|
HC NM MYOCARD PERF SPECT EF WM MU
|
Facility
|
OP
|
$5,027.66
|
|
|
Service Code
|
CPT 78452
|
| Hospital Charge Code |
34100029
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$690.41 |
| Max. Negotiated Rate |
$5,027.66 |
| Rate for Payer: Aetna Commercial |
$4,524.89
|
| Rate for Payer: Aetna Medicare |
$1,262.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,577.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,577.72
|
| Rate for Payer: ASR ASR |
$4,876.83
|
| Rate for Payer: BCBS Complete |
$725.00
|
| Rate for Payer: BCBS MAPPO |
$1,262.18
|
| Rate for Payer: BCBS Trust/PPO |
$3,897.94
|
| Rate for Payer: BCN Commercial |
$3,897.94
|
| Rate for Payer: BCN Medicare Advantage |
$1,262.18
|
| Rate for Payer: Cash Price |
$4,022.13
|
| Rate for Payer: Cash Price |
$4,022.13
|
| Rate for Payer: Cofinity Commercial |
$4,726.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,022.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,262.18
|
| Rate for Payer: Healthscope Commercial |
$5,027.66
|
| Rate for Payer: Healthscope Whirlpool |
$4,876.83
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,262.18
|
| Rate for Payer: Mclaren Commercial |
$4,524.89
|
| Rate for Payer: Mclaren Medicaid |
$690.41
|
| Rate for Payer: Mclaren Medicare |
$1,262.18
|
| Rate for Payer: Meridian Medicaid |
$725.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,325.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,451.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,273.51
|
| Rate for Payer: PACE Medicare |
$1,199.07
|
| Rate for Payer: PACE SWMI |
$1,262.18
|
| Rate for Payer: PHP Commercial |
$1,388.40
|
| Rate for Payer: PHP Medicaid |
$690.41
|
| Rate for Payer: PHP Medicare Advantage |
$1,262.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$690.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,519.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,696.28
|
| Rate for Payer: Priority Health Medicare |
$1,262.18
|
| Rate for Payer: Priority Health Narrow Network |
$2,157.02
|
| Rate for Payer: Railroad Medicare Medicare |
$1,262.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,424.34
|
| Rate for Payer: UHC Medicare Advantage |
$1,300.05
|
| Rate for Payer: VA VA |
$1,262.18
|
|
|
HC NM MYOCARD PERF SPECT EF WM MU
|
Facility
|
IP
|
$5,027.66
|
|
|
Service Code
|
CPT 78452
|
| Hospital Charge Code |
34100029
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$3,519.36 |
| Max. Negotiated Rate |
$5,027.66 |
| Rate for Payer: Aetna Commercial |
$4,524.89
|
| Rate for Payer: ASR ASR |
$4,876.83
|
| Rate for Payer: BCBS Trust/PPO |
$3,897.94
|
| Rate for Payer: BCN Commercial |
$3,897.94
|
| Rate for Payer: Cash Price |
$4,022.13
|
| Rate for Payer: Cofinity Commercial |
$4,726.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,022.13
|
| Rate for Payer: Healthscope Commercial |
$5,027.66
|
| Rate for Payer: Healthscope Whirlpool |
$4,876.83
|
| Rate for Payer: Mclaren Commercial |
$4,524.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,273.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,519.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,424.34
|
|
|
HC NM MYOCARD PERF SPECT EF WM SI
|
Facility
|
OP
|
$1,795.59
|
|
|
Service Code
|
CPT 78451
|
| Hospital Charge Code |
34100067
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$690.41 |
| Max. Negotiated Rate |
$1,795.59 |
| Rate for Payer: Aetna Commercial |
$1,616.03
|
| Rate for Payer: Aetna Medicare |
$1,262.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,577.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,577.72
|
| Rate for Payer: ASR ASR |
$1,741.72
|
| Rate for Payer: BCBS Complete |
$725.00
|
| Rate for Payer: BCBS MAPPO |
$1,262.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,392.12
|
| Rate for Payer: BCN Commercial |
$1,392.12
|
| Rate for Payer: BCN Medicare Advantage |
$1,262.18
|
| Rate for Payer: Cash Price |
$1,436.47
|
| Rate for Payer: Cash Price |
$1,436.47
|
| Rate for Payer: Cofinity Commercial |
$1,687.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,436.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,262.18
|
| Rate for Payer: Healthscope Commercial |
$1,795.59
|
| Rate for Payer: Healthscope Whirlpool |
$1,741.72
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,262.18
|
| Rate for Payer: Mclaren Commercial |
$1,616.03
|
| Rate for Payer: Mclaren Medicaid |
$690.41
|
| Rate for Payer: Mclaren Medicare |
$1,262.18
|
| Rate for Payer: Meridian Medicaid |
$725.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,325.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,451.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,526.25
|
| Rate for Payer: PACE Medicare |
$1,199.07
|
| Rate for Payer: PACE SWMI |
$1,262.18
|
| Rate for Payer: PHP Commercial |
$1,388.40
|
| Rate for Payer: PHP Medicaid |
$690.41
|
| Rate for Payer: PHP Medicare Advantage |
$1,262.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$690.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,256.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,559.79
|
| Rate for Payer: Priority Health Medicare |
$1,262.18
|
| Rate for Payer: Priority Health Narrow Network |
$1,247.83
|
| Rate for Payer: Railroad Medicare Medicare |
$1,262.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,580.12
|
| Rate for Payer: UHC Medicare Advantage |
$1,300.05
|
| Rate for Payer: VA VA |
$1,262.18
|
|
|
HC NM MYOCARD PERF SPECT EF WM SI
|
Facility
|
IP
|
$1,795.59
|
|
|
Service Code
|
CPT 78451
|
| Hospital Charge Code |
34100067
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$1,256.91 |
| Max. Negotiated Rate |
$1,795.59 |
| Rate for Payer: Aetna Commercial |
$1,616.03
|
| Rate for Payer: ASR ASR |
$1,741.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,392.12
|
| Rate for Payer: BCN Commercial |
$1,392.12
|
| Rate for Payer: Cash Price |
$1,436.47
|
| Rate for Payer: Cofinity Commercial |
$1,687.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,436.47
|
| Rate for Payer: Healthscope Commercial |
$1,795.59
|
| Rate for Payer: Healthscope Whirlpool |
$1,741.72
|
| Rate for Payer: Mclaren Commercial |
$1,616.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,526.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,256.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,580.12
|
|
|
HC NMO/AQP4 FACS TITER SERUM
|
Facility
|
IP
|
$100.00
|
|
|
Service Code
|
CPT 86256
|
| Hospital Charge Code |
30200395
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$100.00 |
| Rate for Payer: Aetna Commercial |
$90.00
|
| Rate for Payer: ASR ASR |
$97.00
|
| Rate for Payer: BCBS Trust/PPO |
$77.53
|
| Rate for Payer: BCN Commercial |
$77.53
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cofinity Commercial |
$94.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.00
|
| Rate for Payer: Healthscope Commercial |
$100.00
|
| Rate for Payer: Healthscope Whirlpool |
$97.00
|
| Rate for Payer: Mclaren Commercial |
$90.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$85.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$88.00
|
|
|
HC NMO/AQP4 FACS TITER SERUM
|
Facility
|
OP
|
$100.00
|
|
|
Service Code
|
CPT 86256
|
| Hospital Charge Code |
30200395
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.59 |
| Max. Negotiated Rate |
$180.61 |
| Rate for Payer: Aetna Commercial |
$90.00
|
| Rate for Payer: Aetna Medicare |
$12.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.06
|
| Rate for Payer: ASR ASR |
$97.00
|
| Rate for Payer: BCBS Complete |
$6.92
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCBS Trust/PPO |
$77.53
|
| Rate for Payer: BCN Commercial |
$77.53
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cofinity Commercial |
$94.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$100.00
|
| Rate for Payer: Healthscope Whirlpool |
$97.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.05
|
| Rate for Payer: Mclaren Commercial |
$90.00
|
| Rate for Payer: Mclaren Medicaid |
$6.59
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Medicaid |
$6.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$85.00
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$13.26
|
| Rate for Payer: PHP Medicaid |
$6.59
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$180.61
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health Narrow Network |
$144.49
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$88.00
|
| Rate for Payer: UHC Medicare Advantage |
$12.41
|
| Rate for Payer: VA VA |
$12.05
|
|
|
HC NMO/AQP4-IGG CBA, S
|
Facility
|
IP
|
$345.00
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200422
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$241.50 |
| Max. Negotiated Rate |
$345.00 |
| Rate for Payer: Aetna Commercial |
$310.50
|
| Rate for Payer: ASR ASR |
$334.65
|
| Rate for Payer: BCBS Trust/PPO |
$267.48
|
| Rate for Payer: BCN Commercial |
$267.48
|
| Rate for Payer: Cash Price |
$276.00
|
| Rate for Payer: Cofinity Commercial |
$324.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$276.00
|
| Rate for Payer: Healthscope Commercial |
$345.00
|
| Rate for Payer: Healthscope Whirlpool |
$334.65
|
| Rate for Payer: Mclaren Commercial |
$310.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$293.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$303.60
|
|
|
HC NMO/AQP4-IGG CBA, S
|
Facility
|
OP
|
$345.00
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200422
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.59 |
| Max. Negotiated Rate |
$345.00 |
| Rate for Payer: Aetna Commercial |
$310.50
|
| Rate for Payer: Aetna Medicare |
$12.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.06
|
| Rate for Payer: ASR ASR |
$334.65
|
| Rate for Payer: BCBS Complete |
$6.92
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCBS Trust/PPO |
$267.48
|
| Rate for Payer: BCN Commercial |
$267.48
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$276.00
|
| Rate for Payer: Cash Price |
$276.00
|
| Rate for Payer: Cofinity Commercial |
$324.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$276.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$345.00
|
| Rate for Payer: Healthscope Whirlpool |
$334.65
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.05
|
| Rate for Payer: Mclaren Commercial |
$310.50
|
| Rate for Payer: Mclaren Medicaid |
$6.59
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Medicaid |
$6.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$293.25
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$13.26
|
| Rate for Payer: PHP Medicaid |
$6.59
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$212.42
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health Narrow Network |
$169.94
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$303.60
|
| Rate for Payer: UHC Medicare Advantage |
$12.41
|
| Rate for Payer: VA VA |
$12.05
|
|
|
HC NMO/AQUAPO 4 IGG CBA
|
Facility
|
OP
|
$344.00
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200394
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.59 |
| Max. Negotiated Rate |
$344.00 |
| Rate for Payer: Aetna Commercial |
$309.60
|
| Rate for Payer: Aetna Medicare |
$12.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.06
|
| Rate for Payer: ASR ASR |
$333.68
|
| Rate for Payer: BCBS Complete |
$6.92
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCBS Trust/PPO |
$266.70
|
| Rate for Payer: BCN Commercial |
$266.70
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$275.20
|
| Rate for Payer: Cash Price |
$275.20
|
| Rate for Payer: Cofinity Commercial |
$323.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$344.00
|
| Rate for Payer: Healthscope Whirlpool |
$333.68
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.05
|
| Rate for Payer: Mclaren Commercial |
$309.60
|
| Rate for Payer: Mclaren Medicaid |
$6.59
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Medicaid |
$6.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.40
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$13.26
|
| Rate for Payer: PHP Medicaid |
$6.59
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$240.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$212.42
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health Narrow Network |
$169.94
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$302.72
|
| Rate for Payer: UHC Medicare Advantage |
$12.41
|
| Rate for Payer: VA VA |
$12.05
|
|
|
HC NMO/AQUAPO 4 IGG CBA
|
Facility
|
IP
|
$344.00
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200394
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$240.80 |
| Max. Negotiated Rate |
$344.00 |
| Rate for Payer: Aetna Commercial |
$309.60
|
| Rate for Payer: ASR ASR |
$333.68
|
| Rate for Payer: BCBS Trust/PPO |
$266.70
|
| Rate for Payer: BCN Commercial |
$266.70
|
| Rate for Payer: Cash Price |
$275.20
|
| Rate for Payer: Cofinity Commercial |
$323.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.20
|
| Rate for Payer: Healthscope Commercial |
$344.00
|
| Rate for Payer: Healthscope Whirlpool |
$333.68
|
| Rate for Payer: Mclaren Commercial |
$309.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$240.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$302.72
|
|
|
HC NM PARATHYROID SCAN
|
Facility
|
IP
|
$900.70
|
|
|
Service Code
|
CPT 78070
|
| Hospital Charge Code |
34100007
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$630.49 |
| Max. Negotiated Rate |
$900.70 |
| Rate for Payer: Aetna Commercial |
$810.63
|
| Rate for Payer: ASR ASR |
$873.68
|
| Rate for Payer: BCBS Trust/PPO |
$698.31
|
| Rate for Payer: BCN Commercial |
$698.31
|
| Rate for Payer: Cash Price |
$720.56
|
| Rate for Payer: Cofinity Commercial |
$846.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$720.56
|
| Rate for Payer: Healthscope Commercial |
$900.70
|
| Rate for Payer: Healthscope Whirlpool |
$873.68
|
| Rate for Payer: Mclaren Commercial |
$810.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$765.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$630.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$792.62
|
|
|
HC NM PARATHYROID SCAN
|
Facility
|
OP
|
$900.70
|
|
|
Service Code
|
CPT 78070
|
| Hospital Charge Code |
34100007
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$200.54 |
| Max. Negotiated Rate |
$900.70 |
| Rate for Payer: Aetna Commercial |
$810.63
|
| Rate for Payer: Aetna Medicare |
$366.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$458.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$458.26
|
| Rate for Payer: ASR ASR |
$873.68
|
| Rate for Payer: BCBS Complete |
$210.58
|
| Rate for Payer: BCBS MAPPO |
$366.61
|
| Rate for Payer: BCBS Trust/PPO |
$698.31
|
| Rate for Payer: BCN Commercial |
$698.31
|
| Rate for Payer: BCN Medicare Advantage |
$366.61
|
| Rate for Payer: Cash Price |
$720.56
|
| Rate for Payer: Cash Price |
$720.56
|
| Rate for Payer: Cofinity Commercial |
$846.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$720.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$366.61
|
| Rate for Payer: Healthscope Commercial |
$900.70
|
| Rate for Payer: Healthscope Whirlpool |
$873.68
|
| Rate for Payer: Humana Choice PPO Medicare |
$366.61
|
| Rate for Payer: Mclaren Commercial |
$810.63
|
| Rate for Payer: Mclaren Medicaid |
$200.54
|
| Rate for Payer: Mclaren Medicare |
$366.61
|
| Rate for Payer: Meridian Medicaid |
$210.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$384.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$421.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$765.60
|
| Rate for Payer: PACE Medicare |
$348.28
|
| Rate for Payer: PACE SWMI |
$366.61
|
| Rate for Payer: PHP Commercial |
$403.27
|
| Rate for Payer: PHP Medicaid |
$200.54
|
| Rate for Payer: PHP Medicare Advantage |
$366.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$200.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$630.49
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$853.27
|
| Rate for Payer: Priority Health Medicare |
$366.61
|
| Rate for Payer: Priority Health Narrow Network |
$682.62
|
| Rate for Payer: Railroad Medicare Medicare |
$366.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$792.62
|
| Rate for Payer: UHC Medicare Advantage |
$377.61
|
| Rate for Payer: VA VA |
$366.61
|
|
|
HC NM PARATHYROID SESTAMIBI INJ O
|
Facility
|
IP
|
$400.20
|
|
|
Service Code
|
CPT 78808
|
| Hospital Charge Code |
34100060
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$280.14 |
| Max. Negotiated Rate |
$400.20 |
| Rate for Payer: Aetna Commercial |
$360.18
|
| Rate for Payer: ASR ASR |
$388.19
|
| Rate for Payer: BCBS Trust/PPO |
$310.28
|
| Rate for Payer: BCN Commercial |
$310.28
|
| Rate for Payer: Cash Price |
$320.16
|
| Rate for Payer: Cofinity Commercial |
$376.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$320.16
|
| Rate for Payer: Healthscope Commercial |
$400.20
|
| Rate for Payer: Healthscope Whirlpool |
$388.19
|
| Rate for Payer: Mclaren Commercial |
$360.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$340.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$280.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$352.18
|
|
|
HC NM PARATHYROID SESTAMIBI INJ O
|
Facility
|
OP
|
$400.20
|
|
|
Service Code
|
CPT 78808
|
| Hospital Charge Code |
34100060
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$200.54 |
| Max. Negotiated Rate |
$458.26 |
| Rate for Payer: Aetna Commercial |
$360.18
|
| Rate for Payer: Aetna Medicare |
$366.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$458.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$458.26
|
| Rate for Payer: ASR ASR |
$388.19
|
| Rate for Payer: BCBS Complete |
$210.58
|
| Rate for Payer: BCBS MAPPO |
$366.61
|
| Rate for Payer: BCBS Trust/PPO |
$310.28
|
| Rate for Payer: BCN Commercial |
$310.28
|
| Rate for Payer: BCN Medicare Advantage |
$366.61
|
| Rate for Payer: Cash Price |
$320.16
|
| Rate for Payer: Cash Price |
$320.16
|
| Rate for Payer: Cofinity Commercial |
$376.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$320.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$366.61
|
| Rate for Payer: Healthscope Commercial |
$400.20
|
| Rate for Payer: Healthscope Whirlpool |
$388.19
|
| Rate for Payer: Humana Choice PPO Medicare |
$366.61
|
| Rate for Payer: Mclaren Commercial |
$360.18
|
| Rate for Payer: Mclaren Medicaid |
$200.54
|
| Rate for Payer: Mclaren Medicare |
$366.61
|
| Rate for Payer: Meridian Medicaid |
$210.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$384.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$421.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$340.17
|
| Rate for Payer: PACE Medicare |
$348.28
|
| Rate for Payer: PACE SWMI |
$366.61
|
| Rate for Payer: PHP Commercial |
$403.27
|
| Rate for Payer: PHP Medicaid |
$200.54
|
| Rate for Payer: PHP Medicare Advantage |
$366.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$200.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$280.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$364.18
|
| Rate for Payer: Priority Health Medicare |
$366.61
|
| Rate for Payer: Priority Health Narrow Network |
$284.14
|
| Rate for Payer: Railroad Medicare Medicare |
$366.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$352.18
|
| Rate for Payer: UHC Medicare Advantage |
$377.61
|
| Rate for Payer: VA VA |
$366.61
|
|
|
HC NM PARATHYROID SPECT SCAN
|
Facility
|
OP
|
$1,011.88
|
|
|
Service Code
|
CPT 78071
|
| Hospital Charge Code |
34100077
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$200.54 |
| Max. Negotiated Rate |
$1,011.88 |
| Rate for Payer: Aetna Commercial |
$910.69
|
| Rate for Payer: Aetna Medicare |
$366.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$458.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$458.26
|
| Rate for Payer: ASR ASR |
$981.52
|
| Rate for Payer: BCBS Complete |
$210.58
|
| Rate for Payer: BCBS MAPPO |
$366.61
|
| Rate for Payer: BCBS Trust/PPO |
$784.51
|
| Rate for Payer: BCN Commercial |
$784.51
|
| Rate for Payer: BCN Medicare Advantage |
$366.61
|
| Rate for Payer: Cash Price |
$809.50
|
| Rate for Payer: Cash Price |
$809.50
|
| Rate for Payer: Cofinity Commercial |
$951.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$809.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$366.61
|
| Rate for Payer: Healthscope Commercial |
$1,011.88
|
| Rate for Payer: Healthscope Whirlpool |
$981.52
|
| Rate for Payer: Humana Choice PPO Medicare |
$366.61
|
| Rate for Payer: Mclaren Commercial |
$910.69
|
| Rate for Payer: Mclaren Medicaid |
$200.54
|
| Rate for Payer: Mclaren Medicare |
$366.61
|
| Rate for Payer: Meridian Medicaid |
$210.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$384.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$421.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$860.10
|
| Rate for Payer: PACE Medicare |
$348.28
|
| Rate for Payer: PACE SWMI |
$366.61
|
| Rate for Payer: PHP Commercial |
$403.27
|
| Rate for Payer: PHP Medicaid |
$200.54
|
| Rate for Payer: PHP Medicare Advantage |
$366.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$200.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$708.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$344.58
|
| Rate for Payer: Priority Health Medicare |
$366.61
|
| Rate for Payer: Priority Health Narrow Network |
$275.66
|
| Rate for Payer: Railroad Medicare Medicare |
$366.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$890.45
|
| Rate for Payer: UHC Medicare Advantage |
$377.61
|
| Rate for Payer: VA VA |
$366.61
|
|
|
HC NM PARATHYROID SPECT SCAN
|
Facility
|
IP
|
$1,011.88
|
|
|
Service Code
|
CPT 78071
|
| Hospital Charge Code |
34100077
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$708.32 |
| Max. Negotiated Rate |
$1,011.88 |
| Rate for Payer: Aetna Commercial |
$910.69
|
| Rate for Payer: ASR ASR |
$981.52
|
| Rate for Payer: BCBS Trust/PPO |
$784.51
|
| Rate for Payer: BCN Commercial |
$784.51
|
| Rate for Payer: Cash Price |
$809.50
|
| Rate for Payer: Cofinity Commercial |
$951.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$809.50
|
| Rate for Payer: Healthscope Commercial |
$1,011.88
|
| Rate for Payer: Healthscope Whirlpool |
$981.52
|
| Rate for Payer: Mclaren Commercial |
$910.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$860.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$708.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$890.45
|
|
|
HC NM PERFUSION QUANTITATIVE DIFF
|
Facility
|
IP
|
$1,195.27
|
|
|
Service Code
|
CPT 78597
|
| Hospital Charge Code |
34100069
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$836.69 |
| Max. Negotiated Rate |
$1,195.27 |
| Rate for Payer: Aetna Commercial |
$1,075.74
|
| Rate for Payer: ASR ASR |
$1,159.41
|
| Rate for Payer: BCBS Trust/PPO |
$926.69
|
| Rate for Payer: BCN Commercial |
$926.69
|
| Rate for Payer: Cash Price |
$956.22
|
| Rate for Payer: Cofinity Commercial |
$1,123.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$956.22
|
| Rate for Payer: Healthscope Commercial |
$1,195.27
|
| Rate for Payer: Healthscope Whirlpool |
$1,159.41
|
| Rate for Payer: Mclaren Commercial |
$1,075.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,015.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$836.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,051.84
|
|
|
HC NM PERFUSION QUANTITATIVE DIFF
|
Facility
|
OP
|
$1,195.27
|
|
|
Service Code
|
CPT 78597
|
| Hospital Charge Code |
34100069
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$200.54 |
| Max. Negotiated Rate |
$1,195.27 |
| Rate for Payer: Aetna Commercial |
$1,075.74
|
| Rate for Payer: Aetna Medicare |
$366.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$458.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$458.26
|
| Rate for Payer: ASR ASR |
$1,159.41
|
| Rate for Payer: BCBS Complete |
$210.58
|
| Rate for Payer: BCBS MAPPO |
$366.61
|
| Rate for Payer: BCBS Trust/PPO |
$926.69
|
| Rate for Payer: BCN Commercial |
$926.69
|
| Rate for Payer: BCN Medicare Advantage |
$366.61
|
| Rate for Payer: Cash Price |
$956.22
|
| Rate for Payer: Cash Price |
$956.22
|
| Rate for Payer: Cofinity Commercial |
$1,123.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$956.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$366.61
|
| Rate for Payer: Healthscope Commercial |
$1,195.27
|
| Rate for Payer: Healthscope Whirlpool |
$1,159.41
|
| Rate for Payer: Humana Choice PPO Medicare |
$366.61
|
| Rate for Payer: Mclaren Commercial |
$1,075.74
|
| Rate for Payer: Mclaren Medicaid |
$200.54
|
| Rate for Payer: Mclaren Medicare |
$366.61
|
| Rate for Payer: Meridian Medicaid |
$210.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$384.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$421.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,015.98
|
| Rate for Payer: PACE Medicare |
$348.28
|
| Rate for Payer: PACE SWMI |
$366.61
|
| Rate for Payer: PHP Commercial |
$403.27
|
| Rate for Payer: PHP Medicaid |
$200.54
|
| Rate for Payer: PHP Medicare Advantage |
$366.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$200.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$836.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,087.70
|
| Rate for Payer: Priority Health Medicare |
$366.61
|
| Rate for Payer: Priority Health Narrow Network |
$848.64
|
| Rate for Payer: Railroad Medicare Medicare |
$366.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,051.84
|
| Rate for Payer: UHC Medicare Advantage |
$377.61
|
| Rate for Payer: VA VA |
$366.61
|
|
|
HC NM RADIOPHARM INTRACAVITARY AD
|
Facility
|
OP
|
$762.46
|
|
|
Service Code
|
CPT 79200
|
| Hospital Charge Code |
34100064
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$120.96 |
| Max. Negotiated Rate |
$762.46 |
| Rate for Payer: Aetna Commercial |
$686.21
|
| Rate for Payer: Aetna Medicare |
$221.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$276.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$276.42
|
| Rate for Payer: ASR ASR |
$739.59
|
| Rate for Payer: BCBS Complete |
$127.02
|
| Rate for Payer: BCBS MAPPO |
$221.14
|
| Rate for Payer: BCBS Trust/PPO |
$591.14
|
| Rate for Payer: BCN Commercial |
$591.14
|
| Rate for Payer: BCN Medicare Advantage |
$221.14
|
| Rate for Payer: Cash Price |
$609.97
|
| Rate for Payer: Cash Price |
$609.97
|
| Rate for Payer: Cofinity Commercial |
$716.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$609.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$221.14
|
| Rate for Payer: Healthscope Commercial |
$762.46
|
| Rate for Payer: Healthscope Whirlpool |
$739.59
|
| Rate for Payer: Humana Choice PPO Medicare |
$221.14
|
| Rate for Payer: Mclaren Commercial |
$686.21
|
| Rate for Payer: Mclaren Medicaid |
$120.96
|
| Rate for Payer: Mclaren Medicare |
$221.14
|
| Rate for Payer: Meridian Medicaid |
$127.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$232.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$254.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$648.09
|
| Rate for Payer: PACE Medicare |
$210.08
|
| Rate for Payer: PACE SWMI |
$221.14
|
| Rate for Payer: PHP Commercial |
$243.25
|
| Rate for Payer: PHP Medicaid |
$120.96
|
| Rate for Payer: PHP Medicare Advantage |
$221.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$120.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$533.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$693.84
|
| Rate for Payer: Priority Health Medicare |
$221.14
|
| Rate for Payer: Priority Health Narrow Network |
$541.35
|
| Rate for Payer: Railroad Medicare Medicare |
$221.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$670.96
|
| Rate for Payer: UHC Medicare Advantage |
$227.77
|
| Rate for Payer: VA VA |
$221.14
|
|
|
HC NM RADIOPHARM INTRACAVITARY AD
|
Facility
|
IP
|
$762.46
|
|
|
Service Code
|
CPT 79200
|
| Hospital Charge Code |
34100064
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$533.72 |
| Max. Negotiated Rate |
$762.46 |
| Rate for Payer: Aetna Commercial |
$686.21
|
| Rate for Payer: ASR ASR |
$739.59
|
| Rate for Payer: BCBS Trust/PPO |
$591.14
|
| Rate for Payer: BCN Commercial |
$591.14
|
| Rate for Payer: Cash Price |
$609.97
|
| Rate for Payer: Cofinity Commercial |
$716.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$609.97
|
| Rate for Payer: Healthscope Commercial |
$762.46
|
| Rate for Payer: Healthscope Whirlpool |
$739.59
|
| Rate for Payer: Mclaren Commercial |
$686.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$648.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$533.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$670.96
|
|
|
HC NM RADIOPHARM IV ADMIN
|
Facility
|
IP
|
$762.46
|
|
|
Service Code
|
CPT 79101
|
| Hospital Charge Code |
34100063
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$533.72 |
| Max. Negotiated Rate |
$762.46 |
| Rate for Payer: Aetna Commercial |
$686.21
|
| Rate for Payer: ASR ASR |
$739.59
|
| Rate for Payer: BCBS Trust/PPO |
$591.14
|
| Rate for Payer: BCN Commercial |
$591.14
|
| Rate for Payer: Cash Price |
$609.97
|
| Rate for Payer: Cofinity Commercial |
$716.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$609.97
|
| Rate for Payer: Healthscope Commercial |
$762.46
|
| Rate for Payer: Healthscope Whirlpool |
$739.59
|
| Rate for Payer: Mclaren Commercial |
$686.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$648.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$533.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$670.96
|
|
|
HC NM RADIOPHARM IV ADMIN
|
Facility
|
OP
|
$762.46
|
|
|
Service Code
|
CPT 79101
|
| Hospital Charge Code |
34100063
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$120.96 |
| Max. Negotiated Rate |
$762.46 |
| Rate for Payer: Aetna Commercial |
$686.21
|
| Rate for Payer: Aetna Medicare |
$221.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$276.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$276.42
|
| Rate for Payer: ASR ASR |
$739.59
|
| Rate for Payer: BCBS Complete |
$127.02
|
| Rate for Payer: BCBS MAPPO |
$221.14
|
| Rate for Payer: BCBS Trust/PPO |
$591.14
|
| Rate for Payer: BCN Commercial |
$591.14
|
| Rate for Payer: BCN Medicare Advantage |
$221.14
|
| Rate for Payer: Cash Price |
$609.97
|
| Rate for Payer: Cash Price |
$609.97
|
| Rate for Payer: Cofinity Commercial |
$716.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$609.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$221.14
|
| Rate for Payer: Healthscope Commercial |
$762.46
|
| Rate for Payer: Healthscope Whirlpool |
$739.59
|
| Rate for Payer: Humana Choice PPO Medicare |
$221.14
|
| Rate for Payer: Mclaren Commercial |
$686.21
|
| Rate for Payer: Mclaren Medicaid |
$120.96
|
| Rate for Payer: Mclaren Medicare |
$221.14
|
| Rate for Payer: Meridian Medicaid |
$127.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$232.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$254.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$648.09
|
| Rate for Payer: PACE Medicare |
$210.08
|
| Rate for Payer: PACE SWMI |
$221.14
|
| Rate for Payer: PHP Commercial |
$243.25
|
| Rate for Payer: PHP Medicaid |
$120.96
|
| Rate for Payer: PHP Medicare Advantage |
$221.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$120.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$533.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$693.84
|
| Rate for Payer: Priority Health Medicare |
$221.14
|
| Rate for Payer: Priority Health Narrow Network |
$541.35
|
| Rate for Payer: Railroad Medicare Medicare |
$221.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$670.96
|
| Rate for Payer: UHC Medicare Advantage |
$227.77
|
| Rate for Payer: VA VA |
$221.14
|
|
|
HC NM RADIOPHARM ORAL ADMIN
|
Facility
|
OP
|
$762.46
|
|
|
Service Code
|
CPT 79005
|
| Hospital Charge Code |
34100062
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$120.96 |
| Max. Negotiated Rate |
$762.46 |
| Rate for Payer: Aetna Commercial |
$686.21
|
| Rate for Payer: Aetna Medicare |
$221.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$276.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$276.42
|
| Rate for Payer: ASR ASR |
$739.59
|
| Rate for Payer: BCBS Complete |
$127.02
|
| Rate for Payer: BCBS MAPPO |
$221.14
|
| Rate for Payer: BCBS Trust/PPO |
$591.14
|
| Rate for Payer: BCN Commercial |
$591.14
|
| Rate for Payer: BCN Medicare Advantage |
$221.14
|
| Rate for Payer: Cash Price |
$609.97
|
| Rate for Payer: Cash Price |
$609.97
|
| Rate for Payer: Cofinity Commercial |
$716.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$609.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$221.14
|
| Rate for Payer: Healthscope Commercial |
$762.46
|
| Rate for Payer: Healthscope Whirlpool |
$739.59
|
| Rate for Payer: Humana Choice PPO Medicare |
$221.14
|
| Rate for Payer: Mclaren Commercial |
$686.21
|
| Rate for Payer: Mclaren Medicaid |
$120.96
|
| Rate for Payer: Mclaren Medicare |
$221.14
|
| Rate for Payer: Meridian Medicaid |
$127.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$232.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$254.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$648.09
|
| Rate for Payer: PACE Medicare |
$210.08
|
| Rate for Payer: PACE SWMI |
$221.14
|
| Rate for Payer: PHP Commercial |
$243.25
|
| Rate for Payer: PHP Medicaid |
$120.96
|
| Rate for Payer: PHP Medicare Advantage |
$221.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$120.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$533.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$459.73
|
| Rate for Payer: Priority Health Medicare |
$221.14
|
| Rate for Payer: Priority Health Narrow Network |
$367.78
|
| Rate for Payer: Railroad Medicare Medicare |
$221.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$670.96
|
| Rate for Payer: UHC Medicare Advantage |
$227.77
|
| Rate for Payer: VA VA |
$221.14
|
|
|
HC NM RADIOPHARM ORAL ADMIN
|
Facility
|
IP
|
$762.46
|
|
|
Service Code
|
CPT 79005
|
| Hospital Charge Code |
34100062
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$533.72 |
| Max. Negotiated Rate |
$762.46 |
| Rate for Payer: Aetna Commercial |
$686.21
|
| Rate for Payer: ASR ASR |
$739.59
|
| Rate for Payer: BCBS Trust/PPO |
$591.14
|
| Rate for Payer: BCN Commercial |
$591.14
|
| Rate for Payer: Cash Price |
$609.97
|
| Rate for Payer: Cofinity Commercial |
$716.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$609.97
|
| Rate for Payer: Healthscope Commercial |
$762.46
|
| Rate for Payer: Healthscope Whirlpool |
$739.59
|
| Rate for Payer: Mclaren Commercial |
$686.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$648.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$533.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$670.96
|
|
|
HC NM RENAL NON FLOW STUDY
|
Facility
|
IP
|
$1,334.17
|
|
|
Service Code
|
CPT 78700
|
| Hospital Charge Code |
34100044
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$933.92 |
| Max. Negotiated Rate |
$1,334.17 |
| Rate for Payer: Aetna Commercial |
$1,200.75
|
| Rate for Payer: ASR ASR |
$1,294.14
|
| Rate for Payer: BCBS Trust/PPO |
$1,034.38
|
| Rate for Payer: BCN Commercial |
$1,034.38
|
| Rate for Payer: Cash Price |
$1,067.34
|
| Rate for Payer: Cofinity Commercial |
$1,254.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,067.34
|
| Rate for Payer: Healthscope Commercial |
$1,334.17
|
| Rate for Payer: Healthscope Whirlpool |
$1,294.14
|
| Rate for Payer: Mclaren Commercial |
$1,200.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,134.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$933.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,174.07
|
|
