|
HC MENENCEPH CMPT 10
|
Facility
|
IP
|
$13.87
|
|
|
Service Code
|
CPT 86735
|
| Hospital Charge Code |
30200307
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.71 |
| Max. Negotiated Rate |
$13.87 |
| Rate for Payer: Aetna Commercial |
$12.48
|
| Rate for Payer: ASR ASR |
$13.45
|
| Rate for Payer: BCBS Trust/PPO |
$10.75
|
| Rate for Payer: BCN Commercial |
$10.75
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cofinity Commercial |
$13.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.10
|
| Rate for Payer: Healthscope Commercial |
$13.87
|
| Rate for Payer: Healthscope Whirlpool |
$13.45
|
| Rate for Payer: Mclaren Commercial |
$12.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12.21
|
|
|
HC MENENCEPH CMPT 11
|
Facility
|
IP
|
$13.87
|
|
|
Service Code
|
CPT 86653
|
| Hospital Charge Code |
30200258
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.71 |
| Max. Negotiated Rate |
$13.87 |
| Rate for Payer: Aetna Commercial |
$12.48
|
| Rate for Payer: ASR ASR |
$13.45
|
| Rate for Payer: BCBS Trust/PPO |
$10.75
|
| Rate for Payer: BCN Commercial |
$10.75
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cofinity Commercial |
$13.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.10
|
| Rate for Payer: Healthscope Commercial |
$13.87
|
| Rate for Payer: Healthscope Whirlpool |
$13.45
|
| Rate for Payer: Mclaren Commercial |
$12.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12.21
|
|
|
HC MENENCEPH CMPT 11
|
Facility
|
OP
|
$13.87
|
|
|
Service Code
|
CPT 86653
|
| Hospital Charge Code |
30200258
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.21 |
| Max. Negotiated Rate |
$16.49 |
| Rate for Payer: Aetna Commercial |
$12.48
|
| Rate for Payer: Aetna Medicare |
$13.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.49
|
| Rate for Payer: ASR ASR |
$13.45
|
| Rate for Payer: BCBS Complete |
$7.58
|
| Rate for Payer: BCBS MAPPO |
$13.19
|
| Rate for Payer: BCBS Trust/PPO |
$10.75
|
| Rate for Payer: BCN Commercial |
$10.75
|
| Rate for Payer: BCN Medicare Advantage |
$13.19
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cofinity Commercial |
$13.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.19
|
| Rate for Payer: Healthscope Commercial |
$13.87
|
| Rate for Payer: Healthscope Whirlpool |
$13.45
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.19
|
| Rate for Payer: Mclaren Commercial |
$12.48
|
| Rate for Payer: Mclaren Medicaid |
$7.21
|
| Rate for Payer: Mclaren Medicare |
$13.19
|
| Rate for Payer: Meridian Medicaid |
$7.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.79
|
| Rate for Payer: PACE Medicare |
$12.53
|
| Rate for Payer: PACE SWMI |
$13.19
|
| Rate for Payer: PHP Commercial |
$14.51
|
| Rate for Payer: PHP Medicaid |
$7.21
|
| Rate for Payer: PHP Medicare Advantage |
$13.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.62
|
| Rate for Payer: Priority Health Medicare |
$13.19
|
| Rate for Payer: Priority Health Narrow Network |
$9.85
|
| Rate for Payer: Railroad Medicare Medicare |
$13.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12.21
|
| Rate for Payer: UHC Medicare Advantage |
$13.59
|
| Rate for Payer: VA VA |
$13.19
|
|
|
HC MENENCEPH CMPT 12
|
Facility
|
IP
|
$13.87
|
|
|
Service Code
|
CPT 86787
|
| Hospital Charge Code |
30200328
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.71 |
| Max. Negotiated Rate |
$13.87 |
| Rate for Payer: Aetna Commercial |
$12.48
|
| Rate for Payer: ASR ASR |
$13.45
|
| Rate for Payer: BCBS Trust/PPO |
$10.75
|
| Rate for Payer: BCN Commercial |
$10.75
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cofinity Commercial |
$13.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.10
|
| Rate for Payer: Healthscope Commercial |
$13.87
|
| Rate for Payer: Healthscope Whirlpool |
$13.45
|
| Rate for Payer: Mclaren Commercial |
$12.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12.21
|
|
|
HC MENENCEPH CMPT 12
|
Facility
|
OP
|
$13.87
|
|
|
Service Code
|
CPT 86787
|
| Hospital Charge Code |
30200328
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.05 |
| Max. Negotiated Rate |
$97.49 |
| Rate for Payer: Aetna Commercial |
$12.48
|
| 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 |
$13.45
|
| Rate for Payer: BCBS Complete |
$7.40
|
| Rate for Payer: BCBS MAPPO |
$12.88
|
| Rate for Payer: BCBS Trust/PPO |
$10.75
|
| Rate for Payer: BCN Commercial |
$10.75
|
| Rate for Payer: BCN Medicare Advantage |
$12.88
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cofinity Commercial |
$13.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.88
|
| Rate for Payer: Healthscope Commercial |
$13.87
|
| Rate for Payer: Healthscope Whirlpool |
$13.45
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.88
|
| Rate for Payer: Mclaren Commercial |
$12.48
|
| 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 |
$11.79
|
| 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 |
$9.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$97.49
|
| Rate for Payer: Priority Health Medicare |
$12.88
|
| Rate for Payer: Priority Health Narrow Network |
$77.99
|
| Rate for Payer: Railroad Medicare Medicare |
$12.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12.21
|
| Rate for Payer: UHC Medicare Advantage |
$13.27
|
| Rate for Payer: VA VA |
$12.88
|
|
|
HC MENENCEPH CMPT 13
|
Facility
|
IP
|
$13.87
|
|
|
Service Code
|
CPT 86654
|
| Hospital Charge Code |
30200259
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.71 |
| Max. Negotiated Rate |
$13.87 |
| Rate for Payer: Aetna Commercial |
$12.48
|
| Rate for Payer: ASR ASR |
$13.45
|
| Rate for Payer: BCBS Trust/PPO |
$10.75
|
| Rate for Payer: BCN Commercial |
$10.75
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cofinity Commercial |
$13.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.10
|
| Rate for Payer: Healthscope Commercial |
$13.87
|
| Rate for Payer: Healthscope Whirlpool |
$13.45
|
| Rate for Payer: Mclaren Commercial |
$12.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12.21
|
|
|
HC MENENCEPH CMPT 13
|
Facility
|
OP
|
$13.87
|
|
|
Service Code
|
CPT 86654
|
| Hospital Charge Code |
30200259
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.21 |
| Max. Negotiated Rate |
$16.49 |
| Rate for Payer: Aetna Commercial |
$12.48
|
| Rate for Payer: Aetna Medicare |
$13.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.49
|
| Rate for Payer: ASR ASR |
$13.45
|
| Rate for Payer: BCBS Complete |
$7.58
|
| Rate for Payer: BCBS MAPPO |
$13.19
|
| Rate for Payer: BCBS Trust/PPO |
$10.75
|
| Rate for Payer: BCN Commercial |
$10.75
|
| Rate for Payer: BCN Medicare Advantage |
$13.19
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cofinity Commercial |
$13.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.19
|
| Rate for Payer: Healthscope Commercial |
$13.87
|
| Rate for Payer: Healthscope Whirlpool |
$13.45
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.19
|
| Rate for Payer: Mclaren Commercial |
$12.48
|
| Rate for Payer: Mclaren Medicaid |
$7.21
|
| Rate for Payer: Mclaren Medicare |
$13.19
|
| Rate for Payer: Meridian Medicaid |
$7.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.79
|
| Rate for Payer: PACE Medicare |
$12.53
|
| Rate for Payer: PACE SWMI |
$13.19
|
| Rate for Payer: PHP Commercial |
$14.51
|
| Rate for Payer: PHP Medicaid |
$7.21
|
| Rate for Payer: PHP Medicare Advantage |
$13.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.62
|
| Rate for Payer: Priority Health Medicare |
$13.19
|
| Rate for Payer: Priority Health Narrow Network |
$9.85
|
| Rate for Payer: Railroad Medicare Medicare |
$13.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12.21
|
| Rate for Payer: UHC Medicare Advantage |
$13.59
|
| Rate for Payer: VA VA |
$13.19
|
|
|
HC MENENCEPH CMPT 14
|
Facility
|
OP
|
$13.87
|
|
|
Service Code
|
CPT 86710
|
| Hospital Charge Code |
30200300
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.41 |
| Max. Negotiated Rate |
$16.94 |
| Rate for Payer: Aetna Commercial |
$12.48
|
| Rate for Payer: Aetna Medicare |
$13.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.94
|
| Rate for Payer: ASR ASR |
$13.45
|
| Rate for Payer: BCBS Complete |
$7.78
|
| Rate for Payer: BCBS MAPPO |
$13.55
|
| Rate for Payer: BCBS Trust/PPO |
$10.75
|
| Rate for Payer: BCN Commercial |
$10.75
|
| Rate for Payer: BCN Medicare Advantage |
$13.55
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cofinity Commercial |
$13.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.55
|
| Rate for Payer: Healthscope Commercial |
$13.87
|
| Rate for Payer: Healthscope Whirlpool |
$13.45
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.55
|
| Rate for Payer: Mclaren Commercial |
$12.48
|
| Rate for Payer: Mclaren Medicaid |
$7.41
|
| Rate for Payer: Mclaren Medicare |
$13.55
|
| Rate for Payer: Meridian Medicaid |
$7.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.79
|
| Rate for Payer: PACE Medicare |
$12.87
|
| Rate for Payer: PACE SWMI |
$13.55
|
| Rate for Payer: PHP Commercial |
$14.90
|
| Rate for Payer: PHP Medicaid |
$7.41
|
| Rate for Payer: PHP Medicare Advantage |
$13.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.62
|
| Rate for Payer: Priority Health Medicare |
$13.55
|
| Rate for Payer: Priority Health Narrow Network |
$9.85
|
| Rate for Payer: Railroad Medicare Medicare |
$13.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12.21
|
| Rate for Payer: UHC Medicare Advantage |
$13.96
|
| Rate for Payer: VA VA |
$13.55
|
|
|
HC MENENCEPH CMPT 14
|
Facility
|
IP
|
$13.87
|
|
|
Service Code
|
CPT 86710
|
| Hospital Charge Code |
30200300
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.71 |
| Max. Negotiated Rate |
$13.87 |
| Rate for Payer: Aetna Commercial |
$12.48
|
| Rate for Payer: ASR ASR |
$13.45
|
| Rate for Payer: BCBS Trust/PPO |
$10.75
|
| Rate for Payer: BCN Commercial |
$10.75
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cofinity Commercial |
$13.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.10
|
| Rate for Payer: Healthscope Commercial |
$13.87
|
| Rate for Payer: Healthscope Whirlpool |
$13.45
|
| Rate for Payer: Mclaren Commercial |
$12.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12.21
|
|
|
HC MENENCEPH CMPT 15
|
Facility
|
IP
|
$13.87
|
|
|
Service Code
|
CPT 86765
|
| Hospital Charge Code |
30200319
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.71 |
| Max. Negotiated Rate |
$13.87 |
| Rate for Payer: Aetna Commercial |
$12.48
|
| Rate for Payer: ASR ASR |
$13.45
|
| Rate for Payer: BCBS Trust/PPO |
$10.75
|
| Rate for Payer: BCN Commercial |
$10.75
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cofinity Commercial |
$13.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.10
|
| Rate for Payer: Healthscope Commercial |
$13.87
|
| Rate for Payer: Healthscope Whirlpool |
$13.45
|
| Rate for Payer: Mclaren Commercial |
$12.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12.21
|
|
|
HC MENENCEPH CMPT 15
|
Facility
|
OP
|
$13.87
|
|
|
Service Code
|
CPT 86765
|
| Hospital Charge Code |
30200319
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.05 |
| Max. Negotiated Rate |
$143.67 |
| Rate for Payer: Aetna Commercial |
$12.48
|
| 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 |
$13.45
|
| Rate for Payer: BCBS Complete |
$7.40
|
| Rate for Payer: BCBS MAPPO |
$12.88
|
| Rate for Payer: BCBS Trust/PPO |
$10.75
|
| Rate for Payer: BCN Commercial |
$10.75
|
| Rate for Payer: BCN Medicare Advantage |
$12.88
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cofinity Commercial |
$13.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.88
|
| Rate for Payer: Healthscope Commercial |
$13.87
|
| Rate for Payer: Healthscope Whirlpool |
$13.45
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.88
|
| Rate for Payer: Mclaren Commercial |
$12.48
|
| 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 |
$11.79
|
| 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 |
$9.71
|
| 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 |
$12.21
|
| Rate for Payer: UHC Medicare Advantage |
$13.27
|
| Rate for Payer: VA VA |
$12.88
|
|
|
HC MENENCEPH CMPT 16
|
Facility
|
IP
|
$13.87
|
|
|
Service Code
|
CPT 86789
|
| Hospital Charge Code |
30200357
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.71 |
| Max. Negotiated Rate |
$13.87 |
| Rate for Payer: Aetna Commercial |
$12.48
|
| Rate for Payer: ASR ASR |
$13.45
|
| Rate for Payer: BCBS Trust/PPO |
$10.75
|
| Rate for Payer: BCN Commercial |
$10.75
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cofinity Commercial |
$13.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.10
|
| Rate for Payer: Healthscope Commercial |
$13.87
|
| Rate for Payer: Healthscope Whirlpool |
$13.45
|
| Rate for Payer: Mclaren Commercial |
$12.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12.21
|
|
|
HC MENENCEPH CMPT 16
|
Facility
|
OP
|
$13.87
|
|
|
Service Code
|
CPT 86789
|
| Hospital Charge Code |
30200357
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.87 |
| Max. Negotiated Rate |
$17.99 |
| Rate for Payer: Aetna Commercial |
$12.48
|
| Rate for Payer: Aetna Medicare |
$14.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.99
|
| Rate for Payer: ASR ASR |
$13.45
|
| Rate for Payer: BCBS Complete |
$8.27
|
| Rate for Payer: BCBS MAPPO |
$14.39
|
| Rate for Payer: BCBS Trust/PPO |
$10.75
|
| Rate for Payer: BCN Commercial |
$10.75
|
| Rate for Payer: BCN Medicare Advantage |
$14.39
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cofinity Commercial |
$13.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.39
|
| Rate for Payer: Healthscope Commercial |
$13.87
|
| Rate for Payer: Healthscope Whirlpool |
$13.45
|
| Rate for Payer: Humana Choice PPO Medicare |
$14.39
|
| Rate for Payer: Mclaren Commercial |
$12.48
|
| Rate for Payer: Mclaren Medicaid |
$7.87
|
| Rate for Payer: Mclaren Medicare |
$14.39
|
| Rate for Payer: Meridian Medicaid |
$8.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.79
|
| Rate for Payer: PACE Medicare |
$13.67
|
| Rate for Payer: PACE SWMI |
$14.39
|
| Rate for Payer: PHP Commercial |
$15.83
|
| Rate for Payer: PHP Medicaid |
$7.87
|
| Rate for Payer: PHP Medicare Advantage |
$14.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.62
|
| Rate for Payer: Priority Health Medicare |
$14.39
|
| Rate for Payer: Priority Health Narrow Network |
$9.85
|
| Rate for Payer: Railroad Medicare Medicare |
$14.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12.21
|
| Rate for Payer: UHC Medicare Advantage |
$14.82
|
| Rate for Payer: VA VA |
$14.39
|
|
|
HC MENENCEPH CMPT17
|
Facility
|
OP
|
$13.87
|
|
|
Service Code
|
CPT 86788
|
| Hospital Charge Code |
30200358
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.22 |
| Max. Negotiated Rate |
$21.06 |
| Rate for Payer: Aetna Commercial |
$12.48
|
| Rate for Payer: Aetna Medicare |
$16.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.06
|
| Rate for Payer: ASR ASR |
$13.45
|
| Rate for Payer: BCBS Complete |
$9.68
|
| Rate for Payer: BCBS MAPPO |
$16.85
|
| Rate for Payer: BCBS Trust/PPO |
$10.75
|
| Rate for Payer: BCN Commercial |
$10.75
|
| Rate for Payer: BCN Medicare Advantage |
$16.85
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cofinity Commercial |
$13.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.85
|
| Rate for Payer: Healthscope Commercial |
$13.87
|
| Rate for Payer: Healthscope Whirlpool |
$13.45
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.85
|
| Rate for Payer: Mclaren Commercial |
$12.48
|
| Rate for Payer: Mclaren Medicaid |
$9.22
|
| Rate for Payer: Mclaren Medicare |
$16.85
|
| Rate for Payer: Meridian Medicaid |
$9.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$17.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.79
|
| Rate for Payer: PACE Medicare |
$16.01
|
| Rate for Payer: PACE SWMI |
$16.85
|
| Rate for Payer: PHP Commercial |
$18.54
|
| Rate for Payer: PHP Medicaid |
$9.22
|
| Rate for Payer: PHP Medicare Advantage |
$16.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.62
|
| Rate for Payer: Priority Health Medicare |
$16.85
|
| Rate for Payer: Priority Health Narrow Network |
$9.85
|
| Rate for Payer: Railroad Medicare Medicare |
$16.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12.21
|
| Rate for Payer: UHC Medicare Advantage |
$17.36
|
| Rate for Payer: VA VA |
$16.85
|
|
|
HC MENENCEPH CMPT17
|
Facility
|
IP
|
$13.87
|
|
|
Service Code
|
CPT 86788
|
| Hospital Charge Code |
30200358
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.71 |
| Max. Negotiated Rate |
$13.87 |
| Rate for Payer: Aetna Commercial |
$12.48
|
| Rate for Payer: ASR ASR |
$13.45
|
| Rate for Payer: BCBS Trust/PPO |
$10.75
|
| Rate for Payer: BCN Commercial |
$10.75
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cofinity Commercial |
$13.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.10
|
| Rate for Payer: Healthscope Commercial |
$13.87
|
| Rate for Payer: Healthscope Whirlpool |
$13.45
|
| Rate for Payer: Mclaren Commercial |
$12.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12.21
|
|
|
HC MENENCEPH CMPT 18
|
Facility
|
OP
|
$16.65
|
|
|
Service Code
|
CPT 86694
|
| Hospital Charge Code |
30200359
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.87 |
| Max. Negotiated Rate |
$55.42 |
| Rate for Payer: Aetna Commercial |
$14.98
|
| Rate for Payer: Aetna Medicare |
$14.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.99
|
| Rate for Payer: ASR ASR |
$16.15
|
| Rate for Payer: BCBS Complete |
$8.27
|
| Rate for Payer: BCBS MAPPO |
$14.39
|
| Rate for Payer: BCBS Trust/PPO |
$12.91
|
| Rate for Payer: BCN Commercial |
$12.91
|
| Rate for Payer: BCN Medicare Advantage |
$14.39
|
| Rate for Payer: Cash Price |
$13.32
|
| Rate for Payer: Cash Price |
$13.32
|
| Rate for Payer: Cofinity Commercial |
$15.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.39
|
| Rate for Payer: Healthscope Commercial |
$16.65
|
| Rate for Payer: Healthscope Whirlpool |
$16.15
|
| Rate for Payer: Humana Choice PPO Medicare |
$14.39
|
| Rate for Payer: Mclaren Commercial |
$14.98
|
| Rate for Payer: Mclaren Medicaid |
$7.87
|
| Rate for Payer: Mclaren Medicare |
$14.39
|
| Rate for Payer: Meridian Medicaid |
$8.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$14.15
|
| Rate for Payer: PACE Medicare |
$13.67
|
| Rate for Payer: PACE SWMI |
$14.39
|
| Rate for Payer: PHP Commercial |
$15.83
|
| Rate for Payer: PHP Medicaid |
$7.87
|
| Rate for Payer: PHP Medicare Advantage |
$14.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$55.42
|
| Rate for Payer: Priority Health Medicare |
$14.39
|
| Rate for Payer: Priority Health Narrow Network |
$44.34
|
| Rate for Payer: Railroad Medicare Medicare |
$14.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14.65
|
| Rate for Payer: UHC Medicare Advantage |
$14.82
|
| Rate for Payer: VA VA |
$14.39
|
|
|
HC MENENCEPH CMPT 18
|
Facility
|
IP
|
$16.65
|
|
|
Service Code
|
CPT 86694
|
| Hospital Charge Code |
30200359
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.66 |
| Max. Negotiated Rate |
$16.65 |
| Rate for Payer: Aetna Commercial |
$14.98
|
| Rate for Payer: ASR ASR |
$16.15
|
| Rate for Payer: BCBS Trust/PPO |
$12.91
|
| Rate for Payer: BCN Commercial |
$12.91
|
| Rate for Payer: Cash Price |
$13.32
|
| Rate for Payer: Cofinity Commercial |
$15.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.32
|
| Rate for Payer: Healthscope Commercial |
$16.65
|
| Rate for Payer: Healthscope Whirlpool |
$16.15
|
| Rate for Payer: Mclaren Commercial |
$14.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$14.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14.65
|
|
|
HC MENENCEPH CMPT 19
|
Facility
|
OP
|
$13.87
|
|
|
Service Code
|
CPT 86603
|
| Hospital Charge Code |
30200360
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.04 |
| Max. Negotiated Rate |
$16.09 |
| Rate for Payer: Aetna Commercial |
$12.48
|
| Rate for Payer: Aetna Medicare |
$12.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.09
|
| Rate for Payer: ASR ASR |
$13.45
|
| Rate for Payer: BCBS Complete |
$7.39
|
| Rate for Payer: BCBS MAPPO |
$12.87
|
| Rate for Payer: BCBS Trust/PPO |
$10.75
|
| Rate for Payer: BCN Commercial |
$10.75
|
| Rate for Payer: BCN Medicare Advantage |
$12.87
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cofinity Commercial |
$13.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.87
|
| Rate for Payer: Healthscope Commercial |
$13.87
|
| Rate for Payer: Healthscope Whirlpool |
$13.45
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.87
|
| Rate for Payer: Mclaren Commercial |
$12.48
|
| Rate for Payer: Mclaren Medicaid |
$7.04
|
| Rate for Payer: Mclaren Medicare |
$12.87
|
| Rate for Payer: Meridian Medicaid |
$7.39
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.79
|
| Rate for Payer: PACE Medicare |
$12.23
|
| Rate for Payer: PACE SWMI |
$12.87
|
| Rate for Payer: PHP Commercial |
$14.16
|
| Rate for Payer: PHP Medicaid |
$7.04
|
| Rate for Payer: PHP Medicare Advantage |
$12.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.62
|
| Rate for Payer: Priority Health Medicare |
$12.87
|
| Rate for Payer: Priority Health Narrow Network |
$9.85
|
| Rate for Payer: Railroad Medicare Medicare |
$12.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12.21
|
| Rate for Payer: UHC Medicare Advantage |
$13.26
|
| Rate for Payer: VA VA |
$12.87
|
|
|
HC MENENCEPH CMPT 19
|
Facility
|
IP
|
$13.87
|
|
|
Service Code
|
CPT 86603
|
| Hospital Charge Code |
30200360
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.71 |
| Max. Negotiated Rate |
$13.87 |
| Rate for Payer: Aetna Commercial |
$12.48
|
| Rate for Payer: ASR ASR |
$13.45
|
| Rate for Payer: BCBS Trust/PPO |
$10.75
|
| Rate for Payer: BCN Commercial |
$10.75
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cofinity Commercial |
$13.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.10
|
| Rate for Payer: Healthscope Commercial |
$13.87
|
| Rate for Payer: Healthscope Whirlpool |
$13.45
|
| Rate for Payer: Mclaren Commercial |
$12.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12.21
|
|
|
HC MENENCEPH CMPT 2
|
Facility
|
IP
|
$13.87
|
|
|
Service Code
|
CPT 86651
|
| Hospital Charge Code |
30200256
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.71 |
| Max. Negotiated Rate |
$13.87 |
| Rate for Payer: Aetna Commercial |
$12.48
|
| Rate for Payer: ASR ASR |
$13.45
|
| Rate for Payer: BCBS Trust/PPO |
$10.75
|
| Rate for Payer: BCN Commercial |
$10.75
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cofinity Commercial |
$13.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.10
|
| Rate for Payer: Healthscope Commercial |
$13.87
|
| Rate for Payer: Healthscope Whirlpool |
$13.45
|
| Rate for Payer: Mclaren Commercial |
$12.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12.21
|
|
|
HC MENENCEPH CMPT 2
|
Facility
|
OP
|
$13.87
|
|
|
Service Code
|
CPT 86651
|
| Hospital Charge Code |
30200256
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.21 |
| Max. Negotiated Rate |
$16.49 |
| Rate for Payer: Aetna Commercial |
$12.48
|
| Rate for Payer: Aetna Medicare |
$13.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.49
|
| Rate for Payer: ASR ASR |
$13.45
|
| Rate for Payer: BCBS Complete |
$7.58
|
| Rate for Payer: BCBS MAPPO |
$13.19
|
| Rate for Payer: BCBS Trust/PPO |
$10.75
|
| Rate for Payer: BCN Commercial |
$10.75
|
| Rate for Payer: BCN Medicare Advantage |
$13.19
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cofinity Commercial |
$13.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.19
|
| Rate for Payer: Healthscope Commercial |
$13.87
|
| Rate for Payer: Healthscope Whirlpool |
$13.45
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.19
|
| Rate for Payer: Mclaren Commercial |
$12.48
|
| Rate for Payer: Mclaren Medicaid |
$7.21
|
| Rate for Payer: Mclaren Medicare |
$13.19
|
| Rate for Payer: Meridian Medicaid |
$7.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.79
|
| Rate for Payer: PACE Medicare |
$12.53
|
| Rate for Payer: PACE SWMI |
$13.19
|
| Rate for Payer: PHP Commercial |
$14.51
|
| Rate for Payer: PHP Medicaid |
$7.21
|
| Rate for Payer: PHP Medicare Advantage |
$13.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.62
|
| Rate for Payer: Priority Health Medicare |
$13.19
|
| Rate for Payer: Priority Health Narrow Network |
$9.85
|
| Rate for Payer: Railroad Medicare Medicare |
$13.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12.21
|
| Rate for Payer: UHC Medicare Advantage |
$13.59
|
| Rate for Payer: VA VA |
$13.19
|
|
|
HC MENENCEPH CMPT 3
|
Facility
|
IP
|
$13.87
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
30200264
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.71 |
| Max. Negotiated Rate |
$13.87 |
| Rate for Payer: Aetna Commercial |
$12.48
|
| Rate for Payer: ASR ASR |
$13.45
|
| Rate for Payer: BCBS Trust/PPO |
$10.75
|
| Rate for Payer: BCN Commercial |
$10.75
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cofinity Commercial |
$13.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.10
|
| Rate for Payer: Healthscope Commercial |
$13.87
|
| Rate for Payer: Healthscope Whirlpool |
$13.45
|
| Rate for Payer: Mclaren Commercial |
$12.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12.21
|
|
|
HC MENENCEPH CMPT 3
|
Facility
|
OP
|
$13.87
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
30200264
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.13 |
| Max. Negotiated Rate |
$16.29 |
| Rate for Payer: Aetna Commercial |
$12.48
|
| Rate for Payer: Aetna Medicare |
$13.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.29
|
| Rate for Payer: ASR ASR |
$13.45
|
| Rate for Payer: BCBS Complete |
$7.48
|
| Rate for Payer: BCBS MAPPO |
$13.03
|
| Rate for Payer: BCBS Trust/PPO |
$10.75
|
| Rate for Payer: BCN Commercial |
$10.75
|
| Rate for Payer: BCN Medicare Advantage |
$13.03
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cofinity Commercial |
$13.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.03
|
| Rate for Payer: Healthscope Commercial |
$13.87
|
| Rate for Payer: Healthscope Whirlpool |
$13.45
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.03
|
| Rate for Payer: Mclaren Commercial |
$12.48
|
| Rate for Payer: Mclaren Medicaid |
$7.13
|
| Rate for Payer: Mclaren Medicare |
$13.03
|
| Rate for Payer: Meridian Medicaid |
$7.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.79
|
| Rate for Payer: PACE Medicare |
$12.38
|
| Rate for Payer: PACE SWMI |
$13.03
|
| Rate for Payer: PHP Commercial |
$14.33
|
| Rate for Payer: PHP Medicaid |
$7.13
|
| Rate for Payer: PHP Medicare Advantage |
$13.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.62
|
| Rate for Payer: Priority Health Medicare |
$13.03
|
| Rate for Payer: Priority Health Narrow Network |
$9.85
|
| Rate for Payer: Railroad Medicare Medicare |
$13.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12.21
|
| Rate for Payer: UHC Medicare Advantage |
$13.42
|
| Rate for Payer: VA VA |
$13.03
|
|
|
HC MENENCEPH CMPT 4
|
Facility
|
IP
|
$13.87
|
|
|
Service Code
|
CPT 86644
|
| Hospital Charge Code |
30200250
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.71 |
| Max. Negotiated Rate |
$13.87 |
| Rate for Payer: Aetna Commercial |
$12.48
|
| Rate for Payer: ASR ASR |
$13.45
|
| Rate for Payer: BCBS Trust/PPO |
$10.75
|
| Rate for Payer: BCN Commercial |
$10.75
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cofinity Commercial |
$13.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.10
|
| Rate for Payer: Healthscope Commercial |
$13.87
|
| Rate for Payer: Healthscope Whirlpool |
$13.45
|
| Rate for Payer: Mclaren Commercial |
$12.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12.21
|
|
|
HC MENENCEPH CMPT 4
|
Facility
|
OP
|
$13.87
|
|
|
Service Code
|
CPT 86644
|
| Hospital Charge Code |
30200250
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.87 |
| Max. Negotiated Rate |
$48.24 |
| Rate for Payer: Aetna Commercial |
$12.48
|
| Rate for Payer: Aetna Medicare |
$14.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.99
|
| Rate for Payer: ASR ASR |
$13.45
|
| Rate for Payer: BCBS Complete |
$8.27
|
| Rate for Payer: BCBS MAPPO |
$14.39
|
| Rate for Payer: BCBS Trust/PPO |
$10.75
|
| Rate for Payer: BCN Commercial |
$10.75
|
| Rate for Payer: BCN Medicare Advantage |
$14.39
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cofinity Commercial |
$13.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.39
|
| Rate for Payer: Healthscope Commercial |
$13.87
|
| Rate for Payer: Healthscope Whirlpool |
$13.45
|
| Rate for Payer: Humana Choice PPO Medicare |
$14.39
|
| Rate for Payer: Mclaren Commercial |
$12.48
|
| Rate for Payer: Mclaren Medicaid |
$7.87
|
| Rate for Payer: Mclaren Medicare |
$14.39
|
| Rate for Payer: Meridian Medicaid |
$8.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.79
|
| Rate for Payer: PACE Medicare |
$13.67
|
| Rate for Payer: PACE SWMI |
$14.39
|
| Rate for Payer: PHP Commercial |
$15.83
|
| Rate for Payer: PHP Medicaid |
$7.87
|
| Rate for Payer: PHP Medicare Advantage |
$14.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$48.24
|
| Rate for Payer: Priority Health Medicare |
$14.39
|
| Rate for Payer: Priority Health Narrow Network |
$38.59
|
| Rate for Payer: Railroad Medicare Medicare |
$14.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12.21
|
| Rate for Payer: UHC Medicare Advantage |
$14.82
|
| Rate for Payer: VA VA |
$14.39
|
|
