|
HC ENCEPHALOPATHY EVAL, CSF
|
Facility
|
OP
|
$154.02
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
30100723
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.63 |
| Max. Negotiated Rate |
$154.02 |
| Rate for Payer: Aetna Commercial |
$138.62
|
| Rate for Payer: Aetna Medicare |
$23.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.46
|
| Rate for Payer: ASR ASR |
$149.40
|
| Rate for Payer: ASR Commercial |
$149.40
|
| Rate for Payer: BCBS Complete |
$13.27
|
| Rate for Payer: BCBS MAPPO |
$23.57
|
| Rate for Payer: BCBS Trust/PPO |
$126.13
|
| Rate for Payer: BCN Commercial |
$119.41
|
| Rate for Payer: BCN Medicare Advantage |
$23.57
|
| Rate for Payer: Cash Price |
$123.22
|
| 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: Health Alliance Plan Medicare Advantage |
$23.57
|
| Rate for Payer: Healthscope Commercial |
$154.02
|
| Rate for Payer: Healthscope Whirlpool |
$149.40
|
| Rate for Payer: Humana Choice PPO Medicare |
$23.57
|
| Rate for Payer: Mclaren Commercial |
$138.62
|
| Rate for Payer: Mclaren Medicaid |
$12.63
|
| Rate for Payer: Mclaren Medicare |
$23.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.75
|
| Rate for Payer: Meridian Medicaid |
$13.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.92
|
| Rate for Payer: Nomi Health Commercial |
$126.30
|
| Rate for Payer: PACE Medicare |
$22.39
|
| Rate for Payer: PACE SWMI |
$23.57
|
| Rate for Payer: PHP Commercial |
$25.93
|
| Rate for Payer: PHP Medicaid |
$12.63
|
| Rate for Payer: PHP Medicare Advantage |
$23.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$134.95
|
| Rate for Payer: Priority Health Medicare |
$23.57
|
| Rate for Payer: Priority Health Narrow Network |
$107.97
|
| Rate for Payer: Railroad Medicare Medicare |
$23.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$135.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.57
|
| Rate for Payer: UHC Exchange |
$36.53
|
| Rate for Payer: UHC Medicare Advantage |
$23.57
|
| Rate for Payer: UHCCP DNSP |
$23.57
|
| Rate for Payer: UHCCP Medicaid |
$12.63
|
| Rate for Payer: VA VA |
$23.57
|
|
|
HC ENCEPHALOPATHY EVAL, CSF CMPT 1
|
Facility
|
OP
|
$67.02
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200485
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.46 |
| Max. Negotiated Rate |
$67.02 |
| Rate for Payer: Aetna Commercial |
$60.32
|
| 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 |
$65.01
|
| Rate for Payer: ASR Commercial |
$65.01
|
| Rate for Payer: BCBS Complete |
$6.78
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCBS Trust/PPO |
$54.88
|
| Rate for Payer: BCN Commercial |
$51.96
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$53.62
|
| Rate for Payer: Cash Price |
$53.62
|
| Rate for Payer: Cofinity Commercial |
$63.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$67.02
|
| Rate for Payer: Healthscope Whirlpool |
$65.01
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.05
|
| Rate for Payer: Mclaren Commercial |
$60.32
|
| 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 |
$56.97
|
| Rate for Payer: Nomi Health Commercial |
$54.96
|
| 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 |
$43.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$58.72
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health Narrow Network |
$46.98
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$58.98
|
| 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 ENCEPHALOPATHY EVAL, CSF CMPT 1
|
Facility
|
IP
|
$67.02
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200485
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$43.56 |
| Max. Negotiated Rate |
$67.02 |
| Rate for Payer: Aetna Commercial |
$60.32
|
| Rate for Payer: ASR ASR |
$65.01
|
| Rate for Payer: ASR Commercial |
$65.01
|
| Rate for Payer: BCBS Trust/PPO |
$54.61
|
| Rate for Payer: BCN Commercial |
$51.96
|
| Rate for Payer: Cash Price |
$53.62
|
| Rate for Payer: Cofinity Commercial |
$63.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.62
|
| Rate for Payer: Healthscope Commercial |
$67.02
|
| Rate for Payer: Healthscope Whirlpool |
$65.01
|
| Rate for Payer: Mclaren Commercial |
$60.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.97
|
| Rate for Payer: Nomi Health Commercial |
$54.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$58.98
|
|
|
HC ENCEPHALOPATHY EVAL, S CMPT 1
|
Facility
|
IP
|
$154.49
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
30100722
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$100.42 |
| Max. Negotiated Rate |
$154.49 |
| Rate for Payer: Aetna Commercial |
$139.04
|
| Rate for Payer: ASR ASR |
$149.86
|
| Rate for Payer: ASR Commercial |
$149.86
|
| Rate for Payer: BCBS Trust/PPO |
$125.89
|
| Rate for Payer: BCN Commercial |
$119.78
|
| Rate for Payer: Cash Price |
$123.59
|
| Rate for Payer: Cofinity Commercial |
$145.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.59
|
| Rate for Payer: Healthscope Commercial |
$154.49
|
| Rate for Payer: Healthscope Whirlpool |
$149.86
|
| Rate for Payer: Mclaren Commercial |
$139.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$131.32
|
| Rate for Payer: Nomi Health Commercial |
$126.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$135.95
|
|
|
HC ENCEPHALOPATHY EVAL, S CMPT 1
|
Facility
|
OP
|
$154.49
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
30100722
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.86 |
| Max. Negotiated Rate |
$154.49 |
| Rate for Payer: Aetna Commercial |
$139.04
|
| Rate for Payer: Aetna Medicare |
$18.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.00
|
| Rate for Payer: ASR ASR |
$149.86
|
| Rate for Payer: ASR Commercial |
$149.86
|
| Rate for Payer: BCBS Complete |
$10.36
|
| Rate for Payer: BCBS MAPPO |
$18.40
|
| Rate for Payer: BCBS Trust/PPO |
$126.51
|
| Rate for Payer: BCN Commercial |
$119.78
|
| Rate for Payer: BCN Medicare Advantage |
$18.40
|
| Rate for Payer: Cash Price |
$123.59
|
| Rate for Payer: Cash Price |
$123.59
|
| Rate for Payer: Cofinity Commercial |
$145.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.40
|
| Rate for Payer: Healthscope Commercial |
$154.49
|
| Rate for Payer: Healthscope Whirlpool |
$149.86
|
| Rate for Payer: Humana Choice PPO Medicare |
$18.40
|
| Rate for Payer: Mclaren Commercial |
$139.04
|
| Rate for Payer: Mclaren Medicaid |
$9.86
|
| Rate for Payer: Mclaren Medicare |
$18.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.32
|
| Rate for Payer: Meridian Medicaid |
$10.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$131.32
|
| Rate for Payer: Nomi Health Commercial |
$126.68
|
| Rate for Payer: PACE Medicare |
$17.48
|
| Rate for Payer: PACE SWMI |
$18.40
|
| Rate for Payer: PHP Commercial |
$20.24
|
| Rate for Payer: PHP Medicaid |
$9.86
|
| Rate for Payer: PHP Medicare Advantage |
$18.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$135.36
|
| Rate for Payer: Priority Health Medicare |
$18.40
|
| Rate for Payer: Priority Health Narrow Network |
$108.30
|
| Rate for Payer: Railroad Medicare Medicare |
$18.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$135.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.40
|
| Rate for Payer: UHC Exchange |
$28.52
|
| Rate for Payer: UHC Medicare Advantage |
$18.40
|
| Rate for Payer: UHCCP DNSP |
$18.40
|
| Rate for Payer: UHCCP Medicaid |
$9.86
|
| Rate for Payer: VA VA |
$18.40
|
|
|
HC ENCEPHALOPATHY EVAL, S CMPT 2
|
Facility
|
OP
|
$94.86
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200484
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.46 |
| Max. Negotiated Rate |
$94.86 |
| Rate for Payer: Aetna Commercial |
$85.37
|
| 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 |
$92.01
|
| Rate for Payer: ASR Commercial |
$92.01
|
| Rate for Payer: BCBS Complete |
$6.78
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCBS Trust/PPO |
$77.68
|
| Rate for Payer: BCN Commercial |
$73.54
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$75.89
|
| Rate for Payer: Cash Price |
$75.89
|
| Rate for Payer: Cofinity Commercial |
$89.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$94.86
|
| Rate for Payer: Healthscope Whirlpool |
$92.01
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.05
|
| Rate for Payer: Mclaren Commercial |
$85.37
|
| 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 |
$80.63
|
| Rate for Payer: Nomi Health Commercial |
$77.79
|
| 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 |
$61.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$83.12
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health Narrow Network |
$66.50
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$83.48
|
| 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 ENCEPHALOPATHY EVAL, S CMPT 2
|
Facility
|
IP
|
$94.86
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200484
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$61.66 |
| Max. Negotiated Rate |
$94.86 |
| Rate for Payer: Aetna Commercial |
$85.37
|
| Rate for Payer: ASR ASR |
$92.01
|
| Rate for Payer: ASR Commercial |
$92.01
|
| Rate for Payer: BCBS Trust/PPO |
$77.30
|
| Rate for Payer: BCN Commercial |
$73.54
|
| Rate for Payer: Cash Price |
$75.89
|
| Rate for Payer: Cofinity Commercial |
$89.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.89
|
| Rate for Payer: Healthscope Commercial |
$94.86
|
| Rate for Payer: Healthscope Whirlpool |
$92.01
|
| Rate for Payer: Mclaren Commercial |
$85.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.63
|
| Rate for Payer: Nomi Health Commercial |
$77.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$83.48
|
|
|
HC ENCEPHALOPATHY EVAL, SERUM
|
Facility
|
OP
|
$209.31
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
30100721
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.63 |
| Max. Negotiated Rate |
$209.31 |
| Rate for Payer: Aetna Commercial |
$188.38
|
| Rate for Payer: Aetna Medicare |
$23.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.46
|
| Rate for Payer: ASR ASR |
$203.03
|
| Rate for Payer: ASR Commercial |
$203.03
|
| Rate for Payer: BCBS Complete |
$13.27
|
| Rate for Payer: BCBS MAPPO |
$23.57
|
| Rate for Payer: BCBS Trust/PPO |
$171.40
|
| Rate for Payer: BCN Commercial |
$162.28
|
| Rate for Payer: BCN Medicare Advantage |
$23.57
|
| Rate for Payer: Cash Price |
$167.45
|
| Rate for Payer: Cash Price |
$167.45
|
| Rate for Payer: Cofinity Commercial |
$196.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$167.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.57
|
| Rate for Payer: Healthscope Commercial |
$209.31
|
| Rate for Payer: Healthscope Whirlpool |
$203.03
|
| Rate for Payer: Humana Choice PPO Medicare |
$23.57
|
| Rate for Payer: Mclaren Commercial |
$188.38
|
| Rate for Payer: Mclaren Medicaid |
$12.63
|
| Rate for Payer: Mclaren Medicare |
$23.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.75
|
| Rate for Payer: Meridian Medicaid |
$13.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$177.91
|
| Rate for Payer: Nomi Health Commercial |
$171.63
|
| Rate for Payer: PACE Medicare |
$22.39
|
| Rate for Payer: PACE SWMI |
$23.57
|
| Rate for Payer: PHP Commercial |
$25.93
|
| Rate for Payer: PHP Medicaid |
$12.63
|
| Rate for Payer: PHP Medicare Advantage |
$23.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$136.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$183.40
|
| Rate for Payer: Priority Health Medicare |
$23.57
|
| Rate for Payer: Priority Health Narrow Network |
$146.73
|
| Rate for Payer: Railroad Medicare Medicare |
$23.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$184.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.57
|
| Rate for Payer: UHC Exchange |
$36.53
|
| Rate for Payer: UHC Medicare Advantage |
$23.57
|
| Rate for Payer: UHCCP DNSP |
$23.57
|
| Rate for Payer: UHCCP Medicaid |
$12.63
|
| Rate for Payer: VA VA |
$23.57
|
|
|
HC ENCEPHALOPATHY EVAL, SERUM
|
Facility
|
IP
|
$209.31
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
30100721
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$136.05 |
| Max. Negotiated Rate |
$209.31 |
| Rate for Payer: Aetna Commercial |
$188.38
|
| Rate for Payer: ASR ASR |
$203.03
|
| Rate for Payer: ASR Commercial |
$203.03
|
| Rate for Payer: BCBS Trust/PPO |
$170.57
|
| Rate for Payer: BCN Commercial |
$162.28
|
| Rate for Payer: Cash Price |
$167.45
|
| Rate for Payer: Cofinity Commercial |
$196.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$167.45
|
| Rate for Payer: Healthscope Commercial |
$209.31
|
| Rate for Payer: Healthscope Whirlpool |
$203.03
|
| Rate for Payer: Mclaren Commercial |
$188.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$177.91
|
| Rate for Payer: Nomi Health Commercial |
$171.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$136.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$184.19
|
|
|
HC ENCEPH AUTOIMMUNE EVAL
|
Facility
|
OP
|
$155.04
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
30200468
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.63 |
| Max. Negotiated Rate |
$155.04 |
| Rate for Payer: Aetna Commercial |
$139.54
|
| Rate for Payer: Aetna Medicare |
$23.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.46
|
| Rate for Payer: ASR ASR |
$150.39
|
| Rate for Payer: ASR Commercial |
$150.39
|
| Rate for Payer: BCBS Complete |
$13.27
|
| Rate for Payer: BCBS MAPPO |
$23.57
|
| Rate for Payer: BCBS Trust/PPO |
$126.96
|
| Rate for Payer: BCN Commercial |
$120.20
|
| Rate for Payer: BCN Medicare Advantage |
$23.57
|
| Rate for Payer: Cash Price |
$124.03
|
| Rate for Payer: Cash Price |
$124.03
|
| Rate for Payer: Cofinity Commercial |
$145.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.57
|
| Rate for Payer: Healthscope Commercial |
$155.04
|
| Rate for Payer: Healthscope Whirlpool |
$150.39
|
| Rate for Payer: Humana Choice PPO Medicare |
$23.57
|
| Rate for Payer: Mclaren Commercial |
$139.54
|
| Rate for Payer: Mclaren Medicaid |
$12.63
|
| Rate for Payer: Mclaren Medicare |
$23.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.75
|
| Rate for Payer: Meridian Medicaid |
$13.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$131.78
|
| Rate for Payer: Nomi Health Commercial |
$127.13
|
| Rate for Payer: PACE Medicare |
$22.39
|
| Rate for Payer: PACE SWMI |
$23.57
|
| Rate for Payer: PHP Commercial |
$25.93
|
| Rate for Payer: PHP Medicaid |
$12.63
|
| Rate for Payer: PHP Medicare Advantage |
$23.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$135.85
|
| Rate for Payer: Priority Health Medicare |
$23.57
|
| Rate for Payer: Priority Health Narrow Network |
$108.68
|
| Rate for Payer: Railroad Medicare Medicare |
$23.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$136.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.57
|
| Rate for Payer: UHC Exchange |
$36.53
|
| Rate for Payer: UHC Medicare Advantage |
$23.57
|
| Rate for Payer: UHCCP DNSP |
$23.57
|
| Rate for Payer: UHCCP Medicaid |
$12.63
|
| Rate for Payer: VA VA |
$23.57
|
|
|
HC ENCEPH AUTOIMMUNE EVAL
|
Facility
|
IP
|
$155.04
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
30200468
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$100.78 |
| Max. Negotiated Rate |
$155.04 |
| Rate for Payer: Aetna Commercial |
$139.54
|
| Rate for Payer: ASR ASR |
$150.39
|
| Rate for Payer: ASR Commercial |
$150.39
|
| Rate for Payer: BCBS Trust/PPO |
$126.34
|
| Rate for Payer: BCN Commercial |
$120.20
|
| Rate for Payer: Cash Price |
$124.03
|
| Rate for Payer: Cofinity Commercial |
$145.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.03
|
| Rate for Payer: Healthscope Commercial |
$155.04
|
| Rate for Payer: Healthscope Whirlpool |
$150.39
|
| Rate for Payer: Mclaren Commercial |
$139.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$131.78
|
| Rate for Payer: Nomi Health Commercial |
$127.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$136.44
|
|
|
HC ENCEPH AUTOIMMUNE EVAL CMPT
|
Facility
|
OP
|
$74.91
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200469
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.46 |
| Max. Negotiated Rate |
$74.91 |
| Rate for Payer: Aetna Commercial |
$67.42
|
| Rate for Payer: Aetna Medicare |
$12.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.06
|
| Rate for Payer: ASR ASR |
$72.66
|
| Rate for Payer: ASR Commercial |
$72.66
|
| Rate for Payer: BCBS Complete |
$6.78
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCBS Trust/PPO |
$61.34
|
| Rate for Payer: BCN Commercial |
$58.08
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$59.93
|
| Rate for Payer: Cash Price |
$59.93
|
| Rate for Payer: Cofinity Commercial |
$70.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$74.91
|
| Rate for Payer: Healthscope Whirlpool |
$72.66
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.05
|
| Rate for Payer: Mclaren Commercial |
$67.42
|
| Rate for Payer: Mclaren Medicaid |
$6.46
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: Meridian Medicaid |
$6.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.67
|
| Rate for Payer: Nomi Health Commercial |
$61.43
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$13.26
|
| Rate for Payer: PHP Medicaid |
$6.46
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$65.64
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health Narrow Network |
$52.51
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$65.92
|
| 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 ENCEPH AUTOIMMUNE EVAL CMPT
|
Facility
|
IP
|
$74.91
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200469
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$48.69 |
| Max. Negotiated Rate |
$74.91 |
| Rate for Payer: Aetna Commercial |
$67.42
|
| Rate for Payer: ASR ASR |
$72.66
|
| Rate for Payer: ASR Commercial |
$72.66
|
| Rate for Payer: BCBS Trust/PPO |
$61.04
|
| Rate for Payer: BCN Commercial |
$58.08
|
| Rate for Payer: Cash Price |
$59.93
|
| Rate for Payer: Cofinity Commercial |
$70.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.93
|
| Rate for Payer: Healthscope Commercial |
$74.91
|
| Rate for Payer: Healthscope Whirlpool |
$72.66
|
| Rate for Payer: Mclaren Commercial |
$67.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.67
|
| Rate for Payer: Nomi Health Commercial |
$61.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$65.92
|
|
|
HC ENCEPH AUTOIMMUNE EVAL CMPT 2
|
Facility
|
OP
|
$107.10
|
|
|
Service Code
|
CPT 84182
|
| Hospital Charge Code |
30100717
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.66 |
| Max. Negotiated Rate |
$107.10 |
| Rate for Payer: Aetna Commercial |
$96.39
|
| Rate for Payer: Aetna Medicare |
$29.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.51
|
| Rate for Payer: ASR ASR |
$103.89
|
| Rate for Payer: ASR Commercial |
$103.89
|
| Rate for Payer: BCBS Complete |
$16.44
|
| Rate for Payer: BCBS MAPPO |
$29.21
|
| Rate for Payer: BCBS Trust/PPO |
$87.70
|
| Rate for Payer: BCN Commercial |
$83.03
|
| Rate for Payer: BCN Medicare Advantage |
$29.21
|
| Rate for Payer: Cash Price |
$85.68
|
| Rate for Payer: Cash Price |
$85.68
|
| Rate for Payer: Cofinity Commercial |
$100.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.21
|
| Rate for Payer: Healthscope Commercial |
$107.10
|
| Rate for Payer: Healthscope Whirlpool |
$103.89
|
| Rate for Payer: Humana Choice PPO Medicare |
$29.21
|
| Rate for Payer: Mclaren Commercial |
$96.39
|
| Rate for Payer: Mclaren Medicaid |
$15.66
|
| Rate for Payer: Mclaren Medicare |
$29.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.67
|
| Rate for Payer: Meridian Medicaid |
$16.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.03
|
| Rate for Payer: Nomi Health Commercial |
$87.82
|
| Rate for Payer: PACE Medicare |
$27.75
|
| Rate for Payer: PACE SWMI |
$29.21
|
| Rate for Payer: PHP Commercial |
$32.13
|
| Rate for Payer: PHP Medicaid |
$15.66
|
| Rate for Payer: PHP Medicare Advantage |
$29.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$93.84
|
| Rate for Payer: Priority Health Medicare |
$29.21
|
| Rate for Payer: Priority Health Narrow Network |
$75.08
|
| Rate for Payer: Railroad Medicare Medicare |
$29.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$94.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.21
|
| Rate for Payer: UHC Exchange |
$45.28
|
| Rate for Payer: UHC Medicare Advantage |
$29.21
|
| Rate for Payer: UHCCP DNSP |
$29.21
|
| Rate for Payer: UHCCP Medicaid |
$15.66
|
| Rate for Payer: VA VA |
$29.21
|
|
|
HC ENCEPH AUTOIMMUNE EVAL CMPT 2
|
Facility
|
IP
|
$107.10
|
|
|
Service Code
|
CPT 84182
|
| Hospital Charge Code |
30100717
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$69.61 |
| Max. Negotiated Rate |
$107.10 |
| Rate for Payer: Aetna Commercial |
$96.39
|
| Rate for Payer: ASR ASR |
$103.89
|
| Rate for Payer: ASR Commercial |
$103.89
|
| Rate for Payer: BCBS Trust/PPO |
$87.28
|
| Rate for Payer: BCN Commercial |
$83.03
|
| Rate for Payer: Cash Price |
$85.68
|
| Rate for Payer: Cofinity Commercial |
$100.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.68
|
| Rate for Payer: Healthscope Commercial |
$107.10
|
| Rate for Payer: Healthscope Whirlpool |
$103.89
|
| Rate for Payer: Mclaren Commercial |
$96.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.03
|
| Rate for Payer: Nomi Health Commercial |
$87.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$94.25
|
|
|
HC ENDO BIOPSY
|
Facility
|
OP
|
$287.49
|
|
| Hospital Charge Code |
36000092
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$115.00 |
| Max. Negotiated Rate |
$287.49 |
| Rate for Payer: Aetna Commercial |
$258.74
|
| Rate for Payer: Aetna Medicare |
$143.75
|
| Rate for Payer: ASR ASR |
$278.87
|
| Rate for Payer: ASR Commercial |
$278.87
|
| Rate for Payer: BCBS Complete |
$115.00
|
| Rate for Payer: BCBS Trust/PPO |
$235.43
|
| Rate for Payer: BCN Commercial |
$222.89
|
| Rate for Payer: Cash Price |
$229.99
|
| Rate for Payer: Cofinity Commercial |
$270.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.99
|
| Rate for Payer: Healthscope Commercial |
$287.49
|
| Rate for Payer: Healthscope Whirlpool |
$278.87
|
| Rate for Payer: Mclaren Commercial |
$258.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$244.37
|
| Rate for Payer: Nomi Health Commercial |
$235.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$186.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$251.90
|
| Rate for Payer: Priority Health Narrow Network |
$201.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$252.99
|
|
|
HC ENDO BIOPSY
|
Facility
|
IP
|
$287.49
|
|
| Hospital Charge Code |
36000092
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$186.87 |
| Max. Negotiated Rate |
$287.49 |
| Rate for Payer: Aetna Commercial |
$258.74
|
| Rate for Payer: ASR ASR |
$278.87
|
| Rate for Payer: ASR Commercial |
$278.87
|
| Rate for Payer: BCBS Trust/PPO |
$234.28
|
| Rate for Payer: BCN Commercial |
$222.89
|
| Rate for Payer: Cash Price |
$229.99
|
| Rate for Payer: Cofinity Commercial |
$270.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.99
|
| Rate for Payer: Healthscope Commercial |
$287.49
|
| Rate for Payer: Healthscope Whirlpool |
$278.87
|
| Rate for Payer: Mclaren Commercial |
$258.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$244.37
|
| Rate for Payer: Nomi Health Commercial |
$235.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$186.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$252.99
|
|
|
HC ENDOCERVICAL CURETTAGE
|
Facility
|
IP
|
$676.26
|
|
|
Service Code
|
CPT 57505
|
| Hospital Charge Code |
76100071
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$439.57 |
| Max. Negotiated Rate |
$676.26 |
| Rate for Payer: Aetna Commercial |
$608.63
|
| Rate for Payer: ASR ASR |
$655.97
|
| Rate for Payer: ASR Commercial |
$655.97
|
| Rate for Payer: BCBS Trust/PPO |
$551.08
|
| Rate for Payer: BCN Commercial |
$524.30
|
| Rate for Payer: Cash Price |
$541.01
|
| Rate for Payer: Cofinity Commercial |
$635.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$541.01
|
| Rate for Payer: Healthscope Commercial |
$676.26
|
| Rate for Payer: Healthscope Whirlpool |
$655.97
|
| Rate for Payer: Mclaren Commercial |
$608.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$574.82
|
| Rate for Payer: Nomi Health Commercial |
$554.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$439.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$595.11
|
|
|
HC ENDOCERVICAL CURETTAGE
|
Facility
|
OP
|
$676.26
|
|
|
Service Code
|
CPT 57505
|
| Hospital Charge Code |
76100071
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$439.57 |
| Max. Negotiated Rate |
$1,316.29 |
| Rate for Payer: Aetna Commercial |
$608.63
|
| Rate for Payer: Aetna Medicare |
$849.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,061.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,061.53
|
| Rate for Payer: ASR ASR |
$655.97
|
| Rate for Payer: ASR Commercial |
$655.97
|
| Rate for Payer: BCBS Complete |
$477.94
|
| Rate for Payer: BCBS MAPPO |
$849.22
|
| Rate for Payer: BCBS Trust/PPO |
$553.79
|
| Rate for Payer: BCN Commercial |
$524.30
|
| Rate for Payer: BCN Medicare Advantage |
$849.22
|
| Rate for Payer: Cash Price |
$541.01
|
| Rate for Payer: Cash Price |
$541.01
|
| Rate for Payer: Cofinity Commercial |
$635.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$541.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$849.22
|
| Rate for Payer: Healthscope Commercial |
$676.26
|
| Rate for Payer: Healthscope Whirlpool |
$655.97
|
| Rate for Payer: Humana Choice PPO Medicare |
$849.22
|
| Rate for Payer: Mclaren Commercial |
$608.63
|
| Rate for Payer: Mclaren Medicaid |
$455.18
|
| Rate for Payer: Mclaren Medicare |
$849.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$891.68
|
| Rate for Payer: Meridian Medicaid |
$477.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$976.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$574.82
|
| Rate for Payer: Nomi Health Commercial |
$554.53
|
| Rate for Payer: PACE Medicare |
$806.76
|
| Rate for Payer: PACE SWMI |
$849.22
|
| Rate for Payer: PHP Commercial |
$934.14
|
| Rate for Payer: PHP Medicaid |
$455.18
|
| Rate for Payer: PHP Medicare Advantage |
$849.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$455.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$439.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$592.54
|
| Rate for Payer: Priority Health Medicare |
$849.22
|
| Rate for Payer: Priority Health Narrow Network |
$474.06
|
| Rate for Payer: Railroad Medicare Medicare |
$849.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$595.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$849.22
|
| Rate for Payer: UHC Exchange |
$1,316.29
|
| Rate for Payer: UHC Medicare Advantage |
$849.22
|
| Rate for Payer: UHCCP DNSP |
$849.22
|
| Rate for Payer: UHCCP Medicaid |
$455.18
|
| Rate for Payer: VA VA |
$849.22
|
|
|
HC ENDO CLIPPING
|
Facility
|
OP
|
$323.34
|
|
| Hospital Charge Code |
36000117
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$129.34 |
| Max. Negotiated Rate |
$323.34 |
| Rate for Payer: Aetna Commercial |
$291.01
|
| Rate for Payer: Aetna Medicare |
$161.67
|
| Rate for Payer: ASR ASR |
$313.64
|
| Rate for Payer: ASR Commercial |
$313.64
|
| Rate for Payer: BCBS Complete |
$129.34
|
| Rate for Payer: BCBS Trust/PPO |
$264.78
|
| Rate for Payer: BCN Commercial |
$250.69
|
| Rate for Payer: Cash Price |
$258.67
|
| Rate for Payer: Cofinity Commercial |
$303.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$258.67
|
| Rate for Payer: Healthscope Commercial |
$323.34
|
| Rate for Payer: Healthscope Whirlpool |
$313.64
|
| Rate for Payer: Mclaren Commercial |
$291.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$274.84
|
| Rate for Payer: Nomi Health Commercial |
$265.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$210.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$283.31
|
| Rate for Payer: Priority Health Narrow Network |
$226.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$284.54
|
|
|
HC ENDO CLIPPING
|
Facility
|
IP
|
$323.34
|
|
| Hospital Charge Code |
36000117
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$210.17 |
| Max. Negotiated Rate |
$323.34 |
| Rate for Payer: Aetna Commercial |
$291.01
|
| Rate for Payer: ASR ASR |
$313.64
|
| Rate for Payer: ASR Commercial |
$313.64
|
| Rate for Payer: BCBS Trust/PPO |
$263.49
|
| Rate for Payer: BCN Commercial |
$250.69
|
| Rate for Payer: Cash Price |
$258.67
|
| Rate for Payer: Cofinity Commercial |
$303.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$258.67
|
| Rate for Payer: Healthscope Commercial |
$323.34
|
| Rate for Payer: Healthscope Whirlpool |
$313.64
|
| Rate for Payer: Mclaren Commercial |
$291.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$274.84
|
| Rate for Payer: Nomi Health Commercial |
$265.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$210.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$284.54
|
|
|
HC ENDO CYTOLOGY/BRUSHING
|
Facility
|
IP
|
$1,805.46
|
|
| Hospital Charge Code |
36000012
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,173.55 |
| Max. Negotiated Rate |
$1,805.46 |
| Rate for Payer: Aetna Commercial |
$1,624.91
|
| Rate for Payer: ASR ASR |
$1,751.30
|
| Rate for Payer: ASR Commercial |
$1,751.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,471.27
|
| Rate for Payer: BCN Commercial |
$1,399.77
|
| Rate for Payer: Cash Price |
$1,444.37
|
| Rate for Payer: Cofinity Commercial |
$1,697.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,444.37
|
| Rate for Payer: Healthscope Commercial |
$1,805.46
|
| Rate for Payer: Healthscope Whirlpool |
$1,751.30
|
| Rate for Payer: Mclaren Commercial |
$1,624.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,534.64
|
| Rate for Payer: Nomi Health Commercial |
$1,480.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,173.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,588.80
|
|
|
HC ENDO CYTOLOGY/BRUSHING
|
Facility
|
OP
|
$1,805.46
|
|
| Hospital Charge Code |
36000012
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$722.18 |
| Max. Negotiated Rate |
$1,805.46 |
| Rate for Payer: Aetna Commercial |
$1,624.91
|
| Rate for Payer: Aetna Medicare |
$902.73
|
| Rate for Payer: ASR ASR |
$1,751.30
|
| Rate for Payer: ASR Commercial |
$1,751.30
|
| Rate for Payer: BCBS Complete |
$722.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,478.49
|
| Rate for Payer: BCN Commercial |
$1,399.77
|
| Rate for Payer: Cash Price |
$1,444.37
|
| Rate for Payer: Cofinity Commercial |
$1,697.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,444.37
|
| Rate for Payer: Healthscope Commercial |
$1,805.46
|
| Rate for Payer: Healthscope Whirlpool |
$1,751.30
|
| Rate for Payer: Mclaren Commercial |
$1,624.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,534.64
|
| Rate for Payer: Nomi Health Commercial |
$1,480.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,173.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,581.94
|
| Rate for Payer: Priority Health Narrow Network |
$1,265.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,588.80
|
|
|
HC ENDO DILATATION
|
Facility
|
IP
|
$1,330.39
|
|
| Hospital Charge Code |
36000115
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$864.75 |
| Max. Negotiated Rate |
$1,330.39 |
| Rate for Payer: Aetna Commercial |
$1,197.35
|
| Rate for Payer: ASR ASR |
$1,290.48
|
| Rate for Payer: ASR Commercial |
$1,290.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,084.13
|
| Rate for Payer: BCN Commercial |
$1,031.45
|
| Rate for Payer: Cash Price |
$1,064.31
|
| Rate for Payer: Cofinity Commercial |
$1,250.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,064.31
|
| Rate for Payer: Healthscope Commercial |
$1,330.39
|
| Rate for Payer: Healthscope Whirlpool |
$1,290.48
|
| Rate for Payer: Mclaren Commercial |
$1,197.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,130.83
|
| Rate for Payer: Nomi Health Commercial |
$1,090.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$864.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,170.74
|
|
|
HC ENDO DILATATION
|
Facility
|
OP
|
$1,330.39
|
|
| Hospital Charge Code |
36000115
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$532.16 |
| Max. Negotiated Rate |
$1,330.39 |
| Rate for Payer: Aetna Commercial |
$1,197.35
|
| Rate for Payer: Aetna Medicare |
$665.20
|
| Rate for Payer: ASR ASR |
$1,290.48
|
| Rate for Payer: ASR Commercial |
$1,290.48
|
| Rate for Payer: BCBS Complete |
$532.16
|
| Rate for Payer: BCBS Trust/PPO |
$1,089.46
|
| Rate for Payer: BCN Commercial |
$1,031.45
|
| Rate for Payer: Cash Price |
$1,064.31
|
| Rate for Payer: Cofinity Commercial |
$1,250.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,064.31
|
| Rate for Payer: Healthscope Commercial |
$1,330.39
|
| Rate for Payer: Healthscope Whirlpool |
$1,290.48
|
| Rate for Payer: Mclaren Commercial |
$1,197.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,130.83
|
| Rate for Payer: Nomi Health Commercial |
$1,090.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$864.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,165.69
|
| Rate for Payer: Priority Health Narrow Network |
$932.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,170.74
|
|
