|
HC FLOSEAL HEMOSTATIC MATRIX
|
Facility
|
IP
|
$745.52
|
|
| Hospital Charge Code |
27200123
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$484.59 |
| Max. Negotiated Rate |
$745.52 |
| Rate for Payer: Aetna Commercial |
$670.97
|
| Rate for Payer: ASR ASR |
$723.15
|
| Rate for Payer: ASR Commercial |
$723.15
|
| Rate for Payer: BCBS Trust/PPO |
$607.52
|
| Rate for Payer: BCN Commercial |
$578.00
|
| Rate for Payer: Cash Price |
$596.42
|
| Rate for Payer: Cofinity Commercial |
$700.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$596.42
|
| Rate for Payer: Healthscope Commercial |
$745.52
|
| Rate for Payer: Healthscope Whirlpool |
$723.15
|
| Rate for Payer: Mclaren Commercial |
$670.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$633.69
|
| Rate for Payer: Nomi Health Commercial |
$611.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$484.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$656.06
|
|
|
HC FLOSEAL HEMOSTATIC MATRIX
|
Facility
|
OP
|
$745.52
|
|
| Hospital Charge Code |
27200123
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$298.21 |
| Max. Negotiated Rate |
$745.52 |
| Rate for Payer: Aetna Commercial |
$670.97
|
| Rate for Payer: Aetna Medicare |
$372.76
|
| Rate for Payer: ASR ASR |
$723.15
|
| Rate for Payer: ASR Commercial |
$723.15
|
| Rate for Payer: BCBS Complete |
$298.21
|
| Rate for Payer: BCBS Trust/PPO |
$610.51
|
| Rate for Payer: BCN Commercial |
$578.00
|
| Rate for Payer: Cash Price |
$596.42
|
| Rate for Payer: Cofinity Commercial |
$700.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$596.42
|
| Rate for Payer: Healthscope Commercial |
$745.52
|
| Rate for Payer: Healthscope Whirlpool |
$723.15
|
| Rate for Payer: Mclaren Commercial |
$670.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$633.69
|
| Rate for Payer: Nomi Health Commercial |
$611.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$484.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$653.22
|
| Rate for Payer: Priority Health Narrow Network |
$522.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$656.06
|
|
|
HC FLOW CYTOMETRY, CELL SURFACE, ADDL
|
Facility
|
IP
|
$61.85
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100041
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$40.20 |
| Max. Negotiated Rate |
$61.85 |
| Rate for Payer: Aetna Commercial |
$55.66
|
| Rate for Payer: ASR ASR |
$59.99
|
| Rate for Payer: ASR Commercial |
$59.99
|
| Rate for Payer: BCBS Trust/PPO |
$50.40
|
| Rate for Payer: BCN Commercial |
$47.95
|
| Rate for Payer: Cash Price |
$49.48
|
| Rate for Payer: Cofinity Commercial |
$58.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.48
|
| Rate for Payer: Healthscope Commercial |
$61.85
|
| Rate for Payer: Healthscope Whirlpool |
$59.99
|
| Rate for Payer: Mclaren Commercial |
$55.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.57
|
| Rate for Payer: Nomi Health Commercial |
$50.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$54.43
|
|
|
HC FLOW CYTOMETRY, CELL SURFACE, ADDL
|
Facility
|
OP
|
$61.85
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100041
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$24.74 |
| Max. Negotiated Rate |
$61.85 |
| Rate for Payer: Aetna Commercial |
$55.66
|
| Rate for Payer: Aetna Medicare |
$30.93
|
| Rate for Payer: ASR ASR |
$59.99
|
| Rate for Payer: ASR Commercial |
$59.99
|
| Rate for Payer: BCBS Complete |
$24.74
|
| Rate for Payer: BCBS Trust/PPO |
$50.65
|
| Rate for Payer: BCN Commercial |
$47.95
|
| Rate for Payer: Cash Price |
$49.48
|
| Rate for Payer: Cofinity Commercial |
$58.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.48
|
| Rate for Payer: Healthscope Commercial |
$61.85
|
| Rate for Payer: Healthscope Whirlpool |
$59.99
|
| Rate for Payer: Mclaren Commercial |
$55.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.57
|
| Rate for Payer: Nomi Health Commercial |
$50.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$54.19
|
| Rate for Payer: Priority Health Narrow Network |
$43.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$54.43
|
|
|
HC FLOW CYTOMETRY, CELL SURFACE, FIRST
|
Facility
|
OP
|
$203.86
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31100040
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$132.51 |
| Max. Negotiated Rate |
$543.79 |
| Rate for Payer: Aetna Commercial |
$183.47
|
| Rate for Payer: Aetna Medicare |
$350.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$438.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$438.54
|
| Rate for Payer: ASR ASR |
$197.74
|
| Rate for Payer: ASR Commercial |
$197.74
|
| Rate for Payer: BCBS Complete |
$197.45
|
| Rate for Payer: BCBS MAPPO |
$350.83
|
| Rate for Payer: BCBS Trust/PPO |
$166.94
|
| Rate for Payer: BCN Commercial |
$158.05
|
| Rate for Payer: BCN Medicare Advantage |
$350.83
|
| Rate for Payer: Cash Price |
$163.09
|
| Rate for Payer: Cash Price |
$163.09
|
| Rate for Payer: Cofinity Commercial |
$191.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$350.83
|
| Rate for Payer: Healthscope Commercial |
$203.86
|
| Rate for Payer: Healthscope Whirlpool |
$197.74
|
| Rate for Payer: Humana Choice PPO Medicare |
$350.83
|
| Rate for Payer: Mclaren Commercial |
$183.47
|
| Rate for Payer: Mclaren Medicaid |
$188.04
|
| Rate for Payer: Mclaren Medicare |
$350.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$368.37
|
| Rate for Payer: Meridian Medicaid |
$197.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$403.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$173.28
|
| Rate for Payer: Nomi Health Commercial |
$167.17
|
| Rate for Payer: PACE Medicare |
$333.29
|
| Rate for Payer: PACE SWMI |
$350.83
|
| Rate for Payer: PHP Commercial |
$385.91
|
| Rate for Payer: PHP Medicaid |
$188.04
|
| Rate for Payer: PHP Medicare Advantage |
$350.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$188.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$132.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$178.62
|
| Rate for Payer: Priority Health Medicare |
$350.83
|
| Rate for Payer: Priority Health Narrow Network |
$142.91
|
| Rate for Payer: Railroad Medicare Medicare |
$350.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$179.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$350.83
|
| Rate for Payer: UHC Exchange |
$543.79
|
| Rate for Payer: UHC Medicare Advantage |
$350.83
|
| Rate for Payer: UHCCP DNSP |
$350.83
|
| Rate for Payer: UHCCP Medicaid |
$188.04
|
| Rate for Payer: VA VA |
$350.83
|
|
|
HC FLOW CYTOMETRY, CELL SURFACE, FIRST
|
Facility
|
IP
|
$203.86
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31100040
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$132.51 |
| Max. Negotiated Rate |
$203.86 |
| Rate for Payer: Aetna Commercial |
$183.47
|
| Rate for Payer: ASR ASR |
$197.74
|
| Rate for Payer: ASR Commercial |
$197.74
|
| Rate for Payer: BCBS Trust/PPO |
$166.13
|
| Rate for Payer: BCN Commercial |
$158.05
|
| Rate for Payer: Cash Price |
$163.09
|
| Rate for Payer: Cofinity Commercial |
$191.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.09
|
| Rate for Payer: Healthscope Commercial |
$203.86
|
| Rate for Payer: Healthscope Whirlpool |
$197.74
|
| Rate for Payer: Mclaren Commercial |
$183.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$173.28
|
| Rate for Payer: Nomi Health Commercial |
$167.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$132.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$179.40
|
|
|
HC FLUID CREATININE
|
Facility
|
IP
|
$20.81
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
30100498
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.53 |
| Max. Negotiated Rate |
$20.81 |
| Rate for Payer: Aetna Commercial |
$18.73
|
| Rate for Payer: ASR ASR |
$20.19
|
| Rate for Payer: ASR Commercial |
$20.19
|
| Rate for Payer: BCBS Trust/PPO |
$16.96
|
| Rate for Payer: BCN Commercial |
$16.13
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$19.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Healthscope Commercial |
$20.81
|
| Rate for Payer: Healthscope Whirlpool |
$20.19
|
| Rate for Payer: Mclaren Commercial |
$18.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: Nomi Health Commercial |
$17.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.31
|
|
|
HC FLUID CREATININE
|
Facility
|
OP
|
$20.81
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
30100498
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.78 |
| Max. Negotiated Rate |
$20.81 |
| Rate for Payer: Aetna Commercial |
$18.73
|
| Rate for Payer: Aetna Medicare |
$5.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.47
|
| Rate for Payer: ASR ASR |
$20.19
|
| Rate for Payer: ASR Commercial |
$20.19
|
| Rate for Payer: BCBS Complete |
$2.92
|
| Rate for Payer: BCBS MAPPO |
$5.18
|
| Rate for Payer: BCBS Trust/PPO |
$17.04
|
| Rate for Payer: BCN Commercial |
$16.13
|
| Rate for Payer: BCN Medicare Advantage |
$5.18
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$19.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.18
|
| Rate for Payer: Healthscope Commercial |
$20.81
|
| Rate for Payer: Healthscope Whirlpool |
$20.19
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.18
|
| Rate for Payer: Mclaren Commercial |
$18.73
|
| Rate for Payer: Mclaren Medicaid |
$2.78
|
| Rate for Payer: Mclaren Medicare |
$5.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.44
|
| Rate for Payer: Meridian Medicaid |
$2.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: Nomi Health Commercial |
$17.06
|
| 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 |
$2.78
|
| Rate for Payer: PHP Medicare Advantage |
$5.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.23
|
| Rate for Payer: Priority Health Medicare |
$5.18
|
| Rate for Payer: Priority Health Narrow Network |
$14.59
|
| Rate for Payer: Railroad Medicare Medicare |
$5.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.18
|
| Rate for Payer: UHC Exchange |
$8.03
|
| Rate for Payer: UHC Medicare Advantage |
$5.18
|
| Rate for Payer: UHCCP DNSP |
$5.18
|
| Rate for Payer: UHCCP Medicaid |
$2.78
|
| Rate for Payer: VA VA |
$5.18
|
|
|
HC FLUIDOTHERAPY
|
Facility
|
IP
|
$108.20
|
|
|
Service Code
|
CPT 97022
|
| Hospital Charge Code |
42000051
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$70.33 |
| Max. Negotiated Rate |
$108.20 |
| Rate for Payer: Aetna Commercial |
$97.38
|
| Rate for Payer: ASR ASR |
$104.95
|
| Rate for Payer: ASR Commercial |
$104.95
|
| Rate for Payer: BCBS Trust/PPO |
$88.17
|
| Rate for Payer: BCN Commercial |
$83.89
|
| Rate for Payer: Cash Price |
$86.56
|
| Rate for Payer: Cofinity Commercial |
$101.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.56
|
| Rate for Payer: Healthscope Commercial |
$108.20
|
| Rate for Payer: Healthscope Whirlpool |
$104.95
|
| Rate for Payer: Mclaren Commercial |
$97.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.97
|
| Rate for Payer: Nomi Health Commercial |
$88.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$95.22
|
|
|
HC FLUIDOTHERAPY
|
Facility
|
OP
|
$108.20
|
|
|
Service Code
|
CPT 97022
|
| Hospital Charge Code |
42000051
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$43.28 |
| Max. Negotiated Rate |
$108.20 |
| Rate for Payer: Aetna Commercial |
$97.38
|
| Rate for Payer: Aetna Medicare |
$54.10
|
| Rate for Payer: ASR ASR |
$104.95
|
| Rate for Payer: ASR Commercial |
$104.95
|
| Rate for Payer: BCBS Complete |
$43.28
|
| Rate for Payer: BCBS Trust/PPO |
$88.60
|
| Rate for Payer: BCN Commercial |
$83.89
|
| Rate for Payer: Cash Price |
$86.56
|
| Rate for Payer: Cofinity Commercial |
$101.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.56
|
| Rate for Payer: Healthscope Commercial |
$108.20
|
| Rate for Payer: Healthscope Whirlpool |
$104.95
|
| Rate for Payer: Mclaren Commercial |
$97.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.97
|
| Rate for Payer: Nomi Health Commercial |
$88.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$94.80
|
| Rate for Payer: Priority Health Narrow Network |
$75.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$95.22
|
|
|
HC FLUID SMEAR AND INTERPRETATION
|
Facility
|
OP
|
$111.95
|
|
|
Service Code
|
CPT 88108
|
| Hospital Charge Code |
31100002
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$20.52 |
| Max. Negotiated Rate |
$111.95 |
| Rate for Payer: Aetna Commercial |
$100.75
|
| Rate for Payer: Aetna Medicare |
$38.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$47.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$47.85
|
| Rate for Payer: ASR ASR |
$108.59
|
| Rate for Payer: ASR Commercial |
$108.59
|
| Rate for Payer: BCBS Complete |
$21.54
|
| Rate for Payer: BCBS MAPPO |
$38.28
|
| Rate for Payer: BCBS Trust/PPO |
$91.68
|
| Rate for Payer: BCN Commercial |
$86.79
|
| Rate for Payer: BCN Medicare Advantage |
$38.28
|
| Rate for Payer: Cash Price |
$89.56
|
| Rate for Payer: Cash Price |
$89.56
|
| Rate for Payer: Cofinity Commercial |
$105.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.28
|
| Rate for Payer: Healthscope Commercial |
$111.95
|
| Rate for Payer: Healthscope Whirlpool |
$108.59
|
| Rate for Payer: Humana Choice PPO Medicare |
$38.28
|
| Rate for Payer: Mclaren Commercial |
$100.75
|
| Rate for Payer: Mclaren Medicaid |
$20.52
|
| Rate for Payer: Mclaren Medicare |
$38.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.19
|
| Rate for Payer: Meridian Medicaid |
$21.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95.16
|
| Rate for Payer: Nomi Health Commercial |
$91.80
|
| Rate for Payer: PACE Medicare |
$36.37
|
| Rate for Payer: PACE SWMI |
$38.28
|
| Rate for Payer: PHP Commercial |
$42.11
|
| Rate for Payer: PHP Medicaid |
$20.52
|
| Rate for Payer: PHP Medicare Advantage |
$38.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$98.09
|
| Rate for Payer: Priority Health Medicare |
$38.28
|
| Rate for Payer: Priority Health Narrow Network |
$78.48
|
| Rate for Payer: Railroad Medicare Medicare |
$38.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$98.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.28
|
| Rate for Payer: UHC Exchange |
$59.33
|
| Rate for Payer: UHC Medicare Advantage |
$38.28
|
| Rate for Payer: UHCCP DNSP |
$38.28
|
| Rate for Payer: UHCCP Medicaid |
$20.52
|
| Rate for Payer: VA VA |
$38.28
|
|
|
HC FLUID SMEAR AND INTERPRETATION
|
Facility
|
IP
|
$111.95
|
|
|
Service Code
|
CPT 88108
|
| Hospital Charge Code |
31100002
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$72.77 |
| Max. Negotiated Rate |
$111.95 |
| Rate for Payer: Aetna Commercial |
$100.75
|
| Rate for Payer: ASR ASR |
$108.59
|
| Rate for Payer: ASR Commercial |
$108.59
|
| Rate for Payer: BCBS Trust/PPO |
$91.23
|
| Rate for Payer: BCN Commercial |
$86.79
|
| Rate for Payer: Cash Price |
$89.56
|
| Rate for Payer: Cofinity Commercial |
$105.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.56
|
| Rate for Payer: Healthscope Commercial |
$111.95
|
| Rate for Payer: Healthscope Whirlpool |
$108.59
|
| Rate for Payer: Mclaren Commercial |
$100.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95.16
|
| Rate for Payer: Nomi Health Commercial |
$91.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$98.52
|
|
|
HC FLUID SMEAR WITH INTERPRETATION
|
Facility
|
IP
|
$111.95
|
|
|
Service Code
|
CPT 88108
|
| Hospital Charge Code |
31100030
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$72.77 |
| Max. Negotiated Rate |
$111.95 |
| Rate for Payer: Aetna Commercial |
$100.75
|
| Rate for Payer: ASR ASR |
$108.59
|
| Rate for Payer: ASR Commercial |
$108.59
|
| Rate for Payer: BCBS Trust/PPO |
$91.23
|
| Rate for Payer: BCN Commercial |
$86.79
|
| Rate for Payer: Cash Price |
$89.56
|
| Rate for Payer: Cofinity Commercial |
$105.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.56
|
| Rate for Payer: Healthscope Commercial |
$111.95
|
| Rate for Payer: Healthscope Whirlpool |
$108.59
|
| Rate for Payer: Mclaren Commercial |
$100.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95.16
|
| Rate for Payer: Nomi Health Commercial |
$91.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$98.52
|
|
|
HC FLUID SMEAR WITH INTERPRETATION
|
Facility
|
OP
|
$111.95
|
|
|
Service Code
|
CPT 88108
|
| Hospital Charge Code |
31100030
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$20.52 |
| Max. Negotiated Rate |
$111.95 |
| Rate for Payer: Aetna Commercial |
$100.75
|
| Rate for Payer: Aetna Medicare |
$38.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$47.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$47.85
|
| Rate for Payer: ASR ASR |
$108.59
|
| Rate for Payer: ASR Commercial |
$108.59
|
| Rate for Payer: BCBS Complete |
$21.54
|
| Rate for Payer: BCBS MAPPO |
$38.28
|
| Rate for Payer: BCBS Trust/PPO |
$91.68
|
| Rate for Payer: BCN Commercial |
$86.79
|
| Rate for Payer: BCN Medicare Advantage |
$38.28
|
| Rate for Payer: Cash Price |
$89.56
|
| Rate for Payer: Cash Price |
$89.56
|
| Rate for Payer: Cofinity Commercial |
$105.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.28
|
| Rate for Payer: Healthscope Commercial |
$111.95
|
| Rate for Payer: Healthscope Whirlpool |
$108.59
|
| Rate for Payer: Humana Choice PPO Medicare |
$38.28
|
| Rate for Payer: Mclaren Commercial |
$100.75
|
| Rate for Payer: Mclaren Medicaid |
$20.52
|
| Rate for Payer: Mclaren Medicare |
$38.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.19
|
| Rate for Payer: Meridian Medicaid |
$21.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95.16
|
| Rate for Payer: Nomi Health Commercial |
$91.80
|
| Rate for Payer: PACE Medicare |
$36.37
|
| Rate for Payer: PACE SWMI |
$38.28
|
| Rate for Payer: PHP Commercial |
$42.11
|
| Rate for Payer: PHP Medicaid |
$20.52
|
| Rate for Payer: PHP Medicare Advantage |
$38.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$98.09
|
| Rate for Payer: Priority Health Medicare |
$38.28
|
| Rate for Payer: Priority Health Narrow Network |
$78.48
|
| Rate for Payer: Railroad Medicare Medicare |
$38.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$98.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.28
|
| Rate for Payer: UHC Exchange |
$59.33
|
| Rate for Payer: UHC Medicare Advantage |
$38.28
|
| Rate for Payer: UHCCP DNSP |
$38.28
|
| Rate for Payer: UHCCP Medicaid |
$20.52
|
| Rate for Payer: VA VA |
$38.28
|
|
|
HC FLUTTER VALVE SUPPLY
|
Facility
|
OP
|
$118.69
|
|
| Hospital Charge Code |
27000078
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$47.48 |
| Max. Negotiated Rate |
$118.69 |
| Rate for Payer: Aetna Commercial |
$106.82
|
| Rate for Payer: Aetna Medicare |
$59.34
|
| Rate for Payer: ASR ASR |
$115.13
|
| Rate for Payer: ASR Commercial |
$115.13
|
| Rate for Payer: BCBS Complete |
$47.48
|
| Rate for Payer: BCBS Trust/PPO |
$97.20
|
| 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: Priority Health HMO/PPO/Tiered Network |
$104.00
|
| Rate for Payer: Priority Health Narrow Network |
$83.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$104.45
|
|
|
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 |
$10.40 |
| Max. Negotiated Rate |
$26.01 |
| Rate for Payer: Aetna Commercial |
$23.41
|
| Rate for Payer: Aetna Medicare |
$13.01
|
| 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: 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 |
$22.79
|
| Rate for Payer: Priority Health Narrow Network |
$18.23
|
| 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 |
$367.80 |
| Max. Negotiated Rate |
$1,063.61 |
| Rate for Payer: Aetna Commercial |
$817.44
|
| Rate for Payer: Aetna Medicare |
$686.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$857.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$857.75
|
| Rate for Payer: ASR ASR |
$881.02
|
| Rate for Payer: ASR Commercial |
$881.02
|
| Rate for Payer: BCBS Complete |
$386.19
|
| Rate for Payer: BCBS MAPPO |
$686.20
|
| Rate for Payer: BCBS Trust/PPO |
$743.78
|
| Rate for Payer: BCN Commercial |
$704.18
|
| Rate for Payer: BCN Medicare Advantage |
$686.20
|
| 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 |
$686.20
|
| Rate for Payer: Healthscope Commercial |
$908.27
|
| Rate for Payer: Healthscope Whirlpool |
$881.02
|
| Rate for Payer: Humana Choice PPO Medicare |
$686.20
|
| Rate for Payer: Mclaren Commercial |
$817.44
|
| Rate for Payer: Mclaren Medicaid |
$367.80
|
| Rate for Payer: Mclaren Medicare |
$686.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$720.51
|
| Rate for Payer: Meridian Medicaid |
$386.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$789.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$772.03
|
| Rate for Payer: Nomi Health Commercial |
$744.78
|
| Rate for Payer: PACE Medicare |
$651.89
|
| Rate for Payer: PACE SWMI |
$686.20
|
| Rate for Payer: PHP Commercial |
$754.82
|
| Rate for Payer: PHP Medicaid |
$367.80
|
| Rate for Payer: PHP Medicare Advantage |
$686.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$590.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$795.83
|
| Rate for Payer: Priority Health Medicare |
$686.20
|
| Rate for Payer: Priority Health Narrow Network |
$636.70
|
| Rate for Payer: Railroad Medicare Medicare |
$686.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$799.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$686.20
|
| Rate for Payer: UHC Exchange |
$1,063.61
|
| Rate for Payer: UHC Medicare Advantage |
$686.20
|
| Rate for Payer: UHCCP DNSP |
$686.20
|
| Rate for Payer: UHCCP Medicaid |
$367.80
|
| Rate for Payer: VA VA |
$686.20
|
|
|
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 |
$367.80 |
| Max. Negotiated Rate |
$1,063.61 |
| Rate for Payer: Aetna Commercial |
$817.44
|
| Rate for Payer: Aetna Medicare |
$686.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$857.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$857.75
|
| Rate for Payer: ASR ASR |
$881.02
|
| Rate for Payer: ASR Commercial |
$881.02
|
| Rate for Payer: BCBS Complete |
$386.19
|
| Rate for Payer: BCBS MAPPO |
$686.20
|
| Rate for Payer: BCBS Trust/PPO |
$743.78
|
| Rate for Payer: BCN Commercial |
$704.18
|
| Rate for Payer: BCN Medicare Advantage |
$686.20
|
| 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 |
$686.20
|
| Rate for Payer: Healthscope Commercial |
$908.27
|
| Rate for Payer: Healthscope Whirlpool |
$881.02
|
| Rate for Payer: Humana Choice PPO Medicare |
$686.20
|
| Rate for Payer: Mclaren Commercial |
$817.44
|
| Rate for Payer: Mclaren Medicaid |
$367.80
|
| Rate for Payer: Mclaren Medicare |
$686.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$720.51
|
| Rate for Payer: Meridian Medicaid |
$386.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$789.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$772.03
|
| Rate for Payer: Nomi Health Commercial |
$744.78
|
| Rate for Payer: PACE Medicare |
$651.89
|
| Rate for Payer: PACE SWMI |
$686.20
|
| Rate for Payer: PHP Commercial |
$754.82
|
| Rate for Payer: PHP Medicaid |
$367.80
|
| Rate for Payer: PHP Medicare Advantage |
$686.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$590.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$795.83
|
| Rate for Payer: Priority Health Medicare |
$686.20
|
| Rate for Payer: Priority Health Narrow Network |
$636.70
|
| Rate for Payer: Railroad Medicare Medicare |
$686.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$799.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$686.20
|
| Rate for Payer: UHC Exchange |
$1,063.61
|
| Rate for Payer: UHC Medicare Advantage |
$686.20
|
| Rate for Payer: UHCCP DNSP |
$686.20
|
| Rate for Payer: UHCCP Medicaid |
$367.80
|
| Rate for Payer: VA VA |
$686.20
|
|
|
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 |
$367.80 |
| Max. Negotiated Rate |
$1,063.61 |
| Rate for Payer: Aetna Commercial |
$817.44
|
| Rate for Payer: Aetna Medicare |
$686.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$857.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$857.75
|
| Rate for Payer: ASR ASR |
$881.02
|
| Rate for Payer: ASR Commercial |
$881.02
|
| Rate for Payer: BCBS Complete |
$386.19
|
| Rate for Payer: BCBS MAPPO |
$686.20
|
| Rate for Payer: BCBS Trust/PPO |
$743.78
|
| Rate for Payer: BCN Commercial |
$704.18
|
| Rate for Payer: BCN Medicare Advantage |
$686.20
|
| 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 |
$686.20
|
| Rate for Payer: Healthscope Commercial |
$908.27
|
| Rate for Payer: Healthscope Whirlpool |
$881.02
|
| Rate for Payer: Humana Choice PPO Medicare |
$686.20
|
| Rate for Payer: Mclaren Commercial |
$817.44
|
| Rate for Payer: Mclaren Medicaid |
$367.80
|
| Rate for Payer: Mclaren Medicare |
$686.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$720.51
|
| Rate for Payer: Meridian Medicaid |
$386.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$789.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$772.03
|
| Rate for Payer: Nomi Health Commercial |
$744.78
|
| Rate for Payer: PACE Medicare |
$651.89
|
| Rate for Payer: PACE SWMI |
$686.20
|
| Rate for Payer: PHP Commercial |
$754.82
|
| Rate for Payer: PHP Medicaid |
$367.80
|
| Rate for Payer: PHP Medicare Advantage |
$686.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$590.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$795.83
|
| Rate for Payer: Priority Health Medicare |
$686.20
|
| Rate for Payer: Priority Health Narrow Network |
$636.70
|
| Rate for Payer: Railroad Medicare Medicare |
$686.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$799.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$686.20
|
| Rate for Payer: UHC Exchange |
$1,063.61
|
| Rate for Payer: UHC Medicare Advantage |
$686.20
|
| Rate for Payer: UHCCP DNSP |
$686.20
|
| Rate for Payer: UHCCP Medicaid |
$367.80
|
| Rate for Payer: VA VA |
$686.20
|
|
|
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
|
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
|
|
