|
HC GRAFT EPIDERMAL 1ST 100 SQ CM LEGS, ARMS, TRUNK
|
Facility
|
OP
|
$3,219.34
|
|
|
Service Code
|
CPT 15110
|
| Hospital Charge Code |
76100066
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$956.23 |
| Max. Negotiated Rate |
$3,219.34 |
| Rate for Payer: Aetna Commercial |
$2,897.41
|
| Rate for Payer: Aetna Medicare |
$1,784.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,230.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,230.01
|
| Rate for Payer: ASR ASR |
$3,122.76
|
| Rate for Payer: ASR Commercial |
$3,122.76
|
| Rate for Payer: BCBS Complete |
$1,004.04
|
| Rate for Payer: BCBS MAPPO |
$1,784.01
|
| Rate for Payer: BCBS Trust/PPO |
$2,636.32
|
| Rate for Payer: BCN Commercial |
$2,495.95
|
| Rate for Payer: BCN Medicare Advantage |
$1,784.01
|
| Rate for Payer: Cash Price |
$2,575.47
|
| Rate for Payer: Cash Price |
$2,575.47
|
| Rate for Payer: Cofinity Commercial |
$3,026.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,575.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,784.01
|
| Rate for Payer: Healthscope Commercial |
$3,219.34
|
| Rate for Payer: Healthscope Whirlpool |
$3,122.76
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,784.01
|
| Rate for Payer: Mclaren Commercial |
$2,897.41
|
| Rate for Payer: Mclaren Medicaid |
$956.23
|
| Rate for Payer: Mclaren Medicare |
$1,784.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,873.21
|
| Rate for Payer: Meridian Medicaid |
$1,004.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,051.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,736.44
|
| Rate for Payer: Nomi Health Commercial |
$2,639.86
|
| Rate for Payer: PACE Medicare |
$1,694.81
|
| Rate for Payer: PACE SWMI |
$1,784.01
|
| Rate for Payer: PHP Commercial |
$1,962.41
|
| Rate for Payer: PHP Medicaid |
$956.23
|
| Rate for Payer: PHP Medicare Advantage |
$1,784.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$956.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,092.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,820.79
|
| Rate for Payer: Priority Health Medicare |
$1,784.01
|
| Rate for Payer: Priority Health Narrow Network |
$2,256.76
|
| Rate for Payer: Railroad Medicare Medicare |
$1,784.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,833.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,784.01
|
| Rate for Payer: UHC Exchange |
$2,765.22
|
| Rate for Payer: UHC Medicare Advantage |
$1,784.01
|
| Rate for Payer: UHCCP DNSP |
$1,784.01
|
| Rate for Payer: UHCCP Medicaid |
$956.23
|
| Rate for Payer: VA VA |
$1,784.01
|
|
|
HC GRAFT EPIDERMAL 1ST 100 SQ CM LEGS, ARMS, TRUNK
|
Facility
|
IP
|
$3,219.34
|
|
|
Service Code
|
CPT 15110
|
| Hospital Charge Code |
76100066
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,092.57 |
| Max. Negotiated Rate |
$3,219.34 |
| Rate for Payer: Aetna Commercial |
$2,897.41
|
| Rate for Payer: ASR ASR |
$3,122.76
|
| Rate for Payer: ASR Commercial |
$3,122.76
|
| Rate for Payer: BCBS Trust/PPO |
$2,623.44
|
| Rate for Payer: BCN Commercial |
$2,495.95
|
| Rate for Payer: Cash Price |
$2,575.47
|
| Rate for Payer: Cofinity Commercial |
$3,026.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,575.47
|
| Rate for Payer: Healthscope Commercial |
$3,219.34
|
| Rate for Payer: Healthscope Whirlpool |
$3,122.76
|
| Rate for Payer: Mclaren Commercial |
$2,897.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,736.44
|
| Rate for Payer: Nomi Health Commercial |
$2,639.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,092.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,833.02
|
|
|
HC GRAM STAIN
|
Facility
|
IP
|
$51.31
|
|
|
Service Code
|
CPT 87205
|
| Hospital Charge Code |
30600104
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$33.35 |
| Max. Negotiated Rate |
$51.31 |
| Rate for Payer: Aetna Commercial |
$46.18
|
| Rate for Payer: ASR ASR |
$49.77
|
| Rate for Payer: ASR Commercial |
$49.77
|
| Rate for Payer: BCBS Trust/PPO |
$41.81
|
| Rate for Payer: BCN Commercial |
$39.78
|
| Rate for Payer: Cash Price |
$41.05
|
| Rate for Payer: Cofinity Commercial |
$48.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.05
|
| Rate for Payer: Healthscope Commercial |
$51.31
|
| Rate for Payer: Healthscope Whirlpool |
$49.77
|
| Rate for Payer: Mclaren Commercial |
$46.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.61
|
| Rate for Payer: Nomi Health Commercial |
$42.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.15
|
|
|
HC GRAM STAIN
|
Facility
|
OP
|
$51.31
|
|
|
Service Code
|
CPT 87205
|
| Hospital Charge Code |
30600104
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$2.29 |
| Max. Negotiated Rate |
$51.31 |
| Rate for Payer: Aetna Commercial |
$46.18
|
| Rate for Payer: Aetna Medicare |
$4.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.34
|
| Rate for Payer: ASR ASR |
$49.77
|
| Rate for Payer: ASR Commercial |
$49.77
|
| Rate for Payer: BCBS Complete |
$2.40
|
| Rate for Payer: BCBS MAPPO |
$4.27
|
| Rate for Payer: BCBS Trust/PPO |
$42.02
|
| Rate for Payer: BCN Commercial |
$39.78
|
| Rate for Payer: BCN Medicare Advantage |
$4.27
|
| Rate for Payer: Cash Price |
$41.05
|
| Rate for Payer: Cash Price |
$41.05
|
| Rate for Payer: Cofinity Commercial |
$48.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.27
|
| Rate for Payer: Healthscope Commercial |
$51.31
|
| Rate for Payer: Healthscope Whirlpool |
$49.77
|
| Rate for Payer: Humana Choice PPO Medicare |
$4.27
|
| Rate for Payer: Mclaren Commercial |
$46.18
|
| Rate for Payer: Mclaren Medicaid |
$2.29
|
| Rate for Payer: Mclaren Medicare |
$4.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.48
|
| Rate for Payer: Meridian Medicaid |
$2.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.61
|
| Rate for Payer: Nomi Health Commercial |
$42.07
|
| Rate for Payer: PACE Medicare |
$4.06
|
| Rate for Payer: PACE SWMI |
$4.27
|
| Rate for Payer: PHP Commercial |
$4.70
|
| Rate for Payer: PHP Medicaid |
$2.29
|
| Rate for Payer: PHP Medicare Advantage |
$4.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.96
|
| Rate for Payer: Priority Health Medicare |
$4.27
|
| Rate for Payer: Priority Health Narrow Network |
$35.97
|
| Rate for Payer: Railroad Medicare Medicare |
$4.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.27
|
| Rate for Payer: UHC Exchange |
$6.62
|
| Rate for Payer: UHC Medicare Advantage |
$4.27
|
| Rate for Payer: UHCCP DNSP |
$4.27
|
| Rate for Payer: UHCCP Medicaid |
$2.29
|
| Rate for Payer: VA VA |
$4.27
|
|
|
HC GRANULOCYTES
|
Facility
|
OP
|
$1,925.76
|
|
|
Service Code
|
HCPCS P9050
|
| Hospital Charge Code |
39000057
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$770.30 |
| Max. Negotiated Rate |
$1,925.76 |
| Rate for Payer: Aetna Commercial |
$1,733.18
|
| Rate for Payer: Aetna Medicare |
$962.88
|
| Rate for Payer: ASR ASR |
$1,867.99
|
| Rate for Payer: ASR Commercial |
$1,867.99
|
| Rate for Payer: BCBS Complete |
$770.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,577.00
|
| Rate for Payer: BCN Commercial |
$1,493.04
|
| Rate for Payer: Cash Price |
$1,540.61
|
| Rate for Payer: Cofinity Commercial |
$1,810.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,540.61
|
| Rate for Payer: Healthscope Commercial |
$1,925.76
|
| Rate for Payer: Healthscope Whirlpool |
$1,867.99
|
| Rate for Payer: Mclaren Commercial |
$1,733.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,636.90
|
| Rate for Payer: Nomi Health Commercial |
$1,579.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,251.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,687.35
|
| Rate for Payer: Priority Health Narrow Network |
$1,349.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,694.67
|
|
|
HC GRANULOCYTES
|
Facility
|
IP
|
$1,925.76
|
|
|
Service Code
|
HCPCS P9050
|
| Hospital Charge Code |
39000057
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$1,251.74 |
| Max. Negotiated Rate |
$1,925.76 |
| Rate for Payer: Aetna Commercial |
$1,733.18
|
| Rate for Payer: ASR ASR |
$1,867.99
|
| Rate for Payer: ASR Commercial |
$1,867.99
|
| Rate for Payer: BCBS Trust/PPO |
$1,569.30
|
| Rate for Payer: BCN Commercial |
$1,493.04
|
| Rate for Payer: Cash Price |
$1,540.61
|
| Rate for Payer: Cofinity Commercial |
$1,810.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,540.61
|
| Rate for Payer: Healthscope Commercial |
$1,925.76
|
| Rate for Payer: Healthscope Whirlpool |
$1,867.99
|
| Rate for Payer: Mclaren Commercial |
$1,733.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,636.90
|
| Rate for Payer: Nomi Health Commercial |
$1,579.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,251.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,694.67
|
|
|
HC GRASS ALLERGEN PANEL
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200122
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$25.39 |
| Rate for Payer: Aetna Commercial |
$22.85
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: ASR ASR |
$24.63
|
| Rate for Payer: ASR Commercial |
$24.63
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$20.79
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$23.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$25.39
|
| Rate for Payer: Healthscope Whirlpool |
$24.63
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$22.85
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$5.74
|
| Rate for Payer: PHP Medicaid |
$2.80
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.25
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$17.80
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP DNSP |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.80
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC GRASS ALLERGEN PANEL
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200122
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$25.39 |
| Rate for Payer: Aetna Commercial |
$22.85
|
| Rate for Payer: ASR ASR |
$24.63
|
| Rate for Payer: ASR Commercial |
$24.63
|
| Rate for Payer: BCBS Trust/PPO |
$20.69
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$23.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$25.39
|
| Rate for Payer: Healthscope Whirlpool |
$24.63
|
| Rate for Payer: Mclaren Commercial |
$22.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.34
|
|
|
HC GREAT LAKES DISABILITY FILM(EACH)
|
Facility
|
OP
|
$20.00
|
|
| Hospital Charge Code |
32000267
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$8.00 |
| Max. Negotiated Rate |
$20.00 |
| Rate for Payer: Aetna Commercial |
$18.00
|
| Rate for Payer: Aetna Medicare |
$10.00
|
| Rate for Payer: ASR ASR |
$19.40
|
| Rate for Payer: ASR Commercial |
$19.40
|
| Rate for Payer: BCBS Complete |
$8.00
|
| Rate for Payer: BCBS Trust/PPO |
$16.38
|
| Rate for Payer: BCN Commercial |
$15.51
|
| Rate for Payer: Cash Price |
$16.00
|
| Rate for Payer: Cofinity Commercial |
$18.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.00
|
| Rate for Payer: Healthscope Commercial |
$20.00
|
| Rate for Payer: Healthscope Whirlpool |
$19.40
|
| Rate for Payer: Mclaren Commercial |
$18.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.00
|
| Rate for Payer: Nomi Health Commercial |
$16.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.52
|
| Rate for Payer: Priority Health Narrow Network |
$14.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17.60
|
|
|
HC GREAT LAKES DISABILITY FILM(EACH)
|
Facility
|
IP
|
$20.00
|
|
| Hospital Charge Code |
32000267
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$13.00 |
| Max. Negotiated Rate |
$20.00 |
| Rate for Payer: Aetna Commercial |
$18.00
|
| Rate for Payer: ASR ASR |
$19.40
|
| Rate for Payer: ASR Commercial |
$19.40
|
| Rate for Payer: BCBS Trust/PPO |
$16.30
|
| Rate for Payer: BCN Commercial |
$15.51
|
| Rate for Payer: Cash Price |
$16.00
|
| Rate for Payer: Cofinity Commercial |
$18.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.00
|
| Rate for Payer: Healthscope Commercial |
$20.00
|
| Rate for Payer: Healthscope Whirlpool |
$19.40
|
| Rate for Payer: Mclaren Commercial |
$18.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.00
|
| Rate for Payer: Nomi Health Commercial |
$16.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17.60
|
|
|
HC GROIN/PSEUDO IMAGING BILATERAL
|
Facility
|
IP
|
$1,443.73
|
|
|
Service Code
|
CPT 93925
|
| Hospital Charge Code |
92100027
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$938.42 |
| Max. Negotiated Rate |
$1,443.73 |
| Rate for Payer: Aetna Commercial |
$1,299.36
|
| Rate for Payer: ASR ASR |
$1,400.42
|
| Rate for Payer: ASR Commercial |
$1,400.42
|
| Rate for Payer: BCBS Trust/PPO |
$1,176.50
|
| Rate for Payer: BCN Commercial |
$1,119.32
|
| Rate for Payer: Cash Price |
$1,154.98
|
| Rate for Payer: Cofinity Commercial |
$1,357.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,154.98
|
| Rate for Payer: Healthscope Commercial |
$1,443.73
|
| Rate for Payer: Healthscope Whirlpool |
$1,400.42
|
| Rate for Payer: Mclaren Commercial |
$1,299.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,227.17
|
| Rate for Payer: Nomi Health Commercial |
$1,183.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$938.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,270.48
|
|
|
HC GROIN/PSEUDO IMAGING BILATERAL
|
Facility
|
OP
|
$1,443.73
|
|
|
Service Code
|
CPT 93925
|
| Hospital Charge Code |
92100027
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$126.36 |
| Max. Negotiated Rate |
$1,443.73 |
| Rate for Payer: Aetna Commercial |
$1,299.36
|
| Rate for Payer: Aetna Medicare |
$235.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$294.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$294.68
|
| Rate for Payer: ASR ASR |
$1,400.42
|
| Rate for Payer: ASR Commercial |
$1,400.42
|
| Rate for Payer: BCBS Complete |
$132.67
|
| Rate for Payer: BCBS MAPPO |
$235.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,182.27
|
| Rate for Payer: BCN Commercial |
$1,119.32
|
| Rate for Payer: BCN Medicare Advantage |
$235.74
|
| Rate for Payer: Cash Price |
$1,154.98
|
| Rate for Payer: Cash Price |
$1,154.98
|
| Rate for Payer: Cofinity Commercial |
$1,357.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,154.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.74
|
| Rate for Payer: Healthscope Commercial |
$1,443.73
|
| Rate for Payer: Healthscope Whirlpool |
$1,400.42
|
| Rate for Payer: Humana Choice PPO Medicare |
$235.74
|
| Rate for Payer: Mclaren Commercial |
$1,299.36
|
| Rate for Payer: Mclaren Medicaid |
$126.36
|
| Rate for Payer: Mclaren Medicare |
$235.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.53
|
| Rate for Payer: Meridian Medicaid |
$132.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$271.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,227.17
|
| Rate for Payer: Nomi Health Commercial |
$1,183.86
|
| Rate for Payer: PACE Medicare |
$223.95
|
| Rate for Payer: PACE SWMI |
$235.74
|
| Rate for Payer: PHP Commercial |
$259.31
|
| Rate for Payer: PHP Medicaid |
$126.36
|
| Rate for Payer: PHP Medicare Advantage |
$235.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$938.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,265.00
|
| Rate for Payer: Priority Health Medicare |
$235.74
|
| Rate for Payer: Priority Health Narrow Network |
$1,012.05
|
| Rate for Payer: Railroad Medicare Medicare |
$235.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,270.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.74
|
| Rate for Payer: UHC Exchange |
$365.40
|
| Rate for Payer: UHC Medicare Advantage |
$235.74
|
| Rate for Payer: UHCCP DNSP |
$235.74
|
| Rate for Payer: UHCCP Medicaid |
$126.36
|
| Rate for Payer: VA VA |
$235.74
|
|
|
HC GROIN/PSEUDO IMAGING (R OR L)
|
Facility
|
OP
|
$922.21
|
|
|
Service Code
|
CPT 93926
|
| Hospital Charge Code |
92100026
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$922.21 |
| Rate for Payer: Aetna Commercial |
$829.99
|
| Rate for Payer: Aetna Medicare |
$103.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.64
|
| Rate for Payer: ASR ASR |
$894.54
|
| Rate for Payer: ASR Commercial |
$894.54
|
| Rate for Payer: BCBS Complete |
$58.37
|
| Rate for Payer: BCBS MAPPO |
$103.71
|
| Rate for Payer: BCBS Trust/PPO |
$755.20
|
| Rate for Payer: BCN Commercial |
$714.99
|
| Rate for Payer: BCN Medicare Advantage |
$103.71
|
| Rate for Payer: Cash Price |
$737.77
|
| Rate for Payer: Cash Price |
$737.77
|
| Rate for Payer: Cofinity Commercial |
$866.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$737.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.71
|
| Rate for Payer: Healthscope Commercial |
$922.21
|
| Rate for Payer: Healthscope Whirlpool |
$894.54
|
| Rate for Payer: Humana Choice PPO Medicare |
$103.71
|
| Rate for Payer: Mclaren Commercial |
$829.99
|
| Rate for Payer: Mclaren Medicaid |
$55.59
|
| Rate for Payer: Mclaren Medicare |
$103.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.90
|
| Rate for Payer: Meridian Medicaid |
$58.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$783.88
|
| Rate for Payer: Nomi Health Commercial |
$756.21
|
| Rate for Payer: PACE Medicare |
$98.52
|
| Rate for Payer: PACE SWMI |
$103.71
|
| Rate for Payer: PHP Commercial |
$114.08
|
| Rate for Payer: PHP Medicaid |
$55.59
|
| Rate for Payer: PHP Medicare Advantage |
$103.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$599.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$808.04
|
| Rate for Payer: Priority Health Medicare |
$103.71
|
| Rate for Payer: Priority Health Narrow Network |
$646.47
|
| Rate for Payer: Railroad Medicare Medicare |
$103.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$811.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.71
|
| Rate for Payer: UHC Exchange |
$160.75
|
| Rate for Payer: UHC Medicare Advantage |
$103.71
|
| Rate for Payer: UHCCP DNSP |
$103.71
|
| Rate for Payer: UHCCP Medicaid |
$55.59
|
| Rate for Payer: VA VA |
$103.71
|
|
|
HC GROIN/PSEUDO IMAGING (R OR L)
|
Facility
|
IP
|
$922.21
|
|
|
Service Code
|
CPT 93926
|
| Hospital Charge Code |
92100026
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$599.44 |
| Max. Negotiated Rate |
$922.21 |
| Rate for Payer: Aetna Commercial |
$829.99
|
| Rate for Payer: ASR ASR |
$894.54
|
| Rate for Payer: ASR Commercial |
$894.54
|
| Rate for Payer: BCBS Trust/PPO |
$751.51
|
| Rate for Payer: BCN Commercial |
$714.99
|
| Rate for Payer: Cash Price |
$737.77
|
| Rate for Payer: Cofinity Commercial |
$866.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$737.77
|
| Rate for Payer: Healthscope Commercial |
$922.21
|
| Rate for Payer: Healthscope Whirlpool |
$894.54
|
| Rate for Payer: Mclaren Commercial |
$829.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$783.88
|
| Rate for Payer: Nomi Health Commercial |
$756.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$599.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$811.54
|
|
|
HC GROSHONG REPAIR KIT
|
Facility
|
OP
|
$464.18
|
|
| Hospital Charge Code |
27200125
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$185.67 |
| Max. Negotiated Rate |
$464.18 |
| Rate for Payer: Aetna Commercial |
$417.76
|
| Rate for Payer: Aetna Medicare |
$232.09
|
| Rate for Payer: ASR ASR |
$450.25
|
| Rate for Payer: ASR Commercial |
$450.25
|
| Rate for Payer: BCBS Complete |
$185.67
|
| Rate for Payer: BCBS Trust/PPO |
$380.12
|
| Rate for Payer: BCN Commercial |
$359.88
|
| Rate for Payer: Cash Price |
$371.34
|
| Rate for Payer: Cofinity Commercial |
$436.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$371.34
|
| Rate for Payer: Healthscope Commercial |
$464.18
|
| Rate for Payer: Healthscope Whirlpool |
$450.25
|
| Rate for Payer: Mclaren Commercial |
$417.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$394.55
|
| Rate for Payer: Nomi Health Commercial |
$380.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$301.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$406.71
|
| Rate for Payer: Priority Health Narrow Network |
$325.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$408.48
|
|
|
HC GROSHONG REPAIR KIT
|
Facility
|
IP
|
$464.18
|
|
| Hospital Charge Code |
27200125
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$301.72 |
| Max. Negotiated Rate |
$464.18 |
| Rate for Payer: Aetna Commercial |
$417.76
|
| Rate for Payer: ASR ASR |
$450.25
|
| Rate for Payer: ASR Commercial |
$450.25
|
| Rate for Payer: BCBS Trust/PPO |
$378.26
|
| Rate for Payer: BCN Commercial |
$359.88
|
| Rate for Payer: Cash Price |
$371.34
|
| Rate for Payer: Cofinity Commercial |
$436.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$371.34
|
| Rate for Payer: Healthscope Commercial |
$464.18
|
| Rate for Payer: Healthscope Whirlpool |
$450.25
|
| Rate for Payer: Mclaren Commercial |
$417.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$394.55
|
| Rate for Payer: Nomi Health Commercial |
$380.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$301.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$408.48
|
|
|
HC GROUP B STREP, AMPLIFIED
|
Facility
|
OP
|
$104.04
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600210
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$104.04 |
| Rate for Payer: Aetna Commercial |
$93.64
|
| Rate for Payer: Aetna Medicare |
$35.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: ASR ASR |
$100.92
|
| Rate for Payer: ASR Commercial |
$100.92
|
| Rate for Payer: BCBS Complete |
$19.75
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$85.20
|
| Rate for Payer: BCN Commercial |
$80.66
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$83.23
|
| Rate for Payer: Cash Price |
$83.23
|
| Rate for Payer: Cofinity Commercial |
$97.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$104.04
|
| Rate for Payer: Healthscope Whirlpool |
$100.92
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$93.64
|
| Rate for Payer: Mclaren Medicaid |
$18.81
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$19.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.43
|
| Rate for Payer: Nomi Health Commercial |
$85.31
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$38.60
|
| Rate for Payer: PHP Medicaid |
$18.81
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$91.16
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$72.93
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$91.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$54.39
|
| Rate for Payer: UHC Medicare Advantage |
$35.09
|
| Rate for Payer: UHCCP DNSP |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$18.81
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC GROUP B STREP, AMPLIFIED
|
Facility
|
IP
|
$104.04
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600210
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$67.63 |
| Max. Negotiated Rate |
$104.04 |
| Rate for Payer: Aetna Commercial |
$93.64
|
| Rate for Payer: ASR ASR |
$100.92
|
| Rate for Payer: ASR Commercial |
$100.92
|
| Rate for Payer: BCBS Trust/PPO |
$84.78
|
| Rate for Payer: BCN Commercial |
$80.66
|
| Rate for Payer: Cash Price |
$83.23
|
| Rate for Payer: Cofinity Commercial |
$97.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.23
|
| Rate for Payer: Healthscope Commercial |
$104.04
|
| Rate for Payer: Healthscope Whirlpool |
$100.92
|
| Rate for Payer: Mclaren Commercial |
$93.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.43
|
| Rate for Payer: Nomi Health Commercial |
$85.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$91.56
|
|
|
HC GROUP CAREGIVER TRAINING
|
Facility
|
OP
|
$53.04
|
|
|
Service Code
|
CPT 97552
|
| Hospital Charge Code |
42000067
|
| Min. Negotiated Rate |
$21.22 |
| Max. Negotiated Rate |
$53.04 |
| Rate for Payer: Aetna Commercial |
$47.74
|
| Rate for Payer: Aetna Medicare |
$26.52
|
| Rate for Payer: ASR ASR |
$51.45
|
| Rate for Payer: ASR Commercial |
$51.45
|
| Rate for Payer: BCBS Complete |
$21.22
|
| Rate for Payer: BCBS Trust/PPO |
$43.43
|
| Rate for Payer: BCN Commercial |
$41.12
|
| Rate for Payer: Cash Price |
$42.43
|
| Rate for Payer: Cofinity Commercial |
$49.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.43
|
| Rate for Payer: Healthscope Commercial |
$53.04
|
| Rate for Payer: Healthscope Whirlpool |
$51.45
|
| Rate for Payer: Mclaren Commercial |
$47.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.08
|
| Rate for Payer: Nomi Health Commercial |
$43.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$46.47
|
| Rate for Payer: Priority Health Narrow Network |
$37.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.68
|
|
|
HC GROUP CAREGIVER TRAINING
|
Facility
|
IP
|
$53.04
|
|
|
Service Code
|
CPT 97552
|
| Hospital Charge Code |
42000067
|
| Min. Negotiated Rate |
$34.48 |
| Max. Negotiated Rate |
$53.04 |
| Rate for Payer: Aetna Commercial |
$47.74
|
| Rate for Payer: ASR ASR |
$51.45
|
| Rate for Payer: ASR Commercial |
$51.45
|
| Rate for Payer: BCBS Trust/PPO |
$43.22
|
| Rate for Payer: BCN Commercial |
$41.12
|
| Rate for Payer: Cash Price |
$42.43
|
| Rate for Payer: Cofinity Commercial |
$49.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.43
|
| Rate for Payer: Healthscope Commercial |
$53.04
|
| Rate for Payer: Healthscope Whirlpool |
$51.45
|
| Rate for Payer: Mclaren Commercial |
$47.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.08
|
| Rate for Payer: Nomi Health Commercial |
$43.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.68
|
|
|
HC GROUP PSYCHOTHERAPY
|
Facility
|
OP
|
$98.84
|
|
|
Service Code
|
CPT 90853
|
| Hospital Charge Code |
91500001
|
|
Hospital Revenue Code
|
915
|
| Min. Negotiated Rate |
$48.35 |
| Max. Negotiated Rate |
$139.83 |
| Rate for Payer: Aetna Commercial |
$88.96
|
| Rate for Payer: Aetna Medicare |
$90.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$112.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$112.76
|
| Rate for Payer: ASR ASR |
$95.87
|
| Rate for Payer: ASR Commercial |
$95.87
|
| Rate for Payer: BCBS Complete |
$50.77
|
| Rate for Payer: BCBS MAPPO |
$90.21
|
| Rate for Payer: BCBS Trust/PPO |
$80.94
|
| Rate for Payer: BCN Commercial |
$76.63
|
| Rate for Payer: BCN Medicare Advantage |
$90.21
|
| Rate for Payer: Cash Price |
$79.07
|
| Rate for Payer: Cash Price |
$79.07
|
| Rate for Payer: Cofinity Commercial |
$92.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$90.21
|
| Rate for Payer: Healthscope Commercial |
$98.84
|
| Rate for Payer: Healthscope Whirlpool |
$95.87
|
| Rate for Payer: Humana Choice PPO Medicare |
$90.21
|
| Rate for Payer: Mclaren Commercial |
$88.96
|
| Rate for Payer: Mclaren Medicaid |
$48.35
|
| Rate for Payer: Mclaren Medicare |
$90.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$94.72
|
| Rate for Payer: Meridian Medicaid |
$50.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$103.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.01
|
| Rate for Payer: Nomi Health Commercial |
$81.05
|
| Rate for Payer: PACE Medicare |
$85.70
|
| Rate for Payer: PACE SWMI |
$90.21
|
| Rate for Payer: PHP Commercial |
$99.23
|
| Rate for Payer: PHP Medicaid |
$48.35
|
| Rate for Payer: PHP Medicare Advantage |
$90.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$86.60
|
| Rate for Payer: Priority Health Medicare |
$90.21
|
| Rate for Payer: Priority Health Narrow Network |
$69.29
|
| Rate for Payer: Railroad Medicare Medicare |
$90.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$86.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$90.21
|
| Rate for Payer: UHC Exchange |
$139.83
|
| Rate for Payer: UHC Medicare Advantage |
$90.21
|
| Rate for Payer: UHCCP DNSP |
$90.21
|
| Rate for Payer: UHCCP Medicaid |
$48.35
|
| Rate for Payer: VA VA |
$90.21
|
|
|
HC GROUP PSYCHOTHERAPY
|
Facility
|
IP
|
$98.84
|
|
|
Service Code
|
CPT 90853
|
| Hospital Charge Code |
91500001
|
|
Hospital Revenue Code
|
915
|
| Min. Negotiated Rate |
$64.25 |
| Max. Negotiated Rate |
$98.84 |
| Rate for Payer: Aetna Commercial |
$88.96
|
| Rate for Payer: ASR ASR |
$95.87
|
| Rate for Payer: ASR Commercial |
$95.87
|
| Rate for Payer: BCBS Trust/PPO |
$80.54
|
| Rate for Payer: BCN Commercial |
$76.63
|
| Rate for Payer: Cash Price |
$79.07
|
| Rate for Payer: Cofinity Commercial |
$92.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.07
|
| Rate for Payer: Healthscope Commercial |
$98.84
|
| Rate for Payer: Healthscope Whirlpool |
$95.87
|
| Rate for Payer: Mclaren Commercial |
$88.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.01
|
| Rate for Payer: Nomi Health Commercial |
$81.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$86.98
|
|
|
HC GROUP SESSION 30 MIN RD G0109
|
Facility
|
OP
|
$63.09
|
|
|
Service Code
|
HCPCS G0109
|
| Hospital Charge Code |
94200028
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$25.24 |
| Max. Negotiated Rate |
$63.09 |
| Rate for Payer: Aetna Commercial |
$56.78
|
| Rate for Payer: Aetna Medicare |
$31.55
|
| Rate for Payer: ASR ASR |
$61.20
|
| Rate for Payer: ASR Commercial |
$61.20
|
| Rate for Payer: BCBS Complete |
$25.24
|
| Rate for Payer: BCBS Trust/PPO |
$51.66
|
| Rate for Payer: BCN Commercial |
$48.91
|
| Rate for Payer: Cash Price |
$50.47
|
| Rate for Payer: Cofinity Commercial |
$59.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.47
|
| Rate for Payer: Healthscope Commercial |
$63.09
|
| Rate for Payer: Healthscope Whirlpool |
$61.20
|
| Rate for Payer: Mclaren Commercial |
$56.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.63
|
| Rate for Payer: Nomi Health Commercial |
$51.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.01
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$55.28
|
| Rate for Payer: Priority Health Narrow Network |
$44.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$55.52
|
|
|
HC GROUP SESSION 30 MIN RD G0109
|
Facility
|
IP
|
$63.09
|
|
|
Service Code
|
HCPCS G0109
|
| Hospital Charge Code |
94200028
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$41.01 |
| Max. Negotiated Rate |
$63.09 |
| Rate for Payer: Aetna Commercial |
$56.78
|
| Rate for Payer: ASR ASR |
$61.20
|
| Rate for Payer: ASR Commercial |
$61.20
|
| Rate for Payer: BCBS Trust/PPO |
$51.41
|
| Rate for Payer: BCN Commercial |
$48.91
|
| Rate for Payer: Cash Price |
$50.47
|
| Rate for Payer: Cofinity Commercial |
$59.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.47
|
| Rate for Payer: Healthscope Commercial |
$63.09
|
| Rate for Payer: Healthscope Whirlpool |
$61.20
|
| Rate for Payer: Mclaren Commercial |
$56.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.63
|
| Rate for Payer: Nomi Health Commercial |
$51.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$55.52
|
|
|
HC GROUP THERAPEUTIC PROCEDURES
|
Facility
|
IP
|
$107.21
|
|
|
Service Code
|
CPT 97150
|
| Hospital Charge Code |
42000027
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$69.69 |
| Max. Negotiated Rate |
$107.21 |
| Rate for Payer: Aetna Commercial |
$96.49
|
| Rate for Payer: ASR ASR |
$103.99
|
| Rate for Payer: ASR Commercial |
$103.99
|
| Rate for Payer: BCBS Trust/PPO |
$87.37
|
| Rate for Payer: BCN Commercial |
$83.12
|
| Rate for Payer: Cash Price |
$85.77
|
| Rate for Payer: Cofinity Commercial |
$100.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.77
|
| Rate for Payer: Healthscope Commercial |
$107.21
|
| Rate for Payer: Healthscope Whirlpool |
$103.99
|
| Rate for Payer: Mclaren Commercial |
$96.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.13
|
| Rate for Payer: Nomi Health Commercial |
$87.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$94.34
|
|
