|
HC MATERNAL SCRN INTEGRATED SERUM 1
|
Facility
|
IP
|
$110.00
|
|
|
Service Code
|
CPT 84163
|
| Hospital Charge Code |
30100641
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$77.00 |
| Max. Negotiated Rate |
$110.00 |
| Rate for Payer: Aetna Commercial |
$99.00
|
| Rate for Payer: ASR ASR |
$106.70
|
| Rate for Payer: BCBS Trust/PPO |
$85.28
|
| Rate for Payer: BCN Commercial |
$85.28
|
| Rate for Payer: Cash Price |
$88.00
|
| Rate for Payer: Cofinity Commercial |
$103.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.00
|
| Rate for Payer: Healthscope Commercial |
$110.00
|
| Rate for Payer: Healthscope Whirlpool |
$106.70
|
| Rate for Payer: Mclaren Commercial |
$99.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$93.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$96.80
|
|
|
HC MATERNAL SCRN INTEGRATED SERUM 2
|
Facility
|
OP
|
$237.60
|
|
|
Service Code
|
CPT 81511
|
| Hospital Charge Code |
30100654
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$237.60 |
| Rate for Payer: Aetna Commercial |
$213.84
|
| Rate for Payer: Aetna Medicare |
$153.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$191.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$191.88
|
| Rate for Payer: ASR ASR |
$230.47
|
| Rate for Payer: BCBS Complete |
$88.17
|
| Rate for Payer: BCBS MAPPO |
$153.50
|
| Rate for Payer: BCBS Trust/PPO |
$184.21
|
| Rate for Payer: BCN Commercial |
$184.21
|
| Rate for Payer: BCN Medicare Advantage |
$153.50
|
| Rate for Payer: Cash Price |
$190.08
|
| Rate for Payer: Cash Price |
$190.08
|
| Rate for Payer: Cofinity Commercial |
$223.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$190.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.50
|
| Rate for Payer: Healthscope Commercial |
$237.60
|
| Rate for Payer: Healthscope Whirlpool |
$230.47
|
| Rate for Payer: Humana Choice PPO Medicare |
$153.50
|
| Rate for Payer: Mclaren Commercial |
$213.84
|
| Rate for Payer: Mclaren Medicaid |
$83.96
|
| Rate for Payer: Mclaren Medicare |
$153.50
|
| Rate for Payer: Meridian Medicaid |
$88.17
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$161.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$176.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$201.96
|
| Rate for Payer: PACE Medicare |
$145.82
|
| Rate for Payer: PACE SWMI |
$153.50
|
| Rate for Payer: PHP Commercial |
$168.85
|
| Rate for Payer: PHP Medicaid |
$83.96
|
| Rate for Payer: PHP Medicare Advantage |
$153.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$166.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$0.01
|
| Rate for Payer: Priority Health Medicare |
$153.50
|
| Rate for Payer: Priority Health Narrow Network |
$0.01
|
| Rate for Payer: Railroad Medicare Medicare |
$153.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$209.09
|
| Rate for Payer: UHC Medicare Advantage |
$158.10
|
| Rate for Payer: VA VA |
$153.50
|
|
|
HC MATERNAL SCRN INTEGRATED SERUM 2
|
Facility
|
IP
|
$237.60
|
|
|
Service Code
|
CPT 81511
|
| Hospital Charge Code |
30100654
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$166.32 |
| Max. Negotiated Rate |
$237.60 |
| Rate for Payer: Aetna Commercial |
$213.84
|
| Rate for Payer: ASR ASR |
$230.47
|
| Rate for Payer: BCBS Trust/PPO |
$184.21
|
| Rate for Payer: BCN Commercial |
$184.21
|
| Rate for Payer: Cash Price |
$190.08
|
| Rate for Payer: Cofinity Commercial |
$223.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$190.08
|
| Rate for Payer: Healthscope Commercial |
$237.60
|
| Rate for Payer: Healthscope Whirlpool |
$230.47
|
| Rate for Payer: Mclaren Commercial |
$213.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$201.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$166.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$209.09
|
|
|
HC MAXIMUM VOLUNTARY VENTILATION
|
Facility
|
OP
|
$120.23
|
|
|
Service Code
|
CPT 94200
|
| Hospital Charge Code |
46000022
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$29.74 |
| Max. Negotiated Rate |
$120.23 |
| Rate for Payer: Aetna Commercial |
$108.21
|
| Rate for Payer: Aetna Medicare |
$54.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$67.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$67.96
|
| Rate for Payer: ASR ASR |
$116.62
|
| Rate for Payer: BCBS Complete |
$31.23
|
| Rate for Payer: BCBS MAPPO |
$54.37
|
| Rate for Payer: BCBS Trust/PPO |
$93.21
|
| Rate for Payer: BCN Commercial |
$93.21
|
| Rate for Payer: BCN Medicare Advantage |
$54.37
|
| Rate for Payer: Cash Price |
$96.18
|
| Rate for Payer: Cash Price |
$96.18
|
| Rate for Payer: Cofinity Commercial |
$113.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.37
|
| Rate for Payer: Healthscope Commercial |
$120.23
|
| Rate for Payer: Healthscope Whirlpool |
$116.62
|
| Rate for Payer: Humana Choice PPO Medicare |
$54.37
|
| Rate for Payer: Mclaren Commercial |
$108.21
|
| Rate for Payer: Mclaren Medicaid |
$29.74
|
| Rate for Payer: Mclaren Medicare |
$54.37
|
| Rate for Payer: Meridian Medicaid |
$31.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$57.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$62.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$102.20
|
| Rate for Payer: PACE Medicare |
$51.65
|
| Rate for Payer: PACE SWMI |
$54.37
|
| Rate for Payer: PHP Commercial |
$59.81
|
| Rate for Payer: PHP Medicaid |
$29.74
|
| Rate for Payer: PHP Medicare Advantage |
$54.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$109.41
|
| Rate for Payer: Priority Health Medicare |
$54.37
|
| Rate for Payer: Priority Health Narrow Network |
$85.36
|
| Rate for Payer: Railroad Medicare Medicare |
$54.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$105.80
|
| Rate for Payer: UHC Medicare Advantage |
$56.00
|
| Rate for Payer: VA VA |
$54.37
|
|
|
HC MAXIMUM VOLUNTARY VENTILATION
|
Facility
|
IP
|
$120.23
|
|
|
Service Code
|
CPT 94200
|
| Hospital Charge Code |
46000022
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$84.16 |
| Max. Negotiated Rate |
$120.23 |
| Rate for Payer: Aetna Commercial |
$108.21
|
| Rate for Payer: ASR ASR |
$116.62
|
| Rate for Payer: BCBS Trust/PPO |
$93.21
|
| Rate for Payer: BCN Commercial |
$93.21
|
| Rate for Payer: Cash Price |
$96.18
|
| Rate for Payer: Cofinity Commercial |
$113.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.18
|
| Rate for Payer: Healthscope Commercial |
$120.23
|
| Rate for Payer: Healthscope Whirlpool |
$116.62
|
| Rate for Payer: Mclaren Commercial |
$108.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$102.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$105.80
|
|
|
HC MAYO CHROMOGENIC FACTOR 8
|
Facility
|
OP
|
$331.60
|
|
|
Service Code
|
CPT 85130
|
| Hospital Charge Code |
30500105
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$6.50 |
| Max. Negotiated Rate |
$331.60 |
| Rate for Payer: Aetna Commercial |
$298.44
|
| Rate for Payer: Aetna Medicare |
$11.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.86
|
| Rate for Payer: ASR ASR |
$321.65
|
| Rate for Payer: BCBS Complete |
$6.83
|
| Rate for Payer: BCBS MAPPO |
$11.89
|
| Rate for Payer: BCBS Trust/PPO |
$257.09
|
| Rate for Payer: BCN Commercial |
$257.09
|
| Rate for Payer: BCN Medicare Advantage |
$11.89
|
| Rate for Payer: Cash Price |
$265.28
|
| Rate for Payer: Cash Price |
$265.28
|
| Rate for Payer: Cofinity Commercial |
$311.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$265.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.89
|
| Rate for Payer: Healthscope Commercial |
$331.60
|
| Rate for Payer: Healthscope Whirlpool |
$321.65
|
| Rate for Payer: Humana Choice PPO Medicare |
$11.89
|
| Rate for Payer: Mclaren Commercial |
$298.44
|
| Rate for Payer: Mclaren Medicaid |
$6.50
|
| Rate for Payer: Mclaren Medicare |
$11.89
|
| Rate for Payer: Meridian Medicaid |
$6.83
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$281.86
|
| Rate for Payer: PACE Medicare |
$11.30
|
| Rate for Payer: PACE SWMI |
$11.89
|
| Rate for Payer: PHP Commercial |
$13.08
|
| Rate for Payer: PHP Medicaid |
$6.50
|
| Rate for Payer: PHP Medicare Advantage |
$11.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$301.76
|
| Rate for Payer: Priority Health Medicare |
$11.89
|
| Rate for Payer: Priority Health Narrow Network |
$235.44
|
| Rate for Payer: Railroad Medicare Medicare |
$11.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$291.81
|
| Rate for Payer: UHC Medicare Advantage |
$12.25
|
| Rate for Payer: VA VA |
$11.89
|
|
|
HC MAYO CHROMOGENIC FACTOR 8
|
Facility
|
IP
|
$331.60
|
|
|
Service Code
|
CPT 85130
|
| Hospital Charge Code |
30500105
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$232.12 |
| Max. Negotiated Rate |
$331.60 |
| Rate for Payer: Aetna Commercial |
$298.44
|
| Rate for Payer: ASR ASR |
$321.65
|
| Rate for Payer: BCBS Trust/PPO |
$257.09
|
| Rate for Payer: BCN Commercial |
$257.09
|
| Rate for Payer: Cash Price |
$265.28
|
| Rate for Payer: Cofinity Commercial |
$311.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$265.28
|
| Rate for Payer: Healthscope Commercial |
$331.60
|
| Rate for Payer: Healthscope Whirlpool |
$321.65
|
| Rate for Payer: Mclaren Commercial |
$298.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$281.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$291.81
|
|
|
HC MAYO CHROMOGENIC FACTOR 9
|
Facility
|
IP
|
$351.53
|
|
|
Service Code
|
CPT 85130
|
| Hospital Charge Code |
30500104
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$246.07 |
| Max. Negotiated Rate |
$351.53 |
| Rate for Payer: Aetna Commercial |
$316.38
|
| Rate for Payer: ASR ASR |
$340.98
|
| Rate for Payer: BCBS Trust/PPO |
$272.54
|
| Rate for Payer: BCN Commercial |
$272.54
|
| Rate for Payer: Cash Price |
$281.22
|
| Rate for Payer: Cofinity Commercial |
$330.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$281.22
|
| Rate for Payer: Healthscope Commercial |
$351.53
|
| Rate for Payer: Healthscope Whirlpool |
$340.98
|
| Rate for Payer: Mclaren Commercial |
$316.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$298.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$246.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$309.35
|
|
|
HC MAYO CHROMOGENIC FACTOR 9
|
Facility
|
OP
|
$351.53
|
|
|
Service Code
|
CPT 85130
|
| Hospital Charge Code |
30500104
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$6.50 |
| Max. Negotiated Rate |
$351.53 |
| Rate for Payer: Aetna Commercial |
$316.38
|
| Rate for Payer: Aetna Medicare |
$11.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.86
|
| Rate for Payer: ASR ASR |
$340.98
|
| Rate for Payer: BCBS Complete |
$6.83
|
| Rate for Payer: BCBS MAPPO |
$11.89
|
| Rate for Payer: BCBS Trust/PPO |
$272.54
|
| Rate for Payer: BCN Commercial |
$272.54
|
| Rate for Payer: BCN Medicare Advantage |
$11.89
|
| Rate for Payer: Cash Price |
$281.22
|
| Rate for Payer: Cash Price |
$281.22
|
| Rate for Payer: Cofinity Commercial |
$330.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$281.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.89
|
| Rate for Payer: Healthscope Commercial |
$351.53
|
| Rate for Payer: Healthscope Whirlpool |
$340.98
|
| Rate for Payer: Humana Choice PPO Medicare |
$11.89
|
| Rate for Payer: Mclaren Commercial |
$316.38
|
| Rate for Payer: Mclaren Medicaid |
$6.50
|
| Rate for Payer: Mclaren Medicare |
$11.89
|
| Rate for Payer: Meridian Medicaid |
$6.83
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$298.80
|
| Rate for Payer: PACE Medicare |
$11.30
|
| Rate for Payer: PACE SWMI |
$11.89
|
| Rate for Payer: PHP Commercial |
$13.08
|
| Rate for Payer: PHP Medicaid |
$6.50
|
| Rate for Payer: PHP Medicare Advantage |
$11.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$246.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$319.89
|
| Rate for Payer: Priority Health Medicare |
$11.89
|
| Rate for Payer: Priority Health Narrow Network |
$249.59
|
| Rate for Payer: Railroad Medicare Medicare |
$11.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$309.35
|
| Rate for Payer: UHC Medicare Advantage |
$12.25
|
| Rate for Payer: VA VA |
$11.89
|
|
|
HC MAYOCOMPLETE MYELOID NEOPLASMS, NGS
|
Facility
|
OP
|
$1,925.00
|
|
|
Service Code
|
CPT 81450
|
| Hospital Charge Code |
31000084
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$415.46 |
| Max. Negotiated Rate |
$1,925.00 |
| Rate for Payer: Aetna Commercial |
$1,732.50
|
| Rate for Payer: Aetna Medicare |
$759.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$949.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$949.41
|
| Rate for Payer: ASR ASR |
$1,867.25
|
| Rate for Payer: BCBS Complete |
$436.27
|
| Rate for Payer: BCBS MAPPO |
$759.53
|
| Rate for Payer: BCBS Trust/PPO |
$1,492.45
|
| Rate for Payer: BCN Commercial |
$1,492.45
|
| Rate for Payer: BCN Medicare Advantage |
$759.53
|
| Rate for Payer: Cash Price |
$1,540.00
|
| Rate for Payer: Cash Price |
$1,540.00
|
| Rate for Payer: Cofinity Commercial |
$1,809.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,540.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$759.53
|
| Rate for Payer: Healthscope Commercial |
$1,925.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,867.25
|
| Rate for Payer: Humana Choice PPO Medicare |
$759.53
|
| Rate for Payer: Mclaren Commercial |
$1,732.50
|
| Rate for Payer: Mclaren Medicaid |
$415.46
|
| Rate for Payer: Mclaren Medicare |
$759.53
|
| Rate for Payer: Meridian Medicaid |
$436.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$797.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$873.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,636.25
|
| Rate for Payer: PACE Medicare |
$721.55
|
| Rate for Payer: PACE SWMI |
$759.53
|
| Rate for Payer: PHP Commercial |
$835.48
|
| Rate for Payer: PHP Medicaid |
$415.46
|
| Rate for Payer: PHP Medicare Advantage |
$759.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$415.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,347.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,751.75
|
| Rate for Payer: Priority Health Medicare |
$759.53
|
| Rate for Payer: Priority Health Narrow Network |
$1,366.75
|
| Rate for Payer: Railroad Medicare Medicare |
$759.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,694.00
|
| Rate for Payer: UHC Medicare Advantage |
$782.32
|
| Rate for Payer: VA VA |
$759.53
|
|
|
HC MAYOCOMPLETE MYELOID NEOPLASMS, NGS
|
Facility
|
IP
|
$1,925.00
|
|
|
Service Code
|
CPT 81450
|
| Hospital Charge Code |
31000084
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$1,347.50 |
| Max. Negotiated Rate |
$1,925.00 |
| Rate for Payer: Aetna Commercial |
$1,732.50
|
| Rate for Payer: ASR ASR |
$1,867.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,492.45
|
| Rate for Payer: BCN Commercial |
$1,492.45
|
| Rate for Payer: Cash Price |
$1,540.00
|
| Rate for Payer: Cofinity Commercial |
$1,809.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,540.00
|
| Rate for Payer: Healthscope Commercial |
$1,925.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,867.25
|
| Rate for Payer: Mclaren Commercial |
$1,732.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,636.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,347.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,694.00
|
|
|
HC MAYO CREATININE, URINE CMPT
|
Facility
|
OP
|
$10.57
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
30100734
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.83 |
| Max. Negotiated Rate |
$128.27 |
| Rate for Payer: Aetna Commercial |
$9.51
|
| Rate for Payer: Aetna Medicare |
$5.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.48
|
| Rate for Payer: ASR ASR |
$10.25
|
| Rate for Payer: BCBS Complete |
$2.98
|
| Rate for Payer: BCBS MAPPO |
$5.18
|
| Rate for Payer: BCBS Trust/PPO |
$8.19
|
| Rate for Payer: BCN Commercial |
$8.19
|
| Rate for Payer: BCN Medicare Advantage |
$5.18
|
| Rate for Payer: Cash Price |
$8.46
|
| Rate for Payer: Cash Price |
$8.46
|
| Rate for Payer: Cofinity Commercial |
$9.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.18
|
| Rate for Payer: Healthscope Commercial |
$10.57
|
| Rate for Payer: Healthscope Whirlpool |
$10.25
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.18
|
| Rate for Payer: Mclaren Commercial |
$9.51
|
| Rate for Payer: Mclaren Medicaid |
$2.83
|
| Rate for Payer: Mclaren Medicare |
$5.18
|
| Rate for Payer: Meridian Medicaid |
$2.98
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8.98
|
| Rate for Payer: PACE Medicare |
$4.92
|
| Rate for Payer: PACE SWMI |
$5.18
|
| Rate for Payer: PHP Commercial |
$5.70
|
| Rate for Payer: PHP Medicaid |
$2.83
|
| Rate for Payer: PHP Medicare Advantage |
$5.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$128.27
|
| Rate for Payer: Priority Health Medicare |
$5.18
|
| Rate for Payer: Priority Health Narrow Network |
$102.62
|
| Rate for Payer: Railroad Medicare Medicare |
$5.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9.30
|
| Rate for Payer: UHC Medicare Advantage |
$5.34
|
| Rate for Payer: VA VA |
$5.18
|
|
|
HC MAYO CREATININE, URINE CMPT
|
Facility
|
IP
|
$10.57
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
30100734
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.40 |
| Max. Negotiated Rate |
$10.57 |
| Rate for Payer: Aetna Commercial |
$9.51
|
| Rate for Payer: ASR ASR |
$10.25
|
| Rate for Payer: BCBS Trust/PPO |
$8.19
|
| Rate for Payer: BCN Commercial |
$8.19
|
| Rate for Payer: Cash Price |
$8.46
|
| Rate for Payer: Cofinity Commercial |
$9.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.46
|
| Rate for Payer: Healthscope Commercial |
$10.57
|
| Rate for Payer: Healthscope Whirlpool |
$10.25
|
| Rate for Payer: Mclaren Commercial |
$9.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9.30
|
|
|
HC MDI TREATMENT
|
Facility
|
OP
|
$146.74
|
|
|
Service Code
|
CPT 94640
|
| Hospital Charge Code |
41000004
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$86.20 |
| Max. Negotiated Rate |
$236.99 |
| Rate for Payer: Aetna Commercial |
$132.07
|
| Rate for Payer: Aetna Medicare |
$189.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$236.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$236.99
|
| Rate for Payer: ASR ASR |
$142.34
|
| Rate for Payer: BCBS Complete |
$108.90
|
| Rate for Payer: BCBS MAPPO |
$189.59
|
| Rate for Payer: BCBS Trust/PPO |
$113.77
|
| Rate for Payer: BCN Commercial |
$113.77
|
| Rate for Payer: BCN Medicare Advantage |
$189.59
|
| Rate for Payer: Cash Price |
$117.39
|
| Rate for Payer: Cash Price |
$117.39
|
| Rate for Payer: Cofinity Commercial |
$137.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$117.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$189.59
|
| Rate for Payer: Healthscope Commercial |
$146.74
|
| Rate for Payer: Healthscope Whirlpool |
$142.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$189.59
|
| Rate for Payer: Mclaren Commercial |
$132.07
|
| Rate for Payer: Mclaren Medicaid |
$103.71
|
| Rate for Payer: Mclaren Medicare |
$189.59
|
| Rate for Payer: Meridian Medicaid |
$108.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$199.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$218.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$124.73
|
| Rate for Payer: PACE Medicare |
$180.11
|
| Rate for Payer: PACE SWMI |
$189.59
|
| Rate for Payer: PHP Commercial |
$208.55
|
| Rate for Payer: PHP Medicaid |
$103.71
|
| Rate for Payer: PHP Medicare Advantage |
$189.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$107.75
|
| Rate for Payer: Priority Health Medicare |
$189.59
|
| Rate for Payer: Priority Health Narrow Network |
$86.20
|
| Rate for Payer: Railroad Medicare Medicare |
$189.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$129.13
|
| Rate for Payer: UHC Medicare Advantage |
$195.28
|
| Rate for Payer: VA VA |
$189.59
|
|
|
HC MDI TREATMENT
|
Facility
|
IP
|
$146.74
|
|
|
Service Code
|
CPT 94640
|
| Hospital Charge Code |
41000004
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$102.72 |
| Max. Negotiated Rate |
$146.74 |
| Rate for Payer: Aetna Commercial |
$132.07
|
| Rate for Payer: ASR ASR |
$142.34
|
| Rate for Payer: BCBS Trust/PPO |
$113.77
|
| Rate for Payer: BCN Commercial |
$113.77
|
| Rate for Payer: Cash Price |
$117.39
|
| Rate for Payer: Cofinity Commercial |
$137.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$117.39
|
| Rate for Payer: Healthscope Commercial |
$146.74
|
| Rate for Payer: Healthscope Whirlpool |
$142.34
|
| Rate for Payer: Mclaren Commercial |
$132.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$124.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$129.13
|
|
|
HC MEADOW FESCUE IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200092
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.86 |
| Max. Negotiated Rate |
$24.89 |
| Rate for Payer: Aetna Commercial |
$22.40
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: ASR ASR |
$24.14
|
| Rate for Payer: BCBS Complete |
$3.00
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.30
|
| Rate for Payer: BCN Commercial |
$19.30
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$23.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$24.89
|
| Rate for Payer: Healthscope Whirlpool |
$24.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$22.40
|
| Rate for Payer: Mclaren Medicaid |
$2.86
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Medicaid |
$3.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$5.74
|
| Rate for Payer: PHP Medicaid |
$2.86
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.65
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$17.67
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.90
|
| Rate for Payer: UHC Medicare Advantage |
$5.38
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC MEADOW FESCUE IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200092
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$17.42 |
| Max. Negotiated Rate |
$24.89 |
| Rate for Payer: Aetna Commercial |
$22.40
|
| Rate for Payer: ASR ASR |
$24.14
|
| Rate for Payer: BCBS Trust/PPO |
$19.30
|
| Rate for Payer: BCN Commercial |
$19.30
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$23.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$24.89
|
| Rate for Payer: Healthscope Whirlpool |
$24.14
|
| Rate for Payer: Mclaren Commercial |
$22.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.90
|
|
|
HC MEASLES (RUBEOLA) IGM
|
Facility
|
OP
|
$49.98
|
|
|
Service Code
|
CPT 86765
|
| Hospital Charge Code |
30200398
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.05 |
| Max. Negotiated Rate |
$143.67 |
| Rate for Payer: Aetna Commercial |
$44.98
|
| Rate for Payer: Aetna Medicare |
$12.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.10
|
| Rate for Payer: ASR ASR |
$48.48
|
| Rate for Payer: BCBS Complete |
$7.40
|
| Rate for Payer: BCBS MAPPO |
$12.88
|
| Rate for Payer: BCBS Trust/PPO |
$38.75
|
| Rate for Payer: BCN Commercial |
$38.75
|
| Rate for Payer: BCN Medicare Advantage |
$12.88
|
| Rate for Payer: Cash Price |
$39.98
|
| Rate for Payer: Cash Price |
$39.98
|
| Rate for Payer: Cofinity Commercial |
$46.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.88
|
| Rate for Payer: Healthscope Commercial |
$49.98
|
| Rate for Payer: Healthscope Whirlpool |
$48.48
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.88
|
| Rate for Payer: Mclaren Commercial |
$44.98
|
| Rate for Payer: Mclaren Medicaid |
$7.05
|
| Rate for Payer: Mclaren Medicare |
$12.88
|
| Rate for Payer: Meridian Medicaid |
$7.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.48
|
| Rate for Payer: PACE Medicare |
$12.24
|
| Rate for Payer: PACE SWMI |
$12.88
|
| Rate for Payer: PHP Commercial |
$14.17
|
| Rate for Payer: PHP Medicaid |
$7.05
|
| Rate for Payer: PHP Medicare Advantage |
$12.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$143.67
|
| Rate for Payer: Priority Health Medicare |
$12.88
|
| Rate for Payer: Priority Health Narrow Network |
$114.94
|
| Rate for Payer: Railroad Medicare Medicare |
$12.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$43.98
|
| Rate for Payer: UHC Medicare Advantage |
$13.27
|
| Rate for Payer: VA VA |
$12.88
|
|
|
HC MEASLES (RUBEOLA) IGM
|
Facility
|
IP
|
$49.98
|
|
|
Service Code
|
CPT 86765
|
| Hospital Charge Code |
30200398
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$34.99 |
| Max. Negotiated Rate |
$49.98 |
| Rate for Payer: Aetna Commercial |
$44.98
|
| Rate for Payer: ASR ASR |
$48.48
|
| Rate for Payer: BCBS Trust/PPO |
$38.75
|
| Rate for Payer: BCN Commercial |
$38.75
|
| Rate for Payer: Cash Price |
$39.98
|
| Rate for Payer: Cofinity Commercial |
$46.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.98
|
| Rate for Payer: Healthscope Commercial |
$49.98
|
| Rate for Payer: Healthscope Whirlpool |
$48.48
|
| Rate for Payer: Mclaren Commercial |
$44.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$43.98
|
|
|
HC MECHANICAL REMOVAL OBSTRC CVD
|
Facility
|
IP
|
$1,537.29
|
|
|
Service Code
|
CPT 36596
|
| Hospital Charge Code |
36100143
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,076.10 |
| Max. Negotiated Rate |
$1,537.29 |
| Rate for Payer: Aetna Commercial |
$1,383.56
|
| Rate for Payer: ASR ASR |
$1,491.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,191.86
|
| Rate for Payer: BCN Commercial |
$1,191.86
|
| Rate for Payer: Cash Price |
$1,229.83
|
| Rate for Payer: Cofinity Commercial |
$1,445.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,229.83
|
| Rate for Payer: Healthscope Commercial |
$1,537.29
|
| Rate for Payer: Healthscope Whirlpool |
$1,491.17
|
| Rate for Payer: Mclaren Commercial |
$1,383.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,306.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,076.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,352.82
|
|
|
HC MECHANICAL REMOVAL OBSTRC CVD
|
Facility
|
OP
|
$1,537.29
|
|
|
Service Code
|
CPT 36596
|
| Hospital Charge Code |
36100143
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$778.69 |
| Max. Negotiated Rate |
$1,779.46 |
| Rate for Payer: Aetna Commercial |
$1,383.56
|
| Rate for Payer: Aetna Medicare |
$1,423.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,779.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,779.46
|
| Rate for Payer: ASR ASR |
$1,491.17
|
| Rate for Payer: BCBS Complete |
$817.70
|
| Rate for Payer: BCBS MAPPO |
$1,423.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,191.86
|
| Rate for Payer: BCN Commercial |
$1,191.86
|
| Rate for Payer: BCN Medicare Advantage |
$1,423.57
|
| Rate for Payer: Cash Price |
$1,229.83
|
| Rate for Payer: Cash Price |
$1,229.83
|
| Rate for Payer: Cofinity Commercial |
$1,445.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,229.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,423.57
|
| Rate for Payer: Healthscope Commercial |
$1,537.29
|
| Rate for Payer: Healthscope Whirlpool |
$1,491.17
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,423.57
|
| Rate for Payer: Mclaren Commercial |
$1,383.56
|
| Rate for Payer: Mclaren Medicaid |
$778.69
|
| Rate for Payer: Mclaren Medicare |
$1,423.57
|
| Rate for Payer: Meridian Medicaid |
$817.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,494.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,637.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,306.70
|
| Rate for Payer: PACE Medicare |
$1,352.39
|
| Rate for Payer: PACE SWMI |
$1,423.57
|
| Rate for Payer: PHP Commercial |
$1,565.93
|
| Rate for Payer: PHP Medicaid |
$778.69
|
| Rate for Payer: PHP Medicare Advantage |
$1,423.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$778.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,076.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,398.93
|
| Rate for Payer: Priority Health Medicare |
$1,423.57
|
| Rate for Payer: Priority Health Narrow Network |
$1,091.48
|
| Rate for Payer: Railroad Medicare Medicare |
$1,423.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,352.82
|
| Rate for Payer: UHC Medicare Advantage |
$1,466.28
|
| Rate for Payer: VA VA |
$1,423.57
|
|
|
HC MECHANICAL REMOVAL OF PERICATHETER OBSTRUCTION
|
Facility
|
OP
|
$2,904.48
|
|
|
Service Code
|
CPT 36595
|
| Hospital Charge Code |
36100142
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,549.81 |
| Max. Negotiated Rate |
$3,541.61 |
| Rate for Payer: Aetna Commercial |
$2,614.03
|
| Rate for Payer: Aetna Medicare |
$2,833.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,541.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,541.61
|
| Rate for Payer: ASR ASR |
$2,817.35
|
| Rate for Payer: BCBS Complete |
$1,627.44
|
| Rate for Payer: BCBS MAPPO |
$2,833.29
|
| Rate for Payer: BCBS Trust/PPO |
$2,251.84
|
| Rate for Payer: BCN Commercial |
$2,251.84
|
| Rate for Payer: BCN Medicare Advantage |
$2,833.29
|
| Rate for Payer: Cash Price |
$2,323.58
|
| Rate for Payer: Cash Price |
$2,323.58
|
| Rate for Payer: Cofinity Commercial |
$2,730.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,323.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,833.29
|
| Rate for Payer: Healthscope Commercial |
$2,904.48
|
| Rate for Payer: Healthscope Whirlpool |
$2,817.35
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,833.29
|
| Rate for Payer: Mclaren Commercial |
$2,614.03
|
| Rate for Payer: Mclaren Medicaid |
$1,549.81
|
| Rate for Payer: Mclaren Medicare |
$2,833.29
|
| Rate for Payer: Meridian Medicaid |
$1,627.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,974.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,258.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,468.81
|
| Rate for Payer: PACE Medicare |
$2,691.63
|
| Rate for Payer: PACE SWMI |
$2,833.29
|
| Rate for Payer: PHP Commercial |
$3,116.62
|
| Rate for Payer: PHP Medicaid |
$1,549.81
|
| Rate for Payer: PHP Medicare Advantage |
$2,833.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,549.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,033.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,643.08
|
| Rate for Payer: Priority Health Medicare |
$2,833.29
|
| Rate for Payer: Priority Health Narrow Network |
$2,062.18
|
| Rate for Payer: Railroad Medicare Medicare |
$2,833.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,555.94
|
| Rate for Payer: UHC Medicare Advantage |
$2,918.29
|
| Rate for Payer: VA VA |
$2,833.29
|
|
|
HC MECHANICAL REMOVAL OF PERICATHETER OBSTRUCTION
|
Facility
|
IP
|
$2,904.48
|
|
|
Service Code
|
CPT 36595
|
| Hospital Charge Code |
36100142
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,033.14 |
| Max. Negotiated Rate |
$2,904.48 |
| Rate for Payer: Aetna Commercial |
$2,614.03
|
| Rate for Payer: ASR ASR |
$2,817.35
|
| Rate for Payer: BCBS Trust/PPO |
$2,251.84
|
| Rate for Payer: BCN Commercial |
$2,251.84
|
| Rate for Payer: Cash Price |
$2,323.58
|
| Rate for Payer: Cofinity Commercial |
$2,730.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,323.58
|
| Rate for Payer: Healthscope Commercial |
$2,904.48
|
| Rate for Payer: Healthscope Whirlpool |
$2,817.35
|
| Rate for Payer: Mclaren Commercial |
$2,614.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,468.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,033.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,555.94
|
|
|
HC MECH CHEST WALL OSCILLATION
|
Facility
|
IP
|
$314.32
|
|
|
Service Code
|
CPT 94669
|
| Hospital Charge Code |
41000043
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$220.02 |
| Max. Negotiated Rate |
$314.32 |
| Rate for Payer: Aetna Commercial |
$282.89
|
| Rate for Payer: ASR ASR |
$304.89
|
| Rate for Payer: BCBS Trust/PPO |
$243.69
|
| Rate for Payer: BCN Commercial |
$243.69
|
| Rate for Payer: Cash Price |
$251.46
|
| Rate for Payer: Cofinity Commercial |
$295.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$251.46
|
| Rate for Payer: Healthscope Commercial |
$314.32
|
| Rate for Payer: Healthscope Whirlpool |
$304.89
|
| Rate for Payer: Mclaren Commercial |
$282.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$267.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$220.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$276.60
|
|
|
HC MECH CHEST WALL OSCILLATION
|
Facility
|
OP
|
$314.32
|
|
|
Service Code
|
CPT 94669
|
| Hospital Charge Code |
41000043
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$33.68 |
| Max. Negotiated Rate |
$314.32 |
| Rate for Payer: Aetna Commercial |
$282.89
|
| Rate for Payer: Aetna Medicare |
$189.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$236.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$236.99
|
| Rate for Payer: ASR ASR |
$304.89
|
| Rate for Payer: BCBS Complete |
$108.90
|
| Rate for Payer: BCBS MAPPO |
$189.59
|
| Rate for Payer: BCBS Trust/PPO |
$243.69
|
| Rate for Payer: BCN Commercial |
$243.69
|
| Rate for Payer: BCN Medicare Advantage |
$189.59
|
| Rate for Payer: Cash Price |
$251.46
|
| Rate for Payer: Cash Price |
$251.46
|
| Rate for Payer: Cofinity Commercial |
$295.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$251.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$189.59
|
| Rate for Payer: Healthscope Commercial |
$314.32
|
| Rate for Payer: Healthscope Whirlpool |
$304.89
|
| Rate for Payer: Humana Choice PPO Medicare |
$189.59
|
| Rate for Payer: Mclaren Commercial |
$282.89
|
| Rate for Payer: Mclaren Medicaid |
$103.71
|
| Rate for Payer: Mclaren Medicare |
$189.59
|
| Rate for Payer: Meridian Medicaid |
$108.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$199.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$218.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$267.17
|
| Rate for Payer: PACE Medicare |
$180.11
|
| Rate for Payer: PACE SWMI |
$189.59
|
| Rate for Payer: PHP Commercial |
$208.55
|
| Rate for Payer: PHP Medicaid |
$103.71
|
| Rate for Payer: PHP Medicare Advantage |
$189.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$220.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$42.10
|
| Rate for Payer: Priority Health Medicare |
$189.59
|
| Rate for Payer: Priority Health Narrow Network |
$33.68
|
| Rate for Payer: Railroad Medicare Medicare |
$189.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$276.60
|
| Rate for Payer: UHC Medicare Advantage |
$195.28
|
| Rate for Payer: VA VA |
$189.59
|
|
