|
HC HERPES SIMPLEX IGM TYPE 1&2
|
Facility
|
IP
|
$48.90
|
|
|
Service Code
|
CPT 86694
|
| Hospital Charge Code |
30200278
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$31.78 |
| Max. Negotiated Rate |
$48.90 |
| Rate for Payer: Aetna Commercial |
$44.01
|
| Rate for Payer: ASR ASR |
$47.43
|
| Rate for Payer: ASR Commercial |
$47.43
|
| Rate for Payer: BCBS Trust/PPO |
$39.85
|
| Rate for Payer: BCN Commercial |
$37.91
|
| Rate for Payer: Cash Price |
$39.12
|
| Rate for Payer: Cofinity Commercial |
$45.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.12
|
| Rate for Payer: Healthscope Commercial |
$48.90
|
| Rate for Payer: Healthscope Whirlpool |
$47.43
|
| Rate for Payer: Mclaren Commercial |
$44.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.56
|
| Rate for Payer: Nomi Health Commercial |
$40.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$43.03
|
|
|
HC HERPES SIMPLEX NON-SPECIFIC
|
Facility
|
OP
|
$39.54
|
|
|
Service Code
|
CPT 86694
|
| Hospital Charge Code |
30200277
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.71 |
| Max. Negotiated Rate |
$59.30 |
| Rate for Payer: Aetna Commercial |
$35.59
|
| Rate for Payer: Aetna Medicare |
$14.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.99
|
| Rate for Payer: ASR ASR |
$38.35
|
| Rate for Payer: ASR Commercial |
$38.35
|
| Rate for Payer: BCBS Complete |
$8.10
|
| Rate for Payer: BCBS MAPPO |
$14.39
|
| Rate for Payer: BCBS Trust/PPO |
$32.38
|
| Rate for Payer: BCN Commercial |
$30.66
|
| Rate for Payer: BCN Medicare Advantage |
$14.39
|
| Rate for Payer: Cash Price |
$31.63
|
| Rate for Payer: Cash Price |
$31.63
|
| Rate for Payer: Cofinity Commercial |
$37.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.39
|
| Rate for Payer: Healthscope Commercial |
$39.54
|
| Rate for Payer: Healthscope Whirlpool |
$38.35
|
| Rate for Payer: Humana Choice PPO Medicare |
$14.39
|
| Rate for Payer: Mclaren Commercial |
$35.59
|
| Rate for Payer: Mclaren Medicaid |
$7.71
|
| Rate for Payer: Mclaren Medicare |
$14.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.11
|
| Rate for Payer: Meridian Medicaid |
$8.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.61
|
| Rate for Payer: Nomi Health Commercial |
$32.42
|
| Rate for Payer: PACE Medicare |
$13.67
|
| Rate for Payer: PACE SWMI |
$14.39
|
| Rate for Payer: PHP Commercial |
$15.83
|
| Rate for Payer: PHP Medicaid |
$7.71
|
| Rate for Payer: PHP Medicare Advantage |
$14.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$59.30
|
| Rate for Payer: Priority Health Medicare |
$14.39
|
| Rate for Payer: Priority Health Narrow Network |
$47.44
|
| Rate for Payer: Railroad Medicare Medicare |
$14.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$34.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.39
|
| Rate for Payer: UHC Exchange |
$22.30
|
| Rate for Payer: UHC Medicare Advantage |
$14.39
|
| Rate for Payer: UHCCP DNSP |
$14.39
|
| Rate for Payer: UHCCP Medicaid |
$7.71
|
| Rate for Payer: VA VA |
$14.39
|
|
|
HC HERPES SIMPLEX NON-SPECIFIC
|
Facility
|
IP
|
$39.54
|
|
|
Service Code
|
CPT 86694
|
| Hospital Charge Code |
30200277
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$25.70 |
| Max. Negotiated Rate |
$39.54 |
| Rate for Payer: Aetna Commercial |
$35.59
|
| Rate for Payer: ASR ASR |
$38.35
|
| Rate for Payer: ASR Commercial |
$38.35
|
| Rate for Payer: BCBS Trust/PPO |
$32.22
|
| Rate for Payer: BCN Commercial |
$30.66
|
| Rate for Payer: Cash Price |
$31.63
|
| Rate for Payer: Cofinity Commercial |
$37.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.63
|
| Rate for Payer: Healthscope Commercial |
$39.54
|
| Rate for Payer: Healthscope Whirlpool |
$38.35
|
| Rate for Payer: Mclaren Commercial |
$35.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.61
|
| Rate for Payer: Nomi Health Commercial |
$32.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$34.80
|
|
|
HC HERPES SIMPLEX PCR
|
Facility
|
IP
|
$56.10
|
|
|
Service Code
|
CPT 87529
|
| Hospital Charge Code |
30600158
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$36.46 |
| Max. Negotiated Rate |
$56.10 |
| Rate for Payer: Aetna Commercial |
$50.49
|
| Rate for Payer: ASR ASR |
$54.42
|
| Rate for Payer: ASR Commercial |
$54.42
|
| Rate for Payer: BCBS Trust/PPO |
$45.72
|
| Rate for Payer: BCN Commercial |
$43.49
|
| Rate for Payer: Cash Price |
$44.88
|
| Rate for Payer: Cofinity Commercial |
$52.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.88
|
| Rate for Payer: Healthscope Commercial |
$56.10
|
| Rate for Payer: Healthscope Whirlpool |
$54.42
|
| Rate for Payer: Mclaren Commercial |
$50.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.68
|
| Rate for Payer: Nomi Health Commercial |
$46.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$49.37
|
|
|
HC HERPES SIMPLEX PCR
|
Facility
|
OP
|
$56.10
|
|
|
Service Code
|
CPT 87529
|
| Hospital Charge Code |
30600158
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$56.10 |
| Rate for Payer: Aetna Commercial |
$50.49
|
| Rate for Payer: Aetna Medicare |
$35.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: ASR ASR |
$54.42
|
| Rate for Payer: ASR Commercial |
$54.42
|
| Rate for Payer: BCBS Complete |
$19.75
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$45.94
|
| Rate for Payer: BCN Commercial |
$43.49
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$44.88
|
| Rate for Payer: Cash Price |
$44.88
|
| Rate for Payer: Cofinity Commercial |
$52.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$56.10
|
| Rate for Payer: Healthscope Whirlpool |
$54.42
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$50.49
|
| Rate for Payer: Mclaren Medicaid |
$18.81
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$19.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.68
|
| Rate for Payer: Nomi Health Commercial |
$46.00
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$38.60
|
| Rate for Payer: PHP Medicaid |
$18.81
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$49.15
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$39.33
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$49.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$54.39
|
| Rate for Payer: UHC Medicare Advantage |
$35.09
|
| Rate for Payer: UHCCP DNSP |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$18.81
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC HERPES SIMPLEX VIRUS 1 (HSV-1)
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 87529
|
| Hospital Charge Code |
30600270
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$54.39 |
| Rate for Payer: Aetna Commercial |
$46.82
|
| Rate for Payer: Aetna Medicare |
$35.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: ASR ASR |
$50.46
|
| Rate for Payer: ASR Commercial |
$50.46
|
| Rate for Payer: BCBS Complete |
$19.75
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$42.60
|
| Rate for Payer: BCN Commercial |
$40.33
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$48.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$52.02
|
| Rate for Payer: Healthscope Whirlpool |
$50.46
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$46.82
|
| Rate for Payer: Mclaren Medicaid |
$18.81
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$19.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$38.60
|
| Rate for Payer: PHP Medicaid |
$18.81
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45.58
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$36.47
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$54.39
|
| Rate for Payer: UHC Medicare Advantage |
$35.09
|
| Rate for Payer: UHCCP DNSP |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$18.81
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC HERPES SIMPLEX VIRUS 1 (HSV-1)
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 87529
|
| Hospital Charge Code |
30600270
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$33.81 |
| Max. Negotiated Rate |
$52.02 |
| Rate for Payer: Aetna Commercial |
$46.82
|
| Rate for Payer: ASR ASR |
$50.46
|
| Rate for Payer: ASR Commercial |
$50.46
|
| Rate for Payer: BCBS Trust/PPO |
$42.39
|
| Rate for Payer: BCN Commercial |
$40.33
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$48.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$52.02
|
| Rate for Payer: Healthscope Whirlpool |
$50.46
|
| Rate for Payer: Mclaren Commercial |
$46.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.78
|
|
|
HC HERPES SIMPLEX VIRUS CULTURE
|
Facility
|
OP
|
$104.04
|
|
|
Service Code
|
CPT 87255
|
| Hospital Charge Code |
30600116
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.15 |
| Max. Negotiated Rate |
$104.31 |
| Rate for Payer: Aetna Commercial |
$93.64
|
| Rate for Payer: Aetna Medicare |
$33.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$42.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$42.32
|
| Rate for Payer: ASR ASR |
$100.92
|
| Rate for Payer: ASR Commercial |
$100.92
|
| Rate for Payer: BCBS Complete |
$19.06
|
| Rate for Payer: BCBS MAPPO |
$33.86
|
| Rate for Payer: BCBS Trust/PPO |
$85.20
|
| Rate for Payer: BCN Commercial |
$80.66
|
| Rate for Payer: BCN Medicare Advantage |
$33.86
|
| Rate for Payer: Cash Price |
$83.23
|
| Rate for Payer: Cash Price |
$83.23
|
| Rate for Payer: Cofinity Commercial |
$97.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.86
|
| Rate for Payer: Healthscope Commercial |
$104.04
|
| Rate for Payer: Healthscope Whirlpool |
$100.92
|
| Rate for Payer: Humana Choice PPO Medicare |
$33.86
|
| Rate for Payer: Mclaren Commercial |
$93.64
|
| Rate for Payer: Mclaren Medicaid |
$18.15
|
| Rate for Payer: Mclaren Medicare |
$33.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.55
|
| Rate for Payer: Meridian Medicaid |
$19.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.43
|
| Rate for Payer: Nomi Health Commercial |
$85.31
|
| Rate for Payer: PACE Medicare |
$32.17
|
| Rate for Payer: PACE SWMI |
$33.86
|
| Rate for Payer: PHP Commercial |
$37.25
|
| Rate for Payer: PHP Medicaid |
$18.15
|
| Rate for Payer: PHP Medicare Advantage |
$33.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$104.31
|
| Rate for Payer: Priority Health Medicare |
$33.86
|
| Rate for Payer: Priority Health Narrow Network |
$83.45
|
| Rate for Payer: Railroad Medicare Medicare |
$33.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$91.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.86
|
| Rate for Payer: UHC Exchange |
$52.48
|
| Rate for Payer: UHC Medicare Advantage |
$33.86
|
| Rate for Payer: UHCCP DNSP |
$33.86
|
| Rate for Payer: UHCCP Medicaid |
$18.15
|
| Rate for Payer: VA VA |
$33.86
|
|
|
HC HERPES SIMPLEX VIRUS CULTURE
|
Facility
|
IP
|
$104.04
|
|
|
Service Code
|
CPT 87255
|
| Hospital Charge Code |
30600116
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$67.63 |
| Max. Negotiated Rate |
$104.04 |
| Rate for Payer: Aetna Commercial |
$93.64
|
| Rate for Payer: ASR ASR |
$100.92
|
| Rate for Payer: ASR Commercial |
$100.92
|
| Rate for Payer: BCBS Trust/PPO |
$84.78
|
| Rate for Payer: BCN Commercial |
$80.66
|
| Rate for Payer: Cash Price |
$83.23
|
| Rate for Payer: Cofinity Commercial |
$97.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.23
|
| Rate for Payer: Healthscope Commercial |
$104.04
|
| Rate for Payer: Healthscope Whirlpool |
$100.92
|
| Rate for Payer: Mclaren Commercial |
$93.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.43
|
| Rate for Payer: Nomi Health Commercial |
$85.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$91.56
|
|
|
HC HERPES SIMPLEX VIRUS (HSV-2)
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 87529
|
| Hospital Charge Code |
30600271
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$54.39 |
| Rate for Payer: Aetna Commercial |
$46.82
|
| Rate for Payer: Aetna Medicare |
$35.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: ASR ASR |
$50.46
|
| Rate for Payer: ASR Commercial |
$50.46
|
| Rate for Payer: BCBS Complete |
$19.75
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$42.60
|
| Rate for Payer: BCN Commercial |
$40.33
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$48.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$52.02
|
| Rate for Payer: Healthscope Whirlpool |
$50.46
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$46.82
|
| Rate for Payer: Mclaren Medicaid |
$18.81
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$19.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$38.60
|
| Rate for Payer: PHP Medicaid |
$18.81
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45.58
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$36.47
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$54.39
|
| Rate for Payer: UHC Medicare Advantage |
$35.09
|
| Rate for Payer: UHCCP DNSP |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$18.81
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC HERPES SIMPLEX VIRUS (HSV-2)
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 87529
|
| Hospital Charge Code |
30600271
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$33.81 |
| Max. Negotiated Rate |
$52.02 |
| Rate for Payer: Aetna Commercial |
$46.82
|
| Rate for Payer: ASR ASR |
$50.46
|
| Rate for Payer: ASR Commercial |
$50.46
|
| Rate for Payer: BCBS Trust/PPO |
$42.39
|
| Rate for Payer: BCN Commercial |
$40.33
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$48.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$52.02
|
| Rate for Payer: Healthscope Whirlpool |
$50.46
|
| Rate for Payer: Mclaren Commercial |
$46.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.78
|
|
|
HC HERPES SIMPLEX VIRUS PCR, BLD
|
Facility
|
OP
|
$48.54
|
|
|
Service Code
|
CPT 87529
|
| Hospital Charge Code |
30600340
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$54.39 |
| Rate for Payer: Aetna Commercial |
$43.69
|
| Rate for Payer: Aetna Medicare |
$35.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: ASR ASR |
$47.08
|
| Rate for Payer: ASR Commercial |
$47.08
|
| Rate for Payer: BCBS Complete |
$19.75
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$39.75
|
| Rate for Payer: BCN Commercial |
$37.63
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$38.83
|
| Rate for Payer: Cash Price |
$38.83
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$48.54
|
| Rate for Payer: Healthscope Whirlpool |
$47.08
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$43.69
|
| Rate for Payer: Mclaren Medicaid |
$18.81
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$19.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.26
|
| Rate for Payer: Nomi Health Commercial |
$39.80
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$38.60
|
| Rate for Payer: PHP Medicaid |
$18.81
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$42.53
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$34.03
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$42.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$54.39
|
| Rate for Payer: UHC Medicare Advantage |
$35.09
|
| Rate for Payer: UHCCP DNSP |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$18.81
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC HERPES SIMPLEX VIRUS PCR, BLD
|
Facility
|
IP
|
$48.54
|
|
|
Service Code
|
CPT 87529
|
| Hospital Charge Code |
30600340
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$31.55 |
| Max. Negotiated Rate |
$48.54 |
| Rate for Payer: Aetna Commercial |
$43.69
|
| Rate for Payer: ASR ASR |
$47.08
|
| Rate for Payer: ASR Commercial |
$47.08
|
| Rate for Payer: BCBS Trust/PPO |
$39.56
|
| Rate for Payer: BCN Commercial |
$37.63
|
| Rate for Payer: Cash Price |
$38.83
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.83
|
| Rate for Payer: Healthscope Commercial |
$48.54
|
| Rate for Payer: Healthscope Whirlpool |
$47.08
|
| Rate for Payer: Mclaren Commercial |
$43.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.26
|
| Rate for Payer: Nomi Health Commercial |
$39.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$42.72
|
|
|
HC HH ALOE VESTA CLEANSER
|
Facility
|
IP
|
$18.07
|
|
| Hospital Charge Code |
27100003
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$11.75 |
| Max. Negotiated Rate |
$18.07 |
| Rate for Payer: Aetna Commercial |
$16.26
|
| Rate for Payer: ASR ASR |
$17.53
|
| Rate for Payer: ASR Commercial |
$17.53
|
| Rate for Payer: BCBS Trust/PPO |
$14.73
|
| Rate for Payer: BCN Commercial |
$14.01
|
| Rate for Payer: Cash Price |
$14.46
|
| Rate for Payer: Cofinity Commercial |
$16.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.46
|
| Rate for Payer: Healthscope Commercial |
$18.07
|
| Rate for Payer: Healthscope Whirlpool |
$17.53
|
| Rate for Payer: Mclaren Commercial |
$16.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.36
|
| Rate for Payer: Nomi Health Commercial |
$14.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15.90
|
|
|
HC HH ALOE VESTA CLEANSER
|
Facility
|
OP
|
$18.07
|
|
| Hospital Charge Code |
27100003
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$7.23 |
| Max. Negotiated Rate |
$18.07 |
| Rate for Payer: Aetna Commercial |
$16.26
|
| Rate for Payer: Aetna Medicare |
$9.04
|
| Rate for Payer: ASR ASR |
$17.53
|
| Rate for Payer: ASR Commercial |
$17.53
|
| Rate for Payer: BCBS Complete |
$7.23
|
| Rate for Payer: BCBS Trust/PPO |
$14.80
|
| Rate for Payer: BCN Commercial |
$14.01
|
| Rate for Payer: Cash Price |
$14.46
|
| Rate for Payer: Cofinity Commercial |
$16.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.46
|
| Rate for Payer: Healthscope Commercial |
$18.07
|
| Rate for Payer: Healthscope Whirlpool |
$17.53
|
| Rate for Payer: Mclaren Commercial |
$16.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.36
|
| Rate for Payer: Nomi Health Commercial |
$14.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.83
|
| Rate for Payer: Priority Health Narrow Network |
$12.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15.90
|
|
|
HC HH POUCH CLOSURE CLAMP
|
Facility
|
IP
|
$16.83
|
|
| Hospital Charge Code |
27000138
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$10.94 |
| Max. Negotiated Rate |
$16.83 |
| Rate for Payer: Aetna Commercial |
$15.15
|
| Rate for Payer: ASR ASR |
$16.33
|
| Rate for Payer: ASR Commercial |
$16.33
|
| Rate for Payer: BCBS Trust/PPO |
$13.71
|
| Rate for Payer: BCN Commercial |
$13.05
|
| Rate for Payer: Cash Price |
$13.46
|
| Rate for Payer: Cofinity Commercial |
$15.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.46
|
| Rate for Payer: Healthscope Commercial |
$16.83
|
| Rate for Payer: Healthscope Whirlpool |
$16.33
|
| Rate for Payer: Mclaren Commercial |
$15.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.31
|
| Rate for Payer: Nomi Health Commercial |
$13.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14.81
|
|
|
HC HH POUCH CLOSURE CLAMP
|
Facility
|
OP
|
$16.83
|
|
| Hospital Charge Code |
27000138
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$6.73 |
| Max. Negotiated Rate |
$16.83 |
| Rate for Payer: Aetna Commercial |
$15.15
|
| Rate for Payer: Aetna Medicare |
$8.42
|
| Rate for Payer: ASR ASR |
$16.33
|
| Rate for Payer: ASR Commercial |
$16.33
|
| Rate for Payer: BCBS Complete |
$6.73
|
| Rate for Payer: BCBS Trust/PPO |
$13.78
|
| Rate for Payer: BCN Commercial |
$13.05
|
| Rate for Payer: Cash Price |
$13.46
|
| Rate for Payer: Cofinity Commercial |
$15.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.46
|
| Rate for Payer: Healthscope Commercial |
$16.83
|
| Rate for Payer: Healthscope Whirlpool |
$16.33
|
| Rate for Payer: Mclaren Commercial |
$15.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.31
|
| Rate for Payer: Nomi Health Commercial |
$13.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14.75
|
| Rate for Payer: Priority Health Narrow Network |
$11.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14.81
|
|
|
HC HH WET ONES
|
Facility
|
IP
|
$16.05
|
|
| Hospital Charge Code |
27000170
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$10.43 |
| Max. Negotiated Rate |
$16.05 |
| Rate for Payer: Aetna Commercial |
$14.44
|
| Rate for Payer: ASR ASR |
$15.57
|
| Rate for Payer: ASR Commercial |
$15.57
|
| Rate for Payer: BCBS Trust/PPO |
$13.08
|
| Rate for Payer: BCN Commercial |
$12.44
|
| Rate for Payer: Cash Price |
$12.84
|
| Rate for Payer: Cofinity Commercial |
$15.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.84
|
| Rate for Payer: Healthscope Commercial |
$16.05
|
| Rate for Payer: Healthscope Whirlpool |
$15.57
|
| Rate for Payer: Mclaren Commercial |
$14.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.64
|
| Rate for Payer: Nomi Health Commercial |
$13.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14.12
|
|
|
HC HH WET ONES
|
Facility
|
OP
|
$16.05
|
|
| Hospital Charge Code |
27000170
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$6.42 |
| Max. Negotiated Rate |
$16.05 |
| Rate for Payer: Aetna Commercial |
$14.44
|
| Rate for Payer: Aetna Medicare |
$8.02
|
| Rate for Payer: ASR ASR |
$15.57
|
| Rate for Payer: ASR Commercial |
$15.57
|
| Rate for Payer: BCBS Complete |
$6.42
|
| Rate for Payer: BCBS Trust/PPO |
$13.14
|
| Rate for Payer: BCN Commercial |
$12.44
|
| Rate for Payer: Cash Price |
$12.84
|
| Rate for Payer: Cofinity Commercial |
$15.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.84
|
| Rate for Payer: Healthscope Commercial |
$16.05
|
| Rate for Payer: Healthscope Whirlpool |
$15.57
|
| Rate for Payer: Mclaren Commercial |
$14.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.64
|
| Rate for Payer: Nomi Health Commercial |
$13.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14.06
|
| Rate for Payer: Priority Health Narrow Network |
$11.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14.12
|
|
|
HC HIAA SEROTONIN URINE
|
Facility
|
IP
|
$44.74
|
|
|
Service Code
|
CPT 83497
|
| Hospital Charge Code |
30100248
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$29.08 |
| Max. Negotiated Rate |
$44.74 |
| Rate for Payer: Aetna Commercial |
$40.27
|
| Rate for Payer: ASR ASR |
$43.40
|
| Rate for Payer: ASR Commercial |
$43.40
|
| Rate for Payer: BCBS Trust/PPO |
$36.46
|
| Rate for Payer: BCN Commercial |
$34.69
|
| Rate for Payer: Cash Price |
$35.79
|
| Rate for Payer: Cofinity Commercial |
$42.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.79
|
| Rate for Payer: Healthscope Commercial |
$44.74
|
| Rate for Payer: Healthscope Whirlpool |
$43.40
|
| Rate for Payer: Mclaren Commercial |
$40.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.03
|
| Rate for Payer: Nomi Health Commercial |
$36.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$39.37
|
|
|
HC HIAA SEROTONIN URINE
|
Facility
|
OP
|
$44.74
|
|
|
Service Code
|
CPT 83497
|
| Hospital Charge Code |
30100248
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.91 |
| Max. Negotiated Rate |
$66.98 |
| Rate for Payer: Aetna Commercial |
$40.27
|
| Rate for Payer: Aetna Medicare |
$12.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.12
|
| Rate for Payer: ASR ASR |
$43.40
|
| Rate for Payer: ASR Commercial |
$43.40
|
| Rate for Payer: BCBS Complete |
$7.26
|
| Rate for Payer: BCBS MAPPO |
$12.90
|
| Rate for Payer: BCBS Trust/PPO |
$36.64
|
| Rate for Payer: BCN Commercial |
$34.69
|
| Rate for Payer: BCN Medicare Advantage |
$12.90
|
| Rate for Payer: Cash Price |
$35.79
|
| Rate for Payer: Cash Price |
$35.79
|
| Rate for Payer: Cofinity Commercial |
$42.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.90
|
| Rate for Payer: Healthscope Commercial |
$44.74
|
| Rate for Payer: Healthscope Whirlpool |
$43.40
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.90
|
| Rate for Payer: Mclaren Commercial |
$40.27
|
| Rate for Payer: Mclaren Medicaid |
$6.91
|
| Rate for Payer: Mclaren Medicare |
$12.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.54
|
| Rate for Payer: Meridian Medicaid |
$7.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.03
|
| Rate for Payer: Nomi Health Commercial |
$36.69
|
| Rate for Payer: PACE Medicare |
$12.26
|
| Rate for Payer: PACE SWMI |
$12.90
|
| Rate for Payer: PHP Commercial |
$14.19
|
| Rate for Payer: PHP Medicaid |
$6.91
|
| Rate for Payer: PHP Medicare Advantage |
$12.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$66.98
|
| Rate for Payer: Priority Health Medicare |
$12.90
|
| Rate for Payer: Priority Health Narrow Network |
$53.58
|
| Rate for Payer: Railroad Medicare Medicare |
$12.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$39.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.90
|
| Rate for Payer: UHC Exchange |
$20.00
|
| Rate for Payer: UHC Medicare Advantage |
$12.90
|
| Rate for Payer: UHCCP DNSP |
$12.90
|
| Rate for Payer: UHCCP Medicaid |
$6.91
|
| Rate for Payer: VA VA |
$12.90
|
|
|
HC HIB PRP-OMP VACC 3 DOSE IM
|
Facility
|
OP
|
$42.17
|
|
|
Service Code
|
CPT 90647
|
| Hospital Charge Code |
63600180
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$16.87 |
| Max. Negotiated Rate |
$42.17 |
| Rate for Payer: Aetna Commercial |
$37.95
|
| Rate for Payer: Aetna Medicare |
$21.08
|
| Rate for Payer: ASR ASR |
$40.90
|
| Rate for Payer: ASR Commercial |
$40.90
|
| Rate for Payer: BCBS Complete |
$16.87
|
| Rate for Payer: BCBS Trust/PPO |
$34.53
|
| Rate for Payer: BCN Commercial |
$32.69
|
| Rate for Payer: Cash Price |
$33.74
|
| Rate for Payer: Cash Price |
$33.74
|
| Rate for Payer: Cofinity Commercial |
$39.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.74
|
| Rate for Payer: Healthscope Commercial |
$42.17
|
| Rate for Payer: Healthscope Whirlpool |
$40.90
|
| Rate for Payer: Mclaren Commercial |
$37.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.84
|
| Rate for Payer: Nomi Health Commercial |
$34.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34.71
|
| Rate for Payer: Priority Health Narrow Network |
$27.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.11
|
|
|
HC HIB PRP-OMP VACC 3 DOSE IM
|
Facility
|
IP
|
$42.17
|
|
|
Service Code
|
CPT 90647
|
| Hospital Charge Code |
63600180
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$27.41 |
| Max. Negotiated Rate |
$42.17 |
| Rate for Payer: Aetna Commercial |
$37.95
|
| Rate for Payer: ASR ASR |
$40.90
|
| Rate for Payer: ASR Commercial |
$40.90
|
| Rate for Payer: BCBS Trust/PPO |
$34.36
|
| Rate for Payer: BCN Commercial |
$32.69
|
| Rate for Payer: Cash Price |
$33.74
|
| Rate for Payer: Cofinity Commercial |
$39.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.74
|
| Rate for Payer: Healthscope Commercial |
$42.17
|
| Rate for Payer: Healthscope Whirlpool |
$40.90
|
| Rate for Payer: Mclaren Commercial |
$37.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.84
|
| Rate for Payer: Nomi Health Commercial |
$34.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.11
|
|
|
HC HIGH FLOW JET VENT
|
Facility
|
OP
|
$1,043.46
|
|
| Hospital Charge Code |
27000699
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$417.38 |
| Max. Negotiated Rate |
$1,043.46 |
| Rate for Payer: Aetna Commercial |
$939.11
|
| Rate for Payer: Aetna Medicare |
$521.73
|
| Rate for Payer: ASR ASR |
$1,012.16
|
| Rate for Payer: ASR Commercial |
$1,012.16
|
| Rate for Payer: BCBS Complete |
$417.38
|
| Rate for Payer: BCBS Trust/PPO |
$854.49
|
| Rate for Payer: BCN Commercial |
$808.99
|
| Rate for Payer: Cash Price |
$834.77
|
| Rate for Payer: Cofinity Commercial |
$980.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$834.77
|
| Rate for Payer: Healthscope Commercial |
$1,043.46
|
| Rate for Payer: Healthscope Whirlpool |
$1,012.16
|
| Rate for Payer: Mclaren Commercial |
$939.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$886.94
|
| Rate for Payer: Nomi Health Commercial |
$855.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$678.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$914.28
|
| Rate for Payer: Priority Health Narrow Network |
$731.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$918.24
|
|
|
HC HIGH FLOW JET VENT
|
Facility
|
IP
|
$1,043.46
|
|
| Hospital Charge Code |
27000699
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$678.25 |
| Max. Negotiated Rate |
$1,043.46 |
| Rate for Payer: Aetna Commercial |
$939.11
|
| Rate for Payer: ASR ASR |
$1,012.16
|
| Rate for Payer: ASR Commercial |
$1,012.16
|
| Rate for Payer: BCBS Trust/PPO |
$850.32
|
| Rate for Payer: BCN Commercial |
$808.99
|
| Rate for Payer: Cash Price |
$834.77
|
| Rate for Payer: Cofinity Commercial |
$980.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$834.77
|
| Rate for Payer: Healthscope Commercial |
$1,043.46
|
| Rate for Payer: Healthscope Whirlpool |
$1,012.16
|
| Rate for Payer: Mclaren Commercial |
$939.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$886.94
|
| Rate for Payer: Nomi Health Commercial |
$855.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$678.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$918.24
|
|
