|
HC HYALUORAN OR DERIVATIVE, SYN OR SYN1, INTRA-ARTICULAR INJ, 1MG
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT J7325
|
| Hospital Charge Code |
63600107
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.91 |
| Max. Negotiated Rate |
$52.02 |
| Rate for Payer: Aetna Commercial |
$46.82
|
| Rate for Payer: Aetna Medicare |
$9.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.45
|
| Rate for Payer: ASR ASR |
$50.46
|
| Rate for Payer: ASR Commercial |
$50.46
|
| Rate for Payer: BCBS Complete |
$5.16
|
| Rate for Payer: BCBS MAPPO |
$9.16
|
| Rate for Payer: BCBS Trust/PPO |
$42.60
|
| Rate for Payer: BCN Commercial |
$40.33
|
| Rate for Payer: BCN Medicare Advantage |
$9.16
|
| 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 |
$9.16
|
| Rate for Payer: Healthscope Commercial |
$52.02
|
| Rate for Payer: Healthscope Whirlpool |
$50.46
|
| Rate for Payer: Humana Choice PPO Medicare |
$9.16
|
| Rate for Payer: Mclaren Commercial |
$46.82
|
| Rate for Payer: Mclaren Medicaid |
$4.91
|
| Rate for Payer: Mclaren Medicare |
$9.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.62
|
| Rate for Payer: Meridian Medicaid |
$5.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: PACE Medicare |
$8.70
|
| Rate for Payer: PACE SWMI |
$9.16
|
| Rate for Payer: PHP Commercial |
$10.08
|
| Rate for Payer: PHP Medicaid |
$4.91
|
| Rate for Payer: PHP Medicare Advantage |
$9.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9.60
|
| Rate for Payer: Priority Health Medicare |
$9.16
|
| Rate for Payer: Priority Health Narrow Network |
$7.68
|
| Rate for Payer: Railroad Medicare Medicare |
$9.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.16
|
| Rate for Payer: UHC Exchange |
$14.20
|
| Rate for Payer: UHC Medicare Advantage |
$9.16
|
| Rate for Payer: UHCCP DNSP |
$9.16
|
| Rate for Payer: UHCCP Medicaid |
$4.91
|
| Rate for Payer: VA VA |
$9.16
|
|
|
HC HYALUORAN OR DERIVATIVE, SYN OR SYN1, INTRA-ARTICULAR INJ, 1MG
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT J7325
|
| Hospital Charge Code |
63600107
|
|
Hospital Revenue Code
|
636
|
| 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 HYALURONAN FOR IA INJ PER DOSE
|
Facility
|
IP
|
$309.00
|
|
|
Service Code
|
HCPCS J7321
|
| Hospital Charge Code |
63600157
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$200.85 |
| Max. Negotiated Rate |
$309.00 |
| Rate for Payer: Aetna Commercial |
$278.10
|
| Rate for Payer: ASR ASR |
$299.73
|
| Rate for Payer: ASR Commercial |
$299.73
|
| Rate for Payer: BCBS Trust/PPO |
$251.80
|
| Rate for Payer: BCN Commercial |
$239.57
|
| Rate for Payer: Cash Price |
$247.20
|
| Rate for Payer: Cofinity Commercial |
$290.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$247.20
|
| Rate for Payer: Healthscope Commercial |
$309.00
|
| Rate for Payer: Healthscope Whirlpool |
$299.73
|
| Rate for Payer: Mclaren Commercial |
$278.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$262.65
|
| Rate for Payer: Nomi Health Commercial |
$253.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$200.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$271.92
|
|
|
HC HYALURONAN FOR IA INJ PER DOSE
|
Facility
|
OP
|
$309.00
|
|
|
Service Code
|
HCPCS J7321
|
| Hospital Charge Code |
63600157
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$61.40 |
| Max. Negotiated Rate |
$309.00 |
| Rate for Payer: Aetna Commercial |
$278.10
|
| Rate for Payer: Aetna Medicare |
$154.50
|
| Rate for Payer: ASR ASR |
$299.73
|
| Rate for Payer: ASR Commercial |
$299.73
|
| Rate for Payer: BCBS Complete |
$123.60
|
| Rate for Payer: BCBS Trust/PPO |
$253.04
|
| Rate for Payer: BCN Commercial |
$239.57
|
| Rate for Payer: Cash Price |
$247.20
|
| Rate for Payer: Cash Price |
$247.20
|
| Rate for Payer: Cofinity Commercial |
$290.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$247.20
|
| Rate for Payer: Healthscope Commercial |
$309.00
|
| Rate for Payer: Healthscope Whirlpool |
$299.73
|
| Rate for Payer: Mclaren Commercial |
$278.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$262.65
|
| Rate for Payer: Nomi Health Commercial |
$253.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$200.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$76.75
|
| Rate for Payer: Priority Health Narrow Network |
$61.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$271.92
|
|
|
HC HYALURONAN OR DERIVATIVE, DURALONE, INTRAARTICULAR INJ, 1MG
|
Facility
|
IP
|
$21.50
|
|
|
Service Code
|
HCPCS J7318
|
| Hospital Charge Code |
63600163
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$13.98 |
| Max. Negotiated Rate |
$21.50 |
| Rate for Payer: Aetna Commercial |
$19.35
|
| Rate for Payer: ASR ASR |
$20.86
|
| Rate for Payer: ASR Commercial |
$20.86
|
| Rate for Payer: BCBS Trust/PPO |
$17.52
|
| Rate for Payer: BCN Commercial |
$16.67
|
| Rate for Payer: Cash Price |
$17.20
|
| Rate for Payer: Cofinity Commercial |
$20.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.20
|
| Rate for Payer: Healthscope Commercial |
$21.50
|
| Rate for Payer: Healthscope Whirlpool |
$20.86
|
| Rate for Payer: Mclaren Commercial |
$19.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.28
|
| Rate for Payer: Nomi Health Commercial |
$17.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.92
|
|
|
HC HYALURONAN OR DERIVATIVE, DURALONE, INTRAARTICULAR INJ, 1MG
|
Facility
|
OP
|
$21.50
|
|
|
Service Code
|
HCPCS J7318
|
| Hospital Charge Code |
63600163
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.59 |
| Max. Negotiated Rate |
$21.50 |
| Rate for Payer: Aetna Commercial |
$19.35
|
| Rate for Payer: Aetna Medicare |
$6.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.38
|
| Rate for Payer: ASR ASR |
$20.86
|
| Rate for Payer: ASR Commercial |
$20.86
|
| Rate for Payer: BCBS Complete |
$3.77
|
| Rate for Payer: BCBS MAPPO |
$6.70
|
| Rate for Payer: BCBS Trust/PPO |
$17.61
|
| Rate for Payer: BCN Commercial |
$16.67
|
| Rate for Payer: BCN Medicare Advantage |
$6.70
|
| Rate for Payer: Cash Price |
$17.20
|
| Rate for Payer: Cash Price |
$17.20
|
| Rate for Payer: Cofinity Commercial |
$20.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.70
|
| Rate for Payer: Healthscope Commercial |
$21.50
|
| Rate for Payer: Healthscope Whirlpool |
$20.86
|
| Rate for Payer: Humana Choice PPO Medicare |
$6.70
|
| Rate for Payer: Mclaren Commercial |
$19.35
|
| Rate for Payer: Mclaren Medicaid |
$3.59
|
| Rate for Payer: Mclaren Medicare |
$6.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.04
|
| Rate for Payer: Meridian Medicaid |
$3.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.28
|
| Rate for Payer: Nomi Health Commercial |
$17.63
|
| Rate for Payer: PACE Medicare |
$6.36
|
| Rate for Payer: PACE SWMI |
$6.70
|
| Rate for Payer: PHP Commercial |
$7.37
|
| Rate for Payer: PHP Medicaid |
$3.59
|
| Rate for Payer: PHP Medicare Advantage |
$6.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7.19
|
| Rate for Payer: Priority Health Medicare |
$6.70
|
| Rate for Payer: Priority Health Narrow Network |
$5.75
|
| Rate for Payer: Railroad Medicare Medicare |
$6.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.70
|
| Rate for Payer: UHC Exchange |
$10.38
|
| Rate for Payer: UHC Medicare Advantage |
$6.70
|
| Rate for Payer: UHCCP DNSP |
$6.70
|
| Rate for Payer: UHCCP Medicaid |
$3.59
|
| Rate for Payer: VA VA |
$6.70
|
|
|
HC HYALURONAN OR DERIVATIVE, GEL 1, INTRA-ARTICULAR INJ PER DOSE
|
Facility
|
IP
|
$1,394.14
|
|
|
Service Code
|
CPT J7326
|
| Hospital Charge Code |
63600108
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$906.19 |
| Max. Negotiated Rate |
$1,394.14 |
| Rate for Payer: Aetna Commercial |
$1,254.73
|
| Rate for Payer: ASR ASR |
$1,352.32
|
| Rate for Payer: ASR Commercial |
$1,352.32
|
| Rate for Payer: BCBS Trust/PPO |
$1,136.08
|
| Rate for Payer: BCN Commercial |
$1,080.88
|
| Rate for Payer: Cash Price |
$1,115.31
|
| Rate for Payer: Cofinity Commercial |
$1,310.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,115.31
|
| Rate for Payer: Healthscope Commercial |
$1,394.14
|
| Rate for Payer: Healthscope Whirlpool |
$1,352.32
|
| Rate for Payer: Mclaren Commercial |
$1,254.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,185.02
|
| Rate for Payer: Nomi Health Commercial |
$1,143.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$906.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,226.84
|
|
|
HC HYALURONAN OR DERIVATIVE, GEL 1, INTRA-ARTICULAR INJ PER DOSE
|
Facility
|
OP
|
$1,394.14
|
|
|
Service Code
|
CPT J7326
|
| Hospital Charge Code |
63600108
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$282.14 |
| Max. Negotiated Rate |
$1,394.14 |
| Rate for Payer: Aetna Commercial |
$1,254.73
|
| Rate for Payer: Aetna Medicare |
$526.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$657.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$657.98
|
| Rate for Payer: ASR ASR |
$1,352.32
|
| Rate for Payer: ASR Commercial |
$1,352.32
|
| Rate for Payer: BCBS Complete |
$296.25
|
| Rate for Payer: BCBS MAPPO |
$526.38
|
| Rate for Payer: BCBS Trust/PPO |
$1,141.66
|
| Rate for Payer: BCN Commercial |
$1,080.88
|
| Rate for Payer: BCN Medicare Advantage |
$526.38
|
| Rate for Payer: Cash Price |
$1,115.31
|
| Rate for Payer: Cash Price |
$1,115.31
|
| Rate for Payer: Cofinity Commercial |
$1,310.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,115.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$526.38
|
| Rate for Payer: Healthscope Commercial |
$1,394.14
|
| Rate for Payer: Healthscope Whirlpool |
$1,352.32
|
| Rate for Payer: Humana Choice PPO Medicare |
$526.38
|
| Rate for Payer: Mclaren Commercial |
$1,254.73
|
| Rate for Payer: Mclaren Medicaid |
$282.14
|
| Rate for Payer: Mclaren Medicare |
$526.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$552.70
|
| Rate for Payer: Meridian Medicaid |
$296.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$605.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,185.02
|
| Rate for Payer: Nomi Health Commercial |
$1,143.19
|
| Rate for Payer: PACE Medicare |
$500.06
|
| Rate for Payer: PACE SWMI |
$526.38
|
| Rate for Payer: PHP Commercial |
$579.02
|
| Rate for Payer: PHP Medicaid |
$282.14
|
| Rate for Payer: PHP Medicare Advantage |
$526.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$282.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$906.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$558.80
|
| Rate for Payer: Priority Health Medicare |
$526.38
|
| Rate for Payer: Priority Health Narrow Network |
$447.04
|
| Rate for Payer: Railroad Medicare Medicare |
$526.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,226.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$526.38
|
| Rate for Payer: UHC Exchange |
$815.89
|
| Rate for Payer: UHC Medicare Advantage |
$526.38
|
| Rate for Payer: UHCCP DNSP |
$526.38
|
| Rate for Payer: UHCCP Medicaid |
$282.14
|
| Rate for Payer: VA VA |
$526.38
|
|
|
HC HYDROCODONE AND MTB, FREE
|
Facility
|
IP
|
$99.96
|
|
|
Service Code
|
CPT 80361
|
| Hospital Charge Code |
30100685
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$64.97 |
| Max. Negotiated Rate |
$99.96 |
| Rate for Payer: Aetna Commercial |
$89.96
|
| Rate for Payer: ASR ASR |
$96.96
|
| Rate for Payer: ASR Commercial |
$96.96
|
| Rate for Payer: BCBS Trust/PPO |
$81.46
|
| Rate for Payer: BCN Commercial |
$77.50
|
| Rate for Payer: Cash Price |
$79.97
|
| Rate for Payer: Cofinity Commercial |
$93.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.97
|
| Rate for Payer: Healthscope Commercial |
$99.96
|
| Rate for Payer: Healthscope Whirlpool |
$96.96
|
| Rate for Payer: Mclaren Commercial |
$89.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.97
|
| Rate for Payer: Nomi Health Commercial |
$81.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$87.96
|
|
|
HC HYDROCODONE AND MTB, FREE
|
Facility
|
OP
|
$99.96
|
|
|
Service Code
|
CPT 80361
|
| Hospital Charge Code |
30100685
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$39.98 |
| Max. Negotiated Rate |
$99.96 |
| Rate for Payer: Aetna Commercial |
$89.96
|
| Rate for Payer: Aetna Medicare |
$49.98
|
| Rate for Payer: ASR ASR |
$96.96
|
| Rate for Payer: ASR Commercial |
$96.96
|
| Rate for Payer: BCBS Complete |
$39.98
|
| Rate for Payer: BCBS Trust/PPO |
$81.86
|
| Rate for Payer: BCN Commercial |
$77.50
|
| Rate for Payer: Cash Price |
$79.97
|
| Rate for Payer: Cofinity Commercial |
$93.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.97
|
| Rate for Payer: Healthscope Commercial |
$99.96
|
| Rate for Payer: Healthscope Whirlpool |
$96.96
|
| Rate for Payer: Mclaren Commercial |
$89.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.97
|
| Rate for Payer: Nomi Health Commercial |
$81.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$87.58
|
| Rate for Payer: Priority Health Narrow Network |
$70.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$87.96
|
|
|
HC HYDROCORTIZONE CREAM
|
Facility
|
OP
|
$9.92
|
|
| Hospital Charge Code |
27000116
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.97 |
| Max. Negotiated Rate |
$9.92 |
| Rate for Payer: Aetna Commercial |
$8.93
|
| Rate for Payer: Aetna Medicare |
$4.96
|
| Rate for Payer: ASR ASR |
$9.62
|
| Rate for Payer: ASR Commercial |
$9.62
|
| Rate for Payer: BCBS Complete |
$3.97
|
| Rate for Payer: BCBS Trust/PPO |
$8.12
|
| Rate for Payer: BCN Commercial |
$7.69
|
| Rate for Payer: Cash Price |
$7.94
|
| Rate for Payer: Cofinity Commercial |
$9.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.94
|
| Rate for Payer: Healthscope Commercial |
$9.92
|
| Rate for Payer: Healthscope Whirlpool |
$9.62
|
| Rate for Payer: Mclaren Commercial |
$8.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.43
|
| Rate for Payer: Nomi Health Commercial |
$8.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8.69
|
| Rate for Payer: Priority Health Narrow Network |
$6.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8.73
|
|
|
HC HYDROCORTIZONE CREAM
|
Facility
|
IP
|
$9.92
|
|
| Hospital Charge Code |
27000116
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$6.45 |
| Max. Negotiated Rate |
$9.92 |
| Rate for Payer: Aetna Commercial |
$8.93
|
| Rate for Payer: ASR ASR |
$9.62
|
| Rate for Payer: ASR Commercial |
$9.62
|
| Rate for Payer: BCBS Trust/PPO |
$8.08
|
| Rate for Payer: BCN Commercial |
$7.69
|
| Rate for Payer: Cash Price |
$7.94
|
| Rate for Payer: Cofinity Commercial |
$9.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.94
|
| Rate for Payer: Healthscope Commercial |
$9.92
|
| Rate for Payer: Healthscope Whirlpool |
$9.62
|
| Rate for Payer: Mclaren Commercial |
$8.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.43
|
| Rate for Payer: Nomi Health Commercial |
$8.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8.73
|
|
|
HC HYDRODISSECTION TENDON LEG/ANKLE
|
Facility
|
OP
|
$673.20
|
|
|
Service Code
|
CPT 27899
|
| Hospital Charge Code |
76100417
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$125.98 |
| Max. Negotiated Rate |
$673.20 |
| Rate for Payer: Aetna Commercial |
$605.88
|
| Rate for Payer: Aetna Medicare |
$235.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$293.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$293.79
|
| Rate for Payer: ASR ASR |
$653.00
|
| Rate for Payer: ASR Commercial |
$653.00
|
| Rate for Payer: BCBS Complete |
$132.27
|
| Rate for Payer: BCBS MAPPO |
$235.03
|
| Rate for Payer: BCBS Trust/PPO |
$551.28
|
| Rate for Payer: BCN Commercial |
$521.93
|
| Rate for Payer: BCN Medicare Advantage |
$235.03
|
| Rate for Payer: Cash Price |
$538.56
|
| Rate for Payer: Cash Price |
$538.56
|
| Rate for Payer: Cofinity Commercial |
$632.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$538.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.03
|
| Rate for Payer: Healthscope Commercial |
$673.20
|
| Rate for Payer: Healthscope Whirlpool |
$653.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$235.03
|
| Rate for Payer: Mclaren Commercial |
$605.88
|
| Rate for Payer: Mclaren Medicaid |
$125.98
|
| Rate for Payer: Mclaren Medicare |
$235.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$246.78
|
| Rate for Payer: Meridian Medicaid |
$132.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$270.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$572.22
|
| Rate for Payer: Nomi Health Commercial |
$552.02
|
| Rate for Payer: PACE Medicare |
$223.28
|
| Rate for Payer: PACE SWMI |
$235.03
|
| Rate for Payer: PHP Commercial |
$258.53
|
| Rate for Payer: PHP Medicaid |
$125.98
|
| Rate for Payer: PHP Medicare Advantage |
$235.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$437.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$273.06
|
| Rate for Payer: Priority Health Medicare |
$235.03
|
| Rate for Payer: Priority Health Narrow Network |
$218.45
|
| Rate for Payer: Railroad Medicare Medicare |
$235.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$592.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.03
|
| Rate for Payer: UHC Exchange |
$364.30
|
| Rate for Payer: UHC Medicare Advantage |
$235.03
|
| Rate for Payer: UHCCP DNSP |
$235.03
|
| Rate for Payer: UHCCP Medicaid |
$125.98
|
| Rate for Payer: VA VA |
$235.03
|
|
|
HC HYDRODISSECTION TENDON LEG/ANKLE
|
Facility
|
IP
|
$673.20
|
|
|
Service Code
|
CPT 27899
|
| Hospital Charge Code |
76100417
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$437.58 |
| Max. Negotiated Rate |
$673.20 |
| Rate for Payer: Aetna Commercial |
$605.88
|
| Rate for Payer: ASR ASR |
$653.00
|
| Rate for Payer: ASR Commercial |
$653.00
|
| Rate for Payer: BCBS Trust/PPO |
$548.59
|
| Rate for Payer: BCN Commercial |
$521.93
|
| Rate for Payer: Cash Price |
$538.56
|
| Rate for Payer: Cofinity Commercial |
$632.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$538.56
|
| Rate for Payer: Healthscope Commercial |
$673.20
|
| Rate for Payer: Healthscope Whirlpool |
$653.00
|
| Rate for Payer: Mclaren Commercial |
$605.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$572.22
|
| Rate for Payer: Nomi Health Commercial |
$552.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$437.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$592.42
|
|
|
HC HYDROXYPREGNENOLONE 17
|
Facility
|
IP
|
$88.74
|
|
|
Service Code
|
CPT 84143
|
| Hospital Charge Code |
30100399
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$57.68 |
| Max. Negotiated Rate |
$88.74 |
| Rate for Payer: Aetna Commercial |
$79.87
|
| Rate for Payer: ASR ASR |
$86.08
|
| Rate for Payer: ASR Commercial |
$86.08
|
| Rate for Payer: BCBS Trust/PPO |
$72.31
|
| Rate for Payer: BCN Commercial |
$68.80
|
| Rate for Payer: Cash Price |
$70.99
|
| Rate for Payer: Cofinity Commercial |
$83.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.99
|
| Rate for Payer: Healthscope Commercial |
$88.74
|
| Rate for Payer: Healthscope Whirlpool |
$86.08
|
| Rate for Payer: Mclaren Commercial |
$79.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$75.43
|
| Rate for Payer: Nomi Health Commercial |
$72.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$78.09
|
|
|
HC HYDROXYPREGNENOLONE 17
|
Facility
|
OP
|
$88.74
|
|
|
Service Code
|
CPT 84143
|
| Hospital Charge Code |
30100399
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.23 |
| Max. Negotiated Rate |
$88.74 |
| Rate for Payer: Aetna Commercial |
$79.87
|
| Rate for Payer: Aetna Medicare |
$22.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.51
|
| Rate for Payer: ASR ASR |
$86.08
|
| Rate for Payer: ASR Commercial |
$86.08
|
| Rate for Payer: BCBS Complete |
$12.84
|
| Rate for Payer: BCBS MAPPO |
$22.81
|
| Rate for Payer: BCBS Trust/PPO |
$72.67
|
| Rate for Payer: BCN Commercial |
$68.80
|
| Rate for Payer: BCN Medicare Advantage |
$22.81
|
| Rate for Payer: Cash Price |
$70.99
|
| Rate for Payer: Cash Price |
$70.99
|
| Rate for Payer: Cofinity Commercial |
$83.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.81
|
| Rate for Payer: Healthscope Commercial |
$88.74
|
| Rate for Payer: Healthscope Whirlpool |
$86.08
|
| Rate for Payer: Humana Choice PPO Medicare |
$22.81
|
| Rate for Payer: Mclaren Commercial |
$79.87
|
| Rate for Payer: Mclaren Medicaid |
$12.23
|
| Rate for Payer: Mclaren Medicare |
$22.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.95
|
| Rate for Payer: Meridian Medicaid |
$12.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$75.43
|
| Rate for Payer: Nomi Health Commercial |
$72.77
|
| Rate for Payer: PACE Medicare |
$21.67
|
| Rate for Payer: PACE SWMI |
$22.81
|
| Rate for Payer: PHP Commercial |
$25.09
|
| Rate for Payer: PHP Medicaid |
$12.23
|
| Rate for Payer: PHP Medicare Advantage |
$22.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$77.75
|
| Rate for Payer: Priority Health Medicare |
$22.81
|
| Rate for Payer: Priority Health Narrow Network |
$62.21
|
| Rate for Payer: Railroad Medicare Medicare |
$22.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$78.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.81
|
| Rate for Payer: UHC Exchange |
$35.36
|
| Rate for Payer: UHC Medicare Advantage |
$22.81
|
| Rate for Payer: UHCCP DNSP |
$22.81
|
| Rate for Payer: UHCCP Medicaid |
$12.23
|
| Rate for Payer: VA VA |
$22.81
|
|
|
HC HYDROXYPROGESTERONE 17
|
Facility
|
OP
|
$46.00
|
|
|
Service Code
|
CPT 83498
|
| Hospital Charge Code |
30100249
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.56 |
| Max. Negotiated Rate |
$62.60 |
| Rate for Payer: Aetna Commercial |
$41.40
|
| Rate for Payer: Aetna Medicare |
$27.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.96
|
| Rate for Payer: ASR ASR |
$44.62
|
| Rate for Payer: ASR Commercial |
$44.62
|
| Rate for Payer: BCBS Complete |
$15.29
|
| Rate for Payer: BCBS MAPPO |
$27.17
|
| Rate for Payer: BCBS Trust/PPO |
$37.67
|
| Rate for Payer: BCN Commercial |
$35.66
|
| Rate for Payer: BCN Medicare Advantage |
$27.17
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Cofinity Commercial |
$43.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.17
|
| Rate for Payer: Healthscope Commercial |
$46.00
|
| Rate for Payer: Healthscope Whirlpool |
$44.62
|
| Rate for Payer: Humana Choice PPO Medicare |
$27.17
|
| Rate for Payer: Mclaren Commercial |
$41.40
|
| Rate for Payer: Mclaren Medicaid |
$14.56
|
| Rate for Payer: Mclaren Medicare |
$27.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.53
|
| Rate for Payer: Meridian Medicaid |
$15.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.10
|
| Rate for Payer: Nomi Health Commercial |
$37.72
|
| Rate for Payer: PACE Medicare |
$25.81
|
| Rate for Payer: PACE SWMI |
$27.17
|
| Rate for Payer: PHP Commercial |
$29.89
|
| Rate for Payer: PHP Medicaid |
$14.56
|
| Rate for Payer: PHP Medicare Advantage |
$27.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$62.60
|
| Rate for Payer: Priority Health Medicare |
$27.17
|
| Rate for Payer: Priority Health Narrow Network |
$50.08
|
| Rate for Payer: Railroad Medicare Medicare |
$27.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$27.17
|
| Rate for Payer: UHC Exchange |
$42.11
|
| Rate for Payer: UHC Medicare Advantage |
$27.17
|
| Rate for Payer: UHCCP DNSP |
$27.17
|
| Rate for Payer: UHCCP Medicaid |
$14.56
|
| Rate for Payer: VA VA |
$27.17
|
|
|
HC HYDROXYPROGESTERONE 17
|
Facility
|
IP
|
$46.00
|
|
|
Service Code
|
CPT 83498
|
| Hospital Charge Code |
30100249
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$29.90 |
| Max. Negotiated Rate |
$46.00 |
| Rate for Payer: Aetna Commercial |
$41.40
|
| Rate for Payer: ASR ASR |
$44.62
|
| Rate for Payer: ASR Commercial |
$44.62
|
| Rate for Payer: BCBS Trust/PPO |
$37.49
|
| Rate for Payer: BCN Commercial |
$35.66
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Cofinity Commercial |
$43.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.80
|
| Rate for Payer: Healthscope Commercial |
$46.00
|
| Rate for Payer: Healthscope Whirlpool |
$44.62
|
| Rate for Payer: Mclaren Commercial |
$41.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.10
|
| Rate for Payer: Nomi Health Commercial |
$37.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.48
|
|
|
HC HYPERSENSITIVITY PNEUMO-CMPTS
|
Facility
|
OP
|
$28.09
|
|
|
Service Code
|
CPT 86671
|
| Hospital Charge Code |
30200270
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.57 |
| Max. Negotiated Rate |
$28.09 |
| Rate for Payer: Aetna Commercial |
$25.28
|
| Rate for Payer: Aetna Medicare |
$12.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.31
|
| Rate for Payer: ASR ASR |
$27.25
|
| Rate for Payer: ASR Commercial |
$27.25
|
| Rate for Payer: BCBS Complete |
$6.89
|
| Rate for Payer: BCBS MAPPO |
$12.25
|
| Rate for Payer: BCBS Trust/PPO |
$23.00
|
| Rate for Payer: BCN Commercial |
$21.78
|
| Rate for Payer: BCN Medicare Advantage |
$12.25
|
| Rate for Payer: Cash Price |
$22.47
|
| Rate for Payer: Cash Price |
$22.47
|
| Rate for Payer: Cofinity Commercial |
$26.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.25
|
| Rate for Payer: Healthscope Commercial |
$28.09
|
| Rate for Payer: Healthscope Whirlpool |
$27.25
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.25
|
| Rate for Payer: Mclaren Commercial |
$25.28
|
| Rate for Payer: Mclaren Medicaid |
$6.57
|
| Rate for Payer: Mclaren Medicare |
$12.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.86
|
| Rate for Payer: Meridian Medicaid |
$6.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.88
|
| Rate for Payer: Nomi Health Commercial |
$23.03
|
| Rate for Payer: PACE Medicare |
$11.64
|
| Rate for Payer: PACE SWMI |
$12.25
|
| Rate for Payer: PHP Commercial |
$13.48
|
| Rate for Payer: PHP Medicaid |
$6.57
|
| Rate for Payer: PHP Medicare Advantage |
$12.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.61
|
| Rate for Payer: Priority Health Medicare |
$12.25
|
| Rate for Payer: Priority Health Narrow Network |
$19.69
|
| Rate for Payer: Railroad Medicare Medicare |
$12.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$24.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.25
|
| Rate for Payer: UHC Exchange |
$18.99
|
| Rate for Payer: UHC Medicare Advantage |
$12.25
|
| Rate for Payer: UHCCP DNSP |
$12.25
|
| Rate for Payer: UHCCP Medicaid |
$6.57
|
| Rate for Payer: VA VA |
$12.25
|
|
|
HC HYPERSENSITIVITY PNEUMO-CMPTS
|
Facility
|
IP
|
$28.09
|
|
|
Service Code
|
CPT 86671
|
| Hospital Charge Code |
30200270
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.26 |
| Max. Negotiated Rate |
$28.09 |
| Rate for Payer: Aetna Commercial |
$25.28
|
| Rate for Payer: ASR ASR |
$27.25
|
| Rate for Payer: ASR Commercial |
$27.25
|
| Rate for Payer: BCBS Trust/PPO |
$22.89
|
| Rate for Payer: BCN Commercial |
$21.78
|
| Rate for Payer: Cash Price |
$22.47
|
| Rate for Payer: Cofinity Commercial |
$26.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.47
|
| Rate for Payer: Healthscope Commercial |
$28.09
|
| Rate for Payer: Healthscope Whirlpool |
$27.25
|
| Rate for Payer: Mclaren Commercial |
$25.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.88
|
| Rate for Payer: Nomi Health Commercial |
$23.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$24.72
|
|
|
HC HYPERSENSITIVITY PNEUMONITIS P
|
Facility
|
IP
|
$29.13
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
30200223
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.93 |
| Max. Negotiated Rate |
$29.13 |
| Rate for Payer: Aetna Commercial |
$26.22
|
| Rate for Payer: ASR ASR |
$28.26
|
| Rate for Payer: ASR Commercial |
$28.26
|
| Rate for Payer: BCBS Trust/PPO |
$23.74
|
| Rate for Payer: BCN Commercial |
$22.58
|
| Rate for Payer: Cash Price |
$23.30
|
| Rate for Payer: Cofinity Commercial |
$27.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.30
|
| Rate for Payer: Healthscope Commercial |
$29.13
|
| Rate for Payer: Healthscope Whirlpool |
$28.26
|
| Rate for Payer: Mclaren Commercial |
$26.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.76
|
| Rate for Payer: Nomi Health Commercial |
$23.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.63
|
|
|
HC HYPERSENSITIVITY PNEUMONITIS P
|
Facility
|
OP
|
$29.13
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
30200223
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.07 |
| Max. Negotiated Rate |
$29.13 |
| Rate for Payer: Aetna Commercial |
$26.22
|
| Rate for Payer: Aetna Medicare |
$15.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.81
|
| Rate for Payer: ASR ASR |
$28.26
|
| Rate for Payer: ASR Commercial |
$28.26
|
| Rate for Payer: BCBS Complete |
$8.47
|
| Rate for Payer: BCBS MAPPO |
$15.05
|
| Rate for Payer: BCBS Trust/PPO |
$23.85
|
| Rate for Payer: BCN Commercial |
$22.58
|
| Rate for Payer: BCN Medicare Advantage |
$15.05
|
| Rate for Payer: Cash Price |
$23.30
|
| Rate for Payer: Cash Price |
$23.30
|
| Rate for Payer: Cofinity Commercial |
$27.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.05
|
| Rate for Payer: Healthscope Commercial |
$29.13
|
| Rate for Payer: Healthscope Whirlpool |
$28.26
|
| Rate for Payer: Humana Choice PPO Medicare |
$15.05
|
| Rate for Payer: Mclaren Commercial |
$26.22
|
| Rate for Payer: Mclaren Medicaid |
$8.07
|
| Rate for Payer: Mclaren Medicare |
$15.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.80
|
| Rate for Payer: Meridian Medicaid |
$8.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.76
|
| Rate for Payer: Nomi Health Commercial |
$23.89
|
| Rate for Payer: PACE Medicare |
$14.30
|
| Rate for Payer: PACE SWMI |
$15.05
|
| Rate for Payer: PHP Commercial |
$16.56
|
| Rate for Payer: PHP Medicaid |
$8.07
|
| Rate for Payer: PHP Medicare Advantage |
$15.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25.52
|
| Rate for Payer: Priority Health Medicare |
$15.05
|
| Rate for Payer: Priority Health Narrow Network |
$20.42
|
| Rate for Payer: Railroad Medicare Medicare |
$15.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.05
|
| Rate for Payer: UHC Exchange |
$23.33
|
| Rate for Payer: UHC Medicare Advantage |
$15.05
|
| Rate for Payer: UHCCP DNSP |
$15.05
|
| Rate for Payer: UHCCP Medicaid |
$8.07
|
| Rate for Payer: VA VA |
$15.05
|
|
|
HC HYPERSENSITIVITY PNEUMO PANEL
|
Facility
|
IP
|
$22.75
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
30200496
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.79 |
| Max. Negotiated Rate |
$22.75 |
| Rate for Payer: Aetna Commercial |
$20.48
|
| Rate for Payer: ASR ASR |
$22.07
|
| Rate for Payer: ASR Commercial |
$22.07
|
| Rate for Payer: BCBS Trust/PPO |
$18.54
|
| Rate for Payer: BCN Commercial |
$17.64
|
| Rate for Payer: Cash Price |
$18.20
|
| Rate for Payer: Cofinity Commercial |
$21.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.20
|
| Rate for Payer: Healthscope Commercial |
$22.75
|
| Rate for Payer: Healthscope Whirlpool |
$22.07
|
| Rate for Payer: Mclaren Commercial |
$20.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.34
|
| Rate for Payer: Nomi Health Commercial |
$18.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$20.02
|
|
|
HC HYPERSENSITIVITY PNEUMO PANEL
|
Facility
|
OP
|
$22.75
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
30200496
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.19 |
| Max. Negotiated Rate |
$22.75 |
| Rate for Payer: Aetna Commercial |
$20.48
|
| Rate for Payer: Aetna Medicare |
$7.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.78
|
| Rate for Payer: ASR ASR |
$22.07
|
| Rate for Payer: ASR Commercial |
$22.07
|
| Rate for Payer: BCBS Complete |
$4.40
|
| Rate for Payer: BCBS MAPPO |
$7.82
|
| Rate for Payer: BCBS Trust/PPO |
$18.63
|
| Rate for Payer: BCN Commercial |
$17.64
|
| Rate for Payer: BCN Medicare Advantage |
$7.82
|
| Rate for Payer: Cash Price |
$18.20
|
| Rate for Payer: Cash Price |
$18.20
|
| Rate for Payer: Cofinity Commercial |
$21.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.82
|
| Rate for Payer: Healthscope Commercial |
$22.75
|
| Rate for Payer: Healthscope Whirlpool |
$22.07
|
| Rate for Payer: Humana Choice PPO Medicare |
$7.82
|
| Rate for Payer: Mclaren Commercial |
$20.48
|
| Rate for Payer: Mclaren Medicaid |
$4.19
|
| Rate for Payer: Mclaren Medicare |
$7.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.21
|
| Rate for Payer: Meridian Medicaid |
$4.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.34
|
| Rate for Payer: Nomi Health Commercial |
$18.66
|
| Rate for Payer: PACE Medicare |
$7.43
|
| Rate for Payer: PACE SWMI |
$7.82
|
| Rate for Payer: PHP Commercial |
$8.60
|
| Rate for Payer: PHP Medicaid |
$4.19
|
| Rate for Payer: PHP Medicare Advantage |
$7.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19.93
|
| Rate for Payer: Priority Health Medicare |
$7.82
|
| Rate for Payer: Priority Health Narrow Network |
$15.95
|
| Rate for Payer: Railroad Medicare Medicare |
$7.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$20.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.82
|
| Rate for Payer: UHC Exchange |
$12.12
|
| Rate for Payer: UHC Medicare Advantage |
$7.82
|
| Rate for Payer: UHCCP DNSP |
$7.82
|
| Rate for Payer: UHCCP Medicaid |
$4.19
|
| Rate for Payer: VA VA |
$7.82
|
|
|
HC HYSTEROSCOPY DIAGNOSTIC
|
Facility
|
OP
|
$4,093.79
|
|
|
Service Code
|
CPT 58555
|
| Hospital Charge Code |
76100303
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,669.77 |
| Max. Negotiated Rate |
$4,828.62 |
| Rate for Payer: Aetna Commercial |
$3,684.41
|
| Rate for Payer: Aetna Medicare |
$3,115.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,894.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,894.05
|
| Rate for Payer: ASR ASR |
$3,970.98
|
| Rate for Payer: ASR Commercial |
$3,970.98
|
| Rate for Payer: BCBS Complete |
$1,753.26
|
| Rate for Payer: BCBS MAPPO |
$3,115.24
|
| Rate for Payer: BCBS Trust/PPO |
$3,352.40
|
| Rate for Payer: BCN Commercial |
$3,173.92
|
| Rate for Payer: BCN Medicare Advantage |
$3,115.24
|
| Rate for Payer: Cash Price |
$3,275.03
|
| Rate for Payer: Cash Price |
$3,275.03
|
| Rate for Payer: Cofinity Commercial |
$3,848.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,275.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,115.24
|
| Rate for Payer: Healthscope Commercial |
$4,093.79
|
| Rate for Payer: Healthscope Whirlpool |
$3,970.98
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,115.24
|
| Rate for Payer: Mclaren Commercial |
$3,684.41
|
| Rate for Payer: Mclaren Medicaid |
$1,669.77
|
| Rate for Payer: Mclaren Medicare |
$3,115.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,271.00
|
| Rate for Payer: Meridian Medicaid |
$1,753.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,582.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,479.72
|
| Rate for Payer: Nomi Health Commercial |
$3,356.91
|
| Rate for Payer: PACE Medicare |
$2,959.48
|
| Rate for Payer: PACE SWMI |
$3,115.24
|
| Rate for Payer: PHP Commercial |
$3,426.76
|
| Rate for Payer: PHP Medicaid |
$1,669.77
|
| Rate for Payer: PHP Medicare Advantage |
$3,115.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,669.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,660.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,586.98
|
| Rate for Payer: Priority Health Medicare |
$3,115.24
|
| Rate for Payer: Priority Health Narrow Network |
$2,869.75
|
| Rate for Payer: Railroad Medicare Medicare |
$3,115.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,602.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,115.24
|
| Rate for Payer: UHC Exchange |
$4,828.62
|
| Rate for Payer: UHC Medicare Advantage |
$3,115.24
|
| Rate for Payer: UHCCP DNSP |
$3,115.24
|
| Rate for Payer: UHCCP Medicaid |
$1,669.77
|
| Rate for Payer: VA VA |
$3,115.24
|
|
