|
HC HAI PICC FLUSH
|
Facility
|
OP
|
$134.71
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
51000060
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$21.87 |
| Max. Negotiated Rate |
$134.71 |
| Rate for Payer: Aetna Commercial |
$121.24
|
| Rate for Payer: Aetna Medicare |
$49.84
|
| Rate for Payer: ASR ASR |
$130.67
|
| Rate for Payer: BCBS Complete |
$53.88
|
| Rate for Payer: BCBS Trust/PPO |
$111.07
|
| Rate for Payer: BCCCP Commercial |
$21.87
|
| Rate for Payer: BCN Commercial |
$111.07
|
| Rate for Payer: Cash Price |
$107.77
|
| Rate for Payer: Cash Price |
$107.77
|
| Rate for Payer: Cofinity Commercial |
$126.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.77
|
| Rate for Payer: Healthscope Commercial |
$130.67
|
| Rate for Payer: Healthscope Whirlpool |
$134.71
|
| Rate for Payer: Mclaren Commercial |
$121.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$107.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$114.50
|
| Rate for Payer: Nomi Health Commercial |
$110.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$101.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$131.95
|
| Rate for Payer: Priority Health Narrow Network |
$105.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$118.54
|
|
|
HC HAI PORTA CATH ACCESS
|
Facility
|
OP
|
$134.71
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
51000058
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$21.87 |
| Max. Negotiated Rate |
$134.71 |
| Rate for Payer: Aetna Commercial |
$121.24
|
| Rate for Payer: Aetna Medicare |
$49.84
|
| Rate for Payer: ASR ASR |
$130.67
|
| Rate for Payer: BCBS Complete |
$53.88
|
| Rate for Payer: BCBS Trust/PPO |
$111.07
|
| Rate for Payer: BCCCP Commercial |
$21.87
|
| Rate for Payer: BCN Commercial |
$111.07
|
| Rate for Payer: Cash Price |
$107.77
|
| Rate for Payer: Cash Price |
$107.77
|
| Rate for Payer: Cofinity Commercial |
$126.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.77
|
| Rate for Payer: Healthscope Commercial |
$130.67
|
| Rate for Payer: Healthscope Whirlpool |
$134.71
|
| Rate for Payer: Mclaren Commercial |
$121.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$107.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$114.50
|
| Rate for Payer: Nomi Health Commercial |
$110.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$101.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$131.95
|
| Rate for Payer: Priority Health Narrow Network |
$105.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$118.54
|
|
|
HC HAI PORTA CATH ACCESS
|
Facility
|
IP
|
$134.71
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
51000058
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$101.03 |
| Max. Negotiated Rate |
$134.71 |
| Rate for Payer: Aetna Commercial |
$121.24
|
| Rate for Payer: ASR ASR |
$130.67
|
| Rate for Payer: BCBS Trust/PPO |
$110.62
|
| Rate for Payer: BCN Commercial |
$110.62
|
| Rate for Payer: Cash Price |
$107.77
|
| Rate for Payer: Cofinity Commercial |
$126.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.77
|
| Rate for Payer: Healthscope Commercial |
$130.67
|
| Rate for Payer: Healthscope Whirlpool |
$134.71
|
| Rate for Payer: Mclaren Commercial |
$121.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$114.50
|
| Rate for Payer: Nomi Health Commercial |
$110.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$101.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$118.54
|
|
|
HC HALOPERIDOL LEVEL
|
Facility
|
IP
|
$108.20
|
|
|
Service Code
|
CPT 80173
|
| Hospital Charge Code |
30100031
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$81.15 |
| Max. Negotiated Rate |
$108.20 |
| Rate for Payer: Aetna Commercial |
$97.38
|
| Rate for Payer: ASR ASR |
$104.95
|
| Rate for Payer: BCBS Trust/PPO |
$88.85
|
| Rate for Payer: BCN Commercial |
$88.85
|
| Rate for Payer: Cash Price |
$86.56
|
| Rate for Payer: Cofinity Commercial |
$101.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.56
|
| Rate for Payer: Healthscope Commercial |
$104.95
|
| Rate for Payer: Healthscope Whirlpool |
$108.20
|
| Rate for Payer: Mclaren Commercial |
$97.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.97
|
| Rate for Payer: Nomi Health Commercial |
$88.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$81.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$95.22
|
|
|
HC HALOPERIDOL LEVEL
|
Facility
|
OP
|
$108.20
|
|
|
Service Code
|
CPT 80173
|
| Hospital Charge Code |
30100031
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.25 |
| Max. Negotiated Rate |
$127.10 |
| Rate for Payer: Aetna Commercial |
$97.38
|
| Rate for Payer: Aetna Medicare |
$15.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.73
|
| Rate for Payer: ASR ASR |
$104.95
|
| Rate for Payer: BCBS Complete |
$8.67
|
| Rate for Payer: BCBS MAPPO |
$15.78
|
| Rate for Payer: BCBS Trust/PPO |
$89.21
|
| Rate for Payer: BCN Commercial |
$89.21
|
| Rate for Payer: BCN Medicare Advantage |
$15.78
|
| Rate for Payer: Cash Price |
$86.56
|
| Rate for Payer: Cash Price |
$86.56
|
| Rate for Payer: Cofinity Commercial |
$101.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.78
|
| Rate for Payer: Healthscope Commercial |
$104.95
|
| Rate for Payer: Healthscope Whirlpool |
$108.20
|
| Rate for Payer: Humana Choice PPO Medicare |
$15.78
|
| Rate for Payer: Mclaren Commercial |
$97.38
|
| Rate for Payer: Mclaren Medicaid |
$15.78
|
| Rate for Payer: Mclaren Medicare |
$15.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.57
|
| Rate for Payer: Meridian Medicaid |
$8.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.97
|
| Rate for Payer: Nomi Health Commercial |
$88.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$81.15
|
| Rate for Payer: PACE Medicare |
$14.99
|
| Rate for Payer: PACE SWMI |
$15.78
|
| Rate for Payer: PHP Commercial |
$17.36
|
| Rate for Payer: PHP Medicaid |
$8.46
|
| Rate for Payer: PHP Medicare Advantage |
$15.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$127.10
|
| Rate for Payer: Priority Health Medicare |
$15.78
|
| Rate for Payer: Priority Health Narrow Network |
$101.68
|
| Rate for Payer: Railroad Medicare Medicare |
$15.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$95.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$15.78
|
| Rate for Payer: UHC Exchange |
$24.46
|
| Rate for Payer: UHC Medicaid |
$8.25
|
| Rate for Payer: UHCCP DNSP |
$15.78
|
| Rate for Payer: UHCCP Medicaid |
$8.25
|
| Rate for Payer: VA VA |
$15.78
|
|
|
HC HALO RING APPLICATION
|
Facility
|
IP
|
$2,560.18
|
|
| Hospital Charge Code |
27000085
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,920.13 |
| Max. Negotiated Rate |
$2,560.18 |
| Rate for Payer: Aetna Commercial |
$2,304.16
|
| Rate for Payer: ASR ASR |
$2,483.37
|
| Rate for Payer: BCBS Trust/PPO |
$2,102.42
|
| Rate for Payer: BCN Commercial |
$2,102.42
|
| Rate for Payer: Cash Price |
$2,048.14
|
| Rate for Payer: Cofinity Commercial |
$2,406.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,048.14
|
| Rate for Payer: Healthscope Commercial |
$2,483.37
|
| Rate for Payer: Healthscope Whirlpool |
$2,560.18
|
| Rate for Payer: Mclaren Commercial |
$2,304.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,176.15
|
| Rate for Payer: Nomi Health Commercial |
$2,099.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,920.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,252.96
|
|
|
HC HALO RING APPLICATION
|
Facility
|
OP
|
$2,560.18
|
|
| Hospital Charge Code |
27000085
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$947.27 |
| Max. Negotiated Rate |
$2,560.18 |
| Rate for Payer: Aetna Commercial |
$2,304.16
|
| Rate for Payer: Aetna Medicare |
$947.27
|
| Rate for Payer: ASR ASR |
$2,483.37
|
| Rate for Payer: BCBS Complete |
$1,024.07
|
| Rate for Payer: BCBS Trust/PPO |
$2,110.87
|
| Rate for Payer: BCN Commercial |
$2,110.87
|
| Rate for Payer: Cash Price |
$2,048.14
|
| Rate for Payer: Cofinity Commercial |
$2,406.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,048.14
|
| Rate for Payer: Healthscope Commercial |
$2,483.37
|
| Rate for Payer: Healthscope Whirlpool |
$2,560.18
|
| Rate for Payer: Mclaren Commercial |
$2,304.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,048.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,176.15
|
| Rate for Payer: Nomi Health Commercial |
$2,099.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,920.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,243.23
|
| Rate for Payer: Priority Health Narrow Network |
$1,794.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,252.96
|
|
|
HC HALO RING & VEST
|
Facility
|
IP
|
$6,411.04
|
|
| Hospital Charge Code |
27000084
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4,808.28 |
| Max. Negotiated Rate |
$6,411.04 |
| Rate for Payer: Aetna Commercial |
$5,769.94
|
| Rate for Payer: ASR ASR |
$6,218.71
|
| Rate for Payer: BCBS Trust/PPO |
$5,264.75
|
| Rate for Payer: BCN Commercial |
$5,264.75
|
| Rate for Payer: Cash Price |
$5,128.83
|
| Rate for Payer: Cofinity Commercial |
$6,026.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,128.83
|
| Rate for Payer: Healthscope Commercial |
$6,218.71
|
| Rate for Payer: Healthscope Whirlpool |
$6,411.04
|
| Rate for Payer: Mclaren Commercial |
$5,769.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,449.38
|
| Rate for Payer: Nomi Health Commercial |
$5,257.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,808.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,641.72
|
|
|
HC HALO RING & VEST
|
Facility
|
OP
|
$6,411.04
|
|
| Hospital Charge Code |
27000084
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2,372.08 |
| Max. Negotiated Rate |
$6,411.04 |
| Rate for Payer: Aetna Commercial |
$5,769.94
|
| Rate for Payer: Aetna Medicare |
$2,372.08
|
| Rate for Payer: ASR ASR |
$6,218.71
|
| Rate for Payer: BCBS Complete |
$2,564.42
|
| Rate for Payer: BCBS Trust/PPO |
$5,285.90
|
| Rate for Payer: BCN Commercial |
$5,285.90
|
| Rate for Payer: Cash Price |
$5,128.83
|
| Rate for Payer: Cofinity Commercial |
$6,026.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,128.83
|
| Rate for Payer: Healthscope Commercial |
$6,218.71
|
| Rate for Payer: Healthscope Whirlpool |
$6,411.04
|
| Rate for Payer: Mclaren Commercial |
$5,769.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,128.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,449.38
|
| Rate for Payer: Nomi Health Commercial |
$5,257.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,808.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$5,617.35
|
| Rate for Payer: Priority Health Narrow Network |
$4,494.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,641.72
|
|
|
HC HALO VEST APPLICATION
|
Facility
|
IP
|
$5,881.50
|
|
| Hospital Charge Code |
27000086
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4,411.12 |
| Max. Negotiated Rate |
$5,881.50 |
| Rate for Payer: Aetna Commercial |
$5,293.35
|
| Rate for Payer: ASR ASR |
$5,705.06
|
| Rate for Payer: BCBS Trust/PPO |
$4,829.89
|
| Rate for Payer: BCN Commercial |
$4,829.89
|
| Rate for Payer: Cash Price |
$4,705.20
|
| Rate for Payer: Cofinity Commercial |
$5,528.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,705.20
|
| Rate for Payer: Healthscope Commercial |
$5,705.06
|
| Rate for Payer: Healthscope Whirlpool |
$5,881.50
|
| Rate for Payer: Mclaren Commercial |
$5,293.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,999.27
|
| Rate for Payer: Nomi Health Commercial |
$4,822.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,411.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,175.72
|
|
|
HC HALO VEST APPLICATION
|
Facility
|
OP
|
$5,881.50
|
|
| Hospital Charge Code |
27000086
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2,176.16 |
| Max. Negotiated Rate |
$5,881.50 |
| Rate for Payer: Aetna Commercial |
$5,293.35
|
| Rate for Payer: Aetna Medicare |
$2,176.16
|
| Rate for Payer: ASR ASR |
$5,705.06
|
| Rate for Payer: BCBS Complete |
$2,352.60
|
| Rate for Payer: BCBS Trust/PPO |
$4,849.30
|
| Rate for Payer: BCN Commercial |
$4,849.30
|
| Rate for Payer: Cash Price |
$4,705.20
|
| Rate for Payer: Cofinity Commercial |
$5,528.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,705.20
|
| Rate for Payer: Healthscope Commercial |
$5,705.06
|
| Rate for Payer: Healthscope Whirlpool |
$5,881.50
|
| Rate for Payer: Mclaren Commercial |
$5,293.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,705.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,999.27
|
| Rate for Payer: Nomi Health Commercial |
$4,822.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,411.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$5,153.37
|
| Rate for Payer: Priority Health Narrow Network |
$4,122.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,175.72
|
|
|
HC HAPTOGLOGIN
|
Facility
|
IP
|
$86.35
|
|
|
Service Code
|
CPT 83010
|
| Hospital Charge Code |
30100234
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$64.76 |
| Max. Negotiated Rate |
$86.35 |
| Rate for Payer: Aetna Commercial |
$77.72
|
| Rate for Payer: ASR ASR |
$83.76
|
| Rate for Payer: BCBS Trust/PPO |
$70.91
|
| Rate for Payer: BCN Commercial |
$70.91
|
| Rate for Payer: Cash Price |
$69.08
|
| Rate for Payer: Cofinity Commercial |
$81.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.08
|
| Rate for Payer: Healthscope Commercial |
$83.76
|
| Rate for Payer: Healthscope Whirlpool |
$86.35
|
| Rate for Payer: Mclaren Commercial |
$77.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.40
|
| Rate for Payer: Nomi Health Commercial |
$70.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$64.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$75.99
|
|
|
HC HAPTOGLOGIN
|
Facility
|
OP
|
$86.35
|
|
|
Service Code
|
CPT 83010
|
| Hospital Charge Code |
30100234
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.58 |
| Max. Negotiated Rate |
$86.35 |
| Rate for Payer: Aetna Commercial |
$77.72
|
| Rate for Payer: Aetna Medicare |
$12.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.72
|
| Rate for Payer: ASR ASR |
$83.76
|
| Rate for Payer: BCBS Complete |
$6.91
|
| Rate for Payer: BCBS MAPPO |
$12.58
|
| Rate for Payer: BCBS Trust/PPO |
$71.20
|
| Rate for Payer: BCN Commercial |
$71.20
|
| Rate for Payer: BCN Medicare Advantage |
$12.58
|
| Rate for Payer: Cash Price |
$69.08
|
| Rate for Payer: Cash Price |
$69.08
|
| Rate for Payer: Cofinity Commercial |
$81.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.58
|
| Rate for Payer: Healthscope Commercial |
$83.76
|
| Rate for Payer: Healthscope Whirlpool |
$86.35
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.58
|
| Rate for Payer: Mclaren Commercial |
$77.72
|
| Rate for Payer: Mclaren Medicaid |
$12.58
|
| Rate for Payer: Mclaren Medicare |
$12.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.21
|
| Rate for Payer: Meridian Medicaid |
$6.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.40
|
| Rate for Payer: Nomi Health Commercial |
$70.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$64.76
|
| Rate for Payer: PACE Medicare |
$11.95
|
| Rate for Payer: PACE SWMI |
$12.58
|
| Rate for Payer: PHP Commercial |
$13.84
|
| Rate for Payer: PHP Medicaid |
$6.74
|
| Rate for Payer: PHP Medicare Advantage |
$12.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$48.43
|
| Rate for Payer: Priority Health Medicare |
$12.58
|
| Rate for Payer: Priority Health Narrow Network |
$38.74
|
| Rate for Payer: Railroad Medicare Medicare |
$12.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$75.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.58
|
| Rate for Payer: UHC Exchange |
$19.50
|
| Rate for Payer: UHC Medicaid |
$6.58
|
| Rate for Payer: UHCCP DNSP |
$12.58
|
| Rate for Payer: UHCCP Medicaid |
$6.58
|
| Rate for Payer: VA VA |
$12.58
|
|
|
HC HAZELNUT FILBERT IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200043
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$25.90 |
| Rate for Payer: Aetna Commercial |
$23.31
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: ASR ASR |
$25.12
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$21.35
|
| Rate for Payer: BCN Commercial |
$21.35
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$24.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$25.12
|
| Rate for Payer: Healthscope Whirlpool |
$25.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$23.31
|
| Rate for Payer: Mclaren Medicaid |
$5.22
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| 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 |
$2.80
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$22.69
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$18.16
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP DNSP |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC HAZELNUT FILBERT IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200043
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.43 |
| Max. Negotiated Rate |
$25.90 |
| Rate for Payer: Aetna Commercial |
$23.31
|
| Rate for Payer: ASR ASR |
$25.12
|
| Rate for Payer: BCBS Trust/PPO |
$21.27
|
| Rate for Payer: BCN Commercial |
$21.27
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$24.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$25.12
|
| Rate for Payer: Healthscope Whirlpool |
$25.90
|
| Rate for Payer: Mclaren Commercial |
$23.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.79
|
|
|
HC HBC IGM AB, S
|
Facility
|
OP
|
$51.30
|
|
|
Service Code
|
CPT 86705
|
| Hospital Charge Code |
30200515
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.16 |
| Max. Negotiated Rate |
$51.30 |
| Rate for Payer: Aetna Commercial |
$46.17
|
| Rate for Payer: Aetna Medicare |
$11.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.71
|
| Rate for Payer: ASR ASR |
$49.76
|
| Rate for Payer: BCBS Complete |
$6.46
|
| Rate for Payer: BCBS MAPPO |
$11.77
|
| Rate for Payer: BCBS Trust/PPO |
$42.30
|
| Rate for Payer: BCN Commercial |
$42.30
|
| Rate for Payer: BCN Medicare Advantage |
$11.77
|
| Rate for Payer: Cash Price |
$41.04
|
| Rate for Payer: Cash Price |
$41.04
|
| Rate for Payer: Cofinity Commercial |
$48.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.77
|
| Rate for Payer: Healthscope Commercial |
$49.76
|
| Rate for Payer: Healthscope Whirlpool |
$51.30
|
| Rate for Payer: Humana Choice PPO Medicare |
$11.77
|
| Rate for Payer: Mclaren Commercial |
$46.17
|
| Rate for Payer: Mclaren Medicaid |
$11.77
|
| Rate for Payer: Mclaren Medicare |
$11.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.36
|
| Rate for Payer: Meridian Medicaid |
$6.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.60
|
| Rate for Payer: Nomi Health Commercial |
$42.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38.48
|
| Rate for Payer: PACE Medicare |
$11.18
|
| Rate for Payer: PACE SWMI |
$11.77
|
| Rate for Payer: PHP Commercial |
$12.95
|
| Rate for Payer: PHP Medicaid |
$6.31
|
| Rate for Payer: PHP Medicare Advantage |
$11.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$44.95
|
| Rate for Payer: Priority Health Medicare |
$11.77
|
| Rate for Payer: Priority Health Narrow Network |
$35.96
|
| Rate for Payer: Railroad Medicare Medicare |
$11.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11.77
|
| Rate for Payer: UHC Exchange |
$18.24
|
| Rate for Payer: UHC Medicaid |
$6.16
|
| Rate for Payer: UHCCP DNSP |
$11.77
|
| Rate for Payer: UHCCP Medicaid |
$6.16
|
| Rate for Payer: VA VA |
$11.77
|
|
|
HC HBC IGM AB, S
|
Facility
|
IP
|
$51.30
|
|
|
Service Code
|
CPT 86705
|
| Hospital Charge Code |
30200515
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$38.48 |
| Max. Negotiated Rate |
$51.30 |
| Rate for Payer: Aetna Commercial |
$46.17
|
| Rate for Payer: ASR ASR |
$49.76
|
| Rate for Payer: BCBS Trust/PPO |
$42.13
|
| Rate for Payer: BCN Commercial |
$42.13
|
| Rate for Payer: Cash Price |
$41.04
|
| Rate for Payer: Cofinity Commercial |
$48.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.04
|
| Rate for Payer: Healthscope Commercial |
$49.76
|
| Rate for Payer: Healthscope Whirlpool |
$51.30
|
| Rate for Payer: Mclaren Commercial |
$46.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.60
|
| Rate for Payer: Nomi Health Commercial |
$42.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.14
|
|
|
HC HBO PER 30 MINUTES
|
Facility
|
IP
|
$667.31
|
|
|
Service Code
|
HCPCS G0277
|
| Hospital Charge Code |
41300001
|
|
Hospital Revenue Code
|
413
|
| Min. Negotiated Rate |
$500.48 |
| Max. Negotiated Rate |
$667.31 |
| Rate for Payer: Aetna Commercial |
$600.58
|
| Rate for Payer: ASR ASR |
$647.29
|
| Rate for Payer: BCBS Trust/PPO |
$547.99
|
| Rate for Payer: BCN Commercial |
$547.99
|
| Rate for Payer: Cash Price |
$533.85
|
| Rate for Payer: Cofinity Commercial |
$627.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$533.85
|
| Rate for Payer: Healthscope Commercial |
$647.29
|
| Rate for Payer: Healthscope Whirlpool |
$667.31
|
| Rate for Payer: Mclaren Commercial |
$600.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$567.21
|
| Rate for Payer: Nomi Health Commercial |
$547.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$500.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$587.23
|
|
|
HC HBO PER 30 MINUTES
|
Facility
|
OP
|
$667.31
|
|
|
Service Code
|
HCPCS G0277
|
| Hospital Charge Code |
41300001
|
|
Hospital Revenue Code
|
413
|
| Min. Negotiated Rate |
$71.71 |
| Max. Negotiated Rate |
$667.31 |
| Rate for Payer: Aetna Commercial |
$600.58
|
| Rate for Payer: Aetna Medicare |
$137.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$171.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$171.39
|
| Rate for Payer: ASR ASR |
$647.29
|
| Rate for Payer: BCBS Complete |
$75.30
|
| Rate for Payer: BCBS MAPPO |
$137.11
|
| Rate for Payer: BCBS Trust/PPO |
$550.20
|
| Rate for Payer: BCN Commercial |
$550.20
|
| Rate for Payer: BCN Medicare Advantage |
$137.11
|
| Rate for Payer: Cash Price |
$533.85
|
| Rate for Payer: Cash Price |
$533.85
|
| Rate for Payer: Cofinity Commercial |
$627.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$533.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$137.11
|
| Rate for Payer: Healthscope Commercial |
$647.29
|
| Rate for Payer: Healthscope Whirlpool |
$667.31
|
| Rate for Payer: Humana Choice PPO Medicare |
$137.11
|
| Rate for Payer: Mclaren Commercial |
$600.58
|
| Rate for Payer: Mclaren Medicaid |
$137.11
|
| Rate for Payer: Mclaren Medicare |
$137.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$143.97
|
| Rate for Payer: Meridian Medicaid |
$75.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$157.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$150.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$567.21
|
| Rate for Payer: Nomi Health Commercial |
$547.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$500.48
|
| Rate for Payer: PACE Medicare |
$130.25
|
| Rate for Payer: PACE SWMI |
$137.11
|
| Rate for Payer: PHP Commercial |
$150.82
|
| Rate for Payer: PHP Medicaid |
$73.49
|
| Rate for Payer: PHP Medicare Advantage |
$137.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$71.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$584.70
|
| Rate for Payer: Priority Health Medicare |
$137.11
|
| Rate for Payer: Priority Health Narrow Network |
$467.78
|
| Rate for Payer: Railroad Medicare Medicare |
$137.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$587.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$137.11
|
| Rate for Payer: UHC Exchange |
$212.52
|
| Rate for Payer: UHC Medicaid |
$71.71
|
| Rate for Payer: UHCCP DNSP |
$137.11
|
| Rate for Payer: UHCCP Medicaid |
$71.71
|
| Rate for Payer: VA VA |
$137.11
|
|
|
HC HBO TCPO2 ARTERIAL STUDY COMPLETE
|
Facility
|
OP
|
$852.13
|
|
|
Service Code
|
CPT 93923
|
| Hospital Charge Code |
92100005
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$112.52 |
| Max. Negotiated Rate |
$852.13 |
| Rate for Payer: Aetna Commercial |
$766.92
|
| Rate for Payer: Aetna Medicare |
$215.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$268.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$268.94
|
| Rate for Payer: ASR ASR |
$826.57
|
| Rate for Payer: BCBS Complete |
$118.16
|
| Rate for Payer: BCBS MAPPO |
$215.15
|
| Rate for Payer: BCBS Trust/PPO |
$702.58
|
| Rate for Payer: BCN Commercial |
$702.58
|
| Rate for Payer: BCN Medicare Advantage |
$215.15
|
| Rate for Payer: Cash Price |
$681.70
|
| Rate for Payer: Cash Price |
$681.70
|
| Rate for Payer: Cofinity Commercial |
$801.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$681.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$215.15
|
| Rate for Payer: Healthscope Commercial |
$826.57
|
| Rate for Payer: Healthscope Whirlpool |
$852.13
|
| Rate for Payer: Humana Choice PPO Medicare |
$215.15
|
| Rate for Payer: Mclaren Commercial |
$766.92
|
| Rate for Payer: Mclaren Medicaid |
$215.15
|
| Rate for Payer: Mclaren Medicare |
$215.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$225.91
|
| Rate for Payer: Meridian Medicaid |
$118.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$247.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$236.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$724.31
|
| Rate for Payer: Nomi Health Commercial |
$698.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$639.10
|
| Rate for Payer: PACE Medicare |
$204.39
|
| Rate for Payer: PACE SWMI |
$215.15
|
| Rate for Payer: PHP Commercial |
$236.66
|
| Rate for Payer: PHP Medicaid |
$115.32
|
| Rate for Payer: PHP Medicare Advantage |
$215.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$257.85
|
| Rate for Payer: Priority Health Medicare |
$215.15
|
| Rate for Payer: Priority Health Narrow Network |
$206.28
|
| Rate for Payer: Railroad Medicare Medicare |
$215.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$749.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$215.15
|
| Rate for Payer: UHC Exchange |
$333.48
|
| Rate for Payer: UHC Medicaid |
$112.52
|
| Rate for Payer: UHCCP DNSP |
$215.15
|
| Rate for Payer: UHCCP Medicaid |
$112.52
|
| Rate for Payer: VA VA |
$215.15
|
|
|
HC HBO TCPO2 ARTERIAL STUDY COMPLETE
|
Facility
|
IP
|
$852.13
|
|
|
Service Code
|
CPT 93923
|
| Hospital Charge Code |
92100005
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$639.10 |
| Max. Negotiated Rate |
$852.13 |
| Rate for Payer: Aetna Commercial |
$766.92
|
| Rate for Payer: ASR ASR |
$826.57
|
| Rate for Payer: BCBS Trust/PPO |
$699.77
|
| Rate for Payer: BCN Commercial |
$699.77
|
| Rate for Payer: Cash Price |
$681.70
|
| Rate for Payer: Cofinity Commercial |
$801.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$681.70
|
| Rate for Payer: Healthscope Commercial |
$826.57
|
| Rate for Payer: Healthscope Whirlpool |
$852.13
|
| Rate for Payer: Mclaren Commercial |
$766.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$724.31
|
| Rate for Payer: Nomi Health Commercial |
$698.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$639.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$749.87
|
|
|
HC HBO TCPO2 ARTERIAL STUDY UNILATERAL OR LIMITED
|
Facility
|
IP
|
$546.48
|
|
|
Service Code
|
CPT 93922
|
| Hospital Charge Code |
92100033
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$409.86 |
| Max. Negotiated Rate |
$546.48 |
| Rate for Payer: Aetna Commercial |
$491.83
|
| Rate for Payer: ASR ASR |
$530.09
|
| Rate for Payer: BCBS Trust/PPO |
$448.77
|
| Rate for Payer: BCN Commercial |
$448.77
|
| Rate for Payer: Cash Price |
$437.18
|
| Rate for Payer: Cofinity Commercial |
$513.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$437.18
|
| Rate for Payer: Healthscope Commercial |
$530.09
|
| Rate for Payer: Healthscope Whirlpool |
$546.48
|
| Rate for Payer: Mclaren Commercial |
$491.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$464.51
|
| Rate for Payer: Nomi Health Commercial |
$448.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$409.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$480.90
|
|
|
HC HBO TCPO2 ARTERIAL STUDY UNILATERAL OR LIMITED
|
Facility
|
OP
|
$546.48
|
|
|
Service Code
|
CPT 93922
|
| Hospital Charge Code |
92100033
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$69.33 |
| Max. Negotiated Rate |
$546.48 |
| Rate for Payer: Aetna Commercial |
$491.83
|
| Rate for Payer: Aetna Medicare |
$132.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$165.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$165.71
|
| Rate for Payer: ASR ASR |
$530.09
|
| Rate for Payer: BCBS Complete |
$72.81
|
| Rate for Payer: BCBS MAPPO |
$132.57
|
| Rate for Payer: BCBS Trust/PPO |
$450.57
|
| Rate for Payer: BCN Commercial |
$450.57
|
| Rate for Payer: BCN Medicare Advantage |
$132.57
|
| Rate for Payer: Cash Price |
$437.18
|
| Rate for Payer: Cash Price |
$437.18
|
| Rate for Payer: Cofinity Commercial |
$513.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$437.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.57
|
| Rate for Payer: Healthscope Commercial |
$530.09
|
| Rate for Payer: Healthscope Whirlpool |
$546.48
|
| Rate for Payer: Humana Choice PPO Medicare |
$132.57
|
| Rate for Payer: Mclaren Commercial |
$491.83
|
| Rate for Payer: Mclaren Medicaid |
$132.57
|
| Rate for Payer: Mclaren Medicare |
$132.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$139.20
|
| Rate for Payer: Meridian Medicaid |
$72.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$145.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$464.51
|
| Rate for Payer: Nomi Health Commercial |
$448.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$409.86
|
| Rate for Payer: PACE Medicare |
$125.94
|
| Rate for Payer: PACE SWMI |
$132.57
|
| Rate for Payer: PHP Commercial |
$145.83
|
| Rate for Payer: PHP Medicaid |
$71.06
|
| Rate for Payer: PHP Medicare Advantage |
$132.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$228.81
|
| Rate for Payer: Priority Health Medicare |
$132.57
|
| Rate for Payer: Priority Health Narrow Network |
$183.04
|
| Rate for Payer: Railroad Medicare Medicare |
$132.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$480.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$132.57
|
| Rate for Payer: UHC Exchange |
$205.48
|
| Rate for Payer: UHC Medicaid |
$69.33
|
| Rate for Payer: UHCCP DNSP |
$132.57
|
| Rate for Payer: UHCCP Medicaid |
$69.33
|
| Rate for Payer: VA VA |
$132.57
|
|
|
HC HCCORO/CABG ANGIOS ONLY
|
Facility
|
OP
|
$6,615.80
|
|
|
Service Code
|
CPT 93455
|
| Hospital Charge Code |
48100014
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,689.43 |
| Max. Negotiated Rate |
$6,615.80 |
| Rate for Payer: Aetna Commercial |
$5,954.22
|
| Rate for Payer: Aetna Medicare |
$3,230.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,037.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,037.84
|
| Rate for Payer: ASR ASR |
$6,417.33
|
| Rate for Payer: BCBS Complete |
$1,774.06
|
| Rate for Payer: BCBS MAPPO |
$3,230.27
|
| Rate for Payer: BCBS Trust/PPO |
$5,454.73
|
| Rate for Payer: BCN Commercial |
$5,454.73
|
| Rate for Payer: BCN Medicare Advantage |
$3,230.27
|
| Rate for Payer: Cash Price |
$5,292.64
|
| Rate for Payer: Cash Price |
$5,292.64
|
| Rate for Payer: Cofinity Commercial |
$6,218.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,292.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,230.27
|
| Rate for Payer: Healthscope Commercial |
$6,417.33
|
| Rate for Payer: Healthscope Whirlpool |
$6,615.80
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,230.27
|
| Rate for Payer: Mclaren Commercial |
$5,954.22
|
| Rate for Payer: Mclaren Medicaid |
$3,230.27
|
| Rate for Payer: Mclaren Medicare |
$3,230.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,391.78
|
| Rate for Payer: Meridian Medicaid |
$1,774.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,714.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,553.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,623.43
|
| Rate for Payer: Nomi Health Commercial |
$5,424.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,961.85
|
| Rate for Payer: PACE Medicare |
$3,068.76
|
| Rate for Payer: PACE SWMI |
$3,230.27
|
| Rate for Payer: PHP Commercial |
$3,553.30
|
| Rate for Payer: PHP Medicaid |
$1,731.42
|
| Rate for Payer: PHP Medicare Advantage |
$3,230.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,689.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$5,796.76
|
| Rate for Payer: Priority Health Medicare |
$3,230.27
|
| Rate for Payer: Priority Health Narrow Network |
$4,637.68
|
| Rate for Payer: Railroad Medicare Medicare |
$3,230.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,821.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,230.27
|
| Rate for Payer: UHC Exchange |
$5,006.92
|
| Rate for Payer: UHC Medicaid |
$1,689.43
|
| Rate for Payer: UHCCP DNSP |
$3,230.27
|
| Rate for Payer: UHCCP Medicaid |
$1,689.43
|
| Rate for Payer: VA VA |
$3,230.27
|
|
|
HC HCCORO/CABG ANGIOS ONLY
|
Facility
|
IP
|
$6,615.80
|
|
|
Service Code
|
CPT 93455
|
| Hospital Charge Code |
48100014
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,961.85 |
| Max. Negotiated Rate |
$6,615.80 |
| Rate for Payer: Aetna Commercial |
$5,954.22
|
| Rate for Payer: ASR ASR |
$6,417.33
|
| Rate for Payer: BCBS Trust/PPO |
$5,432.89
|
| Rate for Payer: BCN Commercial |
$5,432.89
|
| Rate for Payer: Cash Price |
$5,292.64
|
| Rate for Payer: Cofinity Commercial |
$6,218.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,292.64
|
| Rate for Payer: Healthscope Commercial |
$6,417.33
|
| Rate for Payer: Healthscope Whirlpool |
$6,615.80
|
| Rate for Payer: Mclaren Commercial |
$5,954.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,623.43
|
| Rate for Payer: Nomi Health Commercial |
$5,424.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,961.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,821.90
|
|
