|
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 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 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 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 |
$48.58 |
| Max. Negotiated Rate |
$140.48 |
| Rate for Payer: Aetna Commercial |
$88.96
|
| Rate for Payer: Aetna Medicare |
$90.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$113.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$113.29
|
| Rate for Payer: ASR ASR |
$95.87
|
| Rate for Payer: ASR Commercial |
$95.87
|
| Rate for Payer: BCBS Complete |
$51.01
|
| Rate for Payer: BCBS MAPPO |
$90.63
|
| Rate for Payer: BCBS Trust/PPO |
$80.94
|
| Rate for Payer: BCN Commercial |
$76.63
|
| Rate for Payer: BCN Medicare Advantage |
$90.63
|
| 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 |
$90.63
|
| Rate for Payer: Healthscope Commercial |
$98.84
|
| Rate for Payer: Healthscope Whirlpool |
$95.87
|
| Rate for Payer: Humana Choice PPO Medicare |
$90.63
|
| Rate for Payer: Mclaren Commercial |
$88.96
|
| Rate for Payer: Mclaren Medicaid |
$48.58
|
| Rate for Payer: Mclaren Medicare |
$90.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$95.16
|
| Rate for Payer: Meridian Medicaid |
$51.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$104.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.01
|
| Rate for Payer: Nomi Health Commercial |
$81.05
|
| Rate for Payer: PACE Medicare |
$86.10
|
| Rate for Payer: PACE SWMI |
$90.63
|
| Rate for Payer: PHP Commercial |
$99.69
|
| Rate for Payer: PHP Medicaid |
$48.58
|
| Rate for Payer: PHP Medicare Advantage |
$90.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.58
|
| 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 |
$90.63
|
| Rate for Payer: Priority Health Narrow Network |
$69.29
|
| Rate for Payer: Railroad Medicare Medicare |
$90.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$86.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$90.63
|
| Rate for Payer: UHC Exchange |
$140.48
|
| Rate for Payer: UHC Medicare Advantage |
$90.63
|
| Rate for Payer: UHCCP DNSP |
$90.63
|
| Rate for Payer: UHCCP Medicaid |
$48.58
|
| Rate for Payer: VA VA |
$90.63
|
|
|
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
|
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 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 |
$31.54
|
| 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: 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 |
$40.62
|
| Rate for Payer: Priority Health Narrow Network |
$32.50
|
| 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
|
|
|
HC GROUP THERAPEUTIC PROCEDURES
|
Facility
|
OP
|
$107.21
|
|
|
Service Code
|
CPT 97150
|
| Hospital Charge Code |
42000027
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$32.50 |
| Max. Negotiated Rate |
$107.21 |
| Rate for Payer: Aetna Commercial |
$96.49
|
| Rate for Payer: Aetna Medicare |
$53.60
|
| Rate for Payer: ASR ASR |
$103.99
|
| Rate for Payer: ASR Commercial |
$103.99
|
| Rate for Payer: BCBS Complete |
$42.88
|
| Rate for Payer: BCBS Trust/PPO |
$87.79
|
| Rate for Payer: BCN Commercial |
$83.12
|
| Rate for Payer: Cash Price |
$85.77
|
| 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: Priority Health HMO/PPO/Tiered Network |
$40.62
|
| Rate for Payer: Priority Health Narrow Network |
$32.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$94.34
|
|
|
HC GROWTH HORMONE HGH
|
Facility
|
OP
|
$66.30
|
|
|
Service Code
|
CPT 83003
|
| Hospital Charge Code |
30100752
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.94 |
| Max. Negotiated Rate |
$107.61 |
| Rate for Payer: Aetna Commercial |
$59.67
|
| Rate for Payer: Aetna Medicare |
$16.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.84
|
| Rate for Payer: ASR ASR |
$64.31
|
| Rate for Payer: ASR Commercial |
$64.31
|
| Rate for Payer: BCBS Complete |
$9.38
|
| Rate for Payer: BCBS MAPPO |
$16.67
|
| Rate for Payer: BCBS Trust/PPO |
$54.29
|
| Rate for Payer: BCN Commercial |
$51.40
|
| Rate for Payer: BCN Medicare Advantage |
$16.67
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cofinity Commercial |
$62.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.67
|
| Rate for Payer: Healthscope Commercial |
$66.30
|
| Rate for Payer: Healthscope Whirlpool |
$64.31
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.67
|
| Rate for Payer: Mclaren Commercial |
$59.67
|
| Rate for Payer: Mclaren Medicaid |
$8.94
|
| Rate for Payer: Mclaren Medicare |
$16.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.50
|
| Rate for Payer: Meridian Medicaid |
$9.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.36
|
| Rate for Payer: Nomi Health Commercial |
$54.37
|
| Rate for Payer: PACE Medicare |
$15.84
|
| Rate for Payer: PACE SWMI |
$16.67
|
| Rate for Payer: PHP Commercial |
$18.34
|
| Rate for Payer: PHP Medicaid |
$8.94
|
| Rate for Payer: PHP Medicare Advantage |
$16.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$107.61
|
| Rate for Payer: Priority Health Medicare |
$16.67
|
| Rate for Payer: Priority Health Narrow Network |
$86.09
|
| Rate for Payer: Railroad Medicare Medicare |
$16.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$58.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.67
|
| Rate for Payer: UHC Exchange |
$25.84
|
| Rate for Payer: UHC Medicare Advantage |
$16.67
|
| Rate for Payer: UHCCP DNSP |
$16.67
|
| Rate for Payer: UHCCP Medicaid |
$8.94
|
| Rate for Payer: VA VA |
$16.67
|
|
|
HC GROWTH HORMONE HGH
|
Facility
|
IP
|
$66.30
|
|
|
Service Code
|
CPT 83003
|
| Hospital Charge Code |
30100752
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$43.10 |
| Max. Negotiated Rate |
$66.30 |
| Rate for Payer: Aetna Commercial |
$59.67
|
| Rate for Payer: ASR ASR |
$64.31
|
| Rate for Payer: ASR Commercial |
$64.31
|
| Rate for Payer: BCBS Trust/PPO |
$54.03
|
| Rate for Payer: BCN Commercial |
$51.40
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cofinity Commercial |
$62.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.04
|
| Rate for Payer: Healthscope Commercial |
$66.30
|
| Rate for Payer: Healthscope Whirlpool |
$64.31
|
| Rate for Payer: Mclaren Commercial |
$59.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.36
|
| Rate for Payer: Nomi Health Commercial |
$54.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$58.34
|
|
|
HC GROWTH HORMONE STIMULATION TEST
|
Facility
|
IP
|
$676.26
|
|
|
Service Code
|
CPT 96365
|
| Hospital Charge Code |
76100362
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$439.57 |
| Max. Negotiated Rate |
$676.26 |
| Rate for Payer: Aetna Commercial |
$608.63
|
| Rate for Payer: ASR ASR |
$655.97
|
| Rate for Payer: ASR Commercial |
$655.97
|
| Rate for Payer: BCBS Trust/PPO |
$551.08
|
| Rate for Payer: BCN Commercial |
$524.30
|
| Rate for Payer: Cash Price |
$541.01
|
| Rate for Payer: Cofinity Commercial |
$635.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$541.01
|
| Rate for Payer: Healthscope Commercial |
$676.26
|
| Rate for Payer: Healthscope Whirlpool |
$655.97
|
| Rate for Payer: Mclaren Commercial |
$608.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$574.82
|
| Rate for Payer: Nomi Health Commercial |
$554.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$439.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$595.11
|
|
|
HC GROWTH HORMONE STIMULATION TEST
|
Facility
|
OP
|
$676.26
|
|
|
Service Code
|
CPT 96365
|
| Hospital Charge Code |
76100362
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$110.65 |
| Max. Negotiated Rate |
$676.26 |
| Rate for Payer: Aetna Commercial |
$608.63
|
| Rate for Payer: Aetna Medicare |
$206.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$258.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$258.04
|
| Rate for Payer: ASR ASR |
$655.97
|
| Rate for Payer: ASR Commercial |
$655.97
|
| Rate for Payer: BCBS Complete |
$116.18
|
| Rate for Payer: BCBS MAPPO |
$206.43
|
| Rate for Payer: BCBS Trust/PPO |
$553.79
|
| Rate for Payer: BCN Commercial |
$524.30
|
| Rate for Payer: BCN Medicare Advantage |
$206.43
|
| Rate for Payer: Cash Price |
$541.01
|
| Rate for Payer: Cash Price |
$541.01
|
| Rate for Payer: Cofinity Commercial |
$635.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$541.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$206.43
|
| Rate for Payer: Healthscope Commercial |
$676.26
|
| Rate for Payer: Healthscope Whirlpool |
$655.97
|
| Rate for Payer: Humana Choice PPO Medicare |
$206.43
|
| Rate for Payer: Mclaren Commercial |
$608.63
|
| Rate for Payer: Mclaren Medicaid |
$110.65
|
| Rate for Payer: Mclaren Medicare |
$206.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$216.75
|
| Rate for Payer: Meridian Medicaid |
$116.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$237.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$574.82
|
| Rate for Payer: Nomi Health Commercial |
$554.53
|
| Rate for Payer: PACE Medicare |
$196.11
|
| Rate for Payer: PACE SWMI |
$206.43
|
| Rate for Payer: PHP Commercial |
$227.07
|
| Rate for Payer: PHP Medicaid |
$110.65
|
| Rate for Payer: PHP Medicare Advantage |
$206.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$110.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$439.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$282.18
|
| Rate for Payer: Priority Health Medicare |
$206.43
|
| Rate for Payer: Priority Health Narrow Network |
$225.74
|
| Rate for Payer: Railroad Medicare Medicare |
$206.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$595.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$206.43
|
| Rate for Payer: UHC Exchange |
$319.97
|
| Rate for Payer: UHC Medicare Advantage |
$206.43
|
| Rate for Payer: UHCCP DNSP |
$206.43
|
| Rate for Payer: UHCCP Medicaid |
$110.65
|
| Rate for Payer: VA VA |
$206.43
|
|
|
HC GSU OBSERVATION PER HOUR
|
Facility
|
IP
|
$145.08
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200011
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$94.30 |
| Max. Negotiated Rate |
$145.08 |
| Rate for Payer: Aetna Commercial |
$130.57
|
| Rate for Payer: ASR ASR |
$140.73
|
| Rate for Payer: ASR Commercial |
$140.73
|
| Rate for Payer: BCBS Trust/PPO |
$118.23
|
| Rate for Payer: BCN Commercial |
$112.48
|
| Rate for Payer: Cash Price |
$116.06
|
| Rate for Payer: Cofinity Commercial |
$136.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.06
|
| Rate for Payer: Healthscope Commercial |
$145.08
|
| Rate for Payer: Healthscope Whirlpool |
$140.73
|
| Rate for Payer: Mclaren Commercial |
$130.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.32
|
| Rate for Payer: Nomi Health Commercial |
$118.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$127.67
|
|
|
HC GSU OBSERVATION PER HOUR
|
Facility
|
OP
|
$145.08
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200011
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$49.38 |
| Max. Negotiated Rate |
$145.08 |
| Rate for Payer: Aetna Commercial |
$130.57
|
| Rate for Payer: Aetna Medicare |
$72.54
|
| Rate for Payer: ASR ASR |
$140.73
|
| Rate for Payer: ASR Commercial |
$140.73
|
| Rate for Payer: BCBS Complete |
$58.03
|
| Rate for Payer: BCBS Trust/PPO |
$118.81
|
| Rate for Payer: BCN Commercial |
$112.48
|
| Rate for Payer: Cash Price |
$116.06
|
| Rate for Payer: Cash Price |
$116.06
|
| Rate for Payer: Cofinity Commercial |
$136.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.06
|
| Rate for Payer: Healthscope Commercial |
$145.08
|
| Rate for Payer: Healthscope Whirlpool |
$140.73
|
| Rate for Payer: Mclaren Commercial |
$130.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.32
|
| Rate for Payer: Nomi Health Commercial |
$118.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$61.72
|
| Rate for Payer: Priority Health Narrow Network |
$49.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$127.67
|
|
|
HC G TUBE REPLACEMENT
|
Facility
|
OP
|
$576.50
|
|
| Hospital Charge Code |
36000046
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$230.60 |
| Max. Negotiated Rate |
$576.50 |
| Rate for Payer: Aetna Commercial |
$518.85
|
| Rate for Payer: Aetna Medicare |
$288.25
|
| Rate for Payer: ASR ASR |
$559.20
|
| Rate for Payer: ASR Commercial |
$559.20
|
| Rate for Payer: BCBS Complete |
$230.60
|
| Rate for Payer: BCBS Trust/PPO |
$472.10
|
| Rate for Payer: BCN Commercial |
$446.96
|
| Rate for Payer: Cash Price |
$461.20
|
| Rate for Payer: Cofinity Commercial |
$541.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$461.20
|
| Rate for Payer: Healthscope Commercial |
$576.50
|
| Rate for Payer: Healthscope Whirlpool |
$559.20
|
| Rate for Payer: Mclaren Commercial |
$518.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$490.02
|
| Rate for Payer: Nomi Health Commercial |
$472.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$374.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$505.13
|
| Rate for Payer: Priority Health Narrow Network |
$404.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$507.32
|
|
|
HC G TUBE REPLACEMENT
|
Facility
|
IP
|
$576.50
|
|
| Hospital Charge Code |
36000046
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$374.72 |
| Max. Negotiated Rate |
$576.50 |
| Rate for Payer: Aetna Commercial |
$518.85
|
| Rate for Payer: ASR ASR |
$559.20
|
| Rate for Payer: ASR Commercial |
$559.20
|
| Rate for Payer: BCBS Trust/PPO |
$469.79
|
| Rate for Payer: BCN Commercial |
$446.96
|
| Rate for Payer: Cash Price |
$461.20
|
| Rate for Payer: Cofinity Commercial |
$541.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$461.20
|
| Rate for Payer: Healthscope Commercial |
$576.50
|
| Rate for Payer: Healthscope Whirlpool |
$559.20
|
| Rate for Payer: Mclaren Commercial |
$518.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$490.02
|
| Rate for Payer: Nomi Health Commercial |
$472.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$374.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$507.32
|
|
|
HC GUIDANT CAROTID STENT
|
Facility
|
IP
|
$5,821.41
|
|
| Hospital Charge Code |
27800044
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,783.92 |
| Max. Negotiated Rate |
$5,821.41 |
| Rate for Payer: Aetna Commercial |
$5,239.27
|
| Rate for Payer: ASR ASR |
$5,646.77
|
| Rate for Payer: ASR Commercial |
$5,646.77
|
| Rate for Payer: BCBS Trust/PPO |
$4,743.87
|
| Rate for Payer: BCN Commercial |
$4,513.34
|
| Rate for Payer: Cash Price |
$4,657.13
|
| Rate for Payer: Cofinity Commercial |
$5,472.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,657.13
|
| Rate for Payer: Healthscope Commercial |
$5,821.41
|
| Rate for Payer: Healthscope Whirlpool |
$5,646.77
|
| Rate for Payer: Mclaren Commercial |
$5,239.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,948.20
|
| Rate for Payer: Nomi Health Commercial |
$4,773.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,783.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,122.84
|
|
|
HC GUIDANT CAROTID STENT
|
Facility
|
OP
|
$5,821.41
|
|
| Hospital Charge Code |
27800044
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,328.56 |
| Max. Negotiated Rate |
$5,821.41 |
| Rate for Payer: Aetna Commercial |
$5,239.27
|
| Rate for Payer: Aetna Medicare |
$2,910.70
|
| Rate for Payer: ASR ASR |
$5,646.77
|
| Rate for Payer: ASR Commercial |
$5,646.77
|
| Rate for Payer: BCBS Complete |
$2,328.56
|
| Rate for Payer: BCBS Trust/PPO |
$4,767.15
|
| Rate for Payer: BCN Commercial |
$4,513.34
|
| Rate for Payer: Cash Price |
$4,657.13
|
| Rate for Payer: Cofinity Commercial |
$5,472.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,657.13
|
| Rate for Payer: Healthscope Commercial |
$5,821.41
|
| Rate for Payer: Healthscope Whirlpool |
$5,646.77
|
| Rate for Payer: Mclaren Commercial |
$5,239.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,948.20
|
| Rate for Payer: Nomi Health Commercial |
$4,773.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,783.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,100.72
|
| Rate for Payer: Priority Health Narrow Network |
$4,080.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,122.84
|
|
|
HC GUIDANT CRT LEAD
|
Facility
|
IP
|
$10,353.00
|
|
|
Service Code
|
HCPCS C1900
|
| Hospital Charge Code |
27800013
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,729.45 |
| Max. Negotiated Rate |
$10,353.00 |
| Rate for Payer: Aetna Commercial |
$9,317.70
|
| Rate for Payer: ASR ASR |
$10,042.41
|
| Rate for Payer: ASR Commercial |
$10,042.41
|
| Rate for Payer: BCBS Trust/PPO |
$8,436.66
|
| Rate for Payer: BCN Commercial |
$8,026.68
|
| Rate for Payer: Cash Price |
$8,282.40
|
| Rate for Payer: Cofinity Commercial |
$9,731.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,282.40
|
| Rate for Payer: Healthscope Commercial |
$10,353.00
|
| Rate for Payer: Healthscope Whirlpool |
$10,042.41
|
| Rate for Payer: Mclaren Commercial |
$9,317.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,800.05
|
| Rate for Payer: Nomi Health Commercial |
$8,489.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,729.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9,110.64
|
|
|
HC GUIDANT CRT LEAD
|
Facility
|
OP
|
$10,353.00
|
|
|
Service Code
|
HCPCS C1900
|
| Hospital Charge Code |
27800013
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,141.20 |
| Max. Negotiated Rate |
$10,353.00 |
| Rate for Payer: Aetna Commercial |
$9,317.70
|
| Rate for Payer: Aetna Medicare |
$5,176.50
|
| Rate for Payer: ASR ASR |
$10,042.41
|
| Rate for Payer: ASR Commercial |
$10,042.41
|
| Rate for Payer: BCBS Complete |
$4,141.20
|
| Rate for Payer: BCBS Trust/PPO |
$8,478.07
|
| Rate for Payer: BCN Commercial |
$8,026.68
|
| Rate for Payer: Cash Price |
$8,282.40
|
| Rate for Payer: Cofinity Commercial |
$9,731.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,282.40
|
| Rate for Payer: Healthscope Commercial |
$10,353.00
|
| Rate for Payer: Healthscope Whirlpool |
$10,042.41
|
| Rate for Payer: Mclaren Commercial |
$9,317.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,800.05
|
| Rate for Payer: Nomi Health Commercial |
$8,489.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,729.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,071.30
|
| Rate for Payer: Priority Health Narrow Network |
$7,257.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9,110.64
|
|
|
HC GUIDANT TACHY (ICD) LEAD
|
Facility
|
OP
|
$13,252.86
|
|
|
Service Code
|
HCPCS C1895
|
| Hospital Charge Code |
27800014
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,301.14 |
| Max. Negotiated Rate |
$13,252.86 |
| Rate for Payer: Aetna Commercial |
$11,927.57
|
| Rate for Payer: Aetna Medicare |
$6,626.43
|
| Rate for Payer: ASR ASR |
$12,855.27
|
| Rate for Payer: ASR Commercial |
$12,855.27
|
| Rate for Payer: BCBS Complete |
$5,301.14
|
| Rate for Payer: BCBS Trust/PPO |
$10,852.77
|
| Rate for Payer: BCN Commercial |
$10,274.94
|
| Rate for Payer: Cash Price |
$10,602.29
|
| Rate for Payer: Cofinity Commercial |
$12,457.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,602.29
|
| Rate for Payer: Healthscope Commercial |
$13,252.86
|
| Rate for Payer: Healthscope Whirlpool |
$12,855.27
|
| Rate for Payer: Mclaren Commercial |
$11,927.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,264.93
|
| Rate for Payer: Nomi Health Commercial |
$10,867.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,614.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11,612.16
|
| Rate for Payer: Priority Health Narrow Network |
$9,290.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11,662.52
|
|
|
HC GUIDANT TACHY (ICD) LEAD
|
Facility
|
IP
|
$13,252.86
|
|
|
Service Code
|
HCPCS C1895
|
| Hospital Charge Code |
27800014
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8,614.36 |
| Max. Negotiated Rate |
$13,252.86 |
| Rate for Payer: Aetna Commercial |
$11,927.57
|
| Rate for Payer: ASR ASR |
$12,855.27
|
| Rate for Payer: ASR Commercial |
$12,855.27
|
| Rate for Payer: BCBS Trust/PPO |
$10,799.76
|
| Rate for Payer: BCN Commercial |
$10,274.94
|
| Rate for Payer: Cash Price |
$10,602.29
|
| Rate for Payer: Cofinity Commercial |
$12,457.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,602.29
|
| Rate for Payer: Healthscope Commercial |
$13,252.86
|
| Rate for Payer: Healthscope Whirlpool |
$12,855.27
|
| Rate for Payer: Mclaren Commercial |
$11,927.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,264.93
|
| Rate for Payer: Nomi Health Commercial |
$10,867.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,614.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11,662.52
|
|
