|
HC LACTOSE TOLERANCE
|
Facility
|
OP
|
$92.21
|
|
|
Service Code
|
CPT 82951
|
| Hospital Charge Code |
30100226
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.04 |
| Max. Negotiated Rate |
$92.21 |
| Rate for Payer: Aetna Commercial |
$82.99
|
| Rate for Payer: Aetna Medicare |
$12.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.09
|
| Rate for Payer: ASR ASR |
$89.44
|
| Rate for Payer: BCBS Complete |
$7.39
|
| Rate for Payer: BCBS MAPPO |
$12.87
|
| Rate for Payer: BCBS Trust/PPO |
$71.49
|
| Rate for Payer: BCN Commercial |
$71.49
|
| Rate for Payer: BCN Medicare Advantage |
$12.87
|
| Rate for Payer: Cash Price |
$73.77
|
| Rate for Payer: Cash Price |
$73.77
|
| Rate for Payer: Cofinity Commercial |
$86.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.87
|
| Rate for Payer: Healthscope Commercial |
$92.21
|
| Rate for Payer: Healthscope Whirlpool |
$89.44
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.87
|
| Rate for Payer: Mclaren Commercial |
$82.99
|
| Rate for Payer: Mclaren Medicaid |
$7.04
|
| Rate for Payer: Mclaren Medicare |
$12.87
|
| Rate for Payer: Meridian Medicaid |
$7.39
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$78.38
|
| Rate for Payer: PACE Medicare |
$12.23
|
| Rate for Payer: PACE SWMI |
$12.87
|
| Rate for Payer: PHP Commercial |
$14.16
|
| Rate for Payer: PHP Medicaid |
$7.04
|
| Rate for Payer: PHP Medicare Advantage |
$12.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$38.99
|
| Rate for Payer: Priority Health Medicare |
$12.87
|
| Rate for Payer: Priority Health Narrow Network |
$31.19
|
| Rate for Payer: Railroad Medicare Medicare |
$12.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$81.14
|
| Rate for Payer: UHC Medicare Advantage |
$13.26
|
| Rate for Payer: VA VA |
$12.87
|
|
|
HC LACTOSE TOLERANCE
|
Facility
|
IP
|
$92.21
|
|
|
Service Code
|
CPT 82951
|
| Hospital Charge Code |
30100226
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$64.55 |
| Max. Negotiated Rate |
$92.21 |
| Rate for Payer: Aetna Commercial |
$82.99
|
| Rate for Payer: ASR ASR |
$89.44
|
| Rate for Payer: BCBS Trust/PPO |
$71.49
|
| Rate for Payer: BCN Commercial |
$71.49
|
| Rate for Payer: Cash Price |
$73.77
|
| Rate for Payer: Cofinity Commercial |
$86.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.77
|
| Rate for Payer: Healthscope Commercial |
$92.21
|
| Rate for Payer: Healthscope Whirlpool |
$89.44
|
| Rate for Payer: Mclaren Commercial |
$82.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$78.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$81.14
|
|
|
HC LAMBDA FREE LIGHT CHAIN SERUM
|
Facility
|
IP
|
$75.90
|
|
|
Service Code
|
CPT 83521
|
| Hospital Charge Code |
30100308
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$53.13 |
| Max. Negotiated Rate |
$75.90 |
| Rate for Payer: Aetna Commercial |
$68.31
|
| Rate for Payer: ASR ASR |
$73.62
|
| Rate for Payer: BCBS Trust/PPO |
$58.85
|
| Rate for Payer: BCN Commercial |
$58.85
|
| Rate for Payer: Cash Price |
$60.72
|
| Rate for Payer: Cofinity Commercial |
$71.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.72
|
| Rate for Payer: Healthscope Commercial |
$75.90
|
| Rate for Payer: Healthscope Whirlpool |
$73.62
|
| Rate for Payer: Mclaren Commercial |
$68.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$64.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$66.79
|
|
|
HC LAMBDA FREE LIGHT CHAIN SERUM
|
Facility
|
OP
|
$75.90
|
|
|
Service Code
|
CPT 83521
|
| Hospital Charge Code |
30100308
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.45 |
| Max. Negotiated Rate |
$75.90 |
| Rate for Payer: Aetna Commercial |
$68.31
|
| Rate for Payer: Aetna Medicare |
$17.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.59
|
| Rate for Payer: ASR ASR |
$73.62
|
| Rate for Payer: BCBS Complete |
$9.92
|
| Rate for Payer: BCBS MAPPO |
$17.27
|
| Rate for Payer: BCBS Trust/PPO |
$58.85
|
| Rate for Payer: BCN Commercial |
$58.85
|
| Rate for Payer: BCN Medicare Advantage |
$17.27
|
| Rate for Payer: Cash Price |
$60.72
|
| Rate for Payer: Cash Price |
$60.72
|
| Rate for Payer: Cofinity Commercial |
$71.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.27
|
| Rate for Payer: Healthscope Commercial |
$75.90
|
| Rate for Payer: Healthscope Whirlpool |
$73.62
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.27
|
| Rate for Payer: Mclaren Commercial |
$68.31
|
| Rate for Payer: Mclaren Medicaid |
$9.45
|
| Rate for Payer: Mclaren Medicare |
$17.27
|
| Rate for Payer: Meridian Medicaid |
$9.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$18.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$64.52
|
| Rate for Payer: PACE Medicare |
$16.41
|
| Rate for Payer: PACE SWMI |
$17.27
|
| Rate for Payer: PHP Commercial |
$19.00
|
| Rate for Payer: PHP Medicaid |
$9.45
|
| Rate for Payer: PHP Medicare Advantage |
$17.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$69.07
|
| Rate for Payer: Priority Health Medicare |
$17.27
|
| Rate for Payer: Priority Health Narrow Network |
$53.89
|
| Rate for Payer: Railroad Medicare Medicare |
$17.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$66.79
|
| Rate for Payer: UHC Medicare Advantage |
$17.79
|
| Rate for Payer: VA VA |
$17.27
|
|
|
HC LAMBS QUARTERS IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200091
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$17.42 |
| Max. Negotiated Rate |
$24.89 |
| Rate for Payer: Aetna Commercial |
$22.40
|
| Rate for Payer: ASR ASR |
$24.14
|
| Rate for Payer: BCBS Trust/PPO |
$19.30
|
| Rate for Payer: BCN Commercial |
$19.30
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$23.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$24.89
|
| Rate for Payer: Healthscope Whirlpool |
$24.14
|
| Rate for Payer: Mclaren Commercial |
$22.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.90
|
|
|
HC LAMBS QUARTERS IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200091
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.86 |
| Max. Negotiated Rate |
$24.89 |
| Rate for Payer: Aetna Commercial |
$22.40
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: ASR ASR |
$24.14
|
| Rate for Payer: BCBS Complete |
$3.00
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.30
|
| Rate for Payer: BCN Commercial |
$19.30
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$23.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$24.89
|
| Rate for Payer: Healthscope Whirlpool |
$24.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$22.40
|
| Rate for Payer: Mclaren Medicaid |
$2.86
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Medicaid |
$3.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$5.74
|
| Rate for Payer: PHP Medicaid |
$2.86
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.65
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$17.67
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.90
|
| Rate for Payer: UHC Medicare Advantage |
$5.38
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC LAMELLAR BODY COUNT AMNIOTIC
|
Facility
|
IP
|
$70.00
|
|
|
Service Code
|
CPT 83664
|
| Hospital Charge Code |
30100278
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$49.00 |
| Max. Negotiated Rate |
$70.00 |
| Rate for Payer: Aetna Commercial |
$63.00
|
| Rate for Payer: ASR ASR |
$67.90
|
| Rate for Payer: BCBS Trust/PPO |
$54.27
|
| Rate for Payer: BCN Commercial |
$54.27
|
| Rate for Payer: Cash Price |
$56.00
|
| Rate for Payer: Cofinity Commercial |
$65.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.00
|
| Rate for Payer: Healthscope Commercial |
$70.00
|
| Rate for Payer: Healthscope Whirlpool |
$67.90
|
| Rate for Payer: Mclaren Commercial |
$63.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$59.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$61.60
|
|
|
HC LAMELLAR BODY COUNT AMNIOTIC
|
Facility
|
OP
|
$70.00
|
|
|
Service Code
|
CPT 83664
|
| Hospital Charge Code |
30100278
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.57 |
| Max. Negotiated Rate |
$70.00 |
| Rate for Payer: Aetna Commercial |
$63.00
|
| Rate for Payer: Aetna Medicare |
$19.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.15
|
| Rate for Payer: ASR ASR |
$67.90
|
| Rate for Payer: BCBS Complete |
$11.10
|
| Rate for Payer: BCBS MAPPO |
$19.32
|
| Rate for Payer: BCBS Trust/PPO |
$54.27
|
| Rate for Payer: BCN Commercial |
$54.27
|
| Rate for Payer: BCN Medicare Advantage |
$19.32
|
| Rate for Payer: Cash Price |
$56.00
|
| Rate for Payer: Cash Price |
$56.00
|
| Rate for Payer: Cofinity Commercial |
$65.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.32
|
| Rate for Payer: Healthscope Commercial |
$70.00
|
| Rate for Payer: Healthscope Whirlpool |
$67.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$19.32
|
| Rate for Payer: Mclaren Commercial |
$63.00
|
| Rate for Payer: Mclaren Medicaid |
$10.57
|
| Rate for Payer: Mclaren Medicare |
$19.32
|
| Rate for Payer: Meridian Medicaid |
$11.10
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$20.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$59.50
|
| Rate for Payer: PACE Medicare |
$18.35
|
| Rate for Payer: PACE SWMI |
$19.32
|
| Rate for Payer: PHP Commercial |
$21.25
|
| Rate for Payer: PHP Medicaid |
$10.57
|
| Rate for Payer: PHP Medicare Advantage |
$19.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$63.70
|
| Rate for Payer: Priority Health Medicare |
$19.32
|
| Rate for Payer: Priority Health Narrow Network |
$49.70
|
| Rate for Payer: Railroad Medicare Medicare |
$19.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$61.60
|
| Rate for Payer: UHC Medicare Advantage |
$19.90
|
| Rate for Payer: VA VA |
$19.32
|
|
|
HC LAMICTAL LEVEL
|
Facility
|
OP
|
$53.04
|
|
|
Service Code
|
CPT 80175
|
| Hospital Charge Code |
30100054
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.25 |
| Max. Negotiated Rate |
$53.04 |
| Rate for Payer: Aetna Commercial |
$47.74
|
| Rate for Payer: Aetna Medicare |
$13.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.56
|
| Rate for Payer: ASR ASR |
$51.45
|
| Rate for Payer: BCBS Complete |
$7.61
|
| Rate for Payer: BCBS MAPPO |
$13.25
|
| Rate for Payer: BCBS Trust/PPO |
$41.12
|
| Rate for Payer: BCN Commercial |
$41.12
|
| Rate for Payer: BCN Medicare Advantage |
$13.25
|
| Rate for Payer: Cash Price |
$42.43
|
| Rate for Payer: Cash Price |
$42.43
|
| Rate for Payer: Cofinity Commercial |
$49.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.25
|
| Rate for Payer: Healthscope Commercial |
$53.04
|
| Rate for Payer: Healthscope Whirlpool |
$51.45
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.25
|
| Rate for Payer: Mclaren Commercial |
$47.74
|
| Rate for Payer: Mclaren Medicaid |
$7.25
|
| Rate for Payer: Mclaren Medicare |
$13.25
|
| Rate for Payer: Meridian Medicaid |
$7.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$45.08
|
| Rate for Payer: PACE Medicare |
$12.59
|
| Rate for Payer: PACE SWMI |
$13.25
|
| Rate for Payer: PHP Commercial |
$14.58
|
| Rate for Payer: PHP Medicaid |
$7.25
|
| Rate for Payer: PHP Medicare Advantage |
$13.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19.36
|
| Rate for Payer: Priority Health Medicare |
$13.25
|
| Rate for Payer: Priority Health Narrow Network |
$15.49
|
| Rate for Payer: Railroad Medicare Medicare |
$13.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.68
|
| Rate for Payer: UHC Medicare Advantage |
$13.65
|
| Rate for Payer: VA VA |
$13.25
|
|
|
HC LAMICTAL LEVEL
|
Facility
|
IP
|
$53.04
|
|
|
Service Code
|
CPT 80175
|
| Hospital Charge Code |
30100054
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$37.13 |
| Max. Negotiated Rate |
$53.04 |
| Rate for Payer: Aetna Commercial |
$47.74
|
| Rate for Payer: ASR ASR |
$51.45
|
| Rate for Payer: BCBS Trust/PPO |
$41.12
|
| Rate for Payer: BCN Commercial |
$41.12
|
| Rate for Payer: Cash Price |
$42.43
|
| Rate for Payer: Cofinity Commercial |
$49.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.43
|
| Rate for Payer: Healthscope Commercial |
$53.04
|
| Rate for Payer: Healthscope Whirlpool |
$51.45
|
| Rate for Payer: Mclaren Commercial |
$47.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$45.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.68
|
|
|
HC LA RO SSB SJOGRENS AB
|
Facility
|
IP
|
$34.48
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200160
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$24.14 |
| Max. Negotiated Rate |
$34.48 |
| Rate for Payer: Aetna Commercial |
$31.03
|
| Rate for Payer: ASR ASR |
$33.45
|
| Rate for Payer: BCBS Trust/PPO |
$26.73
|
| Rate for Payer: BCN Commercial |
$26.73
|
| Rate for Payer: Cash Price |
$27.58
|
| Rate for Payer: Cofinity Commercial |
$32.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.58
|
| Rate for Payer: Healthscope Commercial |
$34.48
|
| Rate for Payer: Healthscope Whirlpool |
$33.45
|
| Rate for Payer: Mclaren Commercial |
$31.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$29.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$30.34
|
|
|
HC LA RO SSB SJOGRENS AB
|
Facility
|
OP
|
$34.48
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200160
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.81 |
| Max. Negotiated Rate |
$143.67 |
| Rate for Payer: Aetna Commercial |
$31.03
|
| 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 |
$33.45
|
| Rate for Payer: BCBS Complete |
$10.30
|
| Rate for Payer: BCBS MAPPO |
$17.93
|
| Rate for Payer: BCBS Trust/PPO |
$26.73
|
| Rate for Payer: BCN Commercial |
$26.73
|
| Rate for Payer: BCN Medicare Advantage |
$17.93
|
| Rate for Payer: Cash Price |
$27.58
|
| Rate for Payer: Cash Price |
$27.58
|
| Rate for Payer: Cofinity Commercial |
$32.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.93
|
| Rate for Payer: Healthscope Commercial |
$34.48
|
| Rate for Payer: Healthscope Whirlpool |
$33.45
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.93
|
| Rate for Payer: Mclaren Commercial |
$31.03
|
| Rate for Payer: Mclaren Medicaid |
$9.81
|
| Rate for Payer: Mclaren Medicare |
$17.93
|
| Rate for Payer: Meridian Medicaid |
$10.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$18.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$29.31
|
| 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 |
$9.81
|
| Rate for Payer: PHP Medicare Advantage |
$17.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$143.67
|
| Rate for Payer: Priority Health Medicare |
$17.93
|
| Rate for Payer: Priority Health Narrow Network |
$114.94
|
| Rate for Payer: Railroad Medicare Medicare |
$17.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$30.34
|
| Rate for Payer: UHC Medicare Advantage |
$18.47
|
| Rate for Payer: VA VA |
$17.93
|
|
|
HC LARYNGOSCOPY
|
Facility
|
OP
|
$2,514.51
|
|
| Hospital Charge Code |
36000113
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,005.80 |
| Max. Negotiated Rate |
$2,514.51 |
| Rate for Payer: Aetna Commercial |
$2,263.06
|
| Rate for Payer: ASR ASR |
$2,439.07
|
| Rate for Payer: BCBS Complete |
$1,005.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,949.50
|
| Rate for Payer: BCN Commercial |
$1,949.50
|
| Rate for Payer: Cash Price |
$2,011.61
|
| Rate for Payer: Cofinity Commercial |
$2,363.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,011.61
|
| Rate for Payer: Healthscope Commercial |
$2,514.51
|
| Rate for Payer: Healthscope Whirlpool |
$2,439.07
|
| Rate for Payer: Mclaren Commercial |
$2,263.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,137.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,760.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,288.20
|
| Rate for Payer: Priority Health Narrow Network |
$1,785.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,212.77
|
|
|
HC LARYNGOSCOPY
|
Facility
|
IP
|
$2,514.51
|
|
| Hospital Charge Code |
36000113
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,760.16 |
| Max. Negotiated Rate |
$2,514.51 |
| Rate for Payer: Aetna Commercial |
$2,263.06
|
| Rate for Payer: ASR ASR |
$2,439.07
|
| Rate for Payer: BCBS Trust/PPO |
$1,949.50
|
| Rate for Payer: BCN Commercial |
$1,949.50
|
| Rate for Payer: Cash Price |
$2,011.61
|
| Rate for Payer: Cofinity Commercial |
$2,363.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,011.61
|
| Rate for Payer: Healthscope Commercial |
$2,514.51
|
| Rate for Payer: Healthscope Whirlpool |
$2,439.07
|
| Rate for Payer: Mclaren Commercial |
$2,263.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,137.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,760.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,212.77
|
|
|
HC LARYNGOSCOPY FIBEROPTIC
|
Facility
|
OP
|
$311.92
|
|
|
Service Code
|
CPT 31575
|
| Hospital Charge Code |
36100443
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$96.31 |
| Max. Negotiated Rate |
$311.92 |
| Rate for Payer: Aetna Commercial |
$280.73
|
| Rate for Payer: Aetna Medicare |
$176.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$220.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$220.09
|
| Rate for Payer: ASR ASR |
$302.56
|
| Rate for Payer: BCBS Complete |
$101.13
|
| Rate for Payer: BCBS MAPPO |
$176.07
|
| Rate for Payer: BCBS Trust/PPO |
$241.83
|
| Rate for Payer: BCN Commercial |
$241.83
|
| Rate for Payer: BCN Medicare Advantage |
$176.07
|
| Rate for Payer: Cash Price |
$249.54
|
| Rate for Payer: Cash Price |
$249.54
|
| Rate for Payer: Cofinity Commercial |
$293.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$249.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$176.07
|
| Rate for Payer: Healthscope Commercial |
$311.92
|
| Rate for Payer: Healthscope Whirlpool |
$302.56
|
| Rate for Payer: Humana Choice PPO Medicare |
$176.07
|
| Rate for Payer: Mclaren Commercial |
$280.73
|
| Rate for Payer: Mclaren Medicaid |
$96.31
|
| Rate for Payer: Mclaren Medicare |
$176.07
|
| Rate for Payer: Meridian Medicaid |
$101.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$184.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$202.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$265.13
|
| Rate for Payer: PACE Medicare |
$167.27
|
| Rate for Payer: PACE SWMI |
$176.07
|
| Rate for Payer: PHP Commercial |
$193.68
|
| Rate for Payer: PHP Medicaid |
$96.31
|
| Rate for Payer: PHP Medicare Advantage |
$176.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$96.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$218.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$283.85
|
| Rate for Payer: Priority Health Medicare |
$176.07
|
| Rate for Payer: Priority Health Narrow Network |
$221.46
|
| Rate for Payer: Railroad Medicare Medicare |
$176.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$274.49
|
| Rate for Payer: UHC Medicare Advantage |
$181.35
|
| Rate for Payer: VA VA |
$176.07
|
|
|
HC LARYNGOSCOPY FIBEROPTIC
|
Facility
|
IP
|
$311.92
|
|
|
Service Code
|
CPT 31575
|
| Hospital Charge Code |
36100443
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$218.34 |
| Max. Negotiated Rate |
$311.92 |
| Rate for Payer: Aetna Commercial |
$280.73
|
| Rate for Payer: ASR ASR |
$302.56
|
| Rate for Payer: BCBS Trust/PPO |
$241.83
|
| Rate for Payer: BCN Commercial |
$241.83
|
| Rate for Payer: Cash Price |
$249.54
|
| Rate for Payer: Cofinity Commercial |
$293.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$249.54
|
| Rate for Payer: Healthscope Commercial |
$311.92
|
| Rate for Payer: Healthscope Whirlpool |
$302.56
|
| Rate for Payer: Mclaren Commercial |
$280.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$265.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$218.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$274.49
|
|
|
HC LARYNGOSCOPY FLX/RGD TELESCOP W/STROBOSCOP
|
Facility
|
IP
|
$1,100.00
|
|
|
Service Code
|
CPT 31579
|
| Hospital Charge Code |
76100455
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$770.00 |
| Max. Negotiated Rate |
$1,100.00 |
| Rate for Payer: Aetna Commercial |
$990.00
|
| Rate for Payer: ASR ASR |
$1,067.00
|
| Rate for Payer: BCBS Trust/PPO |
$852.83
|
| Rate for Payer: BCN Commercial |
$852.83
|
| Rate for Payer: Cash Price |
$880.00
|
| Rate for Payer: Cofinity Commercial |
$1,034.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$880.00
|
| Rate for Payer: Healthscope Commercial |
$1,100.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,067.00
|
| Rate for Payer: Mclaren Commercial |
$990.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$935.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$770.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$968.00
|
|
|
HC LARYNGOSCOPY FLX/RGD TELESCOP W/STROBOSCOP
|
Facility
|
OP
|
$1,100.00
|
|
|
Service Code
|
CPT 31579
|
| Hospital Charge Code |
76100455
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$198.53 |
| Max. Negotiated Rate |
$1,100.00 |
| Rate for Payer: Aetna Commercial |
$990.00
|
| Rate for Payer: Aetna Medicare |
$362.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$453.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$453.69
|
| Rate for Payer: ASR ASR |
$1,067.00
|
| Rate for Payer: BCBS Complete |
$208.48
|
| Rate for Payer: BCBS MAPPO |
$362.95
|
| Rate for Payer: BCBS Trust/PPO |
$852.83
|
| Rate for Payer: BCN Commercial |
$852.83
|
| Rate for Payer: BCN Medicare Advantage |
$362.95
|
| Rate for Payer: Cash Price |
$880.00
|
| Rate for Payer: Cash Price |
$880.00
|
| Rate for Payer: Cofinity Commercial |
$1,034.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$880.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$362.95
|
| Rate for Payer: Healthscope Commercial |
$1,100.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,067.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$362.95
|
| Rate for Payer: Mclaren Commercial |
$990.00
|
| Rate for Payer: Mclaren Medicaid |
$198.53
|
| Rate for Payer: Mclaren Medicare |
$362.95
|
| Rate for Payer: Meridian Medicaid |
$208.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$381.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$417.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$935.00
|
| Rate for Payer: PACE Medicare |
$344.80
|
| Rate for Payer: PACE SWMI |
$362.95
|
| Rate for Payer: PHP Commercial |
$399.24
|
| Rate for Payer: PHP Medicaid |
$198.53
|
| Rate for Payer: PHP Medicare Advantage |
$362.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$198.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$770.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,001.00
|
| Rate for Payer: Priority Health Medicare |
$362.95
|
| Rate for Payer: Priority Health Narrow Network |
$781.00
|
| Rate for Payer: Railroad Medicare Medicare |
$362.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$968.00
|
| Rate for Payer: UHC Medicare Advantage |
$373.84
|
| Rate for Payer: VA VA |
$362.95
|
|
|
HC LASER CATHETER
|
Facility
|
OP
|
$4,842.47
|
|
|
Service Code
|
HCPCS C1885
|
| Hospital Charge Code |
27200054
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,936.99 |
| Max. Negotiated Rate |
$4,842.47 |
| Rate for Payer: Aetna Commercial |
$4,358.22
|
| Rate for Payer: ASR ASR |
$4,697.20
|
| Rate for Payer: BCBS Complete |
$1,936.99
|
| Rate for Payer: BCBS Trust/PPO |
$3,754.37
|
| Rate for Payer: BCN Commercial |
$3,754.37
|
| Rate for Payer: Cash Price |
$3,873.98
|
| Rate for Payer: Cofinity Commercial |
$4,551.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,873.98
|
| Rate for Payer: Healthscope Commercial |
$4,842.47
|
| Rate for Payer: Healthscope Whirlpool |
$4,697.20
|
| Rate for Payer: Mclaren Commercial |
$4,358.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,116.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,389.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,406.65
|
| Rate for Payer: Priority Health Narrow Network |
$3,438.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,261.37
|
|
|
HC LASER CATHETER
|
Facility
|
IP
|
$4,842.47
|
|
|
Service Code
|
HCPCS C1885
|
| Hospital Charge Code |
27200054
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,389.73 |
| Max. Negotiated Rate |
$4,842.47 |
| Rate for Payer: Aetna Commercial |
$4,358.22
|
| Rate for Payer: ASR ASR |
$4,697.20
|
| Rate for Payer: BCBS Trust/PPO |
$3,754.37
|
| Rate for Payer: BCN Commercial |
$3,754.37
|
| Rate for Payer: Cash Price |
$3,873.98
|
| Rate for Payer: Cofinity Commercial |
$4,551.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,873.98
|
| Rate for Payer: Healthscope Commercial |
$4,842.47
|
| Rate for Payer: Healthscope Whirlpool |
$4,697.20
|
| Rate for Payer: Mclaren Commercial |
$4,358.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,116.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,389.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,261.37
|
|
|
HC LATEX IGE
|
Facility
|
OP
|
$35.09
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200044
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.86 |
| Max. Negotiated Rate |
$35.09 |
| Rate for Payer: Aetna Commercial |
$31.58
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: ASR ASR |
$34.04
|
| Rate for Payer: BCBS Complete |
$3.00
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$27.21
|
| Rate for Payer: BCN Commercial |
$27.21
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$28.07
|
| Rate for Payer: Cash Price |
$28.07
|
| Rate for Payer: Cofinity Commercial |
$32.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$35.09
|
| Rate for Payer: Healthscope Whirlpool |
$34.04
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$31.58
|
| Rate for Payer: Mclaren Medicaid |
$2.86
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Medicaid |
$3.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$29.83
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$5.74
|
| Rate for Payer: PHP Medicaid |
$2.86
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$31.93
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$24.91
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$30.88
|
| Rate for Payer: UHC Medicare Advantage |
$5.38
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC LATEX IGE
|
Facility
|
IP
|
$35.09
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200044
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$24.56 |
| Max. Negotiated Rate |
$35.09 |
| Rate for Payer: Aetna Commercial |
$31.58
|
| Rate for Payer: ASR ASR |
$34.04
|
| Rate for Payer: BCBS Trust/PPO |
$27.21
|
| Rate for Payer: BCN Commercial |
$27.21
|
| Rate for Payer: Cash Price |
$28.07
|
| Rate for Payer: Cofinity Commercial |
$32.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.07
|
| Rate for Payer: Healthscope Commercial |
$35.09
|
| Rate for Payer: Healthscope Whirlpool |
$34.04
|
| Rate for Payer: Mclaren Commercial |
$31.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$29.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$30.88
|
|
|
HC LAYR CLOS WND REST BODY <2.5 CM
|
Facility
|
IP
|
$488.86
|
|
|
Service Code
|
CPT 12041
|
| Hospital Charge Code |
76100228
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$342.20 |
| Max. Negotiated Rate |
$488.86 |
| Rate for Payer: Aetna Commercial |
$439.97
|
| Rate for Payer: ASR ASR |
$474.19
|
| Rate for Payer: BCBS Trust/PPO |
$379.01
|
| Rate for Payer: BCN Commercial |
$379.01
|
| Rate for Payer: Cash Price |
$391.09
|
| Rate for Payer: Cofinity Commercial |
$459.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$391.09
|
| Rate for Payer: Healthscope Commercial |
$488.86
|
| Rate for Payer: Healthscope Whirlpool |
$474.19
|
| Rate for Payer: Mclaren Commercial |
$439.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$415.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$342.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$430.20
|
|
|
HC LAYR CLOS WND REST BODY <2.5 CM
|
Facility
|
OP
|
$488.86
|
|
|
Service Code
|
CPT 12041
|
| Hospital Charge Code |
76100228
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$193.87 |
| Max. Negotiated Rate |
$488.86 |
| Rate for Payer: Aetna Commercial |
$439.97
|
| Rate for Payer: Aetna Medicare |
$354.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$443.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$443.04
|
| Rate for Payer: ASR ASR |
$474.19
|
| Rate for Payer: BCBS Complete |
$203.58
|
| Rate for Payer: BCBS MAPPO |
$354.43
|
| Rate for Payer: BCBS Trust/PPO |
$379.01
|
| Rate for Payer: BCN Commercial |
$379.01
|
| Rate for Payer: BCN Medicare Advantage |
$354.43
|
| Rate for Payer: Cash Price |
$391.09
|
| Rate for Payer: Cash Price |
$391.09
|
| Rate for Payer: Cofinity Commercial |
$459.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$391.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$354.43
|
| Rate for Payer: Healthscope Commercial |
$488.86
|
| Rate for Payer: Healthscope Whirlpool |
$474.19
|
| Rate for Payer: Humana Choice PPO Medicare |
$354.43
|
| Rate for Payer: Mclaren Commercial |
$439.97
|
| Rate for Payer: Mclaren Medicaid |
$193.87
|
| Rate for Payer: Mclaren Medicare |
$354.43
|
| Rate for Payer: Meridian Medicaid |
$203.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$372.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$407.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$415.53
|
| Rate for Payer: PACE Medicare |
$336.71
|
| Rate for Payer: PACE SWMI |
$354.43
|
| Rate for Payer: PHP Commercial |
$389.87
|
| Rate for Payer: PHP Medicaid |
$193.87
|
| Rate for Payer: PHP Medicare Advantage |
$354.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$193.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$342.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$248.58
|
| Rate for Payer: Priority Health Medicare |
$354.43
|
| Rate for Payer: Priority Health Narrow Network |
$198.86
|
| Rate for Payer: Railroad Medicare Medicare |
$354.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$430.20
|
| Rate for Payer: UHC Medicare Advantage |
$365.06
|
| Rate for Payer: VA VA |
$354.43
|
|
|
HC LC/CABG'S W INTERVENTION
|
Facility
|
IP
|
$10,797.39
|
|
|
Service Code
|
CPT 93459
|
| Hospital Charge Code |
48100050
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$7,558.17 |
| Max. Negotiated Rate |
$10,797.39 |
| Rate for Payer: Aetna Commercial |
$9,717.65
|
| Rate for Payer: ASR ASR |
$10,473.47
|
| Rate for Payer: BCBS Trust/PPO |
$8,371.22
|
| Rate for Payer: BCN Commercial |
$8,371.22
|
| Rate for Payer: Cash Price |
$8,637.91
|
| Rate for Payer: Cofinity Commercial |
$10,149.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,637.91
|
| Rate for Payer: Healthscope Commercial |
$10,797.39
|
| Rate for Payer: Healthscope Whirlpool |
$10,473.47
|
| Rate for Payer: Mclaren Commercial |
$9,717.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9,177.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,558.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9,501.70
|
|
