|
HC HIGH FLOW OXYGEN THERAPY
|
Facility
|
IP
|
$217.39
|
|
| Hospital Charge Code |
27000632
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$141.30 |
| Max. Negotiated Rate |
$217.39 |
| Rate for Payer: Aetna Commercial |
$195.65
|
| Rate for Payer: ASR ASR |
$210.87
|
| Rate for Payer: ASR Commercial |
$210.87
|
| Rate for Payer: BCBS Trust/PPO |
$177.15
|
| Rate for Payer: BCN Commercial |
$168.54
|
| Rate for Payer: Cash Price |
$173.91
|
| Rate for Payer: Cofinity Commercial |
$204.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$173.91
|
| Rate for Payer: Healthscope Commercial |
$217.39
|
| Rate for Payer: Healthscope Whirlpool |
$210.87
|
| Rate for Payer: Mclaren Commercial |
$195.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$184.78
|
| Rate for Payer: Nomi Health Commercial |
$178.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$141.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$191.30
|
|
|
HC HIGH FLOW OXYGEN THERAPY
|
Facility
|
OP
|
$217.39
|
|
| Hospital Charge Code |
27000632
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$86.96 |
| Max. Negotiated Rate |
$217.39 |
| Rate for Payer: Aetna Commercial |
$195.65
|
| Rate for Payer: Aetna Medicare |
$108.70
|
| Rate for Payer: ASR ASR |
$210.87
|
| Rate for Payer: ASR Commercial |
$210.87
|
| Rate for Payer: BCBS Complete |
$86.96
|
| Rate for Payer: BCBS Trust/PPO |
$178.02
|
| Rate for Payer: BCN Commercial |
$168.54
|
| Rate for Payer: Cash Price |
$173.91
|
| Rate for Payer: Cofinity Commercial |
$204.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$173.91
|
| Rate for Payer: Healthscope Commercial |
$217.39
|
| Rate for Payer: Healthscope Whirlpool |
$210.87
|
| Rate for Payer: Mclaren Commercial |
$195.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$184.78
|
| Rate for Payer: Nomi Health Commercial |
$178.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$141.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$190.48
|
| Rate for Payer: Priority Health Narrow Network |
$152.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$191.30
|
|
|
HC HINGE EXTENSION/FLEX WRIST/F
|
Facility
|
OP
|
$1,541.87
|
|
|
Service Code
|
HCPCS L3900
|
| Hospital Charge Code |
27400048
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$616.75 |
| Max. Negotiated Rate |
$1,541.87 |
| Rate for Payer: Aetna Commercial |
$1,387.68
|
| Rate for Payer: Aetna Medicare |
$770.94
|
| Rate for Payer: ASR ASR |
$1,495.61
|
| Rate for Payer: ASR Commercial |
$1,495.61
|
| Rate for Payer: BCBS Complete |
$616.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,262.64
|
| Rate for Payer: BCN Commercial |
$1,195.41
|
| Rate for Payer: Cash Price |
$1,233.50
|
| Rate for Payer: Cofinity Commercial |
$1,449.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,233.50
|
| Rate for Payer: Healthscope Commercial |
$1,541.87
|
| Rate for Payer: Healthscope Whirlpool |
$1,495.61
|
| Rate for Payer: Mclaren Commercial |
$1,387.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,310.59
|
| Rate for Payer: Nomi Health Commercial |
$1,264.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,002.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,350.99
|
| Rate for Payer: Priority Health Narrow Network |
$1,080.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,356.85
|
|
|
HC HINGE EXTENSION/FLEX WRIST/F
|
Facility
|
IP
|
$1,541.87
|
|
|
Service Code
|
HCPCS L3900
|
| Hospital Charge Code |
27400048
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$1,002.22 |
| Max. Negotiated Rate |
$1,541.87 |
| Rate for Payer: Aetna Commercial |
$1,387.68
|
| Rate for Payer: ASR ASR |
$1,495.61
|
| Rate for Payer: ASR Commercial |
$1,495.61
|
| Rate for Payer: BCBS Trust/PPO |
$1,256.47
|
| Rate for Payer: BCN Commercial |
$1,195.41
|
| Rate for Payer: Cash Price |
$1,233.50
|
| Rate for Payer: Cofinity Commercial |
$1,449.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,233.50
|
| Rate for Payer: Healthscope Commercial |
$1,541.87
|
| Rate for Payer: Healthscope Whirlpool |
$1,495.61
|
| Rate for Payer: Mclaren Commercial |
$1,387.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,310.59
|
| Rate for Payer: Nomi Health Commercial |
$1,264.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,002.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,356.85
|
|
|
HC HIPS BIL WITH PELVIS IF PERFORMED 2 VIEWS
|
Facility
|
IP
|
$391.43
|
|
|
Service Code
|
CPT 73521
|
| Hospital Charge Code |
32000312
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$254.43 |
| Max. Negotiated Rate |
$391.43 |
| Rate for Payer: Aetna Commercial |
$352.29
|
| Rate for Payer: ASR ASR |
$379.69
|
| Rate for Payer: ASR Commercial |
$379.69
|
| Rate for Payer: BCBS Trust/PPO |
$318.98
|
| Rate for Payer: BCN Commercial |
$303.48
|
| Rate for Payer: Cash Price |
$313.14
|
| Rate for Payer: Cofinity Commercial |
$367.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$313.14
|
| Rate for Payer: Healthscope Commercial |
$391.43
|
| Rate for Payer: Healthscope Whirlpool |
$379.69
|
| Rate for Payer: Mclaren Commercial |
$352.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$332.72
|
| Rate for Payer: Nomi Health Commercial |
$320.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$254.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$344.46
|
|
|
HC HIPS BIL WITH PELVIS IF PERFORMED 2 VIEWS
|
Facility
|
OP
|
$391.43
|
|
|
Service Code
|
CPT 73521
|
| Hospital Charge Code |
32000312
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$55.85 |
| Max. Negotiated Rate |
$391.43 |
| Rate for Payer: Aetna Commercial |
$352.29
|
| Rate for Payer: Aetna Medicare |
$104.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.24
|
| Rate for Payer: ASR ASR |
$379.69
|
| Rate for Payer: ASR Commercial |
$379.69
|
| Rate for Payer: BCBS Complete |
$58.64
|
| Rate for Payer: BCBS MAPPO |
$104.19
|
| Rate for Payer: BCBS Trust/PPO |
$320.54
|
| Rate for Payer: BCN Commercial |
$303.48
|
| Rate for Payer: BCN Medicare Advantage |
$104.19
|
| Rate for Payer: Cash Price |
$313.14
|
| Rate for Payer: Cash Price |
$313.14
|
| Rate for Payer: Cofinity Commercial |
$367.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$313.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.19
|
| Rate for Payer: Healthscope Commercial |
$391.43
|
| Rate for Payer: Healthscope Whirlpool |
$379.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$104.19
|
| Rate for Payer: Mclaren Commercial |
$352.29
|
| Rate for Payer: Mclaren Medicaid |
$55.85
|
| Rate for Payer: Mclaren Medicare |
$104.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.40
|
| Rate for Payer: Meridian Medicaid |
$58.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$332.72
|
| Rate for Payer: Nomi Health Commercial |
$320.97
|
| Rate for Payer: PACE Medicare |
$98.98
|
| Rate for Payer: PACE SWMI |
$104.19
|
| Rate for Payer: PHP Commercial |
$114.61
|
| Rate for Payer: PHP Medicaid |
$55.85
|
| Rate for Payer: PHP Medicare Advantage |
$104.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$254.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$342.97
|
| Rate for Payer: Priority Health Medicare |
$104.19
|
| Rate for Payer: Priority Health Narrow Network |
$274.39
|
| Rate for Payer: Railroad Medicare Medicare |
$104.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$344.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$104.19
|
| Rate for Payer: UHC Exchange |
$161.49
|
| Rate for Payer: UHC Medicare Advantage |
$104.19
|
| Rate for Payer: UHCCP DNSP |
$104.19
|
| Rate for Payer: UHCCP Medicaid |
$55.85
|
| Rate for Payer: VA VA |
$104.19
|
|
|
HC HIPS BIL WITH PELVIS IF PERFORMED 3 TO 4 VIEWS
|
Facility
|
OP
|
$481.76
|
|
|
Service Code
|
CPT 73522
|
| Hospital Charge Code |
32000313
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$55.85 |
| Max. Negotiated Rate |
$481.76 |
| Rate for Payer: Aetna Commercial |
$433.58
|
| Rate for Payer: Aetna Medicare |
$104.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.24
|
| Rate for Payer: ASR ASR |
$467.31
|
| Rate for Payer: ASR Commercial |
$467.31
|
| Rate for Payer: BCBS Complete |
$58.64
|
| Rate for Payer: BCBS MAPPO |
$104.19
|
| Rate for Payer: BCBS Trust/PPO |
$394.51
|
| Rate for Payer: BCN Commercial |
$373.51
|
| Rate for Payer: BCN Medicare Advantage |
$104.19
|
| Rate for Payer: Cash Price |
$385.41
|
| Rate for Payer: Cash Price |
$385.41
|
| Rate for Payer: Cofinity Commercial |
$452.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$385.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.19
|
| Rate for Payer: Healthscope Commercial |
$481.76
|
| Rate for Payer: Healthscope Whirlpool |
$467.31
|
| Rate for Payer: Humana Choice PPO Medicare |
$104.19
|
| Rate for Payer: Mclaren Commercial |
$433.58
|
| Rate for Payer: Mclaren Medicaid |
$55.85
|
| Rate for Payer: Mclaren Medicare |
$104.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.40
|
| Rate for Payer: Meridian Medicaid |
$58.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$409.50
|
| Rate for Payer: Nomi Health Commercial |
$395.04
|
| Rate for Payer: PACE Medicare |
$98.98
|
| Rate for Payer: PACE SWMI |
$104.19
|
| Rate for Payer: PHP Commercial |
$114.61
|
| Rate for Payer: PHP Medicaid |
$55.85
|
| Rate for Payer: PHP Medicare Advantage |
$104.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$313.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$422.12
|
| Rate for Payer: Priority Health Medicare |
$104.19
|
| Rate for Payer: Priority Health Narrow Network |
$337.71
|
| Rate for Payer: Railroad Medicare Medicare |
$104.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$423.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$104.19
|
| Rate for Payer: UHC Exchange |
$161.49
|
| Rate for Payer: UHC Medicare Advantage |
$104.19
|
| Rate for Payer: UHCCP DNSP |
$104.19
|
| Rate for Payer: UHCCP Medicaid |
$55.85
|
| Rate for Payer: VA VA |
$104.19
|
|
|
HC HIPS BIL WITH PELVIS IF PERFORMED 3 TO 4 VIEWS
|
Facility
|
IP
|
$481.76
|
|
|
Service Code
|
CPT 73522
|
| Hospital Charge Code |
32000313
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$313.14 |
| Max. Negotiated Rate |
$481.76 |
| Rate for Payer: Aetna Commercial |
$433.58
|
| Rate for Payer: ASR ASR |
$467.31
|
| Rate for Payer: ASR Commercial |
$467.31
|
| Rate for Payer: BCBS Trust/PPO |
$392.59
|
| Rate for Payer: BCN Commercial |
$373.51
|
| Rate for Payer: Cash Price |
$385.41
|
| Rate for Payer: Cofinity Commercial |
$452.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$385.41
|
| Rate for Payer: Healthscope Commercial |
$481.76
|
| Rate for Payer: Healthscope Whirlpool |
$467.31
|
| Rate for Payer: Mclaren Commercial |
$433.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$409.50
|
| Rate for Payer: Nomi Health Commercial |
$395.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$313.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$423.95
|
|
|
HC HIPS BIL WITH PELVIS IF PERFORMED MIN 5 VIEWS
|
Facility
|
OP
|
$541.99
|
|
|
Service Code
|
CPT 73523
|
| Hospital Charge Code |
32000314
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$55.85 |
| Max. Negotiated Rate |
$541.99 |
| Rate for Payer: Aetna Commercial |
$487.79
|
| Rate for Payer: Aetna Medicare |
$104.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.24
|
| Rate for Payer: ASR ASR |
$525.73
|
| Rate for Payer: ASR Commercial |
$525.73
|
| Rate for Payer: BCBS Complete |
$58.64
|
| Rate for Payer: BCBS MAPPO |
$104.19
|
| Rate for Payer: BCBS Trust/PPO |
$443.84
|
| Rate for Payer: BCN Commercial |
$420.20
|
| Rate for Payer: BCN Medicare Advantage |
$104.19
|
| Rate for Payer: Cash Price |
$433.59
|
| Rate for Payer: Cash Price |
$433.59
|
| Rate for Payer: Cofinity Commercial |
$509.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$433.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.19
|
| Rate for Payer: Healthscope Commercial |
$541.99
|
| Rate for Payer: Healthscope Whirlpool |
$525.73
|
| Rate for Payer: Humana Choice PPO Medicare |
$104.19
|
| Rate for Payer: Mclaren Commercial |
$487.79
|
| Rate for Payer: Mclaren Medicaid |
$55.85
|
| Rate for Payer: Mclaren Medicare |
$104.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.40
|
| Rate for Payer: Meridian Medicaid |
$58.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$460.69
|
| Rate for Payer: Nomi Health Commercial |
$444.43
|
| Rate for Payer: PACE Medicare |
$98.98
|
| Rate for Payer: PACE SWMI |
$104.19
|
| Rate for Payer: PHP Commercial |
$114.61
|
| Rate for Payer: PHP Medicaid |
$55.85
|
| Rate for Payer: PHP Medicare Advantage |
$104.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$352.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$474.89
|
| Rate for Payer: Priority Health Medicare |
$104.19
|
| Rate for Payer: Priority Health Narrow Network |
$379.93
|
| Rate for Payer: Railroad Medicare Medicare |
$104.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$476.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$104.19
|
| Rate for Payer: UHC Exchange |
$161.49
|
| Rate for Payer: UHC Medicare Advantage |
$104.19
|
| Rate for Payer: UHCCP DNSP |
$104.19
|
| Rate for Payer: UHCCP Medicaid |
$55.85
|
| Rate for Payer: VA VA |
$104.19
|
|
|
HC HIPS BIL WITH PELVIS IF PERFORMED MIN 5 VIEWS
|
Facility
|
IP
|
$541.99
|
|
|
Service Code
|
CPT 73523
|
| Hospital Charge Code |
32000314
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$352.29 |
| Max. Negotiated Rate |
$541.99 |
| Rate for Payer: Aetna Commercial |
$487.79
|
| Rate for Payer: ASR ASR |
$525.73
|
| Rate for Payer: ASR Commercial |
$525.73
|
| Rate for Payer: BCBS Trust/PPO |
$441.67
|
| Rate for Payer: BCN Commercial |
$420.20
|
| Rate for Payer: Cash Price |
$433.59
|
| Rate for Payer: Cofinity Commercial |
$509.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$433.59
|
| Rate for Payer: Healthscope Commercial |
$541.99
|
| Rate for Payer: Healthscope Whirlpool |
$525.73
|
| Rate for Payer: Mclaren Commercial |
$487.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$460.69
|
| Rate for Payer: Nomi Health Commercial |
$444.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$352.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$476.95
|
|
|
HC HIP UNI W PELVIS IF PERFORMED 1 VIEW
|
Facility
|
IP
|
$150.54
|
|
|
Service Code
|
CPT 73501
|
| Hospital Charge Code |
32000309
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$97.85 |
| Max. Negotiated Rate |
$150.54 |
| Rate for Payer: Aetna Commercial |
$135.49
|
| Rate for Payer: ASR ASR |
$146.02
|
| Rate for Payer: ASR Commercial |
$146.02
|
| Rate for Payer: BCBS Trust/PPO |
$122.68
|
| Rate for Payer: BCN Commercial |
$116.71
|
| Rate for Payer: Cash Price |
$120.43
|
| Rate for Payer: Cofinity Commercial |
$141.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.43
|
| Rate for Payer: Healthscope Commercial |
$150.54
|
| Rate for Payer: Healthscope Whirlpool |
$146.02
|
| Rate for Payer: Mclaren Commercial |
$135.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$127.96
|
| Rate for Payer: Nomi Health Commercial |
$123.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$97.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$132.48
|
|
|
HC HIP UNI W PELVIS IF PERFORMED 1 VIEW
|
Facility
|
OP
|
$150.54
|
|
|
Service Code
|
CPT 73501
|
| Hospital Charge Code |
32000309
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$46.24 |
| Max. Negotiated Rate |
$150.54 |
| Rate for Payer: Aetna Commercial |
$135.49
|
| Rate for Payer: Aetna Medicare |
$86.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.84
|
| Rate for Payer: ASR ASR |
$146.02
|
| Rate for Payer: ASR Commercial |
$146.02
|
| Rate for Payer: BCBS Complete |
$48.55
|
| Rate for Payer: BCBS MAPPO |
$86.27
|
| Rate for Payer: BCBS Trust/PPO |
$123.28
|
| Rate for Payer: BCN Commercial |
$116.71
|
| Rate for Payer: BCN Medicare Advantage |
$86.27
|
| Rate for Payer: Cash Price |
$120.43
|
| Rate for Payer: Cash Price |
$120.43
|
| Rate for Payer: Cofinity Commercial |
$141.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.27
|
| Rate for Payer: Healthscope Commercial |
$150.54
|
| Rate for Payer: Healthscope Whirlpool |
$146.02
|
| Rate for Payer: Humana Choice PPO Medicare |
$86.27
|
| Rate for Payer: Mclaren Commercial |
$135.49
|
| Rate for Payer: Mclaren Medicaid |
$46.24
|
| Rate for Payer: Mclaren Medicare |
$86.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.58
|
| Rate for Payer: Meridian Medicaid |
$48.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$127.96
|
| Rate for Payer: Nomi Health Commercial |
$123.44
|
| Rate for Payer: PACE Medicare |
$81.96
|
| Rate for Payer: PACE SWMI |
$86.27
|
| Rate for Payer: PHP Commercial |
$94.90
|
| Rate for Payer: PHP Medicaid |
$46.24
|
| Rate for Payer: PHP Medicare Advantage |
$86.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$97.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$131.90
|
| Rate for Payer: Priority Health Medicare |
$86.27
|
| Rate for Payer: Priority Health Narrow Network |
$105.53
|
| Rate for Payer: Railroad Medicare Medicare |
$86.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$132.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.27
|
| Rate for Payer: UHC Exchange |
$133.72
|
| Rate for Payer: UHC Medicare Advantage |
$86.27
|
| Rate for Payer: UHCCP DNSP |
$86.27
|
| Rate for Payer: UHCCP Medicaid |
$46.24
|
| Rate for Payer: VA VA |
$86.27
|
|
|
HC HIP UNI W PELVIS IF PERFORMED 2 OR 3 VIEWS
|
Facility
|
IP
|
$301.10
|
|
|
Service Code
|
CPT 73502
|
| Hospital Charge Code |
32000310
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$195.72 |
| Max. Negotiated Rate |
$301.10 |
| Rate for Payer: Aetna Commercial |
$270.99
|
| Rate for Payer: ASR ASR |
$292.07
|
| Rate for Payer: ASR Commercial |
$292.07
|
| Rate for Payer: BCBS Trust/PPO |
$245.37
|
| Rate for Payer: BCN Commercial |
$233.44
|
| Rate for Payer: Cash Price |
$240.88
|
| Rate for Payer: Cofinity Commercial |
$283.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$240.88
|
| Rate for Payer: Healthscope Commercial |
$301.10
|
| Rate for Payer: Healthscope Whirlpool |
$292.07
|
| Rate for Payer: Mclaren Commercial |
$270.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$255.94
|
| Rate for Payer: Nomi Health Commercial |
$246.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$195.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$264.97
|
|
|
HC HIP UNI W PELVIS IF PERFORMED 2 OR 3 VIEWS
|
Facility
|
OP
|
$301.10
|
|
|
Service Code
|
CPT 73502
|
| Hospital Charge Code |
32000310
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$46.24 |
| Max. Negotiated Rate |
$301.10 |
| Rate for Payer: Aetna Commercial |
$270.99
|
| Rate for Payer: Aetna Medicare |
$86.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.84
|
| Rate for Payer: ASR ASR |
$292.07
|
| Rate for Payer: ASR Commercial |
$292.07
|
| Rate for Payer: BCBS Complete |
$48.55
|
| Rate for Payer: BCBS MAPPO |
$86.27
|
| Rate for Payer: BCBS Trust/PPO |
$246.57
|
| Rate for Payer: BCN Commercial |
$233.44
|
| Rate for Payer: BCN Medicare Advantage |
$86.27
|
| Rate for Payer: Cash Price |
$240.88
|
| Rate for Payer: Cash Price |
$240.88
|
| Rate for Payer: Cofinity Commercial |
$283.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$240.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.27
|
| Rate for Payer: Healthscope Commercial |
$301.10
|
| Rate for Payer: Healthscope Whirlpool |
$292.07
|
| Rate for Payer: Humana Choice PPO Medicare |
$86.27
|
| Rate for Payer: Mclaren Commercial |
$270.99
|
| Rate for Payer: Mclaren Medicaid |
$46.24
|
| Rate for Payer: Mclaren Medicare |
$86.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.58
|
| Rate for Payer: Meridian Medicaid |
$48.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$255.94
|
| Rate for Payer: Nomi Health Commercial |
$246.90
|
| Rate for Payer: PACE Medicare |
$81.96
|
| Rate for Payer: PACE SWMI |
$86.27
|
| Rate for Payer: PHP Commercial |
$94.90
|
| Rate for Payer: PHP Medicaid |
$46.24
|
| Rate for Payer: PHP Medicare Advantage |
$86.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$195.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$263.82
|
| Rate for Payer: Priority Health Medicare |
$86.27
|
| Rate for Payer: Priority Health Narrow Network |
$211.07
|
| Rate for Payer: Railroad Medicare Medicare |
$86.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$264.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.27
|
| Rate for Payer: UHC Exchange |
$133.72
|
| Rate for Payer: UHC Medicare Advantage |
$86.27
|
| Rate for Payer: UHCCP DNSP |
$86.27
|
| Rate for Payer: UHCCP Medicaid |
$46.24
|
| Rate for Payer: VA VA |
$86.27
|
|
|
HC HIP UNI W PELVIS IF PERFORMED MIN 4 VIEWS
|
Facility
|
IP
|
$391.43
|
|
|
Service Code
|
CPT 73503
|
| Hospital Charge Code |
32000311
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$254.43 |
| Max. Negotiated Rate |
$391.43 |
| Rate for Payer: Aetna Commercial |
$352.29
|
| Rate for Payer: ASR ASR |
$379.69
|
| Rate for Payer: ASR Commercial |
$379.69
|
| Rate for Payer: BCBS Trust/PPO |
$318.98
|
| Rate for Payer: BCN Commercial |
$303.48
|
| Rate for Payer: Cash Price |
$313.14
|
| Rate for Payer: Cofinity Commercial |
$367.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$313.14
|
| Rate for Payer: Healthscope Commercial |
$391.43
|
| Rate for Payer: Healthscope Whirlpool |
$379.69
|
| Rate for Payer: Mclaren Commercial |
$352.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$332.72
|
| Rate for Payer: Nomi Health Commercial |
$320.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$254.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$344.46
|
|
|
HC HIP UNI W PELVIS IF PERFORMED MIN 4 VIEWS
|
Facility
|
OP
|
$391.43
|
|
|
Service Code
|
CPT 73503
|
| Hospital Charge Code |
32000311
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$55.85 |
| Max. Negotiated Rate |
$391.43 |
| Rate for Payer: Aetna Commercial |
$352.29
|
| Rate for Payer: Aetna Medicare |
$104.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.24
|
| Rate for Payer: ASR ASR |
$379.69
|
| Rate for Payer: ASR Commercial |
$379.69
|
| Rate for Payer: BCBS Complete |
$58.64
|
| Rate for Payer: BCBS MAPPO |
$104.19
|
| Rate for Payer: BCBS Trust/PPO |
$320.54
|
| Rate for Payer: BCN Commercial |
$303.48
|
| Rate for Payer: BCN Medicare Advantage |
$104.19
|
| Rate for Payer: Cash Price |
$313.14
|
| Rate for Payer: Cash Price |
$313.14
|
| Rate for Payer: Cofinity Commercial |
$367.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$313.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.19
|
| Rate for Payer: Healthscope Commercial |
$391.43
|
| Rate for Payer: Healthscope Whirlpool |
$379.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$104.19
|
| Rate for Payer: Mclaren Commercial |
$352.29
|
| Rate for Payer: Mclaren Medicaid |
$55.85
|
| Rate for Payer: Mclaren Medicare |
$104.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.40
|
| Rate for Payer: Meridian Medicaid |
$58.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$332.72
|
| Rate for Payer: Nomi Health Commercial |
$320.97
|
| Rate for Payer: PACE Medicare |
$98.98
|
| Rate for Payer: PACE SWMI |
$104.19
|
| Rate for Payer: PHP Commercial |
$114.61
|
| Rate for Payer: PHP Medicaid |
$55.85
|
| Rate for Payer: PHP Medicare Advantage |
$104.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$254.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$342.97
|
| Rate for Payer: Priority Health Medicare |
$104.19
|
| Rate for Payer: Priority Health Narrow Network |
$274.39
|
| Rate for Payer: Railroad Medicare Medicare |
$104.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$344.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$104.19
|
| Rate for Payer: UHC Exchange |
$161.49
|
| Rate for Payer: UHC Medicare Advantage |
$104.19
|
| Rate for Payer: UHCCP DNSP |
$104.19
|
| Rate for Payer: UHCCP Medicaid |
$55.85
|
| Rate for Payer: VA VA |
$104.19
|
|
|
HC HIS LEAD
|
Facility
|
OP
|
$1,441.99
|
|
|
Service Code
|
HCPCS C1898
|
| Hospital Charge Code |
27800121
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$576.80 |
| Max. Negotiated Rate |
$1,441.99 |
| Rate for Payer: Aetna Commercial |
$1,297.79
|
| Rate for Payer: Aetna Medicare |
$721.00
|
| Rate for Payer: ASR ASR |
$1,398.73
|
| Rate for Payer: ASR Commercial |
$1,398.73
|
| Rate for Payer: BCBS Complete |
$576.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,180.85
|
| Rate for Payer: BCN Commercial |
$1,117.97
|
| Rate for Payer: Cash Price |
$1,153.59
|
| Rate for Payer: Cofinity Commercial |
$1,355.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,153.59
|
| Rate for Payer: Healthscope Commercial |
$1,441.99
|
| Rate for Payer: Healthscope Whirlpool |
$1,398.73
|
| Rate for Payer: Mclaren Commercial |
$1,297.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,225.69
|
| Rate for Payer: Nomi Health Commercial |
$1,182.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$937.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,263.47
|
| Rate for Payer: Priority Health Narrow Network |
$1,010.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,268.95
|
|
|
HC HIS LEAD
|
Facility
|
IP
|
$1,441.99
|
|
|
Service Code
|
HCPCS C1898
|
| Hospital Charge Code |
27800121
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$937.29 |
| Max. Negotiated Rate |
$1,441.99 |
| Rate for Payer: Aetna Commercial |
$1,297.79
|
| Rate for Payer: ASR ASR |
$1,398.73
|
| Rate for Payer: ASR Commercial |
$1,398.73
|
| Rate for Payer: BCBS Trust/PPO |
$1,175.08
|
| Rate for Payer: BCN Commercial |
$1,117.97
|
| Rate for Payer: Cash Price |
$1,153.59
|
| Rate for Payer: Cofinity Commercial |
$1,355.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,153.59
|
| Rate for Payer: Healthscope Commercial |
$1,441.99
|
| Rate for Payer: Healthscope Whirlpool |
$1,398.73
|
| Rate for Payer: Mclaren Commercial |
$1,297.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,225.69
|
| Rate for Payer: Nomi Health Commercial |
$1,182.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$937.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,268.95
|
|
|
HC HISTONE AUTOANTIBODIES, S
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100601
|
|
Hospital Revenue Code
|
301
|
| 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 HISTONE AUTOANTIBODIES, S
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100601
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.18 |
| Max. Negotiated Rate |
$210.82 |
| Rate for Payer: Aetna Commercial |
$46.82
|
| Rate for Payer: Aetna Medicare |
$11.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.41
|
| Rate for Payer: ASR ASR |
$50.46
|
| Rate for Payer: ASR Commercial |
$50.46
|
| Rate for Payer: BCBS Complete |
$6.49
|
| Rate for Payer: BCBS MAPPO |
$11.53
|
| Rate for Payer: BCBS Trust/PPO |
$42.60
|
| Rate for Payer: BCN Commercial |
$40.33
|
| Rate for Payer: BCN Medicare Advantage |
$11.53
|
| 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 |
$11.53
|
| Rate for Payer: Healthscope Commercial |
$52.02
|
| Rate for Payer: Healthscope Whirlpool |
$50.46
|
| Rate for Payer: Humana Choice PPO Medicare |
$11.53
|
| Rate for Payer: Mclaren Commercial |
$46.82
|
| Rate for Payer: Mclaren Medicaid |
$6.18
|
| Rate for Payer: Mclaren Medicare |
$11.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.11
|
| Rate for Payer: Meridian Medicaid |
$6.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: PACE Medicare |
$10.95
|
| Rate for Payer: PACE SWMI |
$11.53
|
| Rate for Payer: PHP Commercial |
$12.68
|
| Rate for Payer: PHP Medicaid |
$6.18
|
| Rate for Payer: PHP Medicare Advantage |
$11.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$210.82
|
| Rate for Payer: Priority Health Medicare |
$11.53
|
| Rate for Payer: Priority Health Narrow Network |
$168.66
|
| Rate for Payer: Railroad Medicare Medicare |
$11.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.53
|
| Rate for Payer: UHC Exchange |
$17.87
|
| Rate for Payer: UHC Medicare Advantage |
$11.53
|
| Rate for Payer: UHCCP DNSP |
$11.53
|
| Rate for Payer: UHCCP Medicaid |
$6.18
|
| Rate for Payer: VA VA |
$11.53
|
|
|
HC HISTOPLASMA AB
|
Facility
|
IP
|
$60.18
|
|
|
Service Code
|
CPT 86698
|
| Hospital Charge Code |
30200286
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$39.12 |
| Max. Negotiated Rate |
$60.18 |
| Rate for Payer: Aetna Commercial |
$54.16
|
| Rate for Payer: ASR ASR |
$58.37
|
| Rate for Payer: ASR Commercial |
$58.37
|
| Rate for Payer: BCBS Trust/PPO |
$49.04
|
| Rate for Payer: BCN Commercial |
$46.66
|
| Rate for Payer: Cash Price |
$48.14
|
| Rate for Payer: Cofinity Commercial |
$56.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.14
|
| Rate for Payer: Healthscope Commercial |
$60.18
|
| Rate for Payer: Healthscope Whirlpool |
$58.37
|
| Rate for Payer: Mclaren Commercial |
$54.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51.15
|
| Rate for Payer: Nomi Health Commercial |
$49.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$52.96
|
|
|
HC HISTOPLASMA AB
|
Facility
|
OP
|
$60.18
|
|
|
Service Code
|
CPT 86698
|
| Hospital Charge Code |
30200286
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.39 |
| Max. Negotiated Rate |
$60.18 |
| Rate for Payer: Aetna Commercial |
$54.16
|
| Rate for Payer: Aetna Medicare |
$13.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.24
|
| Rate for Payer: ASR ASR |
$58.37
|
| Rate for Payer: ASR Commercial |
$58.37
|
| Rate for Payer: BCBS Complete |
$7.76
|
| Rate for Payer: BCBS MAPPO |
$13.79
|
| Rate for Payer: BCBS Trust/PPO |
$49.28
|
| Rate for Payer: BCN Commercial |
$46.66
|
| Rate for Payer: BCN Medicare Advantage |
$13.79
|
| Rate for Payer: Cash Price |
$48.14
|
| Rate for Payer: Cash Price |
$48.14
|
| Rate for Payer: Cofinity Commercial |
$56.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.79
|
| Rate for Payer: Healthscope Commercial |
$60.18
|
| Rate for Payer: Healthscope Whirlpool |
$58.37
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.79
|
| Rate for Payer: Mclaren Commercial |
$54.16
|
| Rate for Payer: Mclaren Medicaid |
$7.39
|
| Rate for Payer: Mclaren Medicare |
$13.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.48
|
| Rate for Payer: Meridian Medicaid |
$7.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51.15
|
| Rate for Payer: Nomi Health Commercial |
$49.35
|
| Rate for Payer: PACE Medicare |
$13.10
|
| Rate for Payer: PACE SWMI |
$13.79
|
| Rate for Payer: PHP Commercial |
$15.17
|
| Rate for Payer: PHP Medicaid |
$7.39
|
| Rate for Payer: PHP Medicare Advantage |
$13.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$52.73
|
| Rate for Payer: Priority Health Medicare |
$13.79
|
| Rate for Payer: Priority Health Narrow Network |
$42.19
|
| Rate for Payer: Railroad Medicare Medicare |
$13.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$52.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.79
|
| Rate for Payer: UHC Exchange |
$21.37
|
| Rate for Payer: UHC Medicare Advantage |
$13.79
|
| Rate for Payer: UHCCP DNSP |
$13.79
|
| Rate for Payer: UHCCP Medicaid |
$7.39
|
| Rate for Payer: VA VA |
$13.79
|
|
|
HC HISTOPLASMA AB CMPT
|
Facility
|
OP
|
$25.50
|
|
|
Service Code
|
CPT 86698
|
| Hospital Charge Code |
30200289
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.39 |
| Max. Negotiated Rate |
$25.50 |
| Rate for Payer: Aetna Commercial |
$22.95
|
| Rate for Payer: Aetna Medicare |
$13.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.24
|
| Rate for Payer: ASR ASR |
$24.74
|
| Rate for Payer: ASR Commercial |
$24.74
|
| Rate for Payer: BCBS Complete |
$7.76
|
| Rate for Payer: BCBS MAPPO |
$13.79
|
| Rate for Payer: BCBS Trust/PPO |
$20.88
|
| Rate for Payer: BCN Commercial |
$19.77
|
| Rate for Payer: BCN Medicare Advantage |
$13.79
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$23.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.79
|
| Rate for Payer: Healthscope Commercial |
$25.50
|
| Rate for Payer: Healthscope Whirlpool |
$24.74
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.79
|
| Rate for Payer: Mclaren Commercial |
$22.95
|
| Rate for Payer: Mclaren Medicaid |
$7.39
|
| Rate for Payer: Mclaren Medicare |
$13.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.48
|
| Rate for Payer: Meridian Medicaid |
$7.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.68
|
| Rate for Payer: Nomi Health Commercial |
$20.91
|
| Rate for Payer: PACE Medicare |
$13.10
|
| Rate for Payer: PACE SWMI |
$13.79
|
| Rate for Payer: PHP Commercial |
$15.17
|
| Rate for Payer: PHP Medicaid |
$7.39
|
| Rate for Payer: PHP Medicare Advantage |
$13.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.34
|
| Rate for Payer: Priority Health Medicare |
$13.79
|
| Rate for Payer: Priority Health Narrow Network |
$17.88
|
| Rate for Payer: Railroad Medicare Medicare |
$13.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.79
|
| Rate for Payer: UHC Exchange |
$21.37
|
| Rate for Payer: UHC Medicare Advantage |
$13.79
|
| Rate for Payer: UHCCP DNSP |
$13.79
|
| Rate for Payer: UHCCP Medicaid |
$7.39
|
| Rate for Payer: VA VA |
$13.79
|
|
|
HC HISTOPLASMA AB CMPT
|
Facility
|
IP
|
$25.50
|
|
|
Service Code
|
CPT 86698
|
| Hospital Charge Code |
30200289
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.58 |
| Max. Negotiated Rate |
$25.50 |
| Rate for Payer: Aetna Commercial |
$22.95
|
| Rate for Payer: ASR ASR |
$24.74
|
| Rate for Payer: ASR Commercial |
$24.74
|
| Rate for Payer: BCBS Trust/PPO |
$20.78
|
| Rate for Payer: BCN Commercial |
$19.77
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$23.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Healthscope Commercial |
$25.50
|
| Rate for Payer: Healthscope Whirlpool |
$24.74
|
| Rate for Payer: Mclaren Commercial |
$22.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.68
|
| Rate for Payer: Nomi Health Commercial |
$20.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.44
|
|
|
HC HISTOPLASMA AB CONFIRMATION
|
Facility
|
IP
|
$25.50
|
|
|
Service Code
|
CPT 86698
|
| Hospital Charge Code |
30200288
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.58 |
| Max. Negotiated Rate |
$25.50 |
| Rate for Payer: Aetna Commercial |
$22.95
|
| Rate for Payer: ASR ASR |
$24.74
|
| Rate for Payer: ASR Commercial |
$24.74
|
| Rate for Payer: BCBS Trust/PPO |
$20.78
|
| Rate for Payer: BCN Commercial |
$19.77
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$23.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Healthscope Commercial |
$25.50
|
| Rate for Payer: Healthscope Whirlpool |
$24.74
|
| Rate for Payer: Mclaren Commercial |
$22.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.68
|
| Rate for Payer: Nomi Health Commercial |
$20.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.44
|
|
