|
HC PAIN CLINIC DRUG SCREEN, U
|
Facility
|
IP
|
$161.16
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100680
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$112.81 |
| Max. Negotiated Rate |
$161.16 |
| Rate for Payer: Aetna Commercial |
$145.04
|
| Rate for Payer: ASR ASR |
$156.33
|
| Rate for Payer: BCBS Trust/PPO |
$124.95
|
| Rate for Payer: BCN Commercial |
$124.95
|
| Rate for Payer: Cash Price |
$128.93
|
| Rate for Payer: Cofinity Commercial |
$151.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.93
|
| Rate for Payer: Healthscope Commercial |
$161.16
|
| Rate for Payer: Healthscope Whirlpool |
$156.33
|
| Rate for Payer: Mclaren Commercial |
$145.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$136.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$112.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$141.82
|
|
|
HC PAIN PUMP ADJUSTMENT
|
Facility
|
IP
|
$151.79
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
76100028
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$106.25 |
| Max. Negotiated Rate |
$151.79 |
| Rate for Payer: Aetna Commercial |
$136.61
|
| Rate for Payer: ASR ASR |
$147.24
|
| Rate for Payer: BCBS Trust/PPO |
$117.68
|
| Rate for Payer: BCN Commercial |
$117.68
|
| Rate for Payer: Cash Price |
$121.43
|
| Rate for Payer: Cofinity Commercial |
$142.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$121.43
|
| Rate for Payer: Healthscope Commercial |
$151.79
|
| Rate for Payer: Healthscope Whirlpool |
$147.24
|
| Rate for Payer: Mclaren Commercial |
$136.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$129.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$106.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$133.58
|
|
|
HC PAIN PUMP ADJUSTMENT
|
Facility
|
OP
|
$151.79
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
76100028
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$22.00 |
| Max. Negotiated Rate |
$151.79 |
| Rate for Payer: Aetna Commercial |
$136.61
|
| Rate for Payer: ASR ASR |
$147.24
|
| Rate for Payer: BCBS Complete |
$60.72
|
| Rate for Payer: BCBS Trust/PPO |
$117.68
|
| Rate for Payer: BCCCP Commercial |
$22.00
|
| Rate for Payer: BCN Commercial |
$117.68
|
| Rate for Payer: Cash Price |
$121.43
|
| Rate for Payer: Cash Price |
$121.43
|
| Rate for Payer: Cofinity Commercial |
$142.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$121.43
|
| Rate for Payer: Healthscope Commercial |
$151.79
|
| Rate for Payer: Healthscope Whirlpool |
$147.24
|
| Rate for Payer: Mclaren Commercial |
$136.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$129.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$106.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$111.86
|
| Rate for Payer: Priority Health Narrow Network |
$89.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$133.58
|
|
|
HC PAIN PUMP SUPPLY
|
Facility
|
IP
|
$905.51
|
|
| Hospital Charge Code |
27000130
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$633.86 |
| Max. Negotiated Rate |
$905.51 |
| Rate for Payer: Aetna Commercial |
$814.96
|
| Rate for Payer: ASR ASR |
$878.34
|
| Rate for Payer: BCBS Trust/PPO |
$702.04
|
| Rate for Payer: BCN Commercial |
$702.04
|
| Rate for Payer: Cash Price |
$724.41
|
| Rate for Payer: Cofinity Commercial |
$851.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$724.41
|
| Rate for Payer: Healthscope Commercial |
$905.51
|
| Rate for Payer: Healthscope Whirlpool |
$878.34
|
| Rate for Payer: Mclaren Commercial |
$814.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$769.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$633.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$796.85
|
|
|
HC PAIN PUMP SUPPLY
|
Facility
|
OP
|
$905.51
|
|
| Hospital Charge Code |
27000130
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$362.20 |
| Max. Negotiated Rate |
$905.51 |
| Rate for Payer: Aetna Commercial |
$814.96
|
| Rate for Payer: ASR ASR |
$878.34
|
| Rate for Payer: BCBS Complete |
$362.20
|
| Rate for Payer: BCBS Trust/PPO |
$702.04
|
| Rate for Payer: BCN Commercial |
$702.04
|
| Rate for Payer: Cash Price |
$724.41
|
| Rate for Payer: Cofinity Commercial |
$851.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$724.41
|
| Rate for Payer: Healthscope Commercial |
$905.51
|
| Rate for Payer: Healthscope Whirlpool |
$878.34
|
| Rate for Payer: Mclaren Commercial |
$814.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$769.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$633.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$824.01
|
| Rate for Payer: Priority Health Narrow Network |
$642.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$796.85
|
|
|
HC PANCREATIC AMYLASE
|
Facility
|
OP
|
$66.00
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
30100100
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.54 |
| Max. Negotiated Rate |
$103.64 |
| Rate for Payer: Aetna Commercial |
$59.40
|
| Rate for Payer: Aetna Medicare |
$6.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.10
|
| Rate for Payer: ASR ASR |
$64.02
|
| Rate for Payer: BCBS Complete |
$3.72
|
| Rate for Payer: BCBS MAPPO |
$6.48
|
| Rate for Payer: BCBS Trust/PPO |
$51.17
|
| Rate for Payer: BCN Commercial |
$51.17
|
| Rate for Payer: BCN Medicare Advantage |
$6.48
|
| Rate for Payer: Cash Price |
$52.80
|
| Rate for Payer: Cash Price |
$52.80
|
| Rate for Payer: Cofinity Commercial |
$62.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.48
|
| Rate for Payer: Healthscope Commercial |
$66.00
|
| Rate for Payer: Healthscope Whirlpool |
$64.02
|
| Rate for Payer: Humana Choice PPO Medicare |
$6.48
|
| Rate for Payer: Mclaren Commercial |
$59.40
|
| Rate for Payer: Mclaren Medicaid |
$3.54
|
| Rate for Payer: Mclaren Medicare |
$6.48
|
| Rate for Payer: Meridian Medicaid |
$3.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$56.10
|
| Rate for Payer: PACE Medicare |
$6.16
|
| Rate for Payer: PACE SWMI |
$6.48
|
| Rate for Payer: PHP Commercial |
$7.13
|
| Rate for Payer: PHP Medicaid |
$3.54
|
| Rate for Payer: PHP Medicare Advantage |
$6.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$103.64
|
| Rate for Payer: Priority Health Medicare |
$6.48
|
| Rate for Payer: Priority Health Narrow Network |
$82.91
|
| Rate for Payer: Railroad Medicare Medicare |
$6.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$58.08
|
| Rate for Payer: UHC Medicare Advantage |
$6.67
|
| Rate for Payer: VA VA |
$6.48
|
|
|
HC PANCREATIC AMYLASE
|
Facility
|
IP
|
$66.00
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
30100100
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$46.20 |
| Max. Negotiated Rate |
$66.00 |
| Rate for Payer: Aetna Commercial |
$59.40
|
| Rate for Payer: ASR ASR |
$64.02
|
| Rate for Payer: BCBS Trust/PPO |
$51.17
|
| Rate for Payer: BCN Commercial |
$51.17
|
| Rate for Payer: Cash Price |
$52.80
|
| Rate for Payer: Cofinity Commercial |
$62.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.80
|
| Rate for Payer: Healthscope Commercial |
$66.00
|
| Rate for Payer: Healthscope Whirlpool |
$64.02
|
| Rate for Payer: Mclaren Commercial |
$59.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$56.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$58.08
|
|
|
HC PANCREATIC ELAST IN STOOL
|
Facility
|
IP
|
$115.00
|
|
|
Service Code
|
CPT 82653
|
| Hospital Charge Code |
30100632
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$80.50 |
| Max. Negotiated Rate |
$115.00 |
| Rate for Payer: Aetna Commercial |
$103.50
|
| Rate for Payer: ASR ASR |
$111.55
|
| Rate for Payer: BCBS Trust/PPO |
$89.16
|
| Rate for Payer: BCN Commercial |
$89.16
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cofinity Commercial |
$108.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.00
|
| Rate for Payer: Healthscope Commercial |
$115.00
|
| Rate for Payer: Healthscope Whirlpool |
$111.55
|
| Rate for Payer: Mclaren Commercial |
$103.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$97.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$101.20
|
|
|
HC PANCREATIC ELAST IN STOOL
|
Facility
|
OP
|
$115.00
|
|
|
Service Code
|
CPT 82653
|
| Hospital Charge Code |
30100632
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.56 |
| Max. Negotiated Rate |
$115.00 |
| Rate for Payer: Aetna Commercial |
$103.50
|
| Rate for Payer: Aetna Medicare |
$22.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.71
|
| Rate for Payer: ASR ASR |
$111.55
|
| Rate for Payer: BCBS Complete |
$13.19
|
| Rate for Payer: BCBS MAPPO |
$22.97
|
| Rate for Payer: BCBS Trust/PPO |
$89.16
|
| Rate for Payer: BCN Commercial |
$89.16
|
| Rate for Payer: BCN Medicare Advantage |
$22.97
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cofinity Commercial |
$108.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.97
|
| Rate for Payer: Healthscope Commercial |
$115.00
|
| Rate for Payer: Healthscope Whirlpool |
$111.55
|
| Rate for Payer: Humana Choice PPO Medicare |
$22.97
|
| Rate for Payer: Mclaren Commercial |
$103.50
|
| Rate for Payer: Mclaren Medicaid |
$12.56
|
| Rate for Payer: Mclaren Medicare |
$22.97
|
| Rate for Payer: Meridian Medicaid |
$13.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$24.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$97.75
|
| Rate for Payer: PACE Medicare |
$21.82
|
| Rate for Payer: PACE SWMI |
$22.97
|
| Rate for Payer: PHP Commercial |
$25.27
|
| Rate for Payer: PHP Medicaid |
$12.56
|
| Rate for Payer: PHP Medicare Advantage |
$22.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$104.65
|
| Rate for Payer: Priority Health Medicare |
$22.97
|
| Rate for Payer: Priority Health Narrow Network |
$81.65
|
| Rate for Payer: Railroad Medicare Medicare |
$22.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$101.20
|
| Rate for Payer: UHC Medicare Advantage |
$23.66
|
| Rate for Payer: VA VA |
$22.97
|
|
|
HC PAPER WASP IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200096
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.86 |
| Max. Negotiated Rate |
$24.89 |
| Rate for Payer: Aetna Commercial |
$22.40
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: ASR ASR |
$24.14
|
| Rate for Payer: BCBS Complete |
$3.00
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.30
|
| Rate for Payer: BCN Commercial |
$19.30
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$23.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$24.89
|
| Rate for Payer: Healthscope Whirlpool |
$24.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$22.40
|
| Rate for Payer: Mclaren Medicaid |
$2.86
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Medicaid |
$3.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$5.74
|
| Rate for Payer: PHP Medicaid |
$2.86
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.65
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$17.67
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.90
|
| Rate for Payer: UHC Medicare Advantage |
$5.38
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC PAPER WASP IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200096
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$17.42 |
| Max. Negotiated Rate |
$24.89 |
| Rate for Payer: Aetna Commercial |
$22.40
|
| Rate for Payer: ASR ASR |
$24.14
|
| Rate for Payer: BCBS Trust/PPO |
$19.30
|
| Rate for Payer: BCN Commercial |
$19.30
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$23.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$24.89
|
| Rate for Payer: Healthscope Whirlpool |
$24.14
|
| Rate for Payer: Mclaren Commercial |
$22.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.90
|
|
|
HC PAP NAP
|
Facility
|
OP
|
$2,266.90
|
|
|
Service Code
|
CPT 95807
|
| Hospital Charge Code |
92000019
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$260.60 |
| Max. Negotiated Rate |
$2,266.90 |
| Rate for Payer: Aetna Commercial |
$2,040.21
|
| Rate for Payer: Aetna Medicare |
$476.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$595.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$595.52
|
| Rate for Payer: ASR ASR |
$2,198.89
|
| Rate for Payer: BCBS Complete |
$273.66
|
| Rate for Payer: BCBS MAPPO |
$476.42
|
| Rate for Payer: BCBS Trust/PPO |
$1,757.53
|
| Rate for Payer: BCN Commercial |
$1,757.53
|
| Rate for Payer: BCN Medicare Advantage |
$476.42
|
| Rate for Payer: Cash Price |
$1,813.52
|
| Rate for Payer: Cash Price |
$1,813.52
|
| Rate for Payer: Cofinity Commercial |
$2,130.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,813.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$476.42
|
| Rate for Payer: Healthscope Commercial |
$2,266.90
|
| Rate for Payer: Healthscope Whirlpool |
$2,198.89
|
| Rate for Payer: Humana Choice PPO Medicare |
$476.42
|
| Rate for Payer: Mclaren Commercial |
$2,040.21
|
| Rate for Payer: Mclaren Medicaid |
$260.60
|
| Rate for Payer: Mclaren Medicare |
$476.42
|
| Rate for Payer: Meridian Medicaid |
$273.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$500.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$547.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,926.86
|
| Rate for Payer: PACE Medicare |
$452.60
|
| Rate for Payer: PACE SWMI |
$476.42
|
| Rate for Payer: PHP Commercial |
$524.06
|
| Rate for Payer: PHP Medicaid |
$260.60
|
| Rate for Payer: PHP Medicare Advantage |
$476.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$260.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,586.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,062.88
|
| Rate for Payer: Priority Health Medicare |
$476.42
|
| Rate for Payer: Priority Health Narrow Network |
$1,609.50
|
| Rate for Payer: Railroad Medicare Medicare |
$476.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,994.87
|
| Rate for Payer: UHC Medicare Advantage |
$490.71
|
| Rate for Payer: VA VA |
$476.42
|
|
|
HC PAP NAP
|
Facility
|
IP
|
$2,266.90
|
|
|
Service Code
|
CPT 95807
|
| Hospital Charge Code |
92000019
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$1,586.83 |
| Max. Negotiated Rate |
$2,266.90 |
| Rate for Payer: Aetna Commercial |
$2,040.21
|
| Rate for Payer: ASR ASR |
$2,198.89
|
| Rate for Payer: BCBS Trust/PPO |
$1,757.53
|
| Rate for Payer: BCN Commercial |
$1,757.53
|
| Rate for Payer: Cash Price |
$1,813.52
|
| Rate for Payer: Cofinity Commercial |
$2,130.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,813.52
|
| Rate for Payer: Healthscope Commercial |
$2,266.90
|
| Rate for Payer: Healthscope Whirlpool |
$2,198.89
|
| Rate for Payer: Mclaren Commercial |
$2,040.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,926.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,586.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,994.87
|
|
|
HC PAP SMEAR, SCREENING
|
Facility
|
OP
|
$55.00
|
|
|
Service Code
|
HCPCS P3000
|
| Hospital Charge Code |
31100027
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$9.47 |
| Max. Negotiated Rate |
$84.14 |
| Rate for Payer: Aetna Commercial |
$49.50
|
| Rate for Payer: Aetna Medicare |
$17.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.64
|
| Rate for Payer: ASR ASR |
$53.35
|
| Rate for Payer: BCBS Complete |
$9.94
|
| Rate for Payer: BCBS MAPPO |
$17.31
|
| Rate for Payer: BCBS Trust/PPO |
$42.64
|
| Rate for Payer: BCN Commercial |
$42.64
|
| Rate for Payer: BCN Medicare Advantage |
$17.31
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cofinity Commercial |
$51.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.31
|
| Rate for Payer: Healthscope Commercial |
$55.00
|
| Rate for Payer: Healthscope Whirlpool |
$53.35
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.31
|
| Rate for Payer: Mclaren Commercial |
$49.50
|
| Rate for Payer: Mclaren Medicaid |
$9.47
|
| Rate for Payer: Mclaren Medicare |
$17.31
|
| Rate for Payer: Meridian Medicaid |
$9.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$18.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$46.75
|
| Rate for Payer: PACE Medicare |
$16.44
|
| Rate for Payer: PACE SWMI |
$17.31
|
| Rate for Payer: PHP Commercial |
$19.04
|
| Rate for Payer: PHP Medicaid |
$9.47
|
| Rate for Payer: PHP Medicare Advantage |
$17.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$84.14
|
| Rate for Payer: Priority Health Medicare |
$17.31
|
| Rate for Payer: Priority Health Narrow Network |
$67.31
|
| Rate for Payer: Railroad Medicare Medicare |
$17.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$48.40
|
| Rate for Payer: UHC Medicare Advantage |
$17.83
|
| Rate for Payer: VA VA |
$17.31
|
|
|
HC PAP SMEAR, SCREENING
|
Facility
|
IP
|
$55.00
|
|
|
Service Code
|
HCPCS P3000
|
| Hospital Charge Code |
31100027
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$38.50 |
| Max. Negotiated Rate |
$55.00 |
| Rate for Payer: Aetna Commercial |
$49.50
|
| Rate for Payer: ASR ASR |
$53.35
|
| Rate for Payer: BCBS Trust/PPO |
$42.64
|
| Rate for Payer: BCN Commercial |
$42.64
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cofinity Commercial |
$51.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.00
|
| Rate for Payer: Healthscope Commercial |
$55.00
|
| Rate for Payer: Healthscope Whirlpool |
$53.35
|
| Rate for Payer: Mclaren Commercial |
$49.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$46.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$48.40
|
|
|
HC PARACENTESIS
|
Facility
|
IP
|
$976.19
|
|
| Hospital Charge Code |
36000078
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$683.33 |
| Max. Negotiated Rate |
$976.19 |
| Rate for Payer: Aetna Commercial |
$878.57
|
| Rate for Payer: ASR ASR |
$946.90
|
| Rate for Payer: BCBS Trust/PPO |
$756.84
|
| Rate for Payer: BCN Commercial |
$756.84
|
| Rate for Payer: Cash Price |
$780.95
|
| Rate for Payer: Cofinity Commercial |
$917.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$780.95
|
| Rate for Payer: Healthscope Commercial |
$976.19
|
| Rate for Payer: Healthscope Whirlpool |
$946.90
|
| Rate for Payer: Mclaren Commercial |
$878.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$829.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$683.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$859.05
|
|
|
HC PARACENTESIS
|
Facility
|
OP
|
$976.19
|
|
| Hospital Charge Code |
36000078
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$390.48 |
| Max. Negotiated Rate |
$976.19 |
| Rate for Payer: Aetna Commercial |
$878.57
|
| Rate for Payer: ASR ASR |
$946.90
|
| Rate for Payer: BCBS Complete |
$390.48
|
| Rate for Payer: BCBS Trust/PPO |
$756.84
|
| Rate for Payer: BCN Commercial |
$756.84
|
| Rate for Payer: Cash Price |
$780.95
|
| Rate for Payer: Cofinity Commercial |
$917.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$780.95
|
| Rate for Payer: Healthscope Commercial |
$976.19
|
| Rate for Payer: Healthscope Whirlpool |
$946.90
|
| Rate for Payer: Mclaren Commercial |
$878.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$829.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$683.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$888.33
|
| Rate for Payer: Priority Health Narrow Network |
$693.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$859.05
|
|
|
HC PARACERVIAL/PUDENDAL ANES
|
Facility
|
OP
|
$372.88
|
|
| Hospital Charge Code |
37000004
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$149.15 |
| Max. Negotiated Rate |
$372.88 |
| Rate for Payer: Aetna Commercial |
$335.59
|
| Rate for Payer: ASR ASR |
$361.69
|
| Rate for Payer: BCBS Complete |
$149.15
|
| Rate for Payer: BCBS Trust/PPO |
$289.09
|
| Rate for Payer: BCN Commercial |
$289.09
|
| Rate for Payer: Cash Price |
$298.30
|
| Rate for Payer: Cofinity Commercial |
$350.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$298.30
|
| Rate for Payer: Healthscope Commercial |
$372.88
|
| Rate for Payer: Healthscope Whirlpool |
$361.69
|
| Rate for Payer: Mclaren Commercial |
$335.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$316.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$261.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$339.32
|
| Rate for Payer: Priority Health Narrow Network |
$264.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$328.13
|
|
|
HC PARACERVIAL/PUDENDAL ANES
|
Facility
|
IP
|
$372.88
|
|
| Hospital Charge Code |
37000004
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$261.02 |
| Max. Negotiated Rate |
$372.88 |
| Rate for Payer: Aetna Commercial |
$335.59
|
| Rate for Payer: ASR ASR |
$361.69
|
| Rate for Payer: BCBS Trust/PPO |
$289.09
|
| Rate for Payer: BCN Commercial |
$289.09
|
| Rate for Payer: Cash Price |
$298.30
|
| Rate for Payer: Cofinity Commercial |
$350.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$298.30
|
| Rate for Payer: Healthscope Commercial |
$372.88
|
| Rate for Payer: Healthscope Whirlpool |
$361.69
|
| Rate for Payer: Mclaren Commercial |
$335.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$316.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$261.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$328.13
|
|
|
HC PARAFFIN BATH
|
Facility
|
OP
|
$63.24
|
|
|
Service Code
|
CPT 97018
|
| Hospital Charge Code |
43000008
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$25.30 |
| Max. Negotiated Rate |
$63.24 |
| Rate for Payer: Aetna Commercial |
$56.92
|
| Rate for Payer: ASR ASR |
$61.34
|
| Rate for Payer: BCBS Complete |
$25.30
|
| Rate for Payer: BCBS Trust/PPO |
$49.03
|
| Rate for Payer: BCN Commercial |
$49.03
|
| Rate for Payer: Cash Price |
$50.59
|
| Rate for Payer: Cofinity Commercial |
$59.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.59
|
| Rate for Payer: Healthscope Commercial |
$63.24
|
| Rate for Payer: Healthscope Whirlpool |
$61.34
|
| Rate for Payer: Mclaren Commercial |
$56.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$53.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$57.55
|
| Rate for Payer: Priority Health Narrow Network |
$44.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$55.65
|
|
|
HC PARAFFIN BATH
|
Facility
|
IP
|
$63.24
|
|
|
Service Code
|
CPT 97018
|
| Hospital Charge Code |
43000008
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$44.27 |
| Max. Negotiated Rate |
$63.24 |
| Rate for Payer: Aetna Commercial |
$56.92
|
| Rate for Payer: ASR ASR |
$61.34
|
| Rate for Payer: BCBS Trust/PPO |
$49.03
|
| Rate for Payer: BCN Commercial |
$49.03
|
| Rate for Payer: Cash Price |
$50.59
|
| Rate for Payer: Cofinity Commercial |
$59.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.59
|
| Rate for Payer: Healthscope Commercial |
$63.24
|
| Rate for Payer: Healthscope Whirlpool |
$61.34
|
| Rate for Payer: Mclaren Commercial |
$56.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$53.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$55.65
|
|
|
HC PARANEOPLAS AB EVAL CSF
|
Facility
|
OP
|
$104.00
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200470
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.59 |
| Max. Negotiated Rate |
$212.42 |
| Rate for Payer: Aetna Commercial |
$93.60
|
| Rate for Payer: Aetna Medicare |
$12.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.06
|
| Rate for Payer: ASR ASR |
$100.88
|
| Rate for Payer: BCBS Complete |
$6.92
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCBS Trust/PPO |
$80.63
|
| Rate for Payer: BCN Commercial |
$80.63
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$83.20
|
| Rate for Payer: Cash Price |
$83.20
|
| Rate for Payer: Cofinity Commercial |
$97.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$104.00
|
| Rate for Payer: Healthscope Whirlpool |
$100.88
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.05
|
| Rate for Payer: Mclaren Commercial |
$93.60
|
| Rate for Payer: Mclaren Medicaid |
$6.59
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Medicaid |
$6.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$88.40
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$13.26
|
| Rate for Payer: PHP Medicaid |
$6.59
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$212.42
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health Narrow Network |
$169.94
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$91.52
|
| Rate for Payer: UHC Medicare Advantage |
$12.41
|
| Rate for Payer: VA VA |
$12.05
|
|
|
HC PARANEOPLAS AB EVAL CSF
|
Facility
|
IP
|
$104.00
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200470
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$72.80 |
| Max. Negotiated Rate |
$104.00 |
| Rate for Payer: Aetna Commercial |
$93.60
|
| Rate for Payer: ASR ASR |
$100.88
|
| Rate for Payer: BCBS Trust/PPO |
$80.63
|
| Rate for Payer: BCN Commercial |
$80.63
|
| Rate for Payer: Cash Price |
$83.20
|
| Rate for Payer: Cofinity Commercial |
$97.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.20
|
| Rate for Payer: Healthscope Commercial |
$104.00
|
| Rate for Payer: Healthscope Whirlpool |
$100.88
|
| Rate for Payer: Mclaren Commercial |
$93.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$88.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$91.52
|
|
|
HC PARANEOPLAS AB EVAL CSF CMPT
|
Facility
|
OP
|
$80.58
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200471
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.59 |
| Max. Negotiated Rate |
$212.42 |
| Rate for Payer: Aetna Commercial |
$72.52
|
| Rate for Payer: Aetna Medicare |
$12.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.06
|
| Rate for Payer: ASR ASR |
$78.16
|
| Rate for Payer: BCBS Complete |
$6.92
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCBS Trust/PPO |
$62.47
|
| Rate for Payer: BCN Commercial |
$62.47
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$64.46
|
| Rate for Payer: Cash Price |
$64.46
|
| Rate for Payer: Cofinity Commercial |
$75.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$80.58
|
| Rate for Payer: Healthscope Whirlpool |
$78.16
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.05
|
| Rate for Payer: Mclaren Commercial |
$72.52
|
| Rate for Payer: Mclaren Medicaid |
$6.59
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Medicaid |
$6.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$68.49
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$13.26
|
| Rate for Payer: PHP Medicaid |
$6.59
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$212.42
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health Narrow Network |
$169.94
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$70.91
|
| Rate for Payer: UHC Medicare Advantage |
$12.41
|
| Rate for Payer: VA VA |
$12.05
|
|
|
HC PARANEOPLAS AB EVAL CSF CMPT
|
Facility
|
IP
|
$80.58
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200471
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$56.41 |
| Max. Negotiated Rate |
$80.58 |
| Rate for Payer: Aetna Commercial |
$72.52
|
| Rate for Payer: ASR ASR |
$78.16
|
| Rate for Payer: BCBS Trust/PPO |
$62.47
|
| Rate for Payer: BCN Commercial |
$62.47
|
| Rate for Payer: Cash Price |
$64.46
|
| Rate for Payer: Cofinity Commercial |
$75.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.46
|
| Rate for Payer: Healthscope Commercial |
$80.58
|
| Rate for Payer: Healthscope Whirlpool |
$78.16
|
| Rate for Payer: Mclaren Commercial |
$72.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$68.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$70.91
|
|
