|
HC ENVIRONMENTAL CULTURE
|
Facility
|
IP
|
$37.56
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
30600076
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$24.41 |
| Max. Negotiated Rate |
$37.56 |
| Rate for Payer: Aetna Commercial |
$33.80
|
| Rate for Payer: ASR ASR |
$36.43
|
| Rate for Payer: ASR Commercial |
$36.43
|
| Rate for Payer: BCBS Trust/PPO |
$30.61
|
| Rate for Payer: BCN Commercial |
$29.12
|
| Rate for Payer: Cash Price |
$30.05
|
| Rate for Payer: Cofinity Commercial |
$35.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.05
|
| Rate for Payer: Healthscope Commercial |
$37.56
|
| Rate for Payer: Healthscope Whirlpool |
$36.43
|
| Rate for Payer: Mclaren Commercial |
$33.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.93
|
| Rate for Payer: Nomi Health Commercial |
$30.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$33.05
|
|
|
HC ENZYME DETECTION
|
Facility
|
OP
|
$29.27
|
|
|
Service Code
|
CPT 87185
|
| Hospital Charge Code |
30600099
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$2.55 |
| Max. Negotiated Rate |
$29.27 |
| Rate for Payer: Aetna Commercial |
$26.34
|
| Rate for Payer: Aetna Medicare |
$4.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.94
|
| Rate for Payer: ASR ASR |
$28.39
|
| Rate for Payer: ASR Commercial |
$28.39
|
| Rate for Payer: BCBS Complete |
$2.67
|
| Rate for Payer: BCBS MAPPO |
$4.75
|
| Rate for Payer: BCBS Trust/PPO |
$23.97
|
| Rate for Payer: BCN Commercial |
$22.69
|
| Rate for Payer: BCN Medicare Advantage |
$4.75
|
| Rate for Payer: Cash Price |
$23.42
|
| Rate for Payer: Cash Price |
$23.42
|
| Rate for Payer: Cofinity Commercial |
$27.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.75
|
| Rate for Payer: Healthscope Commercial |
$29.27
|
| Rate for Payer: Healthscope Whirlpool |
$28.39
|
| Rate for Payer: Humana Choice PPO Medicare |
$4.75
|
| Rate for Payer: Mclaren Commercial |
$26.34
|
| Rate for Payer: Mclaren Medicaid |
$2.55
|
| Rate for Payer: Mclaren Medicare |
$4.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.99
|
| Rate for Payer: Meridian Medicaid |
$2.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.88
|
| Rate for Payer: Nomi Health Commercial |
$24.00
|
| Rate for Payer: PACE Medicare |
$4.51
|
| Rate for Payer: PACE SWMI |
$4.75
|
| Rate for Payer: PHP Commercial |
$5.22
|
| Rate for Payer: PHP Medicaid |
$2.55
|
| Rate for Payer: PHP Medicare Advantage |
$4.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25.65
|
| Rate for Payer: Priority Health Medicare |
$4.75
|
| Rate for Payer: Priority Health Narrow Network |
$20.52
|
| Rate for Payer: Railroad Medicare Medicare |
$4.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.75
|
| Rate for Payer: UHC Exchange |
$7.36
|
| Rate for Payer: UHC Medicare Advantage |
$4.75
|
| Rate for Payer: UHCCP DNSP |
$4.75
|
| Rate for Payer: UHCCP Medicaid |
$2.55
|
| Rate for Payer: VA VA |
$4.75
|
|
|
HC ENZYME DETECTION
|
Facility
|
IP
|
$29.27
|
|
|
Service Code
|
CPT 87185
|
| Hospital Charge Code |
30600099
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.03 |
| Max. Negotiated Rate |
$29.27 |
| Rate for Payer: Aetna Commercial |
$26.34
|
| Rate for Payer: ASR ASR |
$28.39
|
| Rate for Payer: ASR Commercial |
$28.39
|
| Rate for Payer: BCBS Trust/PPO |
$23.85
|
| Rate for Payer: BCN Commercial |
$22.69
|
| Rate for Payer: Cash Price |
$23.42
|
| Rate for Payer: Cofinity Commercial |
$27.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.42
|
| Rate for Payer: Healthscope Commercial |
$29.27
|
| Rate for Payer: Healthscope Whirlpool |
$28.39
|
| Rate for Payer: Mclaren Commercial |
$26.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.88
|
| Rate for Payer: Nomi Health Commercial |
$24.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.76
|
|
|
HC ENZYME HISTOCHEMISTRY
|
Facility
|
IP
|
$165.24
|
|
|
Service Code
|
CPT 88319
|
| Hospital Charge Code |
31200006
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$107.41 |
| Max. Negotiated Rate |
$165.24 |
| Rate for Payer: Aetna Commercial |
$148.72
|
| Rate for Payer: ASR ASR |
$160.28
|
| Rate for Payer: ASR Commercial |
$160.28
|
| Rate for Payer: BCBS Trust/PPO |
$134.65
|
| Rate for Payer: BCN Commercial |
$128.11
|
| Rate for Payer: Cash Price |
$132.19
|
| Rate for Payer: Cofinity Commercial |
$155.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$132.19
|
| Rate for Payer: Healthscope Commercial |
$165.24
|
| Rate for Payer: Healthscope Whirlpool |
$160.28
|
| Rate for Payer: Mclaren Commercial |
$148.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$140.45
|
| Rate for Payer: Nomi Health Commercial |
$135.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$107.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$145.41
|
|
|
HC ENZYME HISTOCHEMISTRY
|
Facility
|
OP
|
$165.24
|
|
|
Service Code
|
CPT 88319
|
| Hospital Charge Code |
31200006
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$107.41 |
| Max. Negotiated Rate |
$1,240.59 |
| Rate for Payer: Aetna Commercial |
$148.72
|
| Rate for Payer: Aetna Medicare |
$800.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,000.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,000.48
|
| Rate for Payer: ASR ASR |
$160.28
|
| Rate for Payer: ASR Commercial |
$160.28
|
| Rate for Payer: BCBS Complete |
$450.45
|
| Rate for Payer: BCBS MAPPO |
$800.38
|
| Rate for Payer: BCBS Trust/PPO |
$135.32
|
| Rate for Payer: BCN Commercial |
$128.11
|
| Rate for Payer: BCN Medicare Advantage |
$800.38
|
| Rate for Payer: Cash Price |
$132.19
|
| Rate for Payer: Cash Price |
$132.19
|
| Rate for Payer: Cofinity Commercial |
$155.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$132.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$800.38
|
| Rate for Payer: Healthscope Commercial |
$165.24
|
| Rate for Payer: Healthscope Whirlpool |
$160.28
|
| Rate for Payer: Humana Choice PPO Medicare |
$800.38
|
| Rate for Payer: Mclaren Commercial |
$148.72
|
| Rate for Payer: Mclaren Medicaid |
$429.00
|
| Rate for Payer: Mclaren Medicare |
$800.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$840.40
|
| Rate for Payer: Meridian Medicaid |
$450.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$920.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$140.45
|
| Rate for Payer: Nomi Health Commercial |
$135.50
|
| Rate for Payer: PACE Medicare |
$760.36
|
| Rate for Payer: PACE SWMI |
$800.38
|
| Rate for Payer: PHP Commercial |
$880.42
|
| Rate for Payer: PHP Medicaid |
$429.00
|
| Rate for Payer: PHP Medicare Advantage |
$800.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$429.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$107.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$144.78
|
| Rate for Payer: Priority Health Medicare |
$800.38
|
| Rate for Payer: Priority Health Narrow Network |
$115.83
|
| Rate for Payer: Railroad Medicare Medicare |
$800.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$145.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$800.38
|
| Rate for Payer: UHC Exchange |
$1,240.59
|
| Rate for Payer: UHC Medicare Advantage |
$800.38
|
| Rate for Payer: UHCCP DNSP |
$800.38
|
| Rate for Payer: UHCCP Medicaid |
$429.00
|
| Rate for Payer: VA VA |
$800.38
|
|
|
HC EOSINOPHIL NASAL SMEAR
|
Facility
|
OP
|
$46.31
|
|
|
Service Code
|
CPT 89190
|
| Hospital Charge Code |
30000003
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$3.10 |
| Max. Negotiated Rate |
$46.31 |
| Rate for Payer: Aetna Commercial |
$41.68
|
| Rate for Payer: Aetna Medicare |
$5.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.24
|
| Rate for Payer: ASR ASR |
$44.92
|
| Rate for Payer: ASR Commercial |
$44.92
|
| Rate for Payer: BCBS Complete |
$3.26
|
| Rate for Payer: BCBS MAPPO |
$5.79
|
| Rate for Payer: BCBS Trust/PPO |
$37.92
|
| Rate for Payer: BCN Commercial |
$35.90
|
| Rate for Payer: BCN Medicare Advantage |
$5.79
|
| Rate for Payer: Cash Price |
$37.05
|
| Rate for Payer: Cash Price |
$37.05
|
| Rate for Payer: Cofinity Commercial |
$43.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.79
|
| Rate for Payer: Healthscope Commercial |
$46.31
|
| Rate for Payer: Healthscope Whirlpool |
$44.92
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.79
|
| Rate for Payer: Mclaren Commercial |
$41.68
|
| Rate for Payer: Mclaren Medicaid |
$3.10
|
| Rate for Payer: Mclaren Medicare |
$5.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.08
|
| Rate for Payer: Meridian Medicaid |
$3.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.36
|
| Rate for Payer: Nomi Health Commercial |
$37.97
|
| Rate for Payer: PACE Medicare |
$5.50
|
| Rate for Payer: PACE SWMI |
$5.79
|
| Rate for Payer: PHP Commercial |
$6.37
|
| Rate for Payer: PHP Medicaid |
$3.10
|
| Rate for Payer: PHP Medicare Advantage |
$5.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19.21
|
| Rate for Payer: Priority Health Medicare |
$5.79
|
| Rate for Payer: Priority Health Narrow Network |
$15.37
|
| Rate for Payer: Railroad Medicare Medicare |
$5.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.79
|
| Rate for Payer: UHC Exchange |
$8.97
|
| Rate for Payer: UHC Medicare Advantage |
$5.79
|
| Rate for Payer: UHCCP DNSP |
$5.79
|
| Rate for Payer: UHCCP Medicaid |
$3.10
|
| Rate for Payer: VA VA |
$5.79
|
|
|
HC EOSINOPHIL NASAL SMEAR
|
Facility
|
IP
|
$46.31
|
|
|
Service Code
|
CPT 89190
|
| Hospital Charge Code |
30000003
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$30.10 |
| Max. Negotiated Rate |
$46.31 |
| Rate for Payer: Aetna Commercial |
$41.68
|
| Rate for Payer: ASR ASR |
$44.92
|
| Rate for Payer: ASR Commercial |
$44.92
|
| Rate for Payer: BCBS Trust/PPO |
$37.74
|
| Rate for Payer: BCN Commercial |
$35.90
|
| Rate for Payer: Cash Price |
$37.05
|
| Rate for Payer: Cofinity Commercial |
$43.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.05
|
| Rate for Payer: Healthscope Commercial |
$46.31
|
| Rate for Payer: Healthscope Whirlpool |
$44.92
|
| Rate for Payer: Mclaren Commercial |
$41.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.36
|
| Rate for Payer: Nomi Health Commercial |
$37.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.75
|
|
|
HC EOVIST PER ML
|
Facility
|
OP
|
$31.31
|
|
|
Service Code
|
HCPCS A9581
|
| Hospital Charge Code |
63600009
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$12.22 |
| Max. Negotiated Rate |
$31.31 |
| Rate for Payer: Aetna Commercial |
$28.18
|
| Rate for Payer: Aetna Medicare |
$15.66
|
| Rate for Payer: ASR ASR |
$30.37
|
| Rate for Payer: ASR Commercial |
$30.37
|
| Rate for Payer: BCBS Complete |
$12.52
|
| Rate for Payer: BCBS Trust/PPO |
$25.64
|
| Rate for Payer: BCN Commercial |
$24.27
|
| Rate for Payer: Cash Price |
$25.05
|
| Rate for Payer: Cash Price |
$25.05
|
| Rate for Payer: Cofinity Commercial |
$29.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.05
|
| Rate for Payer: Healthscope Commercial |
$31.31
|
| Rate for Payer: Healthscope Whirlpool |
$30.37
|
| Rate for Payer: Mclaren Commercial |
$28.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.61
|
| Rate for Payer: Nomi Health Commercial |
$25.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.27
|
| Rate for Payer: Priority Health Narrow Network |
$12.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.55
|
|
|
HC EOVIST PER ML
|
Facility
|
IP
|
$31.31
|
|
|
Service Code
|
HCPCS A9581
|
| Hospital Charge Code |
63600009
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$20.35 |
| Max. Negotiated Rate |
$31.31 |
| Rate for Payer: Aetna Commercial |
$28.18
|
| Rate for Payer: ASR ASR |
$30.37
|
| Rate for Payer: ASR Commercial |
$30.37
|
| Rate for Payer: BCBS Trust/PPO |
$25.51
|
| Rate for Payer: BCN Commercial |
$24.27
|
| Rate for Payer: Cash Price |
$25.05
|
| Rate for Payer: Cofinity Commercial |
$29.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.05
|
| Rate for Payer: Healthscope Commercial |
$31.31
|
| Rate for Payer: Healthscope Whirlpool |
$30.37
|
| Rate for Payer: Mclaren Commercial |
$28.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.61
|
| Rate for Payer: Nomi Health Commercial |
$25.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.55
|
|
|
HC EO W/O JOINTS CF
|
Facility
|
IP
|
$275.71
|
|
|
Service Code
|
HCPCS L3702
|
| Hospital Charge Code |
27400050
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$179.21 |
| Max. Negotiated Rate |
$275.71 |
| Rate for Payer: Aetna Commercial |
$248.14
|
| Rate for Payer: ASR ASR |
$267.44
|
| Rate for Payer: ASR Commercial |
$267.44
|
| Rate for Payer: BCBS Trust/PPO |
$224.68
|
| Rate for Payer: BCN Commercial |
$213.76
|
| Rate for Payer: Cash Price |
$220.57
|
| Rate for Payer: Cofinity Commercial |
$259.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.57
|
| Rate for Payer: Healthscope Commercial |
$275.71
|
| Rate for Payer: Healthscope Whirlpool |
$267.44
|
| Rate for Payer: Mclaren Commercial |
$248.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$234.35
|
| Rate for Payer: Nomi Health Commercial |
$226.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$179.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$242.62
|
|
|
HC EO W/O JOINTS CF
|
Facility
|
OP
|
$275.71
|
|
|
Service Code
|
HCPCS L3702
|
| Hospital Charge Code |
27400050
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$110.28 |
| Max. Negotiated Rate |
$275.71 |
| Rate for Payer: Aetna Commercial |
$248.14
|
| Rate for Payer: Aetna Medicare |
$137.86
|
| Rate for Payer: ASR ASR |
$267.44
|
| Rate for Payer: ASR Commercial |
$267.44
|
| Rate for Payer: BCBS Complete |
$110.28
|
| Rate for Payer: BCBS Trust/PPO |
$225.78
|
| Rate for Payer: BCN Commercial |
$213.76
|
| Rate for Payer: Cash Price |
$220.57
|
| Rate for Payer: Cofinity Commercial |
$259.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.57
|
| Rate for Payer: Healthscope Commercial |
$275.71
|
| Rate for Payer: Healthscope Whirlpool |
$267.44
|
| Rate for Payer: Mclaren Commercial |
$248.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$234.35
|
| Rate for Payer: Nomi Health Commercial |
$226.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$179.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$241.58
|
| Rate for Payer: Priority Health Narrow Network |
$193.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$242.62
|
|
|
HC EP+ABL ARRHYTHMIA
|
Facility
|
IP
|
$17,739.50
|
|
|
Service Code
|
CPT 93653
|
| Hospital Charge Code |
48100091
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$11,530.68 |
| Max. Negotiated Rate |
$17,739.50 |
| Rate for Payer: Aetna Commercial |
$15,965.55
|
| Rate for Payer: ASR ASR |
$17,207.32
|
| Rate for Payer: ASR Commercial |
$17,207.32
|
| Rate for Payer: BCBS Trust/PPO |
$14,455.92
|
| Rate for Payer: BCN Commercial |
$13,753.43
|
| Rate for Payer: Cash Price |
$14,191.60
|
| Rate for Payer: Cofinity Commercial |
$16,675.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,191.60
|
| Rate for Payer: Healthscope Commercial |
$17,739.50
|
| Rate for Payer: Healthscope Whirlpool |
$17,207.32
|
| Rate for Payer: Mclaren Commercial |
$15,965.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,078.58
|
| Rate for Payer: Nomi Health Commercial |
$14,546.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,530.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15,610.76
|
|
|
HC EP+ABL ARRHYTHMIA
|
Facility
|
OP
|
$17,739.50
|
|
|
Service Code
|
CPT 93653
|
| Hospital Charge Code |
48100091
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$10,208.58 |
| Max. Negotiated Rate |
$37,256.20 |
| Rate for Payer: Aetna Commercial |
$15,965.55
|
| Rate for Payer: Aetna Medicare |
$24,036.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30,045.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30,045.32
|
| Rate for Payer: ASR ASR |
$17,207.32
|
| Rate for Payer: ASR Commercial |
$17,207.32
|
| Rate for Payer: BCBS Complete |
$13,527.61
|
| Rate for Payer: BCBS MAPPO |
$24,036.26
|
| Rate for Payer: BCBS Trust/PPO |
$14,526.88
|
| Rate for Payer: BCN Commercial |
$13,753.43
|
| Rate for Payer: BCN Medicare Advantage |
$24,036.26
|
| Rate for Payer: Cash Price |
$14,191.60
|
| Rate for Payer: Cash Price |
$14,191.60
|
| Rate for Payer: Cofinity Commercial |
$16,675.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,191.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24,036.26
|
| Rate for Payer: Healthscope Commercial |
$17,739.50
|
| Rate for Payer: Healthscope Whirlpool |
$17,207.32
|
| Rate for Payer: Humana Choice PPO Medicare |
$24,036.26
|
| Rate for Payer: Mclaren Commercial |
$15,965.55
|
| Rate for Payer: Mclaren Medicaid |
$12,883.44
|
| Rate for Payer: Mclaren Medicare |
$24,036.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25,238.07
|
| Rate for Payer: Meridian Medicaid |
$13,527.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27,641.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,078.58
|
| Rate for Payer: Nomi Health Commercial |
$14,546.39
|
| Rate for Payer: PACE Medicare |
$22,834.45
|
| Rate for Payer: PACE SWMI |
$24,036.26
|
| Rate for Payer: PHP Commercial |
$26,439.89
|
| Rate for Payer: PHP Medicaid |
$12,883.44
|
| Rate for Payer: PHP Medicare Advantage |
$24,036.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$12,883.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,530.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12,760.73
|
| Rate for Payer: Priority Health Medicare |
$24,036.26
|
| Rate for Payer: Priority Health Narrow Network |
$10,208.58
|
| Rate for Payer: Railroad Medicare Medicare |
$24,036.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15,610.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$24,036.26
|
| Rate for Payer: UHC Exchange |
$37,256.20
|
| Rate for Payer: UHC Medicare Advantage |
$24,036.26
|
| Rate for Payer: UHCCP DNSP |
$24,036.26
|
| Rate for Payer: UHCCP Medicaid |
$12,883.44
|
| Rate for Payer: VA VA |
$24,036.26
|
|
|
HC EP+ABL VT
|
Facility
|
OP
|
$17,739.50
|
|
|
Service Code
|
CPT 93654
|
| Hospital Charge Code |
48100092
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$10,208.58 |
| Max. Negotiated Rate |
$37,256.20 |
| Rate for Payer: Aetna Commercial |
$15,965.55
|
| Rate for Payer: Aetna Medicare |
$24,036.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30,045.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30,045.32
|
| Rate for Payer: ASR ASR |
$17,207.32
|
| Rate for Payer: ASR Commercial |
$17,207.32
|
| Rate for Payer: BCBS Complete |
$13,527.61
|
| Rate for Payer: BCBS MAPPO |
$24,036.26
|
| Rate for Payer: BCBS Trust/PPO |
$14,526.88
|
| Rate for Payer: BCN Commercial |
$13,753.43
|
| Rate for Payer: BCN Medicare Advantage |
$24,036.26
|
| Rate for Payer: Cash Price |
$14,191.60
|
| Rate for Payer: Cash Price |
$14,191.60
|
| Rate for Payer: Cofinity Commercial |
$16,675.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,191.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24,036.26
|
| Rate for Payer: Healthscope Commercial |
$17,739.50
|
| Rate for Payer: Healthscope Whirlpool |
$17,207.32
|
| Rate for Payer: Humana Choice PPO Medicare |
$24,036.26
|
| Rate for Payer: Mclaren Commercial |
$15,965.55
|
| Rate for Payer: Mclaren Medicaid |
$12,883.44
|
| Rate for Payer: Mclaren Medicare |
$24,036.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25,238.07
|
| Rate for Payer: Meridian Medicaid |
$13,527.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27,641.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,078.58
|
| Rate for Payer: Nomi Health Commercial |
$14,546.39
|
| Rate for Payer: PACE Medicare |
$22,834.45
|
| Rate for Payer: PACE SWMI |
$24,036.26
|
| Rate for Payer: PHP Commercial |
$26,439.89
|
| Rate for Payer: PHP Medicaid |
$12,883.44
|
| Rate for Payer: PHP Medicare Advantage |
$24,036.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$12,883.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,530.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12,760.73
|
| Rate for Payer: Priority Health Medicare |
$24,036.26
|
| Rate for Payer: Priority Health Narrow Network |
$10,208.58
|
| Rate for Payer: Railroad Medicare Medicare |
$24,036.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15,610.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$24,036.26
|
| Rate for Payer: UHC Exchange |
$37,256.20
|
| Rate for Payer: UHC Medicare Advantage |
$24,036.26
|
| Rate for Payer: UHCCP DNSP |
$24,036.26
|
| Rate for Payer: UHCCP Medicaid |
$12,883.44
|
| Rate for Payer: VA VA |
$24,036.26
|
|
|
HC EP+ABL VT
|
Facility
|
IP
|
$17,739.50
|
|
|
Service Code
|
CPT 93654
|
| Hospital Charge Code |
48100092
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$11,530.68 |
| Max. Negotiated Rate |
$17,739.50 |
| Rate for Payer: Aetna Commercial |
$15,965.55
|
| Rate for Payer: ASR ASR |
$17,207.32
|
| Rate for Payer: ASR Commercial |
$17,207.32
|
| Rate for Payer: BCBS Trust/PPO |
$14,455.92
|
| Rate for Payer: BCN Commercial |
$13,753.43
|
| Rate for Payer: Cash Price |
$14,191.60
|
| Rate for Payer: Cofinity Commercial |
$16,675.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,191.60
|
| Rate for Payer: Healthscope Commercial |
$17,739.50
|
| Rate for Payer: Healthscope Whirlpool |
$17,207.32
|
| Rate for Payer: Mclaren Commercial |
$15,965.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,078.58
|
| Rate for Payer: Nomi Health Commercial |
$14,546.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,530.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15,610.76
|
|
|
HC EP AFTER DRUGS
|
Facility
|
OP
|
$7,423.93
|
|
|
Service Code
|
CPT 93623
|
| Hospital Charge Code |
48100039
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,969.57 |
| Max. Negotiated Rate |
$7,423.93 |
| Rate for Payer: Aetna Commercial |
$6,681.54
|
| Rate for Payer: Aetna Medicare |
$3,711.96
|
| Rate for Payer: ASR ASR |
$7,201.21
|
| Rate for Payer: ASR Commercial |
$7,201.21
|
| Rate for Payer: BCBS Complete |
$2,969.57
|
| Rate for Payer: BCBS Trust/PPO |
$6,079.46
|
| Rate for Payer: BCN Commercial |
$5,755.77
|
| Rate for Payer: Cash Price |
$5,939.14
|
| Rate for Payer: Cofinity Commercial |
$6,978.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,939.14
|
| Rate for Payer: Healthscope Commercial |
$7,423.93
|
| Rate for Payer: Healthscope Whirlpool |
$7,201.21
|
| Rate for Payer: Mclaren Commercial |
$6,681.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,310.34
|
| Rate for Payer: Nomi Health Commercial |
$6,087.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,825.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,504.85
|
| Rate for Payer: Priority Health Narrow Network |
$5,204.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,533.06
|
|
|
HC EP AFTER DRUGS
|
Facility
|
IP
|
$7,423.93
|
|
|
Service Code
|
CPT 93623
|
| Hospital Charge Code |
48100039
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,825.55 |
| Max. Negotiated Rate |
$7,423.93 |
| Rate for Payer: Aetna Commercial |
$6,681.54
|
| Rate for Payer: ASR ASR |
$7,201.21
|
| Rate for Payer: ASR Commercial |
$7,201.21
|
| Rate for Payer: BCBS Trust/PPO |
$6,049.76
|
| Rate for Payer: BCN Commercial |
$5,755.77
|
| Rate for Payer: Cash Price |
$5,939.14
|
| Rate for Payer: Cofinity Commercial |
$6,978.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,939.14
|
| Rate for Payer: Healthscope Commercial |
$7,423.93
|
| Rate for Payer: Healthscope Whirlpool |
$7,201.21
|
| Rate for Payer: Mclaren Commercial |
$6,681.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,310.34
|
| Rate for Payer: Nomi Health Commercial |
$6,087.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,825.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,533.06
|
|
|
HC EP EVAL OF SQ ICD
|
Facility
|
IP
|
$3,342.81
|
|
|
Service Code
|
CPT 93644
|
| Hospital Charge Code |
48000027
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$2,172.83 |
| Max. Negotiated Rate |
$3,342.81 |
| Rate for Payer: Aetna Commercial |
$3,008.53
|
| Rate for Payer: ASR ASR |
$3,242.53
|
| Rate for Payer: ASR Commercial |
$3,242.53
|
| Rate for Payer: BCBS Trust/PPO |
$2,724.06
|
| Rate for Payer: BCN Commercial |
$2,591.68
|
| Rate for Payer: Cash Price |
$2,674.25
|
| Rate for Payer: Cofinity Commercial |
$3,142.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,674.25
|
| Rate for Payer: Healthscope Commercial |
$3,342.81
|
| Rate for Payer: Healthscope Whirlpool |
$3,242.53
|
| Rate for Payer: Mclaren Commercial |
$3,008.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,841.39
|
| Rate for Payer: Nomi Health Commercial |
$2,741.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,172.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,941.67
|
|
|
HC EP EVAL OF SQ ICD
|
Facility
|
OP
|
$3,342.81
|
|
|
Service Code
|
CPT 93644
|
| Hospital Charge Code |
48000027
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,337.12 |
| Max. Negotiated Rate |
$3,342.81 |
| Rate for Payer: Aetna Commercial |
$3,008.53
|
| Rate for Payer: Aetna Medicare |
$1,671.40
|
| Rate for Payer: ASR ASR |
$3,242.53
|
| Rate for Payer: ASR Commercial |
$3,242.53
|
| Rate for Payer: BCBS Complete |
$1,337.12
|
| Rate for Payer: BCBS Trust/PPO |
$2,737.43
|
| Rate for Payer: BCN Commercial |
$2,591.68
|
| Rate for Payer: Cash Price |
$2,674.25
|
| Rate for Payer: Cofinity Commercial |
$3,142.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,674.25
|
| Rate for Payer: Healthscope Commercial |
$3,342.81
|
| Rate for Payer: Healthscope Whirlpool |
$3,242.53
|
| Rate for Payer: Mclaren Commercial |
$3,008.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,841.39
|
| Rate for Payer: Nomi Health Commercial |
$2,741.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,172.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,928.97
|
| Rate for Payer: Priority Health Narrow Network |
$2,343.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,941.67
|
|
|
HC EP EVALUATION OF GEN/LEADS
|
Facility
|
OP
|
$2,388.64
|
|
|
Service Code
|
CPT 93641
|
| Hospital Charge Code |
48100042
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$955.46 |
| Max. Negotiated Rate |
$2,388.64 |
| Rate for Payer: Aetna Commercial |
$2,149.78
|
| Rate for Payer: Aetna Medicare |
$1,194.32
|
| Rate for Payer: ASR ASR |
$2,316.98
|
| Rate for Payer: ASR Commercial |
$2,316.98
|
| Rate for Payer: BCBS Complete |
$955.46
|
| Rate for Payer: BCBS Trust/PPO |
$1,956.06
|
| Rate for Payer: BCN Commercial |
$1,851.91
|
| Rate for Payer: Cash Price |
$1,910.91
|
| Rate for Payer: Cofinity Commercial |
$2,245.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,910.91
|
| Rate for Payer: Healthscope Commercial |
$2,388.64
|
| Rate for Payer: Healthscope Whirlpool |
$2,316.98
|
| Rate for Payer: Mclaren Commercial |
$2,149.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,030.34
|
| Rate for Payer: Nomi Health Commercial |
$1,958.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,552.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,092.93
|
| Rate for Payer: Priority Health Narrow Network |
$1,674.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,102.00
|
|
|
HC EP EVALUATION OF GEN/LEADS
|
Facility
|
IP
|
$2,388.64
|
|
|
Service Code
|
CPT 93641
|
| Hospital Charge Code |
48100042
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,552.62 |
| Max. Negotiated Rate |
$2,388.64 |
| Rate for Payer: Aetna Commercial |
$2,149.78
|
| Rate for Payer: ASR ASR |
$2,316.98
|
| Rate for Payer: ASR Commercial |
$2,316.98
|
| Rate for Payer: BCBS Trust/PPO |
$1,946.50
|
| Rate for Payer: BCN Commercial |
$1,851.91
|
| Rate for Payer: Cash Price |
$1,910.91
|
| Rate for Payer: Cofinity Commercial |
$2,245.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,910.91
|
| Rate for Payer: Healthscope Commercial |
$2,388.64
|
| Rate for Payer: Healthscope Whirlpool |
$2,316.98
|
| Rate for Payer: Mclaren Commercial |
$2,149.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,030.34
|
| Rate for Payer: Nomi Health Commercial |
$1,958.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,552.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,102.00
|
|
|
HC EP EVALUATION OF LEADS
|
Facility
|
IP
|
$2,189.46
|
|
|
Service Code
|
CPT 93640
|
| Hospital Charge Code |
48100041
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,423.15 |
| Max. Negotiated Rate |
$2,189.46 |
| Rate for Payer: Aetna Commercial |
$1,970.51
|
| Rate for Payer: ASR ASR |
$2,123.78
|
| Rate for Payer: ASR Commercial |
$2,123.78
|
| Rate for Payer: BCBS Trust/PPO |
$1,784.19
|
| Rate for Payer: BCN Commercial |
$1,697.49
|
| Rate for Payer: Cash Price |
$1,751.57
|
| Rate for Payer: Cofinity Commercial |
$2,058.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,751.57
|
| Rate for Payer: Healthscope Commercial |
$2,189.46
|
| Rate for Payer: Healthscope Whirlpool |
$2,123.78
|
| Rate for Payer: Mclaren Commercial |
$1,970.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,861.04
|
| Rate for Payer: Nomi Health Commercial |
$1,795.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,423.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,926.72
|
|
|
HC EP EVALUATION OF LEADS
|
Facility
|
OP
|
$2,189.46
|
|
|
Service Code
|
CPT 93640
|
| Hospital Charge Code |
48100041
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$875.78 |
| Max. Negotiated Rate |
$2,189.46 |
| Rate for Payer: Aetna Commercial |
$1,970.51
|
| Rate for Payer: Aetna Medicare |
$1,094.73
|
| Rate for Payer: ASR ASR |
$2,123.78
|
| Rate for Payer: ASR Commercial |
$2,123.78
|
| Rate for Payer: BCBS Complete |
$875.78
|
| Rate for Payer: BCBS Trust/PPO |
$1,792.95
|
| Rate for Payer: BCN Commercial |
$1,697.49
|
| Rate for Payer: Cash Price |
$1,751.57
|
| Rate for Payer: Cofinity Commercial |
$2,058.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,751.57
|
| Rate for Payer: Healthscope Commercial |
$2,189.46
|
| Rate for Payer: Healthscope Whirlpool |
$2,123.78
|
| Rate for Payer: Mclaren Commercial |
$1,970.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,861.04
|
| Rate for Payer: Nomi Health Commercial |
$1,795.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,423.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,918.40
|
| Rate for Payer: Priority Health Narrow Network |
$1,534.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,926.72
|
|
|
HC EPIDURAL/LOCAL FLAT
|
Facility
|
IP
|
$675.00
|
|
| Hospital Charge Code |
37000023
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$438.75 |
| Max. Negotiated Rate |
$675.00 |
| Rate for Payer: Aetna Commercial |
$607.50
|
| Rate for Payer: ASR ASR |
$654.75
|
| Rate for Payer: ASR Commercial |
$654.75
|
| Rate for Payer: BCBS Trust/PPO |
$550.06
|
| Rate for Payer: BCN Commercial |
$523.33
|
| Rate for Payer: Cash Price |
$540.00
|
| Rate for Payer: Cofinity Commercial |
$634.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$540.00
|
| Rate for Payer: Healthscope Commercial |
$675.00
|
| Rate for Payer: Healthscope Whirlpool |
$654.75
|
| Rate for Payer: Mclaren Commercial |
$607.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$573.75
|
| Rate for Payer: Nomi Health Commercial |
$553.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$438.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$594.00
|
|
|
HC EPIDURAL/LOCAL FLAT
|
Facility
|
OP
|
$675.00
|
|
| Hospital Charge Code |
37000023
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$270.00 |
| Max. Negotiated Rate |
$675.00 |
| Rate for Payer: Aetna Commercial |
$607.50
|
| Rate for Payer: Aetna Medicare |
$337.50
|
| Rate for Payer: ASR ASR |
$654.75
|
| Rate for Payer: ASR Commercial |
$654.75
|
| Rate for Payer: BCBS Complete |
$270.00
|
| Rate for Payer: BCBS Trust/PPO |
$552.76
|
| Rate for Payer: BCN Commercial |
$523.33
|
| Rate for Payer: Cash Price |
$540.00
|
| Rate for Payer: Cofinity Commercial |
$634.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$540.00
|
| Rate for Payer: Healthscope Commercial |
$675.00
|
| Rate for Payer: Healthscope Whirlpool |
$654.75
|
| Rate for Payer: Mclaren Commercial |
$607.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$573.75
|
| Rate for Payer: Nomi Health Commercial |
$553.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$438.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$591.44
|
| Rate for Payer: Priority Health Narrow Network |
$473.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$594.00
|
|
