|
HC HDR IR 192 BRACHY SOURCE NSTRD
|
Facility
|
OP
|
$562.41
|
|
|
Service Code
|
HCPCS C1717
|
| Hospital Charge Code |
27800090
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$178.99 |
| Max. Negotiated Rate |
$562.41 |
| Rate for Payer: Aetna Commercial |
$506.17
|
| Rate for Payer: Aetna Medicare |
$333.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$417.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$417.41
|
| Rate for Payer: ASR ASR |
$545.54
|
| Rate for Payer: ASR Commercial |
$545.54
|
| Rate for Payer: BCBS Complete |
$187.94
|
| Rate for Payer: BCBS MAPPO |
$333.93
|
| Rate for Payer: BCBS Trust/PPO |
$460.56
|
| Rate for Payer: BCN Commercial |
$436.04
|
| Rate for Payer: BCN Medicare Advantage |
$333.93
|
| Rate for Payer: Cash Price |
$449.93
|
| Rate for Payer: Cash Price |
$449.93
|
| Rate for Payer: Cofinity Commercial |
$528.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$449.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$333.93
|
| Rate for Payer: Healthscope Commercial |
$562.41
|
| Rate for Payer: Healthscope Whirlpool |
$545.54
|
| Rate for Payer: Humana Choice PPO Medicare |
$333.93
|
| Rate for Payer: Mclaren Commercial |
$506.17
|
| Rate for Payer: Mclaren Medicaid |
$178.99
|
| Rate for Payer: Mclaren Medicare |
$333.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$350.63
|
| Rate for Payer: Meridian Medicaid |
$187.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$384.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$478.05
|
| Rate for Payer: Nomi Health Commercial |
$461.18
|
| Rate for Payer: PACE Medicare |
$317.23
|
| Rate for Payer: PACE SWMI |
$333.93
|
| Rate for Payer: PHP Commercial |
$367.32
|
| Rate for Payer: PHP Medicaid |
$178.99
|
| Rate for Payer: PHP Medicare Advantage |
$333.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$178.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$365.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$492.78
|
| Rate for Payer: Priority Health Medicare |
$333.93
|
| Rate for Payer: Priority Health Narrow Network |
$394.25
|
| Rate for Payer: Railroad Medicare Medicare |
$333.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$494.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$333.93
|
| Rate for Payer: UHC Exchange |
$517.59
|
| Rate for Payer: UHC Medicare Advantage |
$333.93
|
| Rate for Payer: UHCCP DNSP |
$333.93
|
| Rate for Payer: UHCCP Medicaid |
$178.99
|
| Rate for Payer: VA VA |
$333.93
|
|
|
HC HDR OVER 12 CHANNELS
|
Facility
|
OP
|
$2,438.89
|
|
|
Service Code
|
CPT 77772
|
| Hospital Charge Code |
33300057
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$362.69 |
| Max. Negotiated Rate |
$2,438.89 |
| Rate for Payer: Aetna Commercial |
$2,195.00
|
| Rate for Payer: Aetna Medicare |
$676.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$845.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$845.83
|
| Rate for Payer: ASR ASR |
$2,365.72
|
| Rate for Payer: ASR Commercial |
$2,365.72
|
| Rate for Payer: BCBS Complete |
$380.82
|
| Rate for Payer: BCBS MAPPO |
$676.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,997.21
|
| Rate for Payer: BCN Commercial |
$1,890.87
|
| Rate for Payer: BCN Medicare Advantage |
$676.66
|
| Rate for Payer: Cash Price |
$1,951.11
|
| Rate for Payer: Cash Price |
$1,951.11
|
| Rate for Payer: Cofinity Commercial |
$2,292.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,951.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$676.66
|
| Rate for Payer: Healthscope Commercial |
$2,438.89
|
| Rate for Payer: Healthscope Whirlpool |
$2,365.72
|
| Rate for Payer: Humana Choice PPO Medicare |
$676.66
|
| Rate for Payer: Mclaren Commercial |
$2,195.00
|
| Rate for Payer: Mclaren Medicaid |
$362.69
|
| Rate for Payer: Mclaren Medicare |
$676.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$710.49
|
| Rate for Payer: Meridian Medicaid |
$380.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$778.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,073.06
|
| Rate for Payer: Nomi Health Commercial |
$1,999.89
|
| Rate for Payer: PACE Medicare |
$642.83
|
| Rate for Payer: PACE SWMI |
$676.66
|
| Rate for Payer: PHP Commercial |
$744.33
|
| Rate for Payer: PHP Medicaid |
$362.69
|
| Rate for Payer: PHP Medicare Advantage |
$676.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$362.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,585.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,136.96
|
| Rate for Payer: Priority Health Medicare |
$676.66
|
| Rate for Payer: Priority Health Narrow Network |
$1,709.66
|
| Rate for Payer: Railroad Medicare Medicare |
$676.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,146.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$676.66
|
| Rate for Payer: UHC Exchange |
$1,048.82
|
| Rate for Payer: UHC Medicare Advantage |
$676.66
|
| Rate for Payer: UHCCP DNSP |
$676.66
|
| Rate for Payer: UHCCP Medicaid |
$362.69
|
| Rate for Payer: VA VA |
$676.66
|
|
|
HC HDR OVER 12 CHANNELS
|
Facility
|
IP
|
$2,438.89
|
|
|
Service Code
|
CPT 77772
|
| Hospital Charge Code |
33300057
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$1,585.28 |
| Max. Negotiated Rate |
$2,438.89 |
| Rate for Payer: Aetna Commercial |
$2,195.00
|
| Rate for Payer: ASR ASR |
$2,365.72
|
| Rate for Payer: ASR Commercial |
$2,365.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,987.45
|
| Rate for Payer: BCN Commercial |
$1,890.87
|
| Rate for Payer: Cash Price |
$1,951.11
|
| Rate for Payer: Cofinity Commercial |
$2,292.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,951.11
|
| Rate for Payer: Healthscope Commercial |
$2,438.89
|
| Rate for Payer: Healthscope Whirlpool |
$2,365.72
|
| Rate for Payer: Mclaren Commercial |
$2,195.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,073.06
|
| Rate for Payer: Nomi Health Commercial |
$1,999.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,585.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,146.22
|
|
|
HC HDR SKIN SURFACE 1 CHANNEL
|
Facility
|
OP
|
$481.76
|
|
|
Service Code
|
CPT 77767
|
| Hospital Charge Code |
33300053
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$137.47 |
| Max. Negotiated Rate |
$481.76 |
| Rate for Payer: Aetna Commercial |
$433.58
|
| Rate for Payer: Aetna Medicare |
$256.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$320.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$320.60
|
| Rate for Payer: ASR ASR |
$467.31
|
| Rate for Payer: ASR Commercial |
$467.31
|
| Rate for Payer: BCBS Complete |
$144.35
|
| Rate for Payer: BCBS MAPPO |
$256.48
|
| Rate for Payer: BCBS Trust/PPO |
$394.51
|
| Rate for Payer: BCN Commercial |
$373.51
|
| Rate for Payer: BCN Medicare Advantage |
$256.48
|
| Rate for Payer: Cash Price |
$385.41
|
| Rate for Payer: Cash Price |
$385.41
|
| Rate for Payer: Cofinity Commercial |
$452.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$385.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$256.48
|
| Rate for Payer: Healthscope Commercial |
$481.76
|
| Rate for Payer: Healthscope Whirlpool |
$467.31
|
| Rate for Payer: Humana Choice PPO Medicare |
$256.48
|
| Rate for Payer: Mclaren Commercial |
$433.58
|
| Rate for Payer: Mclaren Medicaid |
$137.47
|
| Rate for Payer: Mclaren Medicare |
$256.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$269.30
|
| Rate for Payer: Meridian Medicaid |
$144.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$294.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$409.50
|
| Rate for Payer: Nomi Health Commercial |
$395.04
|
| Rate for Payer: PACE Medicare |
$243.66
|
| Rate for Payer: PACE SWMI |
$256.48
|
| Rate for Payer: PHP Commercial |
$282.13
|
| Rate for Payer: PHP Medicaid |
$137.47
|
| Rate for Payer: PHP Medicare Advantage |
$256.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$137.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$313.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$422.12
|
| Rate for Payer: Priority Health Medicare |
$256.48
|
| Rate for Payer: Priority Health Narrow Network |
$337.71
|
| Rate for Payer: Railroad Medicare Medicare |
$256.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$423.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$256.48
|
| Rate for Payer: UHC Exchange |
$397.54
|
| Rate for Payer: UHC Medicare Advantage |
$256.48
|
| Rate for Payer: UHCCP DNSP |
$256.48
|
| Rate for Payer: UHCCP Medicaid |
$137.47
|
| Rate for Payer: VA VA |
$256.48
|
|
|
HC HDR SKIN SURFACE 1 CHANNEL
|
Facility
|
IP
|
$481.76
|
|
|
Service Code
|
CPT 77767
|
| Hospital Charge Code |
33300053
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$313.14 |
| Max. Negotiated Rate |
$481.76 |
| Rate for Payer: Aetna Commercial |
$433.58
|
| Rate for Payer: ASR ASR |
$467.31
|
| Rate for Payer: ASR Commercial |
$467.31
|
| Rate for Payer: BCBS Trust/PPO |
$392.59
|
| Rate for Payer: BCN Commercial |
$373.51
|
| Rate for Payer: Cash Price |
$385.41
|
| Rate for Payer: Cofinity Commercial |
$452.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$385.41
|
| Rate for Payer: Healthscope Commercial |
$481.76
|
| Rate for Payer: Healthscope Whirlpool |
$467.31
|
| Rate for Payer: Mclaren Commercial |
$433.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$409.50
|
| Rate for Payer: Nomi Health Commercial |
$395.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$313.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$423.95
|
|
|
HC HDR SKIN SURFACE 2 OR MORE CHANNELS
|
Facility
|
OP
|
$541.99
|
|
|
Service Code
|
CPT 77768
|
| Hospital Charge Code |
33300054
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$137.47 |
| Max. Negotiated Rate |
$541.99 |
| Rate for Payer: Aetna Commercial |
$487.79
|
| Rate for Payer: Aetna Medicare |
$256.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$320.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$320.60
|
| Rate for Payer: ASR ASR |
$525.73
|
| Rate for Payer: ASR Commercial |
$525.73
|
| Rate for Payer: BCBS Complete |
$144.35
|
| Rate for Payer: BCBS MAPPO |
$256.48
|
| Rate for Payer: BCBS Trust/PPO |
$443.84
|
| Rate for Payer: BCN Commercial |
$420.20
|
| Rate for Payer: BCN Medicare Advantage |
$256.48
|
| Rate for Payer: Cash Price |
$433.59
|
| Rate for Payer: Cash Price |
$433.59
|
| Rate for Payer: Cofinity Commercial |
$509.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$433.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$256.48
|
| Rate for Payer: Healthscope Commercial |
$541.99
|
| Rate for Payer: Healthscope Whirlpool |
$525.73
|
| Rate for Payer: Humana Choice PPO Medicare |
$256.48
|
| Rate for Payer: Mclaren Commercial |
$487.79
|
| Rate for Payer: Mclaren Medicaid |
$137.47
|
| Rate for Payer: Mclaren Medicare |
$256.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$269.30
|
| Rate for Payer: Meridian Medicaid |
$144.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$294.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$460.69
|
| Rate for Payer: Nomi Health Commercial |
$444.43
|
| Rate for Payer: PACE Medicare |
$243.66
|
| Rate for Payer: PACE SWMI |
$256.48
|
| Rate for Payer: PHP Commercial |
$282.13
|
| Rate for Payer: PHP Medicaid |
$137.47
|
| Rate for Payer: PHP Medicare Advantage |
$256.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$137.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$352.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$474.89
|
| Rate for Payer: Priority Health Medicare |
$256.48
|
| Rate for Payer: Priority Health Narrow Network |
$379.93
|
| Rate for Payer: Railroad Medicare Medicare |
$256.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$476.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$256.48
|
| Rate for Payer: UHC Exchange |
$397.54
|
| Rate for Payer: UHC Medicare Advantage |
$256.48
|
| Rate for Payer: UHCCP DNSP |
$256.48
|
| Rate for Payer: UHCCP Medicaid |
$137.47
|
| Rate for Payer: VA VA |
$256.48
|
|
|
HC HDR SKIN SURFACE 2 OR MORE CHANNELS
|
Facility
|
IP
|
$541.99
|
|
|
Service Code
|
CPT 77768
|
| Hospital Charge Code |
33300054
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$352.29 |
| Max. Negotiated Rate |
$541.99 |
| Rate for Payer: Aetna Commercial |
$487.79
|
| Rate for Payer: ASR ASR |
$525.73
|
| Rate for Payer: ASR Commercial |
$525.73
|
| Rate for Payer: BCBS Trust/PPO |
$441.67
|
| Rate for Payer: BCN Commercial |
$420.20
|
| Rate for Payer: Cash Price |
$433.59
|
| Rate for Payer: Cofinity Commercial |
$509.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$433.59
|
| Rate for Payer: Healthscope Commercial |
$541.99
|
| Rate for Payer: Healthscope Whirlpool |
$525.73
|
| Rate for Payer: Mclaren Commercial |
$487.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$460.69
|
| Rate for Payer: Nomi Health Commercial |
$444.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$352.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$476.95
|
|
|
HC HEALTH & BEHAV ASSESS OR REASSESS
|
Facility
|
IP
|
$122.77
|
|
|
Service Code
|
CPT 96156
|
| Hospital Charge Code |
91400009
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$79.80 |
| Max. Negotiated Rate |
$122.77 |
| Rate for Payer: Aetna Commercial |
$110.49
|
| Rate for Payer: ASR ASR |
$119.09
|
| Rate for Payer: ASR Commercial |
$119.09
|
| Rate for Payer: BCBS Trust/PPO |
$100.05
|
| Rate for Payer: BCN Commercial |
$95.18
|
| Rate for Payer: Cash Price |
$98.22
|
| Rate for Payer: Cofinity Commercial |
$115.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$98.22
|
| Rate for Payer: Healthscope Commercial |
$122.77
|
| Rate for Payer: Healthscope Whirlpool |
$119.09
|
| Rate for Payer: Mclaren Commercial |
$110.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.35
|
| Rate for Payer: Nomi Health Commercial |
$100.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$108.04
|
|
|
HC HEALTH & BEHAV ASSESS OR REASSESS
|
Facility
|
OP
|
$122.77
|
|
|
Service Code
|
CPT 96156
|
| Hospital Charge Code |
91400009
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$48.35 |
| Max. Negotiated Rate |
$139.83 |
| Rate for Payer: Aetna Commercial |
$110.49
|
| 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 |
$119.09
|
| Rate for Payer: ASR Commercial |
$119.09
|
| Rate for Payer: BCBS Complete |
$50.77
|
| Rate for Payer: BCBS MAPPO |
$90.21
|
| Rate for Payer: BCBS Trust/PPO |
$100.54
|
| Rate for Payer: BCN Commercial |
$95.18
|
| Rate for Payer: BCN Medicare Advantage |
$90.21
|
| Rate for Payer: Cash Price |
$98.22
|
| Rate for Payer: Cash Price |
$98.22
|
| Rate for Payer: Cofinity Commercial |
$115.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$98.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$90.21
|
| Rate for Payer: Healthscope Commercial |
$122.77
|
| Rate for Payer: Healthscope Whirlpool |
$119.09
|
| Rate for Payer: Humana Choice PPO Medicare |
$90.21
|
| Rate for Payer: Mclaren Commercial |
$110.49
|
| 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 |
$104.35
|
| Rate for Payer: Nomi Health Commercial |
$100.67
|
| 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 |
$79.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$107.57
|
| Rate for Payer: Priority Health Medicare |
$90.21
|
| Rate for Payer: Priority Health Narrow Network |
$86.06
|
| Rate for Payer: Railroad Medicare Medicare |
$90.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$108.04
|
| 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 HEALTH & BEHAV INTERVENT INDIV EA ADD 15 MIN
|
Facility
|
OP
|
$61.38
|
|
|
Service Code
|
CPT 96159
|
| Hospital Charge Code |
91400011
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$24.55 |
| Max. Negotiated Rate |
$61.38 |
| Rate for Payer: Aetna Commercial |
$55.24
|
| Rate for Payer: Aetna Medicare |
$30.69
|
| Rate for Payer: ASR ASR |
$59.54
|
| Rate for Payer: ASR Commercial |
$59.54
|
| Rate for Payer: BCBS Complete |
$24.55
|
| Rate for Payer: BCBS Trust/PPO |
$50.26
|
| Rate for Payer: BCN Commercial |
$47.59
|
| Rate for Payer: Cash Price |
$49.10
|
| Rate for Payer: Cofinity Commercial |
$57.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.10
|
| Rate for Payer: Healthscope Commercial |
$61.38
|
| Rate for Payer: Healthscope Whirlpool |
$59.54
|
| Rate for Payer: Mclaren Commercial |
$55.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.17
|
| Rate for Payer: Nomi Health Commercial |
$50.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.78
|
| Rate for Payer: Priority Health Narrow Network |
$43.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$54.01
|
|
|
HC HEALTH & BEHAV INTERVENT INDIV EA ADD 15 MIN
|
Facility
|
IP
|
$61.38
|
|
|
Service Code
|
CPT 96159
|
| Hospital Charge Code |
91400011
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$39.90 |
| Max. Negotiated Rate |
$61.38 |
| Rate for Payer: Aetna Commercial |
$55.24
|
| Rate for Payer: ASR ASR |
$59.54
|
| Rate for Payer: ASR Commercial |
$59.54
|
| Rate for Payer: BCBS Trust/PPO |
$50.02
|
| Rate for Payer: BCN Commercial |
$47.59
|
| Rate for Payer: Cash Price |
$49.10
|
| Rate for Payer: Cofinity Commercial |
$57.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.10
|
| Rate for Payer: Healthscope Commercial |
$61.38
|
| Rate for Payer: Healthscope Whirlpool |
$59.54
|
| Rate for Payer: Mclaren Commercial |
$55.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.17
|
| Rate for Payer: Nomi Health Commercial |
$50.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$54.01
|
|
|
HC HEALTH & BEHAV INTERVENT INDIV INIT 30 MIN
|
Facility
|
OP
|
$122.77
|
|
|
Service Code
|
CPT 96158
|
| Hospital Charge Code |
91400010
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$79.80 |
| Max. Negotiated Rate |
$242.88 |
| Rate for Payer: Aetna Commercial |
$110.49
|
| Rate for Payer: Aetna Medicare |
$156.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$195.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$195.88
|
| Rate for Payer: ASR ASR |
$119.09
|
| Rate for Payer: ASR Commercial |
$119.09
|
| Rate for Payer: BCBS Complete |
$88.19
|
| Rate for Payer: BCBS MAPPO |
$156.70
|
| Rate for Payer: BCBS Trust/PPO |
$100.54
|
| Rate for Payer: BCN Commercial |
$95.18
|
| Rate for Payer: BCN Medicare Advantage |
$156.70
|
| Rate for Payer: Cash Price |
$98.22
|
| Rate for Payer: Cash Price |
$98.22
|
| Rate for Payer: Cofinity Commercial |
$115.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$98.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$156.70
|
| Rate for Payer: Healthscope Commercial |
$122.77
|
| Rate for Payer: Healthscope Whirlpool |
$119.09
|
| Rate for Payer: Humana Choice PPO Medicare |
$156.70
|
| Rate for Payer: Mclaren Commercial |
$110.49
|
| Rate for Payer: Mclaren Medicaid |
$83.99
|
| Rate for Payer: Mclaren Medicare |
$156.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$164.53
|
| Rate for Payer: Meridian Medicaid |
$88.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$180.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.35
|
| Rate for Payer: Nomi Health Commercial |
$100.67
|
| Rate for Payer: PACE Medicare |
$148.87
|
| Rate for Payer: PACE SWMI |
$156.70
|
| Rate for Payer: PHP Commercial |
$172.37
|
| Rate for Payer: PHP Medicaid |
$83.99
|
| Rate for Payer: PHP Medicare Advantage |
$156.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$107.57
|
| Rate for Payer: Priority Health Medicare |
$156.70
|
| Rate for Payer: Priority Health Narrow Network |
$86.06
|
| Rate for Payer: Railroad Medicare Medicare |
$156.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$108.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$156.70
|
| Rate for Payer: UHC Exchange |
$242.88
|
| Rate for Payer: UHC Medicare Advantage |
$156.70
|
| Rate for Payer: UHCCP DNSP |
$156.70
|
| Rate for Payer: UHCCP Medicaid |
$83.99
|
| Rate for Payer: VA VA |
$156.70
|
|
|
HC HEALTH & BEHAV INTERVENT INDIV INIT 30 MIN
|
Facility
|
IP
|
$122.77
|
|
|
Service Code
|
CPT 96158
|
| Hospital Charge Code |
91400010
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$79.80 |
| Max. Negotiated Rate |
$122.77 |
| Rate for Payer: Aetna Commercial |
$110.49
|
| Rate for Payer: ASR ASR |
$119.09
|
| Rate for Payer: ASR Commercial |
$119.09
|
| Rate for Payer: BCBS Trust/PPO |
$100.05
|
| Rate for Payer: BCN Commercial |
$95.18
|
| Rate for Payer: Cash Price |
$98.22
|
| Rate for Payer: Cofinity Commercial |
$115.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$98.22
|
| Rate for Payer: Healthscope Commercial |
$122.77
|
| Rate for Payer: Healthscope Whirlpool |
$119.09
|
| Rate for Payer: Mclaren Commercial |
$110.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.35
|
| Rate for Payer: Nomi Health Commercial |
$100.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$108.04
|
|
|
HC HEARING AID CHECK BINAURAL
|
Facility
|
OP
|
$61.20
|
|
|
Service Code
|
CPT 92593
|
| Hospital Charge Code |
76100499
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$24.48 |
| Max. Negotiated Rate |
$61.20 |
| Rate for Payer: Aetna Commercial |
$55.08
|
| Rate for Payer: Aetna Medicare |
$30.60
|
| Rate for Payer: ASR ASR |
$59.36
|
| Rate for Payer: ASR Commercial |
$59.36
|
| Rate for Payer: BCBS Complete |
$24.48
|
| Rate for Payer: BCBS Trust/PPO |
$50.12
|
| Rate for Payer: BCN Commercial |
$47.45
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$57.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Healthscope Commercial |
$61.20
|
| Rate for Payer: Healthscope Whirlpool |
$59.36
|
| Rate for Payer: Mclaren Commercial |
$55.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.02
|
| Rate for Payer: Nomi Health Commercial |
$50.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.62
|
| Rate for Payer: Priority Health Narrow Network |
$42.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$53.86
|
|
|
HC HEARING AID CHECK BINAURAL
|
Facility
|
IP
|
$61.20
|
|
|
Service Code
|
CPT 92593
|
| Hospital Charge Code |
76100499
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$39.78 |
| Max. Negotiated Rate |
$61.20 |
| Rate for Payer: Aetna Commercial |
$55.08
|
| Rate for Payer: ASR ASR |
$59.36
|
| Rate for Payer: ASR Commercial |
$59.36
|
| Rate for Payer: BCBS Trust/PPO |
$49.87
|
| Rate for Payer: BCN Commercial |
$47.45
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$57.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Healthscope Commercial |
$61.20
|
| Rate for Payer: Healthscope Whirlpool |
$59.36
|
| Rate for Payer: Mclaren Commercial |
$55.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.02
|
| Rate for Payer: Nomi Health Commercial |
$50.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$53.86
|
|
|
HC HEARING AID CHECK MONAURAL
|
Facility
|
IP
|
$54.06
|
|
|
Service Code
|
CPT 92592
|
| Hospital Charge Code |
47100402
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$35.14 |
| Max. Negotiated Rate |
$54.06 |
| Rate for Payer: Aetna Commercial |
$48.65
|
| Rate for Payer: ASR ASR |
$52.44
|
| Rate for Payer: ASR Commercial |
$52.44
|
| Rate for Payer: BCBS Trust/PPO |
$44.05
|
| Rate for Payer: BCN Commercial |
$41.91
|
| Rate for Payer: Cash Price |
$43.25
|
| Rate for Payer: Cofinity Commercial |
$50.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.25
|
| Rate for Payer: Healthscope Commercial |
$54.06
|
| Rate for Payer: Healthscope Whirlpool |
$52.44
|
| Rate for Payer: Mclaren Commercial |
$48.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.95
|
| Rate for Payer: Nomi Health Commercial |
$44.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$47.57
|
|
|
HC HEARING AID CHECK MONAURAL
|
Facility
|
OP
|
$54.06
|
|
|
Service Code
|
CPT 92592
|
| Hospital Charge Code |
47100402
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$21.62 |
| Max. Negotiated Rate |
$54.06 |
| Rate for Payer: Aetna Commercial |
$48.65
|
| Rate for Payer: Aetna Medicare |
$27.03
|
| Rate for Payer: ASR ASR |
$52.44
|
| Rate for Payer: ASR Commercial |
$52.44
|
| Rate for Payer: BCBS Complete |
$21.62
|
| Rate for Payer: BCBS Trust/PPO |
$44.27
|
| Rate for Payer: BCN Commercial |
$41.91
|
| Rate for Payer: Cash Price |
$43.25
|
| Rate for Payer: Cofinity Commercial |
$50.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.25
|
| Rate for Payer: Healthscope Commercial |
$54.06
|
| Rate for Payer: Healthscope Whirlpool |
$52.44
|
| Rate for Payer: Mclaren Commercial |
$48.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.95
|
| Rate for Payer: Nomi Health Commercial |
$44.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$47.37
|
| Rate for Payer: Priority Health Narrow Network |
$37.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$47.57
|
|
|
HC HEARING AID EXAM BOTH EARS
|
Facility
|
IP
|
$121.38
|
|
|
Service Code
|
CPT 92591
|
| Hospital Charge Code |
76100504
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$78.90 |
| Max. Negotiated Rate |
$121.38 |
| Rate for Payer: Aetna Commercial |
$109.24
|
| Rate for Payer: ASR ASR |
$117.74
|
| Rate for Payer: ASR Commercial |
$117.74
|
| Rate for Payer: BCBS Trust/PPO |
$98.91
|
| Rate for Payer: BCN Commercial |
$94.11
|
| Rate for Payer: Cash Price |
$97.10
|
| Rate for Payer: Cofinity Commercial |
$114.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.10
|
| Rate for Payer: Healthscope Commercial |
$121.38
|
| Rate for Payer: Healthscope Whirlpool |
$117.74
|
| Rate for Payer: Mclaren Commercial |
$109.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$103.17
|
| Rate for Payer: Nomi Health Commercial |
$99.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$78.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$106.81
|
|
|
HC HEARING AID EXAM BOTH EARS
|
Facility
|
OP
|
$121.38
|
|
|
Service Code
|
CPT 92591
|
| Hospital Charge Code |
76100504
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$48.55 |
| Max. Negotiated Rate |
$121.38 |
| Rate for Payer: Aetna Commercial |
$109.24
|
| Rate for Payer: Aetna Medicare |
$60.69
|
| Rate for Payer: ASR ASR |
$117.74
|
| Rate for Payer: ASR Commercial |
$117.74
|
| Rate for Payer: BCBS Complete |
$48.55
|
| Rate for Payer: BCBS Trust/PPO |
$99.40
|
| Rate for Payer: BCN Commercial |
$94.11
|
| Rate for Payer: Cash Price |
$97.10
|
| Rate for Payer: Cofinity Commercial |
$114.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.10
|
| Rate for Payer: Healthscope Commercial |
$121.38
|
| Rate for Payer: Healthscope Whirlpool |
$117.74
|
| Rate for Payer: Mclaren Commercial |
$109.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$103.17
|
| Rate for Payer: Nomi Health Commercial |
$99.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$78.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$106.35
|
| Rate for Payer: Priority Health Narrow Network |
$85.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$106.81
|
|
|
HC HEARING AID EXAM ONE EAR
|
Facility
|
IP
|
$111.18
|
|
|
Service Code
|
CPT 92590
|
| Hospital Charge Code |
76100505
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$72.27 |
| Max. Negotiated Rate |
$111.18 |
| Rate for Payer: Aetna Commercial |
$100.06
|
| Rate for Payer: ASR ASR |
$107.84
|
| Rate for Payer: ASR Commercial |
$107.84
|
| Rate for Payer: BCBS Trust/PPO |
$90.60
|
| Rate for Payer: BCN Commercial |
$86.20
|
| Rate for Payer: Cash Price |
$88.94
|
| Rate for Payer: Cofinity Commercial |
$104.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.94
|
| Rate for Payer: Healthscope Commercial |
$111.18
|
| Rate for Payer: Healthscope Whirlpool |
$107.84
|
| Rate for Payer: Mclaren Commercial |
$100.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.50
|
| Rate for Payer: Nomi Health Commercial |
$91.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$97.84
|
|
|
HC HEARING AID EXAM ONE EAR
|
Facility
|
OP
|
$111.18
|
|
|
Service Code
|
CPT 92590
|
| Hospital Charge Code |
76100505
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$44.47 |
| Max. Negotiated Rate |
$111.18 |
| Rate for Payer: Aetna Commercial |
$100.06
|
| Rate for Payer: Aetna Medicare |
$55.59
|
| Rate for Payer: ASR ASR |
$107.84
|
| Rate for Payer: ASR Commercial |
$107.84
|
| Rate for Payer: BCBS Complete |
$44.47
|
| Rate for Payer: BCBS Trust/PPO |
$91.05
|
| Rate for Payer: BCN Commercial |
$86.20
|
| Rate for Payer: Cash Price |
$88.94
|
| Rate for Payer: Cofinity Commercial |
$104.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.94
|
| Rate for Payer: Healthscope Commercial |
$111.18
|
| Rate for Payer: Healthscope Whirlpool |
$107.84
|
| Rate for Payer: Mclaren Commercial |
$100.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.50
|
| Rate for Payer: Nomi Health Commercial |
$91.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$97.42
|
| Rate for Payer: Priority Health Narrow Network |
$77.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$97.84
|
|
|
HC HEART CATH CORONARIES CABG'S
|
Facility
|
OP
|
$12,212.39
|
|
|
Service Code
|
CPT 93459
|
| Hospital Charge Code |
48100018
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,681.38 |
| Max. Negotiated Rate |
$12,212.39 |
| Rate for Payer: Aetna Commercial |
$10,991.15
|
| Rate for Payer: Aetna Medicare |
$3,136.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,921.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,921.12
|
| Rate for Payer: ASR ASR |
$11,846.02
|
| Rate for Payer: ASR Commercial |
$11,846.02
|
| Rate for Payer: BCBS Complete |
$1,765.45
|
| Rate for Payer: BCBS MAPPO |
$3,136.90
|
| Rate for Payer: BCBS Trust/PPO |
$10,000.73
|
| Rate for Payer: BCN Commercial |
$9,468.27
|
| Rate for Payer: BCN Medicare Advantage |
$3,136.90
|
| Rate for Payer: Cash Price |
$9,769.91
|
| Rate for Payer: Cash Price |
$9,769.91
|
| Rate for Payer: Cofinity Commercial |
$11,479.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,769.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,136.90
|
| Rate for Payer: Healthscope Commercial |
$12,212.39
|
| Rate for Payer: Healthscope Whirlpool |
$11,846.02
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,136.90
|
| Rate for Payer: Mclaren Commercial |
$10,991.15
|
| Rate for Payer: Mclaren Medicaid |
$1,681.38
|
| Rate for Payer: Mclaren Medicare |
$3,136.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,293.74
|
| Rate for Payer: Meridian Medicaid |
$1,765.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,607.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,380.53
|
| Rate for Payer: Nomi Health Commercial |
$10,014.16
|
| Rate for Payer: PACE Medicare |
$2,980.05
|
| Rate for Payer: PACE SWMI |
$3,136.90
|
| Rate for Payer: PHP Commercial |
$3,450.59
|
| Rate for Payer: PHP Medicaid |
$1,681.38
|
| Rate for Payer: PHP Medicare Advantage |
$3,136.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,681.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,938.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,700.50
|
| Rate for Payer: Priority Health Medicare |
$3,136.90
|
| Rate for Payer: Priority Health Narrow Network |
$8,560.89
|
| Rate for Payer: Railroad Medicare Medicare |
$3,136.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,746.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,136.90
|
| Rate for Payer: UHC Exchange |
$4,862.19
|
| Rate for Payer: UHC Medicare Advantage |
$3,136.90
|
| Rate for Payer: UHCCP DNSP |
$3,136.90
|
| Rate for Payer: UHCCP Medicaid |
$1,681.38
|
| Rate for Payer: VA VA |
$3,136.90
|
|
|
HC HEART CATH CORONARIES CABG'S
|
Facility
|
IP
|
$12,212.39
|
|
|
Service Code
|
CPT 93459
|
| Hospital Charge Code |
48100018
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$7,938.05 |
| Max. Negotiated Rate |
$12,212.39 |
| Rate for Payer: Aetna Commercial |
$10,991.15
|
| Rate for Payer: ASR ASR |
$11,846.02
|
| Rate for Payer: ASR Commercial |
$11,846.02
|
| Rate for Payer: BCBS Trust/PPO |
$9,951.88
|
| Rate for Payer: BCN Commercial |
$9,468.27
|
| Rate for Payer: Cash Price |
$9,769.91
|
| Rate for Payer: Cofinity Commercial |
$11,479.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,769.91
|
| Rate for Payer: Healthscope Commercial |
$12,212.39
|
| Rate for Payer: Healthscope Whirlpool |
$11,846.02
|
| Rate for Payer: Mclaren Commercial |
$10,991.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,380.53
|
| Rate for Payer: Nomi Health Commercial |
$10,014.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,938.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,746.90
|
|
|
HC HEART CATH EXCHANGE WIRE
|
Facility
|
OP
|
$54.58
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200047
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$21.83 |
| Max. Negotiated Rate |
$54.58 |
| Rate for Payer: Aetna Commercial |
$49.12
|
| Rate for Payer: Aetna Medicare |
$27.29
|
| Rate for Payer: ASR ASR |
$52.94
|
| Rate for Payer: ASR Commercial |
$52.94
|
| Rate for Payer: BCBS Complete |
$21.83
|
| Rate for Payer: BCBS Trust/PPO |
$44.70
|
| Rate for Payer: BCN Commercial |
$42.32
|
| Rate for Payer: Cash Price |
$43.66
|
| Rate for Payer: Cofinity Commercial |
$51.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.66
|
| Rate for Payer: Healthscope Commercial |
$54.58
|
| Rate for Payer: Healthscope Whirlpool |
$52.94
|
| Rate for Payer: Mclaren Commercial |
$49.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.39
|
| Rate for Payer: Nomi Health Commercial |
$44.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$47.82
|
| Rate for Payer: Priority Health Narrow Network |
$38.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$48.03
|
|
|
HC HEART CATH EXCHANGE WIRE
|
Facility
|
IP
|
$54.58
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200047
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$35.48 |
| Max. Negotiated Rate |
$54.58 |
| Rate for Payer: Aetna Commercial |
$49.12
|
| Rate for Payer: ASR ASR |
$52.94
|
| Rate for Payer: ASR Commercial |
$52.94
|
| Rate for Payer: BCBS Trust/PPO |
$44.48
|
| Rate for Payer: BCN Commercial |
$42.32
|
| Rate for Payer: Cash Price |
$43.66
|
| Rate for Payer: Cofinity Commercial |
$51.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.66
|
| Rate for Payer: Healthscope Commercial |
$54.58
|
| Rate for Payer: Healthscope Whirlpool |
$52.94
|
| Rate for Payer: Mclaren Commercial |
$49.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.39
|
| Rate for Payer: Nomi Health Commercial |
$44.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$48.03
|
|
