|
HC FLUTTER VALVE SUPPLY
|
Facility
|
IP
|
$118.69
|
|
| Hospital Charge Code |
27000078
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$77.15 |
| Max. Negotiated Rate |
$118.69 |
| Rate for Payer: Aetna Commercial |
$106.82
|
| Rate for Payer: ASR ASR |
$115.13
|
| Rate for Payer: ASR Commercial |
$115.13
|
| Rate for Payer: BCBS Trust/PPO |
$96.72
|
| Rate for Payer: BCN Commercial |
$92.02
|
| Rate for Payer: Cash Price |
$94.95
|
| Rate for Payer: Cofinity Commercial |
$111.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.95
|
| Rate for Payer: Healthscope Commercial |
$118.69
|
| Rate for Payer: Healthscope Whirlpool |
$115.13
|
| Rate for Payer: Mclaren Commercial |
$106.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.89
|
| Rate for Payer: Nomi Health Commercial |
$97.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$104.45
|
|
|
HC FLU VAC,SPLIT VIRUS, PT 3 YRS OR OLDER, IM
|
Facility
|
IP
|
$26.01
|
|
|
Service Code
|
CPT Q2038
|
| Hospital Charge Code |
63600113
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$16.91 |
| Max. Negotiated Rate |
$26.01 |
| Rate for Payer: Aetna Commercial |
$23.41
|
| Rate for Payer: ASR ASR |
$25.23
|
| Rate for Payer: ASR Commercial |
$25.23
|
| Rate for Payer: BCBS Trust/PPO |
$21.20
|
| Rate for Payer: BCN Commercial |
$20.17
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$24.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$26.01
|
| Rate for Payer: Healthscope Whirlpool |
$25.23
|
| Rate for Payer: Mclaren Commercial |
$23.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: Nomi Health Commercial |
$21.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.89
|
|
|
HC FLU VAC,SPLIT VIRUS, PT 3 YRS OR OLDER, IM
|
Facility
|
OP
|
$26.01
|
|
|
Service Code
|
CPT Q2038
|
| Hospital Charge Code |
63600113
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.64 |
| Max. Negotiated Rate |
$26.01 |
| Rate for Payer: Aetna Commercial |
$23.41
|
| Rate for Payer: Aetna Medicare |
$13.00
|
| Rate for Payer: ASR ASR |
$25.23
|
| Rate for Payer: ASR Commercial |
$25.23
|
| Rate for Payer: BCBS Complete |
$10.40
|
| Rate for Payer: BCBS Trust/PPO |
$21.30
|
| Rate for Payer: BCN Commercial |
$20.17
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$24.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$26.01
|
| Rate for Payer: Healthscope Whirlpool |
$25.23
|
| Rate for Payer: Mclaren Commercial |
$23.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: Nomi Health Commercial |
$21.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.05
|
| Rate for Payer: Priority Health Narrow Network |
$9.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.89
|
|
|
HC FNA BX 1ST LESION CT GUIDE
|
Facility
|
IP
|
$908.27
|
|
|
Service Code
|
CPT 10009
|
| Hospital Charge Code |
36100558
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$590.38 |
| Max. Negotiated Rate |
$908.27 |
| Rate for Payer: Aetna Commercial |
$817.44
|
| Rate for Payer: ASR ASR |
$881.02
|
| Rate for Payer: ASR Commercial |
$881.02
|
| Rate for Payer: BCBS Trust/PPO |
$740.15
|
| Rate for Payer: BCN Commercial |
$704.18
|
| Rate for Payer: Cash Price |
$726.62
|
| Rate for Payer: Cofinity Commercial |
$853.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$726.62
|
| Rate for Payer: Healthscope Commercial |
$908.27
|
| Rate for Payer: Healthscope Whirlpool |
$881.02
|
| Rate for Payer: Mclaren Commercial |
$817.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$772.03
|
| Rate for Payer: Nomi Health Commercial |
$744.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$590.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$799.28
|
|
|
HC FNA BX 1ST LESION CT GUIDE
|
Facility
|
OP
|
$908.27
|
|
|
Service Code
|
CPT 10009
|
| Hospital Charge Code |
36100558
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$369.50 |
| Max. Negotiated Rate |
$1,068.51 |
| Rate for Payer: Aetna Commercial |
$817.44
|
| Rate for Payer: Aetna Medicare |
$689.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$861.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$861.70
|
| Rate for Payer: ASR ASR |
$881.02
|
| Rate for Payer: ASR Commercial |
$881.02
|
| Rate for Payer: BCBS Complete |
$387.97
|
| Rate for Payer: BCBS MAPPO |
$689.36
|
| Rate for Payer: BCBS Trust/PPO |
$743.78
|
| Rate for Payer: BCCCP Commercial |
$391.24
|
| Rate for Payer: BCN Commercial |
$704.18
|
| Rate for Payer: BCN Medicare Advantage |
$689.36
|
| Rate for Payer: Cash Price |
$726.62
|
| Rate for Payer: Cash Price |
$726.62
|
| Rate for Payer: Cofinity Commercial |
$853.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$726.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$689.36
|
| Rate for Payer: Healthscope Commercial |
$908.27
|
| Rate for Payer: Healthscope Whirlpool |
$881.02
|
| Rate for Payer: Humana Choice PPO Medicare |
$689.36
|
| Rate for Payer: Mclaren Commercial |
$817.44
|
| Rate for Payer: Mclaren Medicaid |
$369.50
|
| Rate for Payer: Mclaren Medicare |
$689.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$723.83
|
| Rate for Payer: Meridian Medicaid |
$387.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$792.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$772.03
|
| Rate for Payer: Nomi Health Commercial |
$744.78
|
| Rate for Payer: PACE Medicare |
$654.89
|
| Rate for Payer: PACE SWMI |
$689.36
|
| Rate for Payer: PHP Commercial |
$758.30
|
| Rate for Payer: PHP Medicaid |
$369.50
|
| Rate for Payer: PHP Medicare Advantage |
$689.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$590.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$663.28
|
| Rate for Payer: Priority Health Medicare |
$689.36
|
| Rate for Payer: Priority Health Narrow Network |
$530.62
|
| Rate for Payer: Railroad Medicare Medicare |
$689.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$799.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$689.36
|
| Rate for Payer: UHC Exchange |
$1,068.51
|
| Rate for Payer: UHC Medicare Advantage |
$689.36
|
| Rate for Payer: UHCCP DNSP |
$689.36
|
| Rate for Payer: UHCCP Medicaid |
$369.50
|
| Rate for Payer: VA VA |
$689.36
|
|
|
HC FNA BX 1ST LESION FLUORO GUIDE
|
Facility
|
IP
|
$908.27
|
|
|
Service Code
|
CPT 10007
|
| Hospital Charge Code |
36100556
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$590.38 |
| Max. Negotiated Rate |
$908.27 |
| Rate for Payer: Aetna Commercial |
$817.44
|
| Rate for Payer: ASR ASR |
$881.02
|
| Rate for Payer: ASR Commercial |
$881.02
|
| Rate for Payer: BCBS Trust/PPO |
$740.15
|
| Rate for Payer: BCN Commercial |
$704.18
|
| Rate for Payer: Cash Price |
$726.62
|
| Rate for Payer: Cofinity Commercial |
$853.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$726.62
|
| Rate for Payer: Healthscope Commercial |
$908.27
|
| Rate for Payer: Healthscope Whirlpool |
$881.02
|
| Rate for Payer: Mclaren Commercial |
$817.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$772.03
|
| Rate for Payer: Nomi Health Commercial |
$744.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$590.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$799.28
|
|
|
HC FNA BX 1ST LESION FLUORO GUIDE
|
Facility
|
OP
|
$908.27
|
|
|
Service Code
|
CPT 10007
|
| Hospital Charge Code |
36100556
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$284.96 |
| Max. Negotiated Rate |
$1,068.51 |
| Rate for Payer: Aetna Commercial |
$817.44
|
| Rate for Payer: Aetna Medicare |
$689.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$861.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$861.70
|
| Rate for Payer: ASR ASR |
$881.02
|
| Rate for Payer: ASR Commercial |
$881.02
|
| Rate for Payer: BCBS Complete |
$387.97
|
| Rate for Payer: BCBS MAPPO |
$689.36
|
| Rate for Payer: BCBS Trust/PPO |
$743.78
|
| Rate for Payer: BCCCP Commercial |
$284.96
|
| Rate for Payer: BCN Commercial |
$704.18
|
| Rate for Payer: BCN Medicare Advantage |
$689.36
|
| Rate for Payer: Cash Price |
$726.62
|
| Rate for Payer: Cash Price |
$726.62
|
| Rate for Payer: Cofinity Commercial |
$853.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$726.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$689.36
|
| Rate for Payer: Healthscope Commercial |
$908.27
|
| Rate for Payer: Healthscope Whirlpool |
$881.02
|
| Rate for Payer: Humana Choice PPO Medicare |
$689.36
|
| Rate for Payer: Mclaren Commercial |
$817.44
|
| Rate for Payer: Mclaren Medicaid |
$369.50
|
| Rate for Payer: Mclaren Medicare |
$689.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$723.83
|
| Rate for Payer: Meridian Medicaid |
$387.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$792.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$772.03
|
| Rate for Payer: Nomi Health Commercial |
$744.78
|
| Rate for Payer: PACE Medicare |
$654.89
|
| Rate for Payer: PACE SWMI |
$689.36
|
| Rate for Payer: PHP Commercial |
$758.30
|
| Rate for Payer: PHP Medicaid |
$369.50
|
| Rate for Payer: PHP Medicare Advantage |
$689.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$590.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$663.28
|
| Rate for Payer: Priority Health Medicare |
$689.36
|
| Rate for Payer: Priority Health Narrow Network |
$530.62
|
| Rate for Payer: Railroad Medicare Medicare |
$689.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$799.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$689.36
|
| Rate for Payer: UHC Exchange |
$1,068.51
|
| Rate for Payer: UHC Medicare Advantage |
$689.36
|
| Rate for Payer: UHCCP DNSP |
$689.36
|
| Rate for Payer: UHCCP Medicaid |
$369.50
|
| Rate for Payer: VA VA |
$689.36
|
|
|
HC FNA BX 1ST LESION MR GUIDE
|
Facility
|
OP
|
$908.27
|
|
|
Service Code
|
CPT 10011
|
| Hospital Charge Code |
36100560
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$369.50 |
| Max. Negotiated Rate |
$1,068.51 |
| Rate for Payer: Aetna Commercial |
$817.44
|
| Rate for Payer: Aetna Medicare |
$689.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$861.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$861.70
|
| Rate for Payer: ASR ASR |
$881.02
|
| Rate for Payer: ASR Commercial |
$881.02
|
| Rate for Payer: BCBS Complete |
$387.97
|
| Rate for Payer: BCBS MAPPO |
$689.36
|
| Rate for Payer: BCBS Trust/PPO |
$743.78
|
| Rate for Payer: BCCCP Commercial |
$391.24
|
| Rate for Payer: BCN Commercial |
$704.18
|
| Rate for Payer: BCN Medicare Advantage |
$689.36
|
| Rate for Payer: Cash Price |
$726.62
|
| Rate for Payer: Cash Price |
$726.62
|
| Rate for Payer: Cofinity Commercial |
$853.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$726.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$689.36
|
| Rate for Payer: Healthscope Commercial |
$908.27
|
| Rate for Payer: Healthscope Whirlpool |
$881.02
|
| Rate for Payer: Humana Choice PPO Medicare |
$689.36
|
| Rate for Payer: Mclaren Commercial |
$817.44
|
| Rate for Payer: Mclaren Medicaid |
$369.50
|
| Rate for Payer: Mclaren Medicare |
$689.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$723.83
|
| Rate for Payer: Meridian Medicaid |
$387.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$792.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$772.03
|
| Rate for Payer: Nomi Health Commercial |
$744.78
|
| Rate for Payer: PACE Medicare |
$654.89
|
| Rate for Payer: PACE SWMI |
$689.36
|
| Rate for Payer: PHP Commercial |
$758.30
|
| Rate for Payer: PHP Medicaid |
$369.50
|
| Rate for Payer: PHP Medicare Advantage |
$689.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$590.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$663.28
|
| Rate for Payer: Priority Health Medicare |
$689.36
|
| Rate for Payer: Priority Health Narrow Network |
$530.62
|
| Rate for Payer: Railroad Medicare Medicare |
$689.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$799.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$689.36
|
| Rate for Payer: UHC Exchange |
$1,068.51
|
| Rate for Payer: UHC Medicare Advantage |
$689.36
|
| Rate for Payer: UHCCP DNSP |
$689.36
|
| Rate for Payer: UHCCP Medicaid |
$369.50
|
| Rate for Payer: VA VA |
$689.36
|
|
|
HC FNA BX 1ST LESION MR GUIDE
|
Facility
|
IP
|
$908.27
|
|
|
Service Code
|
CPT 10011
|
| Hospital Charge Code |
36100560
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$590.38 |
| Max. Negotiated Rate |
$908.27 |
| Rate for Payer: Aetna Commercial |
$817.44
|
| Rate for Payer: ASR ASR |
$881.02
|
| Rate for Payer: ASR Commercial |
$881.02
|
| Rate for Payer: BCBS Trust/PPO |
$740.15
|
| Rate for Payer: BCN Commercial |
$704.18
|
| Rate for Payer: Cash Price |
$726.62
|
| Rate for Payer: Cofinity Commercial |
$853.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$726.62
|
| Rate for Payer: Healthscope Commercial |
$908.27
|
| Rate for Payer: Healthscope Whirlpool |
$881.02
|
| Rate for Payer: Mclaren Commercial |
$817.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$772.03
|
| Rate for Payer: Nomi Health Commercial |
$744.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$590.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$799.28
|
|
|
HC FNA BX 1ST LESION US GUIDE
|
Facility
|
OP
|
$1,068.55
|
|
|
Service Code
|
CPT 10005
|
| Hospital Charge Code |
36100554
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$126.90 |
| Max. Negotiated Rate |
$1,068.55 |
| Rate for Payer: Aetna Commercial |
$961.70
|
| Rate for Payer: Aetna Medicare |
$689.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$861.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$861.70
|
| Rate for Payer: ASR ASR |
$1,036.49
|
| Rate for Payer: ASR Commercial |
$1,036.49
|
| Rate for Payer: BCBS Complete |
$387.97
|
| Rate for Payer: BCBS MAPPO |
$689.36
|
| Rate for Payer: BCBS Trust/PPO |
$875.04
|
| Rate for Payer: BCCCP Commercial |
$126.90
|
| Rate for Payer: BCN Commercial |
$828.45
|
| Rate for Payer: BCN Medicare Advantage |
$689.36
|
| Rate for Payer: Cash Price |
$854.84
|
| Rate for Payer: Cash Price |
$854.84
|
| Rate for Payer: Cofinity Commercial |
$1,004.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$854.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$689.36
|
| Rate for Payer: Healthscope Commercial |
$1,068.55
|
| Rate for Payer: Healthscope Whirlpool |
$1,036.49
|
| Rate for Payer: Humana Choice PPO Medicare |
$689.36
|
| Rate for Payer: Mclaren Commercial |
$961.70
|
| Rate for Payer: Mclaren Medicaid |
$369.50
|
| Rate for Payer: Mclaren Medicare |
$689.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$723.83
|
| Rate for Payer: Meridian Medicaid |
$387.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$792.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$908.27
|
| Rate for Payer: Nomi Health Commercial |
$876.21
|
| Rate for Payer: PACE Medicare |
$654.89
|
| Rate for Payer: PACE SWMI |
$689.36
|
| Rate for Payer: PHP Commercial |
$758.30
|
| Rate for Payer: PHP Medicaid |
$369.50
|
| Rate for Payer: PHP Medicare Advantage |
$689.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$694.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$663.28
|
| Rate for Payer: Priority Health Medicare |
$689.36
|
| Rate for Payer: Priority Health Narrow Network |
$530.62
|
| Rate for Payer: Railroad Medicare Medicare |
$689.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$940.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$689.36
|
| Rate for Payer: UHC Exchange |
$1,068.51
|
| Rate for Payer: UHC Medicare Advantage |
$689.36
|
| Rate for Payer: UHCCP DNSP |
$689.36
|
| Rate for Payer: UHCCP Medicaid |
$369.50
|
| Rate for Payer: VA VA |
$689.36
|
|
|
HC FNA BX 1ST LESION US GUIDE
|
Facility
|
IP
|
$1,068.55
|
|
|
Service Code
|
CPT 10005
|
| Hospital Charge Code |
36100554
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$694.56 |
| Max. Negotiated Rate |
$1,068.55 |
| Rate for Payer: Aetna Commercial |
$961.70
|
| Rate for Payer: ASR ASR |
$1,036.49
|
| Rate for Payer: ASR Commercial |
$1,036.49
|
| Rate for Payer: BCBS Trust/PPO |
$870.76
|
| Rate for Payer: BCN Commercial |
$828.45
|
| Rate for Payer: Cash Price |
$854.84
|
| Rate for Payer: Cofinity Commercial |
$1,004.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$854.84
|
| Rate for Payer: Healthscope Commercial |
$1,068.55
|
| Rate for Payer: Healthscope Whirlpool |
$1,036.49
|
| Rate for Payer: Mclaren Commercial |
$961.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$908.27
|
| Rate for Payer: Nomi Health Commercial |
$876.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$694.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$940.32
|
|
|
HC FNA BX EACH ADDL CT GUIDE
|
Facility
|
IP
|
$150.86
|
|
|
Service Code
|
CPT 10010
|
| Hospital Charge Code |
36100559
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$98.06 |
| Max. Negotiated Rate |
$150.86 |
| Rate for Payer: Aetna Commercial |
$135.77
|
| Rate for Payer: ASR ASR |
$146.33
|
| Rate for Payer: ASR Commercial |
$146.33
|
| Rate for Payer: BCBS Trust/PPO |
$122.94
|
| Rate for Payer: BCN Commercial |
$116.96
|
| Rate for Payer: Cash Price |
$120.69
|
| Rate for Payer: Cofinity Commercial |
$141.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.69
|
| Rate for Payer: Healthscope Commercial |
$150.86
|
| Rate for Payer: Healthscope Whirlpool |
$146.33
|
| Rate for Payer: Mclaren Commercial |
$135.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$128.23
|
| Rate for Payer: Nomi Health Commercial |
$123.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$132.76
|
|
|
HC FNA BX EACH ADDL CT GUIDE
|
Facility
|
OP
|
$150.86
|
|
|
Service Code
|
CPT 10010
|
| Hospital Charge Code |
36100559
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$60.34 |
| Max. Negotiated Rate |
$221.53 |
| Rate for Payer: Aetna Commercial |
$135.77
|
| Rate for Payer: Aetna Medicare |
$75.43
|
| Rate for Payer: ASR ASR |
$146.33
|
| Rate for Payer: ASR Commercial |
$146.33
|
| Rate for Payer: BCBS Complete |
$60.34
|
| Rate for Payer: BCBS Trust/PPO |
$123.54
|
| Rate for Payer: BCCCP Commercial |
$221.53
|
| Rate for Payer: BCN Commercial |
$116.96
|
| Rate for Payer: Cash Price |
$120.69
|
| Rate for Payer: Cash Price |
$120.69
|
| Rate for Payer: Cofinity Commercial |
$141.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.69
|
| Rate for Payer: Healthscope Commercial |
$150.86
|
| Rate for Payer: Healthscope Whirlpool |
$146.33
|
| Rate for Payer: Mclaren Commercial |
$135.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$128.23
|
| Rate for Payer: Nomi Health Commercial |
$123.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$132.18
|
| Rate for Payer: Priority Health Narrow Network |
$105.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$132.76
|
|
|
HC FNA BX EACH ADDL FLUORO GUIDE
|
Facility
|
OP
|
$165.94
|
|
|
Service Code
|
CPT 10008
|
| Hospital Charge Code |
36100557
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$66.38 |
| Max. Negotiated Rate |
$165.94 |
| Rate for Payer: Aetna Commercial |
$149.35
|
| Rate for Payer: Aetna Medicare |
$82.97
|
| Rate for Payer: ASR ASR |
$160.96
|
| Rate for Payer: ASR Commercial |
$160.96
|
| Rate for Payer: BCBS Complete |
$66.38
|
| Rate for Payer: BCBS Trust/PPO |
$135.89
|
| Rate for Payer: BCCCP Commercial |
$134.52
|
| Rate for Payer: BCN Commercial |
$128.65
|
| Rate for Payer: Cash Price |
$132.75
|
| Rate for Payer: Cash Price |
$132.75
|
| Rate for Payer: Cofinity Commercial |
$155.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$132.75
|
| Rate for Payer: Healthscope Commercial |
$165.94
|
| Rate for Payer: Healthscope Whirlpool |
$160.96
|
| Rate for Payer: Mclaren Commercial |
$149.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$141.05
|
| Rate for Payer: Nomi Health Commercial |
$136.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$107.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$145.40
|
| Rate for Payer: Priority Health Narrow Network |
$116.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$146.03
|
|
|
HC FNA BX EACH ADDL FLUORO GUIDE
|
Facility
|
IP
|
$165.94
|
|
|
Service Code
|
CPT 10008
|
| Hospital Charge Code |
36100557
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$107.86 |
| Max. Negotiated Rate |
$165.94 |
| Rate for Payer: Aetna Commercial |
$149.35
|
| Rate for Payer: ASR ASR |
$160.96
|
| Rate for Payer: ASR Commercial |
$160.96
|
| Rate for Payer: BCBS Trust/PPO |
$135.22
|
| Rate for Payer: BCN Commercial |
$128.65
|
| Rate for Payer: Cash Price |
$132.75
|
| Rate for Payer: Cofinity Commercial |
$155.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$132.75
|
| Rate for Payer: Healthscope Commercial |
$165.94
|
| Rate for Payer: Healthscope Whirlpool |
$160.96
|
| Rate for Payer: Mclaren Commercial |
$149.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$141.05
|
| Rate for Payer: Nomi Health Commercial |
$136.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$107.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$146.03
|
|
|
HC FNA BX EACH ADDL US GUIDE
|
Facility
|
IP
|
$214.75
|
|
|
Service Code
|
CPT 10006
|
| Hospital Charge Code |
36100555
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$139.59 |
| Max. Negotiated Rate |
$214.75 |
| Rate for Payer: Aetna Commercial |
$193.28
|
| Rate for Payer: ASR ASR |
$208.31
|
| Rate for Payer: ASR Commercial |
$208.31
|
| Rate for Payer: BCBS Trust/PPO |
$175.00
|
| Rate for Payer: BCN Commercial |
$166.50
|
| Rate for Payer: Cash Price |
$171.80
|
| Rate for Payer: Cofinity Commercial |
$201.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$171.80
|
| Rate for Payer: Healthscope Commercial |
$214.75
|
| Rate for Payer: Healthscope Whirlpool |
$208.31
|
| Rate for Payer: Mclaren Commercial |
$193.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$182.54
|
| Rate for Payer: Nomi Health Commercial |
$176.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$139.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$188.98
|
|
|
HC FNA BX EACH ADDL US GUIDE
|
Facility
|
OP
|
$214.75
|
|
|
Service Code
|
CPT 10006
|
| Hospital Charge Code |
36100555
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$58.15 |
| Max. Negotiated Rate |
$214.75 |
| Rate for Payer: Aetna Commercial |
$193.28
|
| Rate for Payer: Aetna Medicare |
$107.38
|
| Rate for Payer: ASR ASR |
$208.31
|
| Rate for Payer: ASR Commercial |
$208.31
|
| Rate for Payer: BCBS Complete |
$85.90
|
| Rate for Payer: BCBS Trust/PPO |
$175.86
|
| Rate for Payer: BCCCP Commercial |
$58.15
|
| Rate for Payer: BCN Commercial |
$166.50
|
| Rate for Payer: Cash Price |
$171.80
|
| Rate for Payer: Cash Price |
$171.80
|
| Rate for Payer: Cofinity Commercial |
$201.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$171.80
|
| Rate for Payer: Healthscope Commercial |
$214.75
|
| Rate for Payer: Healthscope Whirlpool |
$208.31
|
| Rate for Payer: Mclaren Commercial |
$193.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$182.54
|
| Rate for Payer: Nomi Health Commercial |
$176.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$139.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$188.16
|
| Rate for Payer: Priority Health Narrow Network |
$150.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$188.98
|
|
|
HC FNA BX W/O IMG 1ST LESION
|
Facility
|
OP
|
$1,138.32
|
|
|
Service Code
|
CPT 10021
|
| Hospital Charge Code |
76100423
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$96.42 |
| Max. Negotiated Rate |
$1,138.32 |
| Rate for Payer: Aetna Commercial |
$1,024.49
|
| Rate for Payer: Aetna Medicare |
$391.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$489.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$489.31
|
| Rate for Payer: ASR ASR |
$1,104.17
|
| Rate for Payer: ASR Commercial |
$1,104.17
|
| Rate for Payer: BCBS Complete |
$220.31
|
| Rate for Payer: BCBS MAPPO |
$391.45
|
| Rate for Payer: BCBS Trust/PPO |
$932.17
|
| Rate for Payer: BCCCP Commercial |
$96.42
|
| Rate for Payer: BCN Commercial |
$882.54
|
| Rate for Payer: BCN Medicare Advantage |
$391.45
|
| Rate for Payer: Cash Price |
$910.66
|
| Rate for Payer: Cash Price |
$910.66
|
| Rate for Payer: Cofinity Commercial |
$1,070.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$910.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$391.45
|
| Rate for Payer: Healthscope Commercial |
$1,138.32
|
| Rate for Payer: Healthscope Whirlpool |
$1,104.17
|
| Rate for Payer: Humana Choice PPO Medicare |
$391.45
|
| Rate for Payer: Mclaren Commercial |
$1,024.49
|
| Rate for Payer: Mclaren Medicaid |
$209.82
|
| Rate for Payer: Mclaren Medicare |
$391.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$411.02
|
| Rate for Payer: Meridian Medicaid |
$220.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$450.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$967.57
|
| Rate for Payer: Nomi Health Commercial |
$933.42
|
| Rate for Payer: PACE Medicare |
$371.88
|
| Rate for Payer: PACE SWMI |
$391.45
|
| Rate for Payer: PHP Commercial |
$430.60
|
| Rate for Payer: PHP Medicaid |
$209.82
|
| Rate for Payer: PHP Medicare Advantage |
$391.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$209.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$739.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$237.17
|
| Rate for Payer: Priority Health Medicare |
$391.45
|
| Rate for Payer: Priority Health Narrow Network |
$189.74
|
| Rate for Payer: Railroad Medicare Medicare |
$391.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,001.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$391.45
|
| Rate for Payer: UHC Exchange |
$606.75
|
| Rate for Payer: UHC Medicare Advantage |
$391.45
|
| Rate for Payer: UHCCP DNSP |
$391.45
|
| Rate for Payer: UHCCP Medicaid |
$209.82
|
| Rate for Payer: VA VA |
$391.45
|
|
|
HC FNA BX W/O IMG 1ST LESION
|
Facility
|
IP
|
$1,138.32
|
|
|
Service Code
|
CPT 10021
|
| Hospital Charge Code |
76100423
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$739.91 |
| Max. Negotiated Rate |
$1,138.32 |
| Rate for Payer: Aetna Commercial |
$1,024.49
|
| Rate for Payer: ASR ASR |
$1,104.17
|
| Rate for Payer: ASR Commercial |
$1,104.17
|
| Rate for Payer: BCBS Trust/PPO |
$927.62
|
| Rate for Payer: BCN Commercial |
$882.54
|
| Rate for Payer: Cash Price |
$910.66
|
| Rate for Payer: Cofinity Commercial |
$1,070.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$910.66
|
| Rate for Payer: Healthscope Commercial |
$1,138.32
|
| Rate for Payer: Healthscope Whirlpool |
$1,104.17
|
| Rate for Payer: Mclaren Commercial |
$1,024.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$967.57
|
| Rate for Payer: Nomi Health Commercial |
$933.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$739.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,001.72
|
|
|
HC FNA IMED EVAL
|
Facility
|
IP
|
$74.70
|
|
|
Service Code
|
CPT 88172
|
| Hospital Charge Code |
31100006
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$48.56 |
| Max. Negotiated Rate |
$74.70 |
| Rate for Payer: Aetna Commercial |
$67.23
|
| Rate for Payer: ASR ASR |
$72.46
|
| Rate for Payer: ASR Commercial |
$72.46
|
| Rate for Payer: BCBS Trust/PPO |
$60.87
|
| Rate for Payer: BCN Commercial |
$57.91
|
| Rate for Payer: Cash Price |
$59.76
|
| Rate for Payer: Cofinity Commercial |
$70.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.76
|
| Rate for Payer: Healthscope Commercial |
$74.70
|
| Rate for Payer: Healthscope Whirlpool |
$72.46
|
| Rate for Payer: Mclaren Commercial |
$67.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.50
|
| Rate for Payer: Nomi Health Commercial |
$61.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$65.74
|
|
|
HC FNA IMED EVAL
|
Facility
|
OP
|
$74.70
|
|
|
Service Code
|
CPT 88172
|
| Hospital Charge Code |
31100006
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$48.56 |
| Max. Negotiated Rate |
$260.24 |
| Rate for Payer: Aetna Commercial |
$67.23
|
| Rate for Payer: Aetna Medicare |
$167.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$209.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$209.88
|
| Rate for Payer: ASR ASR |
$72.46
|
| Rate for Payer: ASR Commercial |
$72.46
|
| Rate for Payer: BCBS Complete |
$94.49
|
| Rate for Payer: BCBS MAPPO |
$167.90
|
| Rate for Payer: BCBS Trust/PPO |
$61.17
|
| Rate for Payer: BCCCP Commercial |
$53.08
|
| Rate for Payer: BCN Commercial |
$57.91
|
| Rate for Payer: BCN Medicare Advantage |
$167.90
|
| Rate for Payer: Cash Price |
$59.76
|
| Rate for Payer: Cash Price |
$59.76
|
| Rate for Payer: Cofinity Commercial |
$70.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$167.90
|
| Rate for Payer: Healthscope Commercial |
$74.70
|
| Rate for Payer: Healthscope Whirlpool |
$72.46
|
| Rate for Payer: Humana Choice PPO Medicare |
$167.90
|
| Rate for Payer: Mclaren Commercial |
$67.23
|
| Rate for Payer: Mclaren Medicaid |
$89.99
|
| Rate for Payer: Mclaren Medicare |
$167.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$176.30
|
| Rate for Payer: Meridian Medicaid |
$94.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$193.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.50
|
| Rate for Payer: Nomi Health Commercial |
$61.25
|
| Rate for Payer: PACE Medicare |
$159.50
|
| Rate for Payer: PACE SWMI |
$167.90
|
| Rate for Payer: PHP Commercial |
$184.69
|
| Rate for Payer: PHP Medicaid |
$89.99
|
| Rate for Payer: PHP Medicare Advantage |
$167.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$65.45
|
| Rate for Payer: Priority Health Medicare |
$167.90
|
| Rate for Payer: Priority Health Narrow Network |
$52.36
|
| Rate for Payer: Railroad Medicare Medicare |
$167.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$65.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$167.90
|
| Rate for Payer: UHC Exchange |
$260.24
|
| Rate for Payer: UHC Medicare Advantage |
$167.90
|
| Rate for Payer: UHCCP DNSP |
$167.90
|
| Rate for Payer: UHCCP Medicaid |
$89.99
|
| Rate for Payer: VA VA |
$167.90
|
|
|
HC FNA IMMEDIATE EVAL ADDITIONAL
|
Facility
|
IP
|
$22.89
|
|
|
Service Code
|
CPT 88177
|
| Hospital Charge Code |
31000002
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$14.88 |
| Max. Negotiated Rate |
$22.89 |
| Rate for Payer: Aetna Commercial |
$20.60
|
| Rate for Payer: ASR ASR |
$22.20
|
| Rate for Payer: ASR Commercial |
$22.20
|
| Rate for Payer: BCBS Trust/PPO |
$18.65
|
| Rate for Payer: BCN Commercial |
$17.75
|
| Rate for Payer: Cash Price |
$18.31
|
| Rate for Payer: Cofinity Commercial |
$21.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.31
|
| Rate for Payer: Healthscope Commercial |
$22.89
|
| Rate for Payer: Healthscope Whirlpool |
$22.20
|
| Rate for Payer: Mclaren Commercial |
$20.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.46
|
| Rate for Payer: Nomi Health Commercial |
$18.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$20.14
|
|
|
HC FNA IMMEDIATE EVAL ADDITIONAL
|
Facility
|
OP
|
$22.89
|
|
|
Service Code
|
CPT 88177
|
| Hospital Charge Code |
31000002
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$9.16 |
| Max. Negotiated Rate |
$28.02 |
| Rate for Payer: Aetna Commercial |
$20.60
|
| Rate for Payer: Aetna Medicare |
$11.44
|
| Rate for Payer: ASR ASR |
$22.20
|
| Rate for Payer: ASR Commercial |
$22.20
|
| Rate for Payer: BCBS Complete |
$9.16
|
| Rate for Payer: BCBS Trust/PPO |
$18.74
|
| Rate for Payer: BCCCP Commercial |
$28.02
|
| Rate for Payer: BCN Commercial |
$17.75
|
| Rate for Payer: Cash Price |
$18.31
|
| Rate for Payer: Cash Price |
$18.31
|
| Rate for Payer: Cofinity Commercial |
$21.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.31
|
| Rate for Payer: Healthscope Commercial |
$22.89
|
| Rate for Payer: Healthscope Whirlpool |
$22.20
|
| Rate for Payer: Mclaren Commercial |
$20.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.46
|
| Rate for Payer: Nomi Health Commercial |
$18.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20.06
|
| Rate for Payer: Priority Health Narrow Network |
$16.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$20.14
|
|
|
HC FNA INTERPRETATION & REPORT
|
Facility
|
OP
|
$221.80
|
|
|
Service Code
|
CPT 88173
|
| Hospital Charge Code |
31100007
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$28.06 |
| Max. Negotiated Rate |
$221.80 |
| Rate for Payer: Aetna Commercial |
$199.62
|
| Rate for Payer: Aetna Medicare |
$52.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$65.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$65.44
|
| Rate for Payer: ASR ASR |
$215.15
|
| Rate for Payer: ASR Commercial |
$215.15
|
| Rate for Payer: BCBS Complete |
$29.46
|
| Rate for Payer: BCBS MAPPO |
$52.35
|
| Rate for Payer: BCBS Trust/PPO |
$181.63
|
| Rate for Payer: BCCCP Commercial |
$160.49
|
| Rate for Payer: BCN Commercial |
$171.96
|
| Rate for Payer: BCN Medicare Advantage |
$52.35
|
| Rate for Payer: Cash Price |
$177.44
|
| Rate for Payer: Cash Price |
$177.44
|
| Rate for Payer: Cofinity Commercial |
$208.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$177.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.35
|
| Rate for Payer: Healthscope Commercial |
$221.80
|
| Rate for Payer: Healthscope Whirlpool |
$215.15
|
| Rate for Payer: Humana Choice PPO Medicare |
$52.35
|
| Rate for Payer: Mclaren Commercial |
$199.62
|
| Rate for Payer: Mclaren Medicaid |
$28.06
|
| Rate for Payer: Mclaren Medicare |
$52.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$54.97
|
| Rate for Payer: Meridian Medicaid |
$29.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$60.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$188.53
|
| Rate for Payer: Nomi Health Commercial |
$181.88
|
| Rate for Payer: PACE Medicare |
$49.73
|
| Rate for Payer: PACE SWMI |
$52.35
|
| Rate for Payer: PHP Commercial |
$57.58
|
| Rate for Payer: PHP Medicaid |
$28.06
|
| Rate for Payer: PHP Medicare Advantage |
$52.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$144.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$194.34
|
| Rate for Payer: Priority Health Medicare |
$52.35
|
| Rate for Payer: Priority Health Narrow Network |
$155.48
|
| Rate for Payer: Railroad Medicare Medicare |
$52.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$195.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$52.35
|
| Rate for Payer: UHC Exchange |
$81.14
|
| Rate for Payer: UHC Medicare Advantage |
$52.35
|
| Rate for Payer: UHCCP DNSP |
$52.35
|
| Rate for Payer: UHCCP Medicaid |
$28.06
|
| Rate for Payer: VA VA |
$52.35
|
|
|
HC FNA INTERPRETATION & REPORT
|
Facility
|
IP
|
$221.80
|
|
|
Service Code
|
CPT 88173
|
| Hospital Charge Code |
31100007
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$144.17 |
| Max. Negotiated Rate |
$221.80 |
| Rate for Payer: Aetna Commercial |
$199.62
|
| Rate for Payer: ASR ASR |
$215.15
|
| Rate for Payer: ASR Commercial |
$215.15
|
| Rate for Payer: BCBS Trust/PPO |
$180.74
|
| Rate for Payer: BCN Commercial |
$171.96
|
| Rate for Payer: Cash Price |
$177.44
|
| Rate for Payer: Cofinity Commercial |
$208.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$177.44
|
| Rate for Payer: Healthscope Commercial |
$221.80
|
| Rate for Payer: Healthscope Whirlpool |
$215.15
|
| Rate for Payer: Mclaren Commercial |
$199.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$188.53
|
| Rate for Payer: Nomi Health Commercial |
$181.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$144.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$195.18
|
|
