|
HC NM RENAL NON FLOW STUDY
|
Facility
|
OP
|
$1,334.17
|
|
|
Service Code
|
CPT 78700
|
| Hospital Charge Code |
34100044
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$200.54 |
| Max. Negotiated Rate |
$1,334.17 |
| Rate for Payer: Aetna Commercial |
$1,200.75
|
| 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 |
$1,294.14
|
| Rate for Payer: BCBS Complete |
$210.58
|
| Rate for Payer: BCBS MAPPO |
$366.61
|
| Rate for Payer: BCBS Trust/PPO |
$1,034.38
|
| Rate for Payer: BCN Commercial |
$1,034.38
|
| Rate for Payer: BCN Medicare Advantage |
$366.61
|
| Rate for Payer: Cash Price |
$1,067.34
|
| 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: Health Alliance Plan Medicare Advantage |
$366.61
|
| Rate for Payer: Healthscope Commercial |
$1,334.17
|
| Rate for Payer: Healthscope Whirlpool |
$1,294.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$366.61
|
| Rate for Payer: Mclaren Commercial |
$1,200.75
|
| 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 |
$1,134.04
|
| 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 |
$933.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,214.09
|
| Rate for Payer: Priority Health Medicare |
$366.61
|
| Rate for Payer: Priority Health Narrow Network |
$947.26
|
| Rate for Payer: Railroad Medicare Medicare |
$366.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,174.07
|
| Rate for Payer: UHC Medicare Advantage |
$377.61
|
| Rate for Payer: VA VA |
$366.61
|
|
|
HC NM RENOGRAM WITH FLOW
|
Facility
|
OP
|
$1,300.65
|
|
|
Service Code
|
CPT 78707
|
| Hospital Charge Code |
34100045
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$262.80 |
| Max. Negotiated Rate |
$1,300.65 |
| Rate for Payer: Aetna Commercial |
$1,170.58
|
| Rate for Payer: Aetna Medicare |
$480.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$600.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$600.55
|
| Rate for Payer: ASR ASR |
$1,261.63
|
| Rate for Payer: BCBS Complete |
$275.96
|
| Rate for Payer: BCBS MAPPO |
$480.44
|
| Rate for Payer: BCBS Trust/PPO |
$1,008.39
|
| Rate for Payer: BCN Commercial |
$1,008.39
|
| Rate for Payer: BCN Medicare Advantage |
$480.44
|
| Rate for Payer: Cash Price |
$1,040.52
|
| Rate for Payer: Cash Price |
$1,040.52
|
| Rate for Payer: Cofinity Commercial |
$1,222.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,040.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$480.44
|
| Rate for Payer: Healthscope Commercial |
$1,300.65
|
| Rate for Payer: Healthscope Whirlpool |
$1,261.63
|
| Rate for Payer: Humana Choice PPO Medicare |
$480.44
|
| Rate for Payer: Mclaren Commercial |
$1,170.58
|
| Rate for Payer: Mclaren Medicaid |
$262.80
|
| Rate for Payer: Mclaren Medicare |
$480.44
|
| Rate for Payer: Meridian Medicaid |
$275.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$504.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$552.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,105.55
|
| Rate for Payer: PACE Medicare |
$456.42
|
| Rate for Payer: PACE SWMI |
$480.44
|
| Rate for Payer: PHP Commercial |
$528.48
|
| Rate for Payer: PHP Medicaid |
$262.80
|
| Rate for Payer: PHP Medicare Advantage |
$480.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$262.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$910.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,113.40
|
| Rate for Payer: Priority Health Medicare |
$480.44
|
| Rate for Payer: Priority Health Narrow Network |
$890.72
|
| Rate for Payer: Railroad Medicare Medicare |
$480.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,144.57
|
| Rate for Payer: UHC Medicare Advantage |
$494.85
|
| Rate for Payer: VA VA |
$480.44
|
|
|
HC NM RENOGRAM WITH FLOW
|
Facility
|
IP
|
$1,300.65
|
|
|
Service Code
|
CPT 78707
|
| Hospital Charge Code |
34100045
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$910.46 |
| Max. Negotiated Rate |
$1,300.65 |
| Rate for Payer: Aetna Commercial |
$1,170.58
|
| Rate for Payer: ASR ASR |
$1,261.63
|
| Rate for Payer: BCBS Trust/PPO |
$1,008.39
|
| Rate for Payer: BCN Commercial |
$1,008.39
|
| Rate for Payer: Cash Price |
$1,040.52
|
| Rate for Payer: Cofinity Commercial |
$1,222.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,040.52
|
| Rate for Payer: Healthscope Commercial |
$1,300.65
|
| Rate for Payer: Healthscope Whirlpool |
$1,261.63
|
| Rate for Payer: Mclaren Commercial |
$1,170.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,105.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$910.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,144.57
|
|
|
HC NM RENOGRAM WITH PHARM INTERVENTION
|
Facility
|
IP
|
$1,651.13
|
|
|
Service Code
|
CPT 78708
|
| Hospital Charge Code |
34100046
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$1,155.79 |
| Max. Negotiated Rate |
$1,651.13 |
| Rate for Payer: Aetna Commercial |
$1,486.02
|
| Rate for Payer: ASR ASR |
$1,601.60
|
| Rate for Payer: BCBS Trust/PPO |
$1,280.12
|
| Rate for Payer: BCN Commercial |
$1,280.12
|
| Rate for Payer: Cash Price |
$1,320.90
|
| Rate for Payer: Cofinity Commercial |
$1,552.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,320.90
|
| Rate for Payer: Healthscope Commercial |
$1,651.13
|
| Rate for Payer: Healthscope Whirlpool |
$1,601.60
|
| Rate for Payer: Mclaren Commercial |
$1,486.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,403.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,155.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,452.99
|
|
|
HC NM RENOGRAM WITH PHARM INTERVENTION
|
Facility
|
OP
|
$1,651.13
|
|
|
Service Code
|
CPT 78708
|
| Hospital Charge Code |
34100046
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$262.80 |
| Max. Negotiated Rate |
$1,651.13 |
| Rate for Payer: Aetna Commercial |
$1,486.02
|
| Rate for Payer: Aetna Medicare |
$480.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$600.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$600.55
|
| Rate for Payer: ASR ASR |
$1,601.60
|
| Rate for Payer: BCBS Complete |
$275.96
|
| Rate for Payer: BCBS MAPPO |
$480.44
|
| Rate for Payer: BCBS Trust/PPO |
$1,280.12
|
| Rate for Payer: BCN Commercial |
$1,280.12
|
| Rate for Payer: BCN Medicare Advantage |
$480.44
|
| Rate for Payer: Cash Price |
$1,320.90
|
| Rate for Payer: Cash Price |
$1,320.90
|
| Rate for Payer: Cofinity Commercial |
$1,552.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,320.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$480.44
|
| Rate for Payer: Healthscope Commercial |
$1,651.13
|
| Rate for Payer: Healthscope Whirlpool |
$1,601.60
|
| Rate for Payer: Humana Choice PPO Medicare |
$480.44
|
| Rate for Payer: Mclaren Commercial |
$1,486.02
|
| Rate for Payer: Mclaren Medicaid |
$262.80
|
| Rate for Payer: Mclaren Medicare |
$480.44
|
| Rate for Payer: Meridian Medicaid |
$275.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$504.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$552.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,403.46
|
| Rate for Payer: PACE Medicare |
$456.42
|
| Rate for Payer: PACE SWMI |
$480.44
|
| Rate for Payer: PHP Commercial |
$528.48
|
| Rate for Payer: PHP Medicaid |
$262.80
|
| Rate for Payer: PHP Medicare Advantage |
$480.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$262.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,155.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,113.40
|
| Rate for Payer: Priority Health Medicare |
$480.44
|
| Rate for Payer: Priority Health Narrow Network |
$890.72
|
| Rate for Payer: Railroad Medicare Medicare |
$480.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,452.99
|
| Rate for Payer: UHC Medicare Advantage |
$494.85
|
| Rate for Payer: VA VA |
$480.44
|
|
|
HC NM SENTINEL NODE INJECTION NON IMAGE BIL
|
Facility
|
OP
|
$785.40
|
|
|
Service Code
|
CPT 38792
|
| Hospital Charge Code |
36100622
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$200.54 |
| Max. Negotiated Rate |
$785.40 |
| Rate for Payer: Aetna Commercial |
$706.86
|
| 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 |
$761.84
|
| Rate for Payer: BCBS Complete |
$210.58
|
| Rate for Payer: BCBS MAPPO |
$366.61
|
| Rate for Payer: BCBS Trust/PPO |
$608.92
|
| Rate for Payer: BCN Commercial |
$608.92
|
| Rate for Payer: BCN Medicare Advantage |
$366.61
|
| Rate for Payer: Cash Price |
$628.32
|
| Rate for Payer: Cash Price |
$628.32
|
| Rate for Payer: Cofinity Commercial |
$738.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$628.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$366.61
|
| Rate for Payer: Healthscope Commercial |
$785.40
|
| Rate for Payer: Healthscope Whirlpool |
$761.84
|
| Rate for Payer: Humana Choice PPO Medicare |
$366.61
|
| Rate for Payer: Mclaren Commercial |
$706.86
|
| 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 |
$667.59
|
| 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 |
$549.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$714.71
|
| Rate for Payer: Priority Health Medicare |
$366.61
|
| Rate for Payer: Priority Health Narrow Network |
$557.63
|
| Rate for Payer: Railroad Medicare Medicare |
$366.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$691.15
|
| Rate for Payer: UHC Medicare Advantage |
$377.61
|
| Rate for Payer: VA VA |
$366.61
|
|
|
HC NM SENTINEL NODE INJECTION NON IMAGE BIL
|
Facility
|
IP
|
$785.40
|
|
|
Service Code
|
CPT 38792
|
| Hospital Charge Code |
36100622
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$549.78 |
| Max. Negotiated Rate |
$785.40 |
| Rate for Payer: Aetna Commercial |
$706.86
|
| Rate for Payer: ASR ASR |
$761.84
|
| Rate for Payer: BCBS Trust/PPO |
$608.92
|
| Rate for Payer: BCN Commercial |
$608.92
|
| Rate for Payer: Cash Price |
$628.32
|
| Rate for Payer: Cofinity Commercial |
$738.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$628.32
|
| Rate for Payer: Healthscope Commercial |
$785.40
|
| Rate for Payer: Healthscope Whirlpool |
$761.84
|
| Rate for Payer: Mclaren Commercial |
$706.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$667.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$549.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$691.15
|
|
|
HC NM SENTINEL NODE INJ NON-IMAGI
|
Facility
|
OP
|
$971.92
|
|
|
Service Code
|
CPT 38792
|
| Hospital Charge Code |
36100187
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$200.54 |
| Max. Negotiated Rate |
$971.92 |
| Rate for Payer: Aetna Commercial |
$874.73
|
| 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 |
$942.76
|
| Rate for Payer: BCBS Complete |
$210.58
|
| Rate for Payer: BCBS MAPPO |
$366.61
|
| Rate for Payer: BCBS Trust/PPO |
$753.53
|
| Rate for Payer: BCN Commercial |
$753.53
|
| Rate for Payer: BCN Medicare Advantage |
$366.61
|
| Rate for Payer: Cash Price |
$777.54
|
| Rate for Payer: Cash Price |
$777.54
|
| Rate for Payer: Cofinity Commercial |
$913.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$777.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$366.61
|
| Rate for Payer: Healthscope Commercial |
$971.92
|
| Rate for Payer: Healthscope Whirlpool |
$942.76
|
| Rate for Payer: Humana Choice PPO Medicare |
$366.61
|
| Rate for Payer: Mclaren Commercial |
$874.73
|
| 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 |
$826.13
|
| 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 |
$680.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$884.45
|
| Rate for Payer: Priority Health Medicare |
$366.61
|
| Rate for Payer: Priority Health Narrow Network |
$690.06
|
| Rate for Payer: Railroad Medicare Medicare |
$366.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$855.29
|
| Rate for Payer: UHC Medicare Advantage |
$377.61
|
| Rate for Payer: VA VA |
$366.61
|
|
|
HC NM SENTINEL NODE INJ NON-IMAGI
|
Facility
|
IP
|
$971.92
|
|
|
Service Code
|
CPT 38792
|
| Hospital Charge Code |
36100187
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$680.34 |
| Max. Negotiated Rate |
$971.92 |
| Rate for Payer: Aetna Commercial |
$874.73
|
| Rate for Payer: ASR ASR |
$942.76
|
| Rate for Payer: BCBS Trust/PPO |
$753.53
|
| Rate for Payer: BCN Commercial |
$753.53
|
| Rate for Payer: Cash Price |
$777.54
|
| Rate for Payer: Cofinity Commercial |
$913.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$777.54
|
| Rate for Payer: Healthscope Commercial |
$971.92
|
| Rate for Payer: Healthscope Whirlpool |
$942.76
|
| Rate for Payer: Mclaren Commercial |
$874.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$826.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$680.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$855.29
|
|
|
HC NM TC 99M TILMANOCEPT DX PER 0.5 MCI
|
Facility
|
OP
|
$938.10
|
|
|
Service Code
|
HCPCS A9520
|
| Hospital Charge Code |
34300033
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$375.24 |
| Max. Negotiated Rate |
$938.10 |
| Rate for Payer: Aetna Commercial |
$844.29
|
| Rate for Payer: ASR ASR |
$909.96
|
| Rate for Payer: BCBS Complete |
$375.24
|
| Rate for Payer: BCBS Trust/PPO |
$727.31
|
| Rate for Payer: BCN Commercial |
$727.31
|
| Rate for Payer: Cash Price |
$750.48
|
| Rate for Payer: Cofinity Commercial |
$881.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$750.48
|
| Rate for Payer: Healthscope Commercial |
$938.10
|
| Rate for Payer: Healthscope Whirlpool |
$909.96
|
| Rate for Payer: Mclaren Commercial |
$844.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$797.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$656.67
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$853.67
|
| Rate for Payer: Priority Health Narrow Network |
$666.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$825.53
|
|
|
HC NM TC 99M TILMANOCEPT DX PER 0.5 MCI
|
Facility
|
IP
|
$938.10
|
|
|
Service Code
|
HCPCS A9520
|
| Hospital Charge Code |
34300033
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$656.67 |
| Max. Negotiated Rate |
$938.10 |
| Rate for Payer: Aetna Commercial |
$844.29
|
| Rate for Payer: ASR ASR |
$909.96
|
| Rate for Payer: BCBS Trust/PPO |
$727.31
|
| Rate for Payer: BCN Commercial |
$727.31
|
| Rate for Payer: Cash Price |
$750.48
|
| Rate for Payer: Cofinity Commercial |
$881.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$750.48
|
| Rate for Payer: Healthscope Commercial |
$938.10
|
| Rate for Payer: Healthscope Whirlpool |
$909.96
|
| Rate for Payer: Mclaren Commercial |
$844.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$797.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$656.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$825.53
|
|
|
HC NM THYROID CA METS IMGI131 TOTAL
|
Facility
|
IP
|
$1,238.67
|
|
|
Service Code
|
CPT 78018
|
| Hospital Charge Code |
34100006
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$867.07 |
| Max. Negotiated Rate |
$1,238.67 |
| Rate for Payer: Aetna Commercial |
$1,114.80
|
| Rate for Payer: ASR ASR |
$1,201.51
|
| Rate for Payer: BCBS Trust/PPO |
$960.34
|
| Rate for Payer: BCN Commercial |
$960.34
|
| Rate for Payer: Cash Price |
$990.94
|
| Rate for Payer: Cofinity Commercial |
$1,164.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$990.94
|
| Rate for Payer: Healthscope Commercial |
$1,238.67
|
| Rate for Payer: Healthscope Whirlpool |
$1,201.51
|
| Rate for Payer: Mclaren Commercial |
$1,114.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,052.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$867.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,090.03
|
|
|
HC NM THYROID CA METS IMGI131 TOTAL
|
Facility
|
OP
|
$1,238.67
|
|
|
Service Code
|
CPT 78018
|
| Hospital Charge Code |
34100006
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$262.80 |
| Max. Negotiated Rate |
$1,238.67 |
| Rate for Payer: Aetna Commercial |
$1,114.80
|
| Rate for Payer: Aetna Medicare |
$480.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$600.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$600.55
|
| Rate for Payer: ASR ASR |
$1,201.51
|
| Rate for Payer: BCBS Complete |
$275.96
|
| Rate for Payer: BCBS MAPPO |
$480.44
|
| Rate for Payer: BCBS Trust/PPO |
$960.34
|
| Rate for Payer: BCN Commercial |
$960.34
|
| Rate for Payer: BCN Medicare Advantage |
$480.44
|
| Rate for Payer: Cash Price |
$990.94
|
| Rate for Payer: Cash Price |
$990.94
|
| Rate for Payer: Cofinity Commercial |
$1,164.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$990.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$480.44
|
| Rate for Payer: Healthscope Commercial |
$1,238.67
|
| Rate for Payer: Healthscope Whirlpool |
$1,201.51
|
| Rate for Payer: Humana Choice PPO Medicare |
$480.44
|
| Rate for Payer: Mclaren Commercial |
$1,114.80
|
| Rate for Payer: Mclaren Medicaid |
$262.80
|
| Rate for Payer: Mclaren Medicare |
$480.44
|
| Rate for Payer: Meridian Medicaid |
$275.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$504.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$552.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,052.87
|
| Rate for Payer: PACE Medicare |
$456.42
|
| Rate for Payer: PACE SWMI |
$480.44
|
| Rate for Payer: PHP Commercial |
$528.48
|
| Rate for Payer: PHP Medicaid |
$262.80
|
| Rate for Payer: PHP Medicare Advantage |
$480.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$262.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$867.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,127.19
|
| Rate for Payer: Priority Health Medicare |
$480.44
|
| Rate for Payer: Priority Health Narrow Network |
$879.46
|
| Rate for Payer: Railroad Medicare Medicare |
$480.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,090.03
|
| Rate for Payer: UHC Medicare Advantage |
$494.85
|
| Rate for Payer: VA VA |
$480.44
|
|
|
HC NM TUMOR LOCALIZATION SPECT 2 AREAS
|
Facility
|
IP
|
$1,946.46
|
|
|
Service Code
|
CPT 78831
|
| Hospital Charge Code |
34100081
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$1,362.52 |
| Max. Negotiated Rate |
$1,946.46 |
| Rate for Payer: Aetna Commercial |
$1,751.81
|
| Rate for Payer: ASR ASR |
$1,888.07
|
| Rate for Payer: BCBS Trust/PPO |
$1,509.09
|
| Rate for Payer: BCN Commercial |
$1,509.09
|
| Rate for Payer: Cash Price |
$1,557.17
|
| Rate for Payer: Cofinity Commercial |
$1,829.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,557.17
|
| Rate for Payer: Healthscope Commercial |
$1,946.46
|
| Rate for Payer: Healthscope Whirlpool |
$1,888.07
|
| Rate for Payer: Mclaren Commercial |
$1,751.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,654.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,362.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,712.88
|
|
|
HC NM TUMOR LOCALIZATION SPECT 2 AREAS
|
Facility
|
OP
|
$1,946.46
|
|
|
Service Code
|
CPT 78831
|
| Hospital Charge Code |
34100081
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$690.41 |
| Max. Negotiated Rate |
$1,946.46 |
| Rate for Payer: Aetna Commercial |
$1,751.81
|
| 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 |
$1,888.07
|
| Rate for Payer: BCBS Complete |
$725.00
|
| Rate for Payer: BCBS MAPPO |
$1,262.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,509.09
|
| Rate for Payer: BCN Commercial |
$1,509.09
|
| Rate for Payer: BCN Medicare Advantage |
$1,262.18
|
| Rate for Payer: Cash Price |
$1,557.17
|
| Rate for Payer: Cash Price |
$1,557.17
|
| Rate for Payer: Cofinity Commercial |
$1,829.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,557.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,262.18
|
| Rate for Payer: Healthscope Commercial |
$1,946.46
|
| Rate for Payer: Healthscope Whirlpool |
$1,888.07
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,262.18
|
| Rate for Payer: Mclaren Commercial |
$1,751.81
|
| 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 |
$1,654.49
|
| 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 |
$1,362.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,361.09
|
| Rate for Payer: Priority Health Medicare |
$1,262.18
|
| Rate for Payer: Priority Health Narrow Network |
$1,088.87
|
| Rate for Payer: Railroad Medicare Medicare |
$1,262.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,712.88
|
| Rate for Payer: UHC Medicare Advantage |
$1,300.05
|
| Rate for Payer: VA VA |
$1,262.18
|
|
|
HC NM TUMOR SCAN SPECT
|
Facility
|
OP
|
$1,936.98
|
|
|
Service Code
|
CPT 78803
|
| Hospital Charge Code |
34100056
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$690.41 |
| Max. Negotiated Rate |
$2,247.33 |
| Rate for Payer: Aetna Commercial |
$1,743.28
|
| 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 |
$1,878.87
|
| Rate for Payer: BCBS Complete |
$725.00
|
| Rate for Payer: BCBS MAPPO |
$1,262.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,501.74
|
| Rate for Payer: BCN Commercial |
$1,501.74
|
| Rate for Payer: BCN Medicare Advantage |
$1,262.18
|
| Rate for Payer: Cash Price |
$1,549.58
|
| Rate for Payer: Cash Price |
$1,549.58
|
| Rate for Payer: Cofinity Commercial |
$1,820.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,549.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,262.18
|
| Rate for Payer: Healthscope Commercial |
$1,936.98
|
| Rate for Payer: Healthscope Whirlpool |
$1,878.87
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,262.18
|
| Rate for Payer: Mclaren Commercial |
$1,743.28
|
| 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 |
$1,646.43
|
| 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 |
$1,355.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,247.33
|
| Rate for Payer: Priority Health Medicare |
$1,262.18
|
| Rate for Payer: Priority Health Narrow Network |
$1,797.86
|
| Rate for Payer: Railroad Medicare Medicare |
$1,262.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,704.54
|
| Rate for Payer: UHC Medicare Advantage |
$1,300.05
|
| Rate for Payer: VA VA |
$1,262.18
|
|
|
HC NM TUMOR SCAN SPECT
|
Facility
|
IP
|
$1,936.98
|
|
|
Service Code
|
CPT 78803
|
| Hospital Charge Code |
34100056
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$1,355.89 |
| Max. Negotiated Rate |
$1,936.98 |
| Rate for Payer: Aetna Commercial |
$1,743.28
|
| Rate for Payer: ASR ASR |
$1,878.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,501.74
|
| Rate for Payer: BCN Commercial |
$1,501.74
|
| Rate for Payer: Cash Price |
$1,549.58
|
| Rate for Payer: Cofinity Commercial |
$1,820.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,549.58
|
| Rate for Payer: Healthscope Commercial |
$1,936.98
|
| Rate for Payer: Healthscope Whirlpool |
$1,878.87
|
| Rate for Payer: Mclaren Commercial |
$1,743.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,646.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,355.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,704.54
|
|
|
HC NM UNLISTED PROC ENDOCRINE S
|
Facility
|
OP
|
$1,722.73
|
|
|
Service Code
|
CPT 60699
|
| Hospital Charge Code |
36100267
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,205.91 |
| Max. Negotiated Rate |
$6,411.01 |
| Rate for Payer: Aetna Commercial |
$1,550.46
|
| Rate for Payer: Aetna Medicare |
$5,128.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,411.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,411.01
|
| Rate for Payer: ASR ASR |
$1,671.05
|
| Rate for Payer: BCBS Complete |
$2,945.99
|
| Rate for Payer: BCBS MAPPO |
$5,128.81
|
| Rate for Payer: BCBS Trust/PPO |
$1,335.63
|
| Rate for Payer: BCN Commercial |
$1,335.63
|
| Rate for Payer: BCN Medicare Advantage |
$5,128.81
|
| Rate for Payer: Cash Price |
$1,378.18
|
| Rate for Payer: Cash Price |
$1,378.18
|
| Rate for Payer: Cofinity Commercial |
$1,619.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,378.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,128.81
|
| Rate for Payer: Healthscope Commercial |
$1,722.73
|
| Rate for Payer: Healthscope Whirlpool |
$1,671.05
|
| Rate for Payer: Humana Choice PPO Medicare |
$5,128.81
|
| Rate for Payer: Mclaren Commercial |
$1,550.46
|
| Rate for Payer: Mclaren Medicaid |
$2,805.46
|
| Rate for Payer: Mclaren Medicare |
$5,128.81
|
| Rate for Payer: Meridian Medicaid |
$2,945.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5,385.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,898.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,464.32
|
| Rate for Payer: PACE Medicare |
$4,872.37
|
| Rate for Payer: PACE SWMI |
$5,128.81
|
| Rate for Payer: PHP Commercial |
$5,641.69
|
| Rate for Payer: PHP Medicaid |
$2,805.46
|
| Rate for Payer: PHP Medicare Advantage |
$5,128.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,805.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,205.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,567.68
|
| Rate for Payer: Priority Health Medicare |
$5,128.81
|
| Rate for Payer: Priority Health Narrow Network |
$1,223.14
|
| Rate for Payer: Railroad Medicare Medicare |
$5,128.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,516.00
|
| Rate for Payer: UHC Medicare Advantage |
$5,282.67
|
| Rate for Payer: VA VA |
$5,128.81
|
|
|
HC NM UNLISTED PROC ENDOCRINE S
|
Facility
|
IP
|
$1,722.73
|
|
|
Service Code
|
CPT 60699
|
| Hospital Charge Code |
36100267
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,205.91 |
| Max. Negotiated Rate |
$1,722.73 |
| Rate for Payer: Aetna Commercial |
$1,550.46
|
| Rate for Payer: ASR ASR |
$1,671.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,335.63
|
| Rate for Payer: BCN Commercial |
$1,335.63
|
| Rate for Payer: Cash Price |
$1,378.18
|
| Rate for Payer: Cofinity Commercial |
$1,619.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,378.18
|
| Rate for Payer: Healthscope Commercial |
$1,722.73
|
| Rate for Payer: Healthscope Whirlpool |
$1,671.05
|
| Rate for Payer: Mclaren Commercial |
$1,550.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,464.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,205.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,516.00
|
|
|
HC NM VENT AEROSOL/GAS AND PERFUS
|
Facility
|
IP
|
$1,633.68
|
|
|
Service Code
|
CPT 78582
|
| Hospital Charge Code |
34100068
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$1,143.58 |
| Max. Negotiated Rate |
$1,633.68 |
| Rate for Payer: Aetna Commercial |
$1,470.31
|
| Rate for Payer: ASR ASR |
$1,584.67
|
| Rate for Payer: BCBS Trust/PPO |
$1,266.59
|
| Rate for Payer: BCN Commercial |
$1,266.59
|
| Rate for Payer: Cash Price |
$1,306.94
|
| Rate for Payer: Cofinity Commercial |
$1,535.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,306.94
|
| Rate for Payer: Healthscope Commercial |
$1,633.68
|
| Rate for Payer: Healthscope Whirlpool |
$1,584.67
|
| Rate for Payer: Mclaren Commercial |
$1,470.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,388.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,143.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,437.64
|
|
|
HC NM VENT AEROSOL/GAS AND PERFUS
|
Facility
|
OP
|
$1,633.68
|
|
|
Service Code
|
CPT 78582
|
| Hospital Charge Code |
34100068
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$262.80 |
| Max. Negotiated Rate |
$1,633.68 |
| Rate for Payer: Aetna Commercial |
$1,470.31
|
| Rate for Payer: Aetna Medicare |
$480.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$600.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$600.55
|
| Rate for Payer: ASR ASR |
$1,584.67
|
| Rate for Payer: BCBS Complete |
$275.96
|
| Rate for Payer: BCBS MAPPO |
$480.44
|
| Rate for Payer: BCBS Trust/PPO |
$1,266.59
|
| Rate for Payer: BCN Commercial |
$1,266.59
|
| Rate for Payer: BCN Medicare Advantage |
$480.44
|
| Rate for Payer: Cash Price |
$1,306.94
|
| Rate for Payer: Cash Price |
$1,306.94
|
| Rate for Payer: Cofinity Commercial |
$1,535.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,306.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$480.44
|
| Rate for Payer: Healthscope Commercial |
$1,633.68
|
| Rate for Payer: Healthscope Whirlpool |
$1,584.67
|
| Rate for Payer: Humana Choice PPO Medicare |
$480.44
|
| Rate for Payer: Mclaren Commercial |
$1,470.31
|
| Rate for Payer: Mclaren Medicaid |
$262.80
|
| Rate for Payer: Mclaren Medicare |
$480.44
|
| Rate for Payer: Meridian Medicaid |
$275.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$504.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$552.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,388.63
|
| Rate for Payer: PACE Medicare |
$456.42
|
| Rate for Payer: PACE SWMI |
$480.44
|
| Rate for Payer: PHP Commercial |
$528.48
|
| Rate for Payer: PHP Medicaid |
$262.80
|
| Rate for Payer: PHP Medicare Advantage |
$480.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$262.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,143.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$665.99
|
| Rate for Payer: Priority Health Medicare |
$480.44
|
| Rate for Payer: Priority Health Narrow Network |
$532.79
|
| Rate for Payer: Railroad Medicare Medicare |
$480.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,437.64
|
| Rate for Payer: UHC Medicare Advantage |
$494.85
|
| Rate for Payer: VA VA |
$480.44
|
|
|
HC NM VENTILATION AEROSOL OR GAS
|
Facility
|
IP
|
$1,195.27
|
|
|
Service Code
|
CPT 78579
|
| Hospital Charge Code |
34100071
|
|
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 VENTILATION AEROSOL OR GAS
|
Facility
|
OP
|
$1,195.27
|
|
|
Service Code
|
CPT 78579
|
| Hospital Charge Code |
34100071
|
|
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 |
$875.33
|
| Rate for Payer: Priority Health Medicare |
$366.61
|
| Rate for Payer: Priority Health Narrow Network |
$700.26
|
| 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 VENTILATION PERFUS QUANT DIFF
|
Facility
|
IP
|
$1,633.68
|
|
|
Service Code
|
CPT 78598
|
| Hospital Charge Code |
34100070
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$1,143.58 |
| Max. Negotiated Rate |
$1,633.68 |
| Rate for Payer: Aetna Commercial |
$1,470.31
|
| Rate for Payer: ASR ASR |
$1,584.67
|
| Rate for Payer: BCBS Trust/PPO |
$1,266.59
|
| Rate for Payer: BCN Commercial |
$1,266.59
|
| Rate for Payer: Cash Price |
$1,306.94
|
| Rate for Payer: Cofinity Commercial |
$1,535.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,306.94
|
| Rate for Payer: Healthscope Commercial |
$1,633.68
|
| Rate for Payer: Healthscope Whirlpool |
$1,584.67
|
| Rate for Payer: Mclaren Commercial |
$1,470.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,388.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,143.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,437.64
|
|
|
HC NM VENTILATION PERFUS QUANT DIFF
|
Facility
|
OP
|
$1,633.68
|
|
|
Service Code
|
CPT 78598
|
| Hospital Charge Code |
34100070
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$262.80 |
| Max. Negotiated Rate |
$1,633.68 |
| Rate for Payer: Aetna Commercial |
$1,470.31
|
| Rate for Payer: Aetna Medicare |
$480.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$600.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$600.55
|
| Rate for Payer: ASR ASR |
$1,584.67
|
| Rate for Payer: BCBS Complete |
$275.96
|
| Rate for Payer: BCBS MAPPO |
$480.44
|
| Rate for Payer: BCBS Trust/PPO |
$1,266.59
|
| Rate for Payer: BCN Commercial |
$1,266.59
|
| Rate for Payer: BCN Medicare Advantage |
$480.44
|
| Rate for Payer: Cash Price |
$1,306.94
|
| Rate for Payer: Cash Price |
$1,306.94
|
| Rate for Payer: Cofinity Commercial |
$1,535.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,306.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$480.44
|
| Rate for Payer: Healthscope Commercial |
$1,633.68
|
| Rate for Payer: Healthscope Whirlpool |
$1,584.67
|
| Rate for Payer: Humana Choice PPO Medicare |
$480.44
|
| Rate for Payer: Mclaren Commercial |
$1,470.31
|
| Rate for Payer: Mclaren Medicaid |
$262.80
|
| Rate for Payer: Mclaren Medicare |
$480.44
|
| Rate for Payer: Meridian Medicaid |
$275.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$504.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$552.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,388.63
|
| Rate for Payer: PACE Medicare |
$456.42
|
| Rate for Payer: PACE SWMI |
$480.44
|
| Rate for Payer: PHP Commercial |
$528.48
|
| Rate for Payer: PHP Medicaid |
$262.80
|
| Rate for Payer: PHP Medicare Advantage |
$480.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$262.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,143.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,486.65
|
| Rate for Payer: Priority Health Medicare |
$480.44
|
| Rate for Payer: Priority Health Narrow Network |
$1,159.91
|
| Rate for Payer: Railroad Medicare Medicare |
$480.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,437.64
|
| Rate for Payer: UHC Medicare Advantage |
$494.85
|
| Rate for Payer: VA VA |
$480.44
|
|
