: Nomi Health Commercial |
$602.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$477.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$646.74
|
|
|
HC EMG NEEDLE EXAM WITH NCS LIMITED
|
Facility
|
IP
|
$374.98
|
|
|
Service Code
|
CPT 95885
|
| Hospital Charge Code |
92200022
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$243.74 |
| Max. Negotiated Rate |
$374.98 |
| Rate for Payer: Aetna Commercial |
$337.48
|
| Rate for Payer: ASR ASR |
$363.73
|
| Rate for Payer: ASR Commercial |
$363.73
|
| Rate for Payer: BCBS Trust/PPO |
$305.57
|
| Rate for Payer: BCN Commercial |
$290.72
|
| Rate for Payer: Cash Price |
$299.98
|
| Rate for Payer: Cofinity Commercial |
$352.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$299.98
|
| Rate for Payer: Healthscope Commercial |
$374.98
|
| Rate for Payer: Healthscope Whirlpool |
$363.73
|
| Rate for Payer: Mclaren Commercial |
$337.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$318.73
|
| Rate for Payer: Nomi Health Commercial |
$307.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$243.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$329.98
|
|
|
HC EMG NEEDLE EXAM WITH NCS LIMITED
|
Facility
|
OP
|
$374.98
|
|
|
Service Code
|
CPT 95885
|
| Hospital Charge Code |
92200022
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$149.99 |
| Max. Negotiated Rate |
$374.98 |
| Rate for Payer: Aetna Commercial |
$337.48
|
| Rate for Payer: Aetna Medicare |
$187.49
|
| Rate for Payer: ASR ASR |
$363.73
|
| Rate for Payer: ASR Commercial |
$363.73
|
| Rate for Payer: BCBS Complete |
$149.99
|
| Rate for Payer: BCBS Trust/PPO |
$307.07
|
| Rate for Payer: BCN Commercial |
$290.72
|
| Rate for Payer: Cash Price |
$299.98
|
| Rate for Payer: Cofinity Commercial |
$352.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$299.98
|
| Rate for Payer: Healthscope Commercial |
$374.98
|
| Rate for Payer: Healthscope Whirlpool |
$363.73
|
| Rate for Payer: Mclaren Commercial |
$337.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$318.73
|
| Rate for Payer: Nomi Health Commercial |
$307.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$243.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$328.56
|
| Rate for Payer: Priority Health Narrow Network |
$262.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$329.98
|
|
|
HC EMG NEEDLE EXAM WITH NCV COMPLETE
|
Facility
|
IP
|
$454.09
|
|
|
Service Code
|
CPT 95886
|
| Hospital Charge Code |
92200023
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$295.16 |
| Max. Negotiated Rate |
$454.09 |
| Rate for Payer: Aetna Commercial |
$408.68
|
| Rate for Payer: ASR ASR |
$440.47
|
| Rate for Payer: ASR Commercial |
$440.47
|
| Rate for Payer: BCBS Trust/PPO |
$370.04
|
| Rate for Payer: BCN Commercial |
$352.06
|
| Rate for Payer: Cash Price |
$363.27
|
| Rate for Payer: Cofinity Commercial |
$426.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$363.27
|
| Rate for Payer: Healthscope Commercial |
$454.09
|
| Rate for Payer: Healthscope Whirlpool |
$440.47
|
| Rate for Payer: Mclaren Commercial |
$408.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$385.98
|
| Rate for Payer: Nomi Health Commercial |
$372.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$295.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$399.60
|
|
|
HC EMG NEEDLE EXAM WITH NCV COMPLETE
|
Facility
|
OP
|
$454.09
|
|
|
Service Code
|
CPT 95886
|
| Hospital Charge Code |
92200023
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$181.64 |
| Max. Negotiated Rate |
$454.09 |
| Rate for Payer: Aetna Commercial |
$408.68
|
| Rate for Payer: Aetna Medicare |
$227.04
|
| Rate for Payer: ASR ASR |
$440.47
|
| Rate for Payer: ASR Commercial |
$440.47
|
| Rate for Payer: BCBS Complete |
$181.64
|
| Rate for Payer: BCBS Trust/PPO |
$371.85
|
| Rate for Payer: BCN Commercial |
$352.06
|
| Rate for Payer: Cash Price |
$363.27
|
| Rate for Payer: Cofinity Commercial |
$426.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$363.27
|
| Rate for Payer: Healthscope Commercial |
$454.09
|
| Rate for Payer: Healthscope Whirlpool |
$440.47
|
| Rate for Payer: Mclaren Commercial |
$408.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$385.98
|
| Rate for Payer: Nomi Health Commercial |
$372.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$295.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$397.87
|
| Rate for Payer: Priority Health Narrow Network |
$318.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$399.60
|
|
|
HC EMG NEEDLE FROM LARYNX
|
Facility
|
IP
|
$398.14
|
|
|
Service Code
|
CPT 95865
|
| Hospital Charge Code |
92200005
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$258.79 |
| Max. Negotiated Rate |
$398.14 |
| Rate for Payer: Aetna Commercial |
$358.33
|
| Rate for Payer: ASR ASR |
$386.20
|
| Rate for Payer: ASR Commercial |
$386.20
|
| Rate for Payer: BCBS Trust/PPO |
$324.44
|
| Rate for Payer: BCN Commercial |
$308.68
|
| Rate for Payer: Cash Price |
$318.51
|
| Rate for Payer: Cofinity Commercial |
$374.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$318.51
|
| Rate for Payer: Healthscope Commercial |
$398.14
|
| Rate for Payer: Healthscope Whirlpool |
$386.20
|
| Rate for Payer: Mclaren Commercial |
$358.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$338.42
|
| Rate for Payer: Nomi Health Commercial |
$326.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$258.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$350.36
|
|
|
HC EMG NEEDLE FROM LARYNX
|
Facility
|
OP
|
$398.14
|
|
|
Service Code
|
CPT 95865
|
| Hospital Charge Code |
92200005
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$67.38 |
| Max. Negotiated Rate |
$398.14 |
| Rate for Payer: Aetna Commercial |
$358.33
|
| 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 |
$386.20
|
| Rate for Payer: ASR Commercial |
$386.20
|
| Rate for Payer: BCBS Complete |
$70.75
|
| Rate for Payer: BCBS MAPPO |
$125.71
|
| Rate for Payer: BCBS Trust/PPO |
$326.04
|
| Rate for Payer: BCN Commercial |
$308.68
|
| Rate for Payer: BCN Medicare Advantage |
$125.71
|
| Rate for Payer: Cash Price |
$318.51
|
| Rate for Payer: Cash Price |
$318.51
|
| Rate for Payer: Cofinity Commercial |
$374.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$318.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.71
|
| Rate for Payer: Healthscope Commercial |
$398.14
|
| Rate for Payer: Healthscope Whirlpool |
$386.20
|
| Rate for Payer: Humana Choice PPO Medicare |
$125.71
|
| Rate for Payer: Mclaren Commercial |
$358.33
|
| 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 |
$338.42
|
| Rate for Payer: Nomi Health Commercial |
$326.47
|
| 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 |
$258.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$348.85
|
| Rate for Payer: Priority Health Medicare |
$125.71
|
| Rate for Payer: Priority Health Narrow Network |
$279.10
|
| Rate for Payer: Railroad Medicare Medicare |
$125.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$350.36
|
| 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 REPETITIVE STIMULATION
|
Facility
|
OP
|
$439.01
|
|
|
Service Code
|
CPT 95937
|
| Hospital Charge Code |
92200021
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$81.79 |
| Max. Negotiated Rate |
$439.01 |
| Rate for Payer: Aetna Commercial |
$395.11
|
| 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 |
$425.84
|
| Rate for Payer: ASR Commercial |
$425.84
|
| Rate for Payer: BCBS Complete |
$85.88
|
| Rate for Payer: BCBS MAPPO |
$152.59
|
| Rate for Payer: BCBS Trust/PPO |
$359.51
|
| Rate for Payer: BCN Commercial |
$340.36
|
| Rate for Payer: BCN Medicare Advantage |
$152.59
|
| Rate for Payer: Cash Price |
$351.21
|
| Rate for Payer: Cash Price |
$351.21
|
| Rate for Payer: Cofinity Commercial |
$412.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$351.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$152.59
|
| Rate for Payer: Healthscope Commercial |
$439.01
|
| Rate for Payer: Healthscope Whirlpool |
$425.84
|
| Rate for Payer: Humana Choice PPO Medicare |
$152.59
|
| Rate for Payer: Mclaren Commercial |
$395.11
|
| 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 |
$373.16
|
| Rate for Payer: Nomi Health Commercial |
$359.99
|
| 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 |
$285.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$384.66
|
| Rate for Payer: Priority Health Medicare |
$152.59
|
| Rate for Payer: Priority Health Narrow Network |
$307.75
|
| Rate for Payer: Railroad Medicare Medicare |
$152.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$386.33
|
| 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 REPETITIVE STIMULATION
|
Facility
|
IP
|
$439.01
|
|
|
Service Code
|
CPT 95937
|
| Hospital Charge Code |
92200021
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$285.36 |
| Max. Negotiated Rate |
$439.01 |
| Rate for Payer: Aetna Commercial |
$395.11
|
| Rate for Payer: ASR ASR |
$425.84
|
| Rate for Payer: ASR Commercial |
$425.84
|
| Rate for Payer: BCBS Trust/PPO |
$357.75
|
| Rate for Payer: BCN Commercial |
$340.36
|
| Rate for Payer: Cash Price |
$351.21
|
| Rate for Payer: Cofinity Commercial |
$412.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$351.21
|
| Rate for Payer: Healthscope Commercial |
$439.01
|
| Rate for Payer: Healthscope Whirlpool |
$425.84
|
| Rate for Payer: Mclaren Commercial |
$395.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$373.16
|
| Rate for Payer: Nomi Health Commercial |
$359.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$285.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$386.33
|
|
|
HC EMG SINGLE FIBER
|
Facility
|
OP
|
$459.55
|
|
|
Service Code
|
CPT 95872
|
| Hospital Charge Code |
92200010
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$81.79 |
| Max. Negotiated Rate |
$459.55 |
| Rate for Payer: Aetna Commercial |
$413.60
|
| 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 |
$445.76
|
| Rate for Payer: ASR Commercial |
$445.76
|
| Rate for Payer: BCBS Complete |
$85.88
|
| Rate for Payer: BCBS MAPPO |
$152.59
|
| Rate for Payer: BCBS Trust/PPO |
$376.33
|
| Rate for Payer: BCN Commercial |
$356.29
|
| Rate for Payer: BCN Medicare Advantage |
$152.59
|
| Rate for Payer: Cash Price |
$367.64
|
| Rate for Payer: Cash Price |
$367.64
|
| Rate for Payer: Cofinity Commercial |
$431.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$367.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$152.59
|
| Rate for Payer: Healthscope Commercial |
$459.55
|
| Rate for Payer: Healthscope Whirlpool |
$445.76
|
| Rate for Payer: Humana Choice PPO Medicare |
$152.59
|
| Rate for Payer: Mclaren Commercial |
$413.60
|
| 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 |
$390.62
|
| Rate for Payer: Nomi Health Commercial |
$376.83
|
| 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 |
$298.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$402.66
|
| Rate for Payer: Priority Health Medicare |
$152.59
|
| Rate for Payer: Priority Health Narrow Network |
$322.14
|
| Rate for Payer: Railroad Medicare Medicare |
$152.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$404.40
|
| 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 SINGLE FIBER
|
Facility
|
IP
|
$459.55
|
|
|
Service Code
|
CPT 95872
|
| Hospital Charge Code |
92200010
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$298.71 |
| Max. Negotiated Rate |
$459.55 |
| Rate for Payer: Aetna Commercial |
$413.60
|
| Rate for Payer: ASR ASR |
$445.76
|
| Rate for Payer: ASR Commercial |
$445.76
|
| Rate for Payer: BCBS Trust/PPO |
$374.49
|
| Rate for Payer: BCN Commercial |
$356.29
|
| Rate for Payer: Cash Price |
$367.64
|
| Rate for Payer: Cofinity Commercial |
$431.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$367.64
|
| Rate for Payer: Healthscope Commercial |
$459.55
|
| Rate for Payer: Healthscope Whirlpool |
$445.76
|
| Rate for Payer: Mclaren Commercial |
$413.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$390.62
|
| Rate for Payer: Nomi Health Commercial |
$376.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$298.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$404.40
|
|
|
HC EMG SURFACE FROM LARYNX
|
Facility
|
OP
|
$277.87
|
|
|
Service Code
|
CPT 95999
|
| Hospital Charge Code |
92000010
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$81.79 |
| Max. Negotiated Rate |
$277.87 |
| Rate for Payer: Aetna Commercial |
$250.08
|
| 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 |
$269.53
|
| Rate for Payer: ASR Commercial |
$269.53
|
| Rate for Payer: BCBS Complete |
$85.88
|
| Rate for Payer: BCBS MAPPO |
$152.59
|
| Rate for Payer: BCBS Trust/PPO |
$227.55
|
| Rate for Payer: BCN Commercial |
$215.43
|
| Rate for Payer: BCN Medicare Advantage |
$152.59
|
| Rate for Payer: Cash Price |
$222.30
|
| Rate for Payer: Cash Price |
$222.30
|
| Rate for Payer: Cofinity Commercial |
$261.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$222.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$152.59
|
| Rate for Payer: Healthscope Commercial |
$277.87
|
| Rate for Payer: Healthscope Whirlpool |
$269.53
|
| Rate for Payer: Humana Choice PPO Medicare |
$152.59
|
| Rate for Payer: Mclaren Commercial |
$250.08
|
| 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 |
$236.19
|
| Rate for Payer: Nomi Health Commercial |
$227.85
|
| 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 |
$180.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$243.47
|
| Rate for Payer: Priority Health Medicare |
$152.59
|
| Rate for Payer: Priority Health Narrow Network |
$194.79
|
| Rate for Payer: Railroad Medicare Medicare |
$152.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$244.53
|
| 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 SURFACE FROM LARYNX
|
Facility
|
IP
|
$277.87
|
|
|
Service Code
|
CPT 95999
|
| Hospital Charge Code |
92000010
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$180.62 |
| Max. Negotiated Rate |
$277.87 |
| Rate for Payer: Aetna Commercial |
$250.08
|
| Rate for Payer: ASR ASR |
$269.53
|
| Rate for Payer: ASR Commercial |
$269.53
|
| Rate for Payer: BCBS Trust/PPO |
$226.44
|
| Rate for Payer: BCN Commercial |
$215.43
|
| Rate for Payer: Cash Price |
$222.30
|
| Rate for Payer: Cofinity Commercial |
$261.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$222.30
|
| Rate for Payer: Healthscope Commercial |
$277.87
|
| Rate for Payer: Healthscope Whirlpool |
$269.53
|
| Rate for Payer: Mclaren Commercial |
$250.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$236.19
|
| Rate for Payer: Nomi Health Commercial |
$227.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$180.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$244.53
|
|
|
HC EMG THORACIC PSP. NEEDLE EXAM
|
Facility
|
IP
|
$525.20
|
|
|
Service Code
|
CPT 95869
|
| Hospital Charge Code |
92200008
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$341.38 |
| Max. Negotiated Rate |
$525.20 |
| Rate for Payer: Aetna Commercial |
$472.68
|
| Rate for Payer: ASR ASR |
$509.44
|
| Rate for Payer: ASR Commercial |
$509.44
|
| Rate for Payer: BCBS Trust/PPO |
$427.99
|
| Rate for Payer: BCN Commercial |
$407.19
|
| Rate for Payer: Cash Price |
$420.16
|
| Rate for Payer: Cofinity Commercial |
$493.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$420.16
|
| Rate for Payer: Healthscope Commercial |
$525.20
|
| Rate for Payer: Healthscope Whirlpool |
$509.44
|
| Rate for Payer: Mclaren Commercial |
$472.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$446.42
|
| Rate for Payer: Nomi Health Commercial |
$430.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$341.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$462.18
|
|
|
HC EMG THORACIC PSP. NEEDLE EXAM
|
Facility
|
OP
|
$525.20
|
|
|
Service Code
|
CPT 95869
|
| Hospital Charge Code |
92200008
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$162.78 |
| Max. Negotiated Rate |
$525.20 |
| Rate for Payer: Aetna Commercial |
$472.68
|
| Rate for Payer: Aetna Medicare |
$303.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$379.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$379.62
|
| Rate for Payer: ASR ASR |
$509.44
|
| Rate for Payer: ASR Commercial |
$509.44
|
| Rate for Payer: BCBS Complete |
$170.92
|
| Rate for Payer: BCBS MAPPO |
$303.70
|
| Rate for Payer: BCBS Trust/PPO |
$430.09
|
| Rate for Payer: BCN Commercial |
$407.19
|
| Rate for Payer: BCN Medicare Advantage |
$303.70
|
| Rate for Payer: Cash Price |
$420.16
|
| Rate for Payer: Cash Price |
$420.16
|
| Rate for Payer: Cofinity Commercial |
$493.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$420.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$303.70
|
| Rate for Payer: Healthscope Commercial |
$525.20
|
| Rate for Payer: Healthscope Whirlpool |
$509.44
|
| Rate for Payer: Humana Choice PPO Medicare |
$303.70
|
| Rate for Payer: Mclaren Commercial |
$472.68
|
| Rate for Payer: Mclaren Medicaid |
$162.78
|
| Rate for Payer: Mclaren Medicare |
$303.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$318.88
|
| Rate for Payer: Meridian Medicaid |
$170.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$349.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$446.42
|
| Rate for Payer: Nomi Health Commercial |
$430.66
|
| Rate for Payer: PACE Medicare |
$288.51
|
| Rate for Payer: PACE SWMI |
$303.70
|
| Rate for Payer: PHP Commercial |
$334.07
|
| Rate for Payer: PHP Medicaid |
$162.78
|
| Rate for Payer: PHP Medicare Advantage |
$303.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$162.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$341.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$460.18
|
| Rate for Payer: Priority Health Medicare |
$303.70
|
| Rate for Payer: Priority Health Narrow Network |
$368.17
|
| Rate for Payer: Railroad Medicare Medicare |
$303.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$462.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$303.70
|
| Rate for Payer: UHC Exchange |
$470.74
|
| Rate for Payer: UHC Medicare Advantage |
$303.70
|
| Rate for Payer: UHCCP DNSP |
$303.70
|
| Rate for Payer: UHCCP Medicaid |
$162.78
|
| Rate for Payer: VA VA |
$303.70
|
|
|
HC EMR RENAL BIOPSY (BILL ONLY)
|
Facility
|
IP
|
$584.46
|
|
|
Service Code
|
CPT 88348
|
| Hospital Charge Code |
31200008
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$379.90 |
| Max. Negotiated Rate |
$584.46 |
| Rate for Payer: Aetna Commercial |
$526.01
|
| Rate for Payer: ASR ASR |
$566.93
|
| Rate for Payer: ASR Commercial |
$566.93
|
| Rate for Payer: BCBS Trust/PPO |
$476.28
|
| Rate for Payer: BCN Commercial |
$453.13
|
| Rate for Payer: Cash Price |
$467.57
|
| Rate for Payer: Cofinity Commercial |
$549.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$467.57
|
| Rate for Payer: Healthscope Commercial |
$584.46
|
| Rate for Payer: Healthscope Whirlpool |
$566.93
|
| Rate for Payer: Mclaren Commercial |
$526.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$496.79
|
| Rate for Payer: Nomi Health Commercial |
$479.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$379.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$514.32
|
|
|
HC EMR RENAL BIOPSY (BILL ONLY)
|
Facility
|
OP
|
$584.46
|
|
|
Service Code
|
CPT 88348
|
| Hospital Charge Code |
31200008
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$379.90 |
| Max. Negotiated Rate |
$1,234.90 |
| Rate for Payer: Aetna Commercial |
$526.01
|
| Rate for Payer: Aetna Medicare |
$796.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$995.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$995.89
|
| Rate for Payer: ASR ASR |
$566.93
|
| Rate for Payer: ASR Commercial |
$566.93
|
| Rate for Payer: BCBS Complete |
$448.39
|
| Rate for Payer: BCBS MAPPO |
$796.71
|
| Rate for Payer: BCBS Trust/PPO |
$478.61
|
| Rate for Payer: BCN Commercial |
$453.13
|
| Rate for Payer: BCN Medicare Advantage |
$796.71
|
| Rate for Payer: Cash Price |
$467.57
|
| Rate for Payer: Cash Price |
$467.57
|
| Rate for Payer: Cofinity Commercial |
$549.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$467.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$796.71
|
| Rate for Payer: Healthscope Commercial |
$584.46
|
| Rate for Payer: Healthscope Whirlpool |
$566.93
|
| Rate for Payer: Humana Choice PPO Medicare |
$796.71
|
| Rate for Payer: Mclaren Commercial |
$526.01
|
| Rate for Payer: Mclaren Medicaid |
$427.04
|
| Rate for Payer: Mclaren Medicare |
$796.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$836.55
|
| Rate for Payer: Meridian Medicaid |
$448.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$916.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$496.79
|
| Rate for Payer: Nomi Health Commercial |
$479.26
|
| Rate for Payer: PACE Medicare |
$756.87
|
| Rate for Payer: PACE SWMI |
$796.71
|
| Rate for Payer: PHP Commercial |
$876.38
|
| Rate for Payer: PHP Medicaid |
$427.04
|
| Rate for Payer: PHP Medicare Advantage |
$796.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$427.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$379.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$512.10
|
| Rate for Payer: Priority Health Medicare |
$796.71
|
| Rate for Payer: Priority Health Narrow Network |
$409.71
|
| Rate for Payer: Railroad Medicare Medicare |
$796.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$514.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$796.71
|
| Rate for Payer: UHC Exchange |
$1,234.90
|
| Rate for Payer: UHC Medicare Advantage |
$796.71
|
| Rate for Payer: UHCCP DNSP |
$796.71
|
| Rate for Payer: UHCCP Medicaid |
$427.04
|
| Rate for Payer: VA VA |
$796.71
|
|
|
HC ENA EXTRACTABLE NUCLEAR AB PANEL
|
Facility
|
IP
|
$33.10
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200170
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$21.52 |
| Max. Negotiated Rate |
$33.10 |
| Rate for Payer: Aetna Commercial |
$29.79
|
| Rate for Payer: ASR ASR |
$32.11
|
| Rate for Payer: ASR Commercial |
$32.11
|
| Rate for Payer: BCBS Trust/PPO |
$26.97
|
| Rate for Payer: BCN Commercial |
$25.66
|
| Rate for Payer: Cash Price |
$26.48
|
| Rate for Payer: Cofinity Commercial |
$31.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.48
|
| Rate for Payer: Healthscope Commercial |
$33.10
|
| Rate for Payer: Healthscope Whirlpool |
$32.11
|
| Rate for Payer: Mclaren Commercial |
$29.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.14
|
| Rate for Payer: Nomi Health Commercial |
$27.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$29.13
|
|
|
HC ENA EXTRACTABLE NUCLEAR AB PANEL
|
Facility
|
OP
|
$33.10
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200170
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.61 |
| Max. Negotiated Rate |
$33.10 |
| Rate for Payer: Aetna Commercial |
$29.79
|
| Rate for Payer: Aetna Medicare |
$17.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.41
|
| Rate for Payer: ASR ASR |
$32.11
|
| Rate for Payer: ASR Commercial |
$32.11
|
| Rate for Payer: BCBS Complete |
$10.09
|
| Rate for Payer: BCBS MAPPO |
$17.93
|
| Rate for Payer: BCBS Trust/PPO |
$27.11
|
| Rate for Payer: BCN Commercial |
$25.66
|
| Rate for Payer: BCN Medicare Advantage |
$17.93
|
| Rate for Payer: Cash Price |
$26.48
|
| Rate for Payer: Cash Price |
$26.48
|
| Rate for Payer: Cofinity Commercial |
$31.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.93
|
| Rate for Payer: Healthscope Commercial |
$33.10
|
| Rate for Payer: Healthscope Whirlpool |
$32.11
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.93
|
| Rate for Payer: Mclaren Commercial |
$29.79
|
| Rate for Payer: Mclaren Medicaid |
$9.61
|
| Rate for Payer: Mclaren Medicare |
$17.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.83
|
| Rate for Payer: Meridian Medicaid |
$10.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.14
|
| Rate for Payer: Nomi Health Commercial |
$27.14
|
| Rate for Payer: PACE Medicare |
$17.03
|
| Rate for Payer: PACE SWMI |
$17.93
|
| Rate for Payer: PHP Commercial |
$19.72
|
| Rate for Payer: PHP Medicaid |
$9.61
|
| Rate for Payer: PHP Medicare Advantage |
$17.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$29.00
|
| Rate for Payer: Priority Health Medicare |
$17.93
|
| Rate for Payer: Priority Health Narrow Network |
$23.20
|
| Rate for Payer: Railroad Medicare Medicare |
$17.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$29.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.93
|
| Rate for Payer: UHC Exchange |
$27.79
|
| Rate for Payer: UHC Medicare Advantage |
$17.93
|
| Rate for Payer: UHCCP DNSP |
$17.93
|
| Rate for Payer: UHCCP Medicaid |
$9.61
|
| Rate for Payer: VA VA |
$17.93
|
|
|
HC ENA EXTRACTABLE NUCLEAR AB SCREEN
|
Facility
|
IP
|
$35.17
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200169
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$22.86 |
| Max. Negotiated Rate |
$35.17 |
| Rate for Payer: Aetna Commercial |
$31.65
|
| Rate for Payer: ASR ASR |
$34.11
|
| Rate for Payer: ASR Commercial |
$34.11
|
| Rate for Payer: BCBS Trust/PPO |
$28.66
|
| Rate for Payer: BCN Commercial |
$27.27
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cofinity Commercial |
$33.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.14
|
| Rate for Payer: Healthscope Commercial |
$35.17
|
| Rate for Payer: Healthscope Whirlpool |
$34.11
|
| Rate for Payer: Mclaren Commercial |
$31.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.89
|
| Rate for Payer: Nomi Health Commercial |
$28.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$30.95
|
|
|
HC ENA EXTRACTABLE NUCLEAR AB SCREEN
|
Facility
|
OP
|
$35.17
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200169
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.61 |
| Max. Negotiated Rate |
$35.17 |
| Rate for Payer: Aetna Commercial |
$31.65
|
| Rate for Payer: Aetna Medicare |
$17.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.41
|
| Rate for Payer: ASR ASR |
$34.11
|
| Rate for Payer: ASR Commercial |
$34.11
|
| Rate for Payer: BCBS Complete |
$10.09
|
| Rate for Payer: BCBS MAPPO |
$17.93
|
| Rate for Payer: BCBS Trust/PPO |
$28.80
|
| Rate for Payer: BCN Commercial |
$27.27
|
| Rate for Payer: BCN Medicare Advantage |
$17.93
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cofinity Commercial |
$33.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.93
|
| Rate for Payer: Healthscope Commercial |
$35.17
|
| Rate for Payer: Healthscope Whirlpool |
$34.11
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.93
|
| Rate for Payer: Mclaren Commercial |
$31.65
|
| Rate for Payer: Mclaren Medicaid |
$9.61
|
| Rate for Payer: Mclaren Medicare |
$17.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.83
|
| Rate for Payer: Meridian Medicaid |
$10.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.89
|
| Rate for Payer: Nomi Health Commercial |
$28.84
|
| Rate for Payer: PACE Medicare |
$17.03
|
| Rate for Payer: PACE SWMI |
$17.93
|
| Rate for Payer: PHP Commercial |
$19.72
|
| Rate for Payer: PHP Medicaid |
$9.61
|
| Rate for Payer: PHP Medicare Advantage |
$17.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30.82
|
| Rate for Payer: Priority Health Medicare |
$17.93
|
| Rate for Payer: Priority Health Narrow Network |
$24.65
|
| Rate for Payer: Railroad Medicare Medicare |
$17.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$30.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.93
|
| Rate for Payer: UHC Exchange |
$27.79
|
| Rate for Payer: UHC Medicare Advantage |
$17.93
|
| Rate for Payer: UHCCP DNSP |
$17.93
|
| Rate for Payer: UHCCP Medicaid |
$9.61
|
| Rate for Payer: VA VA |
$17.93
|
|
|
HC ENCEPHALOPATHY EVAL, CSF
|
Facility
|
IP
|
$154.02
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
30100723
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$100.11 |
| Max. Negotiated Rate |
$154.02 |
| Rate for Payer: Aetna Commercial |
$138.62
|
| Rate for Payer: ASR ASR |
$149.40
|
| Rate for Payer: ASR Commercial |
$149.40
|
| Rate for Payer: BCBS Trust/PPO |
$125.51
|
| Rate for Payer: BCN Commercial |
$119.41
|
| Rate for Payer: Cash Price |
$123.22
|
| Rate for Payer: Cofinity Commercial |
$144.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.22
|
| Rate for Payer: Healthscope Commercial |
$154.02
|
| Rate for Payer: Healthscope Whirlpool |
$149.40
|
| Rate for Payer: Mclaren Commercial |
$138.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.92
|
| Rate for Payer: Nomi Health Commercial |
$126.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$135.54
|
|
