|
HC FNA BX 1ST LESION CT GUIDE
|
Facility
|
OP
|
$926.44
|
|
|
Service Code
|
CPT 10009
|
| Hospital Charge Code |
36100558
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$369.02 |
| Max. Negotiated Rate |
$1,093.66 |
| Rate for Payer: Aetna Commercial |
$833.80
|
| Rate for Payer: Aetna Medicare |
$705.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$881.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$881.99
|
| Rate for Payer: ASR ASR |
$898.65
|
| Rate for Payer: BCBS Complete |
$387.51
|
| Rate for Payer: BCBS MAPPO |
$705.59
|
| Rate for Payer: BCBS Trust/PPO |
$763.85
|
| Rate for Payer: BCCCP Commercial |
$391.24
|
| Rate for Payer: BCN Commercial |
$763.85
|
| Rate for Payer: BCN Medicare Advantage |
$705.59
|
| Rate for Payer: Cash Price |
$741.15
|
| Rate for Payer: Cash Price |
$741.15
|
| Rate for Payer: Cofinity Commercial |
$870.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$741.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$705.59
|
| Rate for Payer: Healthscope Commercial |
$898.65
|
| Rate for Payer: Healthscope Whirlpool |
$926.44
|
| Rate for Payer: Humana Choice PPO Medicare |
$705.59
|
| Rate for Payer: Mclaren Commercial |
$833.80
|
| Rate for Payer: Mclaren Medicaid |
$705.59
|
| Rate for Payer: Mclaren Medicare |
$705.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$740.87
|
| Rate for Payer: Meridian Medicaid |
$387.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$811.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$776.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$787.47
|
| Rate for Payer: Nomi Health Commercial |
$759.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$694.83
|
| Rate for Payer: PACE Medicare |
$670.31
|
| Rate for Payer: PACE SWMI |
$705.59
|
| Rate for Payer: PHP Commercial |
$776.15
|
| Rate for Payer: PHP Medicaid |
$378.20
|
| Rate for Payer: PHP Medicare Advantage |
$705.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$731.26
|
| Rate for Payer: Priority Health Medicare |
$705.59
|
| Rate for Payer: Priority Health Narrow Network |
$585.01
|
| Rate for Payer: Railroad Medicare Medicare |
$705.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$815.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$705.59
|
| Rate for Payer: UHC Exchange |
$1,093.66
|
| Rate for Payer: UHC Medicaid |
$369.02
|
| Rate for Payer: UHCCP DNSP |
$705.59
|
| Rate for Payer: UHCCP Medicaid |
$369.02
|
| Rate for Payer: VA VA |
$705.59
|
|
|
HC FNA BX 1ST LESION CT GUIDE
|
Facility
|
IP
|
$926.44
|
|
|
Service Code
|
CPT 10009
|
| Hospital Charge Code |
36100558
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$694.83 |
| Max. Negotiated Rate |
$926.44 |
| Rate for Payer: Aetna Commercial |
$833.80
|
| Rate for Payer: ASR ASR |
$898.65
|
| Rate for Payer: BCBS Trust/PPO |
$760.79
|
| Rate for Payer: BCN Commercial |
$760.79
|
| Rate for Payer: Cash Price |
$741.15
|
| Rate for Payer: Cofinity Commercial |
$870.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$741.15
|
| Rate for Payer: Healthscope Commercial |
$898.65
|
| Rate for Payer: Healthscope Whirlpool |
$926.44
|
| Rate for Payer: Mclaren Commercial |
$833.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$787.47
|
| Rate for Payer: Nomi Health Commercial |
$759.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$694.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$815.27
|
|
|
HC FNA BX 1ST LESION FLUORO GUIDE
|
Facility
|
OP
|
$926.44
|
|
|
Service Code
|
CPT 10007
|
| Hospital Charge Code |
36100556
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$284.96 |
| Max. Negotiated Rate |
$1,093.66 |
| Rate for Payer: Aetna Commercial |
$833.80
|
| Rate for Payer: Aetna Medicare |
$705.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$881.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$881.99
|
| Rate for Payer: ASR ASR |
$898.65
|
| Rate for Payer: BCBS Complete |
$387.51
|
| Rate for Payer: BCBS MAPPO |
$705.59
|
| Rate for Payer: BCBS Trust/PPO |
$763.85
|
| Rate for Payer: BCCCP Commercial |
$284.96
|
| Rate for Payer: BCN Commercial |
$763.85
|
| Rate for Payer: BCN Medicare Advantage |
$705.59
|
| Rate for Payer: Cash Price |
$741.15
|
| Rate for Payer: Cash Price |
$741.15
|
| Rate for Payer: Cofinity Commercial |
$870.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$741.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$705.59
|
| Rate for Payer: Healthscope Commercial |
$898.65
|
| Rate for Payer: Healthscope Whirlpool |
$926.44
|
| Rate for Payer: Humana Choice PPO Medicare |
$705.59
|
| Rate for Payer: Mclaren Commercial |
$833.80
|
| Rate for Payer: Mclaren Medicaid |
$705.59
|
| Rate for Payer: Mclaren Medicare |
$705.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$740.87
|
| Rate for Payer: Meridian Medicaid |
$387.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$811.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$776.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$787.47
|
| Rate for Payer: Nomi Health Commercial |
$759.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$694.83
|
| Rate for Payer: PACE Medicare |
$670.31
|
| Rate for Payer: PACE SWMI |
$705.59
|
| Rate for Payer: PHP Commercial |
$776.15
|
| Rate for Payer: PHP Medicaid |
$378.20
|
| Rate for Payer: PHP Medicare Advantage |
$705.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$731.26
|
| Rate for Payer: Priority Health Medicare |
$705.59
|
| Rate for Payer: Priority Health Narrow Network |
$585.01
|
| Rate for Payer: Railroad Medicare Medicare |
$705.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$815.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$705.59
|
| Rate for Payer: UHC Exchange |
$1,093.66
|
| Rate for Payer: UHC Medicaid |
$369.02
|
| Rate for Payer: UHCCP DNSP |
$705.59
|
| Rate for Payer: UHCCP Medicaid |
$369.02
|
| Rate for Payer: VA VA |
$705.59
|
|
|
HC FNA BX 1ST LESION FLUORO GUIDE
|
Facility
|
IP
|
$926.44
|
|
|
Service Code
|
CPT 10007
|
| Hospital Charge Code |
36100556
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$694.83 |
| Max. Negotiated Rate |
$926.44 |
| Rate for Payer: Aetna Commercial |
$833.80
|
| Rate for Payer: ASR ASR |
$898.65
|
| Rate for Payer: BCBS Trust/PPO |
$760.79
|
| Rate for Payer: BCN Commercial |
$760.79
|
| Rate for Payer: Cash Price |
$741.15
|
| Rate for Payer: Cofinity Commercial |
$870.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$741.15
|
| Rate for Payer: Healthscope Commercial |
$898.65
|
| Rate for Payer: Healthscope Whirlpool |
$926.44
|
| Rate for Payer: Mclaren Commercial |
$833.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$787.47
|
| Rate for Payer: Nomi Health Commercial |
$759.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$694.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$815.27
|
|
|
HC FNA BX 1ST LESION MR GUIDE
|
Facility
|
OP
|
$926.44
|
|
|
Service Code
|
CPT 10011
|
| Hospital Charge Code |
36100560
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$369.02 |
| Max. Negotiated Rate |
$1,093.66 |
| Rate for Payer: Aetna Commercial |
$833.80
|
| Rate for Payer: Aetna Medicare |
$705.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$881.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$881.99
|
| Rate for Payer: ASR ASR |
$898.65
|
| Rate for Payer: BCBS Complete |
$387.51
|
| Rate for Payer: BCBS MAPPO |
$705.59
|
| Rate for Payer: BCBS Trust/PPO |
$763.85
|
| Rate for Payer: BCCCP Commercial |
$391.24
|
| Rate for Payer: BCN Commercial |
$763.85
|
| Rate for Payer: BCN Medicare Advantage |
$705.59
|
| Rate for Payer: Cash Price |
$741.15
|
| Rate for Payer: Cash Price |
$741.15
|
| Rate for Payer: Cofinity Commercial |
$870.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$741.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$705.59
|
| Rate for Payer: Healthscope Commercial |
$898.65
|
| Rate for Payer: Healthscope Whirlpool |
$926.44
|
| Rate for Payer: Humana Choice PPO Medicare |
$705.59
|
| Rate for Payer: Mclaren Commercial |
$833.80
|
| Rate for Payer: Mclaren Medicaid |
$705.59
|
| Rate for Payer: Mclaren Medicare |
$705.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$740.87
|
| Rate for Payer: Meridian Medicaid |
$387.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$811.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$776.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$787.47
|
| Rate for Payer: Nomi Health Commercial |
$759.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$694.83
|
| Rate for Payer: PACE Medicare |
$670.31
|
| Rate for Payer: PACE SWMI |
$705.59
|
| Rate for Payer: PHP Commercial |
$776.15
|
| Rate for Payer: PHP Medicaid |
$378.20
|
| Rate for Payer: PHP Medicare Advantage |
$705.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$731.26
|
| Rate for Payer: Priority Health Medicare |
$705.59
|
| Rate for Payer: Priority Health Narrow Network |
$585.01
|
| Rate for Payer: Railroad Medicare Medicare |
$705.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$815.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$705.59
|
| Rate for Payer: UHC Exchange |
$1,093.66
|
| Rate for Payer: UHC Medicaid |
$369.02
|
| Rate for Payer: UHCCP DNSP |
$705.59
|
| Rate for Payer: UHCCP Medicaid |
$369.02
|
| Rate for Payer: VA VA |
$705.59
|
|
|
HC FNA BX 1ST LESION MR GUIDE
|
Facility
|
IP
|
$926.44
|
|
|
Service Code
|
CPT 10011
|
| Hospital Charge Code |
36100560
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$694.83 |
| Max. Negotiated Rate |
$926.44 |
| Rate for Payer: Aetna Commercial |
$833.80
|
| Rate for Payer: ASR ASR |
$898.65
|
| Rate for Payer: BCBS Trust/PPO |
$760.79
|
| Rate for Payer: BCN Commercial |
$760.79
|
| Rate for Payer: Cash Price |
$741.15
|
| Rate for Payer: Cofinity Commercial |
$870.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$741.15
|
| Rate for Payer: Healthscope Commercial |
$898.65
|
| Rate for Payer: Healthscope Whirlpool |
$926.44
|
| Rate for Payer: Mclaren Commercial |
$833.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$787.47
|
| Rate for Payer: Nomi Health Commercial |
$759.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$694.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$815.27
|
|
|
HC FNA BX 1ST LESION US GUIDE
|
Facility
|
OP
|
$1,089.92
|
|
|
Service Code
|
CPT 10005
|
| Hospital Charge Code |
36100554
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$126.90 |
| Max. Negotiated Rate |
$1,093.66 |
| Rate for Payer: Aetna Commercial |
$980.93
|
| Rate for Payer: Aetna Medicare |
$705.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$881.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$881.99
|
| Rate for Payer: ASR ASR |
$1,057.22
|
| Rate for Payer: BCBS Complete |
$387.51
|
| Rate for Payer: BCBS MAPPO |
$705.59
|
| Rate for Payer: BCBS Trust/PPO |
$898.64
|
| Rate for Payer: BCCCP Commercial |
$126.90
|
| Rate for Payer: BCN Commercial |
$898.64
|
| Rate for Payer: BCN Medicare Advantage |
$705.59
|
| Rate for Payer: Cash Price |
$871.94
|
| Rate for Payer: Cash Price |
$871.94
|
| Rate for Payer: Cofinity Commercial |
$1,024.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$871.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$705.59
|
| Rate for Payer: Healthscope Commercial |
$1,057.22
|
| Rate for Payer: Healthscope Whirlpool |
$1,089.92
|
| Rate for Payer: Humana Choice PPO Medicare |
$705.59
|
| Rate for Payer: Mclaren Commercial |
$980.93
|
| Rate for Payer: Mclaren Medicaid |
$705.59
|
| Rate for Payer: Mclaren Medicare |
$705.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$740.87
|
| Rate for Payer: Meridian Medicaid |
$387.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$811.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$776.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$926.43
|
| Rate for Payer: Nomi Health Commercial |
$893.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$817.44
|
| Rate for Payer: PACE Medicare |
$670.31
|
| Rate for Payer: PACE SWMI |
$705.59
|
| Rate for Payer: PHP Commercial |
$776.15
|
| Rate for Payer: PHP Medicaid |
$378.20
|
| Rate for Payer: PHP Medicare Advantage |
$705.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$731.26
|
| Rate for Payer: Priority Health Medicare |
$705.59
|
| Rate for Payer: Priority Health Narrow Network |
$585.01
|
| Rate for Payer: Railroad Medicare Medicare |
$705.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$959.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$705.59
|
| Rate for Payer: UHC Exchange |
$1,093.66
|
| Rate for Payer: UHC Medicaid |
$369.02
|
| Rate for Payer: UHCCP DNSP |
$705.59
|
| Rate for Payer: UHCCP Medicaid |
$369.02
|
| Rate for Payer: VA VA |
$705.59
|
|
|
HC FNA BX 1ST LESION US GUIDE
|
Facility
|
IP
|
$1,089.92
|
|
|
Service Code
|
CPT 10005
|
| Hospital Charge Code |
36100554
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$817.44 |
| Max. Negotiated Rate |
$1,089.92 |
| Rate for Payer: Aetna Commercial |
$980.93
|
| Rate for Payer: ASR ASR |
$1,057.22
|
| Rate for Payer: BCBS Trust/PPO |
$895.04
|
| Rate for Payer: BCN Commercial |
$895.04
|
| Rate for Payer: Cash Price |
$871.94
|
| Rate for Payer: Cofinity Commercial |
$1,024.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$871.94
|
| Rate for Payer: Healthscope Commercial |
$1,057.22
|
| Rate for Payer: Healthscope Whirlpool |
$1,089.92
|
| Rate for Payer: Mclaren Commercial |
$980.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$926.43
|
| Rate for Payer: Nomi Health Commercial |
$893.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$817.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$959.13
|
|
|
HC FNA BX EACH ADDL CT GUIDE
|
Facility
|
IP
|
$153.88
|
|
|
Service Code
|
CPT 10010
|
| Hospital Charge Code |
36100559
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$115.41 |
| Max. Negotiated Rate |
$153.88 |
| Rate for Payer: Aetna Commercial |
$138.49
|
| Rate for Payer: ASR ASR |
$149.26
|
| Rate for Payer: BCBS Trust/PPO |
$126.37
|
| Rate for Payer: BCN Commercial |
$126.37
|
| Rate for Payer: Cash Price |
$123.10
|
| Rate for Payer: Cofinity Commercial |
$144.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.10
|
| Rate for Payer: Healthscope Commercial |
$149.26
|
| Rate for Payer: Healthscope Whirlpool |
$153.88
|
| Rate for Payer: Mclaren Commercial |
$138.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.80
|
| Rate for Payer: Nomi Health Commercial |
$126.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$115.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$135.41
|
|
|
HC FNA BX EACH ADDL CT GUIDE
|
Facility
|
OP
|
$153.88
|
|
|
Service Code
|
CPT 10010
|
| Hospital Charge Code |
36100559
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$56.94 |
| Max. Negotiated Rate |
$221.53 |
| Rate for Payer: Aetna Commercial |
$138.49
|
| Rate for Payer: Aetna Medicare |
$56.94
|
| Rate for Payer: ASR ASR |
$149.26
|
| Rate for Payer: BCBS Complete |
$61.55
|
| Rate for Payer: BCBS Trust/PPO |
$126.87
|
| Rate for Payer: BCCCP Commercial |
$221.53
|
| Rate for Payer: BCN Commercial |
$126.87
|
| Rate for Payer: Cash Price |
$123.10
|
| Rate for Payer: Cash Price |
$123.10
|
| Rate for Payer: Cofinity Commercial |
$144.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.10
|
| Rate for Payer: Healthscope Commercial |
$149.26
|
| Rate for Payer: Healthscope Whirlpool |
$153.88
|
| Rate for Payer: Mclaren Commercial |
$138.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$123.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.80
|
| Rate for Payer: Nomi Health Commercial |
$126.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$115.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$134.83
|
| Rate for Payer: Priority Health Narrow Network |
$107.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$135.41
|
|
|
HC FNA BX EACH ADDL FLUORO GUIDE
|
Facility
|
IP
|
$169.26
|
|
|
Service Code
|
CPT 10008
|
| Hospital Charge Code |
36100557
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$126.94 |
| Max. Negotiated Rate |
$169.26 |
| Rate for Payer: Aetna Commercial |
$152.33
|
| Rate for Payer: ASR ASR |
$164.18
|
| Rate for Payer: BCBS Trust/PPO |
$139.00
|
| Rate for Payer: BCN Commercial |
$139.00
|
| Rate for Payer: Cash Price |
$135.41
|
| Rate for Payer: Cofinity Commercial |
$159.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$135.41
|
| Rate for Payer: Healthscope Commercial |
$164.18
|
| Rate for Payer: Healthscope Whirlpool |
$169.26
|
| Rate for Payer: Mclaren Commercial |
$152.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$143.87
|
| Rate for Payer: Nomi Health Commercial |
$138.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$126.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$148.95
|
|
|
HC FNA BX EACH ADDL FLUORO GUIDE
|
Facility
|
OP
|
$169.26
|
|
|
Service Code
|
CPT 10008
|
| Hospital Charge Code |
36100557
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$62.63 |
| Max. Negotiated Rate |
$169.26 |
| Rate for Payer: Aetna Commercial |
$152.33
|
| Rate for Payer: Aetna Medicare |
$62.63
|
| Rate for Payer: ASR ASR |
$164.18
|
| Rate for Payer: BCBS Complete |
$67.70
|
| Rate for Payer: BCBS Trust/PPO |
$139.55
|
| Rate for Payer: BCCCP Commercial |
$134.52
|
| Rate for Payer: BCN Commercial |
$139.55
|
| Rate for Payer: Cash Price |
$135.41
|
| Rate for Payer: Cash Price |
$135.41
|
| Rate for Payer: Cofinity Commercial |
$159.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$135.41
|
| Rate for Payer: Healthscope Commercial |
$164.18
|
| Rate for Payer: Healthscope Whirlpool |
$169.26
|
| Rate for Payer: Mclaren Commercial |
$152.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$135.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$143.87
|
| Rate for Payer: Nomi Health Commercial |
$138.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$126.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$148.31
|
| Rate for Payer: Priority Health Narrow Network |
$118.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$148.95
|
|
|
HC FNA BX EACH ADDL US GUIDE
|
Facility
|
IP
|
$219.05
|
|
|
Service Code
|
CPT 10006
|
| Hospital Charge Code |
36100555
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$164.29 |
| Max. Negotiated Rate |
$219.05 |
| Rate for Payer: Aetna Commercial |
$197.15
|
| Rate for Payer: ASR ASR |
$212.48
|
| Rate for Payer: BCBS Trust/PPO |
$179.88
|
| Rate for Payer: BCN Commercial |
$179.88
|
| Rate for Payer: Cash Price |
$175.24
|
| Rate for Payer: Cofinity Commercial |
$205.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$175.24
|
| Rate for Payer: Healthscope Commercial |
$212.48
|
| Rate for Payer: Healthscope Whirlpool |
$219.05
|
| Rate for Payer: Mclaren Commercial |
$197.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$186.19
|
| Rate for Payer: Nomi Health Commercial |
$179.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$164.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$192.76
|
|
|
HC FNA BX EACH ADDL US GUIDE
|
Facility
|
OP
|
$219.05
|
|
|
Service Code
|
CPT 10006
|
| Hospital Charge Code |
36100555
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$58.15 |
| Max. Negotiated Rate |
$219.05 |
| Rate for Payer: Aetna Commercial |
$197.15
|
| Rate for Payer: Aetna Medicare |
$81.05
|
| Rate for Payer: ASR ASR |
$212.48
|
| Rate for Payer: BCBS Complete |
$87.62
|
| Rate for Payer: BCBS Trust/PPO |
$180.61
|
| Rate for Payer: BCCCP Commercial |
$58.15
|
| Rate for Payer: BCN Commercial |
$180.61
|
| Rate for Payer: Cash Price |
$175.24
|
| Rate for Payer: Cash Price |
$175.24
|
| Rate for Payer: Cofinity Commercial |
$205.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$175.24
|
| Rate for Payer: Healthscope Commercial |
$212.48
|
| Rate for Payer: Healthscope Whirlpool |
$219.05
|
| Rate for Payer: Mclaren Commercial |
$197.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$175.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$186.19
|
| Rate for Payer: Nomi Health Commercial |
$179.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$164.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$191.93
|
| Rate for Payer: Priority Health Narrow Network |
$153.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$192.76
|
|
|
HC FNA BX W/O IMG 1ST LESION
|
Facility
|
OP
|
$1,161.09
|
|
|
Service Code
|
CPT 10021
|
| Hospital Charge Code |
76100423
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$96.42 |
| Max. Negotiated Rate |
$1,161.09 |
| Rate for Payer: Aetna Commercial |
$1,044.98
|
| Rate for Payer: Aetna Medicare |
$405.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$506.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$506.31
|
| Rate for Payer: ASR ASR |
$1,126.26
|
| Rate for Payer: BCBS Complete |
$222.45
|
| Rate for Payer: BCBS MAPPO |
$405.05
|
| Rate for Payer: BCBS Trust/PPO |
$957.32
|
| Rate for Payer: BCCCP Commercial |
$96.42
|
| Rate for Payer: BCN Commercial |
$957.32
|
| Rate for Payer: BCN Medicare Advantage |
$405.05
|
| Rate for Payer: Cash Price |
$928.87
|
| Rate for Payer: Cash Price |
$928.87
|
| Rate for Payer: Cofinity Commercial |
$1,091.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$928.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$405.05
|
| Rate for Payer: Healthscope Commercial |
$1,126.26
|
| Rate for Payer: Healthscope Whirlpool |
$1,161.09
|
| Rate for Payer: Humana Choice PPO Medicare |
$405.05
|
| Rate for Payer: Mclaren Commercial |
$1,044.98
|
| Rate for Payer: Mclaren Medicaid |
$405.05
|
| Rate for Payer: Mclaren Medicare |
$405.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$425.30
|
| Rate for Payer: Meridian Medicaid |
$222.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$465.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$445.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$986.93
|
| Rate for Payer: Nomi Health Commercial |
$952.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$870.82
|
| Rate for Payer: PACE Medicare |
$384.80
|
| Rate for Payer: PACE SWMI |
$405.05
|
| Rate for Payer: PHP Commercial |
$445.56
|
| Rate for Payer: PHP Medicaid |
$217.11
|
| Rate for Payer: PHP Medicare Advantage |
$405.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$261.48
|
| Rate for Payer: Priority Health Medicare |
$405.05
|
| Rate for Payer: Priority Health Narrow Network |
$209.19
|
| Rate for Payer: Railroad Medicare Medicare |
$405.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,021.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$405.05
|
| Rate for Payer: UHC Exchange |
$627.83
|
| Rate for Payer: UHC Medicaid |
$211.84
|
| Rate for Payer: UHCCP DNSP |
$405.05
|
| Rate for Payer: UHCCP Medicaid |
$211.84
|
| Rate for Payer: VA VA |
$405.05
|
|
|
HC FNA BX W/O IMG 1ST LESION
|
Facility
|
IP
|
$1,161.09
|
|
|
Service Code
|
CPT 10021
|
| Hospital Charge Code |
76100423
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$870.82 |
| Max. Negotiated Rate |
$1,161.09 |
| Rate for Payer: Aetna Commercial |
$1,044.98
|
| Rate for Payer: ASR ASR |
$1,126.26
|
| Rate for Payer: BCBS Trust/PPO |
$953.49
|
| Rate for Payer: BCN Commercial |
$953.49
|
| Rate for Payer: Cash Price |
$928.87
|
| Rate for Payer: Cofinity Commercial |
$1,091.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$928.87
|
| Rate for Payer: Healthscope Commercial |
$1,126.26
|
| Rate for Payer: Healthscope Whirlpool |
$1,161.09
|
| Rate for Payer: Mclaren Commercial |
$1,044.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$986.93
|
| Rate for Payer: Nomi Health Commercial |
$952.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$870.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,021.76
|
|
|
HC FNA IMED EVAL
|
Facility
|
OP
|
$76.19
|
|
|
Service Code
|
CPT 88172
|
| Hospital Charge Code |
31100006
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$53.08 |
| Max. Negotiated Rate |
$263.13 |
| Rate for Payer: Aetna Commercial |
$68.57
|
| Rate for Payer: Aetna Medicare |
$169.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$212.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$212.20
|
| Rate for Payer: ASR ASR |
$73.90
|
| Rate for Payer: BCBS Complete |
$93.23
|
| Rate for Payer: BCBS MAPPO |
$169.76
|
| Rate for Payer: BCBS Trust/PPO |
$62.82
|
| Rate for Payer: BCCCP Commercial |
$53.08
|
| Rate for Payer: BCN Commercial |
$62.82
|
| Rate for Payer: BCN Medicare Advantage |
$169.76
|
| Rate for Payer: Cash Price |
$60.95
|
| Rate for Payer: Cash Price |
$60.95
|
| Rate for Payer: Cofinity Commercial |
$71.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$169.76
|
| Rate for Payer: Healthscope Commercial |
$73.90
|
| Rate for Payer: Healthscope Whirlpool |
$76.19
|
| Rate for Payer: Humana Choice PPO Medicare |
$169.76
|
| Rate for Payer: Mclaren Commercial |
$68.57
|
| Rate for Payer: Mclaren Medicaid |
$169.76
|
| Rate for Payer: Mclaren Medicare |
$169.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$178.25
|
| Rate for Payer: Meridian Medicaid |
$93.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$195.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$186.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.76
|
| Rate for Payer: Nomi Health Commercial |
$62.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.14
|
| Rate for Payer: PACE Medicare |
$161.27
|
| Rate for Payer: PACE SWMI |
$169.76
|
| Rate for Payer: PHP Commercial |
$186.74
|
| Rate for Payer: PHP Medicaid |
$90.99
|
| Rate for Payer: PHP Medicare Advantage |
$169.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$88.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$66.76
|
| Rate for Payer: Priority Health Medicare |
$169.76
|
| Rate for Payer: Priority Health Narrow Network |
$53.41
|
| Rate for Payer: Railroad Medicare Medicare |
$169.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$67.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$169.76
|
| Rate for Payer: UHC Exchange |
$263.13
|
| Rate for Payer: UHC Medicaid |
$88.78
|
| Rate for Payer: UHCCP DNSP |
$169.76
|
| Rate for Payer: UHCCP Medicaid |
$88.78
|
| Rate for Payer: VA VA |
$169.76
|
|
|
HC FNA IMED EVAL
|
Facility
|
IP
|
$76.19
|
|
|
Service Code
|
CPT 88172
|
| Hospital Charge Code |
31100006
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$57.14 |
| Max. Negotiated Rate |
$76.19 |
| Rate for Payer: Aetna Commercial |
$68.57
|
| Rate for Payer: ASR ASR |
$73.90
|
| Rate for Payer: BCBS Trust/PPO |
$62.57
|
| Rate for Payer: BCN Commercial |
$62.57
|
| Rate for Payer: Cash Price |
$60.95
|
| Rate for Payer: Cofinity Commercial |
$71.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.95
|
| Rate for Payer: Healthscope Commercial |
$73.90
|
| Rate for Payer: Healthscope Whirlpool |
$76.19
|
| Rate for Payer: Mclaren Commercial |
$68.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.76
|
| Rate for Payer: Nomi Health Commercial |
$62.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$67.05
|
|
|
HC FNA IMMEDIATE EVAL ADDITIONAL
|
Facility
|
OP
|
$24.80
|
|
|
Service Code
|
CPT 88177
|
| Hospital Charge Code |
31000002
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$9.18 |
| Max. Negotiated Rate |
$28.02 |
| Rate for Payer: Aetna Commercial |
$22.32
|
| Rate for Payer: Aetna Medicare |
$9.18
|
| Rate for Payer: ASR ASR |
$24.06
|
| Rate for Payer: BCBS Complete |
$9.92
|
| Rate for Payer: BCBS Trust/PPO |
$20.45
|
| Rate for Payer: BCCCP Commercial |
$28.02
|
| Rate for Payer: BCN Commercial |
$20.45
|
| Rate for Payer: Cash Price |
$19.84
|
| Rate for Payer: Cash Price |
$19.84
|
| Rate for Payer: Cofinity Commercial |
$23.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.84
|
| Rate for Payer: Healthscope Commercial |
$24.06
|
| Rate for Payer: Healthscope Whirlpool |
$24.80
|
| Rate for Payer: Mclaren Commercial |
$22.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.08
|
| Rate for Payer: Nomi Health Commercial |
$20.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$21.73
|
| Rate for Payer: Priority Health Narrow Network |
$17.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.82
|
|
|
HC FNA IMMEDIATE EVAL ADDITIONAL
|
Facility
|
IP
|
$24.80
|
|
|
Service Code
|
CPT 88177
|
| Hospital Charge Code |
31000002
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$18.60 |
| Max. Negotiated Rate |
$24.80 |
| Rate for Payer: Aetna Commercial |
$22.32
|
| Rate for Payer: ASR ASR |
$24.06
|
| Rate for Payer: BCBS Trust/PPO |
$20.37
|
| Rate for Payer: BCN Commercial |
$20.37
|
| Rate for Payer: Cash Price |
$19.84
|
| Rate for Payer: Cofinity Commercial |
$23.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.84
|
| Rate for Payer: Healthscope Commercial |
$24.06
|
| Rate for Payer: Healthscope Whirlpool |
$24.80
|
| Rate for Payer: Mclaren Commercial |
$22.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.08
|
| Rate for Payer: Nomi Health Commercial |
$20.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.82
|
|
|
HC FNA INTERPRETATION & REPORT
|
Facility
|
OP
|
$266.16
|
|
|
Service Code
|
CPT 88173
|
| Hospital Charge Code |
31100007
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$27.15 |
| Max. Negotiated Rate |
$266.16 |
| Rate for Payer: Aetna Commercial |
$239.54
|
| Rate for Payer: Aetna Medicare |
$51.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$64.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$64.90
|
| Rate for Payer: ASR ASR |
$258.18
|
| Rate for Payer: BCBS Complete |
$28.51
|
| Rate for Payer: BCBS MAPPO |
$51.92
|
| Rate for Payer: BCBS Trust/PPO |
$219.45
|
| Rate for Payer: BCCCP Commercial |
$160.49
|
| Rate for Payer: BCN Commercial |
$219.45
|
| Rate for Payer: BCN Medicare Advantage |
$51.92
|
| Rate for Payer: Cash Price |
$212.93
|
| Rate for Payer: Cash Price |
$212.93
|
| Rate for Payer: Cofinity Commercial |
$250.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$212.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.92
|
| Rate for Payer: Healthscope Commercial |
$258.18
|
| Rate for Payer: Healthscope Whirlpool |
$266.16
|
| Rate for Payer: Humana Choice PPO Medicare |
$51.92
|
| Rate for Payer: Mclaren Commercial |
$239.54
|
| Rate for Payer: Mclaren Medicaid |
$51.92
|
| Rate for Payer: Mclaren Medicare |
$51.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$54.52
|
| Rate for Payer: Meridian Medicaid |
$28.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$57.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$226.24
|
| Rate for Payer: Nomi Health Commercial |
$218.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$199.62
|
| Rate for Payer: PACE Medicare |
$49.32
|
| Rate for Payer: PACE SWMI |
$51.92
|
| Rate for Payer: PHP Commercial |
$57.11
|
| Rate for Payer: PHP Medicaid |
$27.83
|
| Rate for Payer: PHP Medicare Advantage |
$51.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$233.21
|
| Rate for Payer: Priority Health Medicare |
$51.92
|
| Rate for Payer: Priority Health Narrow Network |
$186.58
|
| Rate for Payer: Railroad Medicare Medicare |
$51.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$234.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$51.92
|
| Rate for Payer: UHC Exchange |
$80.48
|
| Rate for Payer: UHC Medicaid |
$27.15
|
| Rate for Payer: UHCCP DNSP |
$51.92
|
| Rate for Payer: UHCCP Medicaid |
$27.15
|
| Rate for Payer: VA VA |
$51.92
|
|
|
HC FNA INTERPRETATION & REPORT
|
Facility
|
IP
|
$266.16
|
|
|
Service Code
|
CPT 88173
|
| Hospital Charge Code |
31100007
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$199.62 |
| Max. Negotiated Rate |
$266.16 |
| Rate for Payer: Aetna Commercial |
$239.54
|
| Rate for Payer: ASR ASR |
$258.18
|
| Rate for Payer: BCBS Trust/PPO |
$218.57
|
| Rate for Payer: BCN Commercial |
$218.57
|
| Rate for Payer: Cash Price |
$212.93
|
| Rate for Payer: Cofinity Commercial |
$250.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$212.93
|
| Rate for Payer: Healthscope Commercial |
$258.18
|
| Rate for Payer: Healthscope Whirlpool |
$266.16
|
| Rate for Payer: Mclaren Commercial |
$239.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$226.24
|
| Rate for Payer: Nomi Health Commercial |
$218.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$199.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$234.22
|
|
|
HC FOLATE SERUM
|
Facility
|
OP
|
$63.67
|
|
|
Service Code
|
CPT 82746
|
| Hospital Charge Code |
30100204
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.69 |
| Max. Negotiated Rate |
$63.67 |
| Rate for Payer: Aetna Commercial |
$57.30
|
| Rate for Payer: Aetna Medicare |
$14.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.38
|
| Rate for Payer: ASR ASR |
$61.76
|
| Rate for Payer: BCBS Complete |
$8.07
|
| Rate for Payer: BCBS MAPPO |
$14.70
|
| Rate for Payer: BCBS Trust/PPO |
$52.50
|
| Rate for Payer: BCN Commercial |
$52.50
|
| Rate for Payer: BCN Medicare Advantage |
$14.70
|
| Rate for Payer: Cash Price |
$50.94
|
| Rate for Payer: Cash Price |
$50.94
|
| Rate for Payer: Cofinity Commercial |
$59.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.70
|
| Rate for Payer: Healthscope Commercial |
$61.76
|
| Rate for Payer: Healthscope Whirlpool |
$63.67
|
| Rate for Payer: Humana Choice PPO Medicare |
$14.70
|
| Rate for Payer: Mclaren Commercial |
$57.30
|
| Rate for Payer: Mclaren Medicaid |
$14.70
|
| Rate for Payer: Mclaren Medicare |
$14.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.44
|
| Rate for Payer: Meridian Medicaid |
$8.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.12
|
| Rate for Payer: Nomi Health Commercial |
$52.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.75
|
| Rate for Payer: PACE Medicare |
$13.96
|
| Rate for Payer: PACE SWMI |
$14.70
|
| Rate for Payer: PHP Commercial |
$16.17
|
| Rate for Payer: PHP Medicaid |
$7.88
|
| Rate for Payer: PHP Medicare Advantage |
$14.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$49.62
|
| Rate for Payer: Priority Health Medicare |
$14.70
|
| Rate for Payer: Priority Health Narrow Network |
$39.70
|
| Rate for Payer: Railroad Medicare Medicare |
$14.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$56.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$14.70
|
| Rate for Payer: UHC Exchange |
$22.79
|
| Rate for Payer: UHC Medicaid |
$7.69
|
| Rate for Payer: UHCCP DNSP |
$14.70
|
| Rate for Payer: UHCCP Medicaid |
$7.69
|
| Rate for Payer: VA VA |
$14.70
|
|
|
HC FOLATE SERUM
|
Facility
|
IP
|
$63.67
|
|
|
Service Code
|
CPT 82746
|
| Hospital Charge Code |
30100204
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$47.75 |
| Max. Negotiated Rate |
$63.67 |
| Rate for Payer: Aetna Commercial |
$57.30
|
| Rate for Payer: ASR ASR |
$61.76
|
| Rate for Payer: BCBS Trust/PPO |
$52.29
|
| Rate for Payer: BCN Commercial |
$52.29
|
| Rate for Payer: Cash Price |
$50.94
|
| Rate for Payer: Cofinity Commercial |
$59.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.94
|
| Rate for Payer: Healthscope Commercial |
$61.76
|
| Rate for Payer: Healthscope Whirlpool |
$63.67
|
| Rate for Payer: Mclaren Commercial |
$57.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.12
|
| Rate for Payer: Nomi Health Commercial |
$52.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$56.03
|
|
|
HC FOLEY INSERT BY PHYSICIAN
|
Facility
|
IP
|
$510.33
|
|
| Hospital Charge Code |
45000041
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$382.75 |
| Max. Negotiated Rate |
$510.33 |
| Rate for Payer: Aetna Commercial |
$459.30
|
| Rate for Payer: ASR ASR |
$495.02
|
| Rate for Payer: BCBS Trust/PPO |
$419.08
|
| Rate for Payer: BCN Commercial |
$419.08
|
| Rate for Payer: Cash Price |
$408.26
|
| Rate for Payer: Cofinity Commercial |
$479.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$408.26
|
| Rate for Payer: Healthscope Commercial |
$495.02
|
| Rate for Payer: Healthscope Whirlpool |
$510.33
|
| Rate for Payer: Mclaren Commercial |
$459.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$433.78
|
| Rate for Payer: Nomi Health Commercial |
$418.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$382.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$449.09
|
|
