|
HC IR VASCULAR UNLISTED PROCEDURE
|
Facility
|
IP
|
$500.21
|
|
|
Service Code
|
CPT 36299
|
| Hospital Charge Code |
36100114
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$375.16 |
| Max. Negotiated Rate |
$500.21 |
| Rate for Payer: Aetna Commercial |
$450.19
|
| Rate for Payer: ASR ASR |
$485.20
|
| Rate for Payer: BCBS Trust/PPO |
$410.77
|
| Rate for Payer: BCN Commercial |
$410.77
|
| Rate for Payer: Cash Price |
$400.17
|
| Rate for Payer: Cofinity Commercial |
$470.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$400.17
|
| Rate for Payer: Healthscope Commercial |
$485.20
|
| Rate for Payer: Healthscope Whirlpool |
$500.21
|
| Rate for Payer: Mclaren Commercial |
$450.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$425.18
|
| Rate for Payer: Nomi Health Commercial |
$410.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$375.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$440.18
|
|
|
HC IR VASCULAR UNLISTED PROCEDURE
|
Facility
|
OP
|
$500.21
|
|
|
Service Code
|
CPT 36299
|
| Hospital Charge Code |
36100114
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$185.08 |
| Max. Negotiated Rate |
$500.21 |
| Rate for Payer: Aetna Commercial |
$450.19
|
| Rate for Payer: Aetna Medicare |
$185.08
|
| Rate for Payer: ASR ASR |
$485.20
|
| Rate for Payer: BCBS Complete |
$200.08
|
| Rate for Payer: BCBS Trust/PPO |
$412.42
|
| Rate for Payer: BCN Commercial |
$412.42
|
| Rate for Payer: Cash Price |
$400.17
|
| Rate for Payer: Cofinity Commercial |
$470.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$400.17
|
| Rate for Payer: Healthscope Commercial |
$485.20
|
| Rate for Payer: Healthscope Whirlpool |
$500.21
|
| Rate for Payer: Mclaren Commercial |
$450.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$400.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$425.18
|
| Rate for Payer: Nomi Health Commercial |
$410.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$375.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$438.28
|
| Rate for Payer: Priority Health Narrow Network |
$350.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$440.18
|
|
|
HC IR VENOGRAM
|
Facility
|
OP
|
$1,145.14
|
|
|
Service Code
|
CPT 75820
|
| Hospital Charge Code |
32000203
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$802.74 |
| Max. Negotiated Rate |
$2,431.16 |
| Rate for Payer: Aetna Commercial |
$1,030.63
|
| Rate for Payer: Aetna Medicare |
$1,568.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,960.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,960.61
|
| Rate for Payer: ASR ASR |
$1,110.79
|
| Rate for Payer: BCBS Complete |
$861.41
|
| Rate for Payer: BCBS MAPPO |
$1,568.49
|
| Rate for Payer: BCBS Trust/PPO |
$944.17
|
| Rate for Payer: BCN Commercial |
$944.17
|
| Rate for Payer: BCN Medicare Advantage |
$1,568.49
|
| Rate for Payer: Cash Price |
$916.11
|
| Rate for Payer: Cash Price |
$916.11
|
| Rate for Payer: Cofinity Commercial |
$1,076.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$916.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,568.49
|
| Rate for Payer: Healthscope Commercial |
$1,110.79
|
| Rate for Payer: Healthscope Whirlpool |
$1,145.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,568.49
|
| Rate for Payer: Mclaren Commercial |
$1,030.63
|
| Rate for Payer: Mclaren Medicaid |
$1,568.49
|
| Rate for Payer: Mclaren Medicare |
$1,568.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,646.91
|
| Rate for Payer: Meridian Medicaid |
$861.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,803.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,725.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$973.37
|
| Rate for Payer: Nomi Health Commercial |
$939.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$858.86
|
| Rate for Payer: PACE Medicare |
$1,490.07
|
| Rate for Payer: PACE SWMI |
$1,568.49
|
| Rate for Payer: PHP Commercial |
$1,725.34
|
| Rate for Payer: PHP Medicaid |
$840.71
|
| Rate for Payer: PHP Medicare Advantage |
$1,568.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$820.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,003.37
|
| Rate for Payer: Priority Health Medicare |
$1,568.49
|
| Rate for Payer: Priority Health Narrow Network |
$802.74
|
| Rate for Payer: Railroad Medicare Medicare |
$1,568.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,007.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,568.49
|
| Rate for Payer: UHC Exchange |
$2,431.16
|
| Rate for Payer: UHC Medicaid |
$820.32
|
| Rate for Payer: UHCCP DNSP |
$1,568.49
|
| Rate for Payer: UHCCP Medicaid |
$820.32
|
| Rate for Payer: VA VA |
$1,568.49
|
|
|
HC IR VENOGRAM
|
Facility
|
IP
|
$1,145.14
|
|
|
Service Code
|
CPT 75820
|
| Hospital Charge Code |
32000203
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$858.86 |
| Max. Negotiated Rate |
$1,145.14 |
| Rate for Payer: Aetna Commercial |
$1,030.63
|
| Rate for Payer: ASR ASR |
$1,110.79
|
| Rate for Payer: BCBS Trust/PPO |
$940.39
|
| Rate for Payer: BCN Commercial |
$940.39
|
| Rate for Payer: Cash Price |
$916.11
|
| Rate for Payer: Cofinity Commercial |
$1,076.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$916.11
|
| Rate for Payer: Healthscope Commercial |
$1,110.79
|
| Rate for Payer: Healthscope Whirlpool |
$1,145.14
|
| Rate for Payer: Mclaren Commercial |
$1,030.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$973.37
|
| Rate for Payer: Nomi Health Commercial |
$939.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$858.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,007.72
|
|
|
HC IR VENOGRAM BIL
|
Facility
|
OP
|
$1,457.43
|
|
|
Service Code
|
CPT 75822
|
| Hospital Charge Code |
32000204
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$820.32 |
| Max. Negotiated Rate |
$2,431.16 |
| Rate for Payer: Aetna Commercial |
$1,311.69
|
| Rate for Payer: Aetna Medicare |
$1,568.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,960.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,960.61
|
| Rate for Payer: ASR ASR |
$1,413.71
|
| Rate for Payer: BCBS Complete |
$861.41
|
| Rate for Payer: BCBS MAPPO |
$1,568.49
|
| Rate for Payer: BCBS Trust/PPO |
$1,201.65
|
| Rate for Payer: BCN Commercial |
$1,201.65
|
| Rate for Payer: BCN Medicare Advantage |
$1,568.49
|
| Rate for Payer: Cash Price |
$1,165.94
|
| Rate for Payer: Cash Price |
$1,165.94
|
| Rate for Payer: Cofinity Commercial |
$1,369.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,165.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,568.49
|
| Rate for Payer: Healthscope Commercial |
$1,413.71
|
| Rate for Payer: Healthscope Whirlpool |
$1,457.43
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,568.49
|
| Rate for Payer: Mclaren Commercial |
$1,311.69
|
| Rate for Payer: Mclaren Medicaid |
$1,568.49
|
| Rate for Payer: Mclaren Medicare |
$1,568.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,646.91
|
| Rate for Payer: Meridian Medicaid |
$861.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,803.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,725.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,238.82
|
| Rate for Payer: Nomi Health Commercial |
$1,195.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,093.07
|
| Rate for Payer: PACE Medicare |
$1,490.07
|
| Rate for Payer: PACE SWMI |
$1,568.49
|
| Rate for Payer: PHP Commercial |
$1,725.34
|
| Rate for Payer: PHP Medicaid |
$840.71
|
| Rate for Payer: PHP Medicare Advantage |
$1,568.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$820.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,277.00
|
| Rate for Payer: Priority Health Medicare |
$1,568.49
|
| Rate for Payer: Priority Health Narrow Network |
$1,021.66
|
| Rate for Payer: Railroad Medicare Medicare |
$1,568.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,282.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,568.49
|
| Rate for Payer: UHC Exchange |
$2,431.16
|
| Rate for Payer: UHC Medicaid |
$820.32
|
| Rate for Payer: UHCCP DNSP |
$1,568.49
|
| Rate for Payer: UHCCP Medicaid |
$820.32
|
| Rate for Payer: VA VA |
$1,568.49
|
|
|
HC IR VENOGRAM BIL
|
Facility
|
IP
|
$1,457.43
|
|
|
Service Code
|
CPT 75822
|
| Hospital Charge Code |
32000204
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,093.07 |
| Max. Negotiated Rate |
$1,457.43 |
| Rate for Payer: Aetna Commercial |
$1,311.69
|
| Rate for Payer: ASR ASR |
$1,413.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,196.84
|
| Rate for Payer: BCN Commercial |
$1,196.84
|
| Rate for Payer: Cash Price |
$1,165.94
|
| Rate for Payer: Cofinity Commercial |
$1,369.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,165.94
|
| Rate for Payer: Healthscope Commercial |
$1,413.71
|
| Rate for Payer: Healthscope Whirlpool |
$1,457.43
|
| Rate for Payer: Mclaren Commercial |
$1,311.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,238.82
|
| Rate for Payer: Nomi Health Commercial |
$1,195.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,093.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,282.54
|
|
|
HC IR VENOGRAM RENAL BILAT SELECT
|
Facility
|
IP
|
$3,877.70
|
|
|
Service Code
|
CPT 75833
|
| Hospital Charge Code |
32000207
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,908.28 |
| Max. Negotiated Rate |
$3,877.70 |
| Rate for Payer: Aetna Commercial |
$3,489.93
|
| Rate for Payer: ASR ASR |
$3,761.37
|
| Rate for Payer: BCBS Trust/PPO |
$3,184.37
|
| Rate for Payer: BCN Commercial |
$3,184.37
|
| Rate for Payer: Cash Price |
$3,102.16
|
| Rate for Payer: Cofinity Commercial |
$3,645.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,102.16
|
| Rate for Payer: Healthscope Commercial |
$3,761.37
|
| Rate for Payer: Healthscope Whirlpool |
$3,877.70
|
| Rate for Payer: Mclaren Commercial |
$3,489.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,296.05
|
| Rate for Payer: Nomi Health Commercial |
$3,179.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,908.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,412.38
|
|
|
HC IR VENOGRAM RENAL BILAT SELECT
|
Facility
|
OP
|
$3,877.70
|
|
|
Service Code
|
CPT 75833
|
| Hospital Charge Code |
32000207
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,645.43 |
| Max. Negotiated Rate |
$4,876.50 |
| Rate for Payer: Aetna Commercial |
$3,489.93
|
| Rate for Payer: Aetna Medicare |
$3,146.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: ASR ASR |
$3,761.37
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$3,197.16
|
| Rate for Payer: BCN Commercial |
$3,197.16
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$3,102.16
|
| Rate for Payer: Cash Price |
$3,102.16
|
| Rate for Payer: Cofinity Commercial |
$3,645.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,102.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$3,761.37
|
| Rate for Payer: Healthscope Whirlpool |
$3,877.70
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,146.13
|
| Rate for Payer: Mclaren Commercial |
$3,489.93
|
| Rate for Payer: Mclaren Medicaid |
$3,146.13
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$1,727.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,296.05
|
| Rate for Payer: Nomi Health Commercial |
$3,179.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,908.28
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$3,460.74
|
| Rate for Payer: PHP Medicaid |
$1,686.33
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,397.64
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health Narrow Network |
$2,718.27
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,412.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Exchange |
$4,876.50
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP DNSP |
$3,146.13
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: VA VA |
$3,146.13
|
|
|
HC IR VENOGRAM RENAL UNI SELECT
|
Facility
|
OP
|
$3,641.57
|
|
|
Service Code
|
CPT 75831
|
| Hospital Charge Code |
32000322
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,645.43 |
| Max. Negotiated Rate |
$4,876.50 |
| Rate for Payer: Aetna Commercial |
$3,277.41
|
| Rate for Payer: Aetna Medicare |
$3,146.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: ASR ASR |
$3,532.32
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$3,002.47
|
| Rate for Payer: BCN Commercial |
$3,002.47
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$2,913.26
|
| Rate for Payer: Cash Price |
$2,913.26
|
| Rate for Payer: Cofinity Commercial |
$3,423.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,913.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$3,532.32
|
| Rate for Payer: Healthscope Whirlpool |
$3,641.57
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,146.13
|
| Rate for Payer: Mclaren Commercial |
$3,277.41
|
| Rate for Payer: Mclaren Medicaid |
$3,146.13
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$1,727.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,095.33
|
| Rate for Payer: Nomi Health Commercial |
$2,986.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,731.18
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$3,460.74
|
| Rate for Payer: PHP Medicaid |
$1,686.33
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,190.74
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health Narrow Network |
$2,552.74
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,204.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Exchange |
$4,876.50
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP DNSP |
$3,146.13
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: VA VA |
$3,146.13
|
|
|
HC IR VENOGRAM RENAL UNI SELECT
|
Facility
|
IP
|
$3,641.57
|
|
|
Service Code
|
CPT 75831
|
| Hospital Charge Code |
32000322
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,731.18 |
| Max. Negotiated Rate |
$3,641.57 |
| Rate for Payer: Aetna Commercial |
$3,277.41
|
| Rate for Payer: ASR ASR |
$3,532.32
|
| Rate for Payer: BCBS Trust/PPO |
$2,990.46
|
| Rate for Payer: BCN Commercial |
$2,990.46
|
| Rate for Payer: Cash Price |
$2,913.26
|
| Rate for Payer: Cofinity Commercial |
$3,423.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,913.26
|
| Rate for Payer: Healthscope Commercial |
$3,532.32
|
| Rate for Payer: Healthscope Whirlpool |
$3,641.57
|
| Rate for Payer: Mclaren Commercial |
$3,277.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,095.33
|
| Rate for Payer: Nomi Health Commercial |
$2,986.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,731.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,204.58
|
|
|
HC IR Z ABSCESS PERIANAL
|
Facility
|
OP
|
$1,232.52
|
|
|
Service Code
|
CPT 46050
|
| Hospital Charge Code |
36100369
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$484.62 |
| Max. Negotiated Rate |
$2,687.44 |
| Rate for Payer: Aetna Commercial |
$1,109.27
|
| Rate for Payer: Aetna Medicare |
$926.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,158.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,158.26
|
| Rate for Payer: ASR ASR |
$1,195.54
|
| Rate for Payer: BCBS Complete |
$508.89
|
| Rate for Payer: BCBS MAPPO |
$926.61
|
| Rate for Payer: BCBS Trust/PPO |
$1,016.21
|
| Rate for Payer: BCN Commercial |
$1,016.21
|
| Rate for Payer: BCN Medicare Advantage |
$926.61
|
| Rate for Payer: Cash Price |
$986.02
|
| Rate for Payer: Cash Price |
$986.02
|
| Rate for Payer: Cofinity Commercial |
$1,158.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$986.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$926.61
|
| Rate for Payer: Healthscope Commercial |
$1,195.54
|
| Rate for Payer: Healthscope Whirlpool |
$1,232.52
|
| Rate for Payer: Humana Choice PPO Medicare |
$926.61
|
| Rate for Payer: Mclaren Commercial |
$1,109.27
|
| Rate for Payer: Mclaren Medicaid |
$926.61
|
| Rate for Payer: Mclaren Medicare |
$926.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$972.94
|
| Rate for Payer: Meridian Medicaid |
$508.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,065.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,019.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,047.64
|
| Rate for Payer: Nomi Health Commercial |
$1,010.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$924.39
|
| Rate for Payer: PACE Medicare |
$880.28
|
| Rate for Payer: PACE SWMI |
$926.61
|
| Rate for Payer: PHP Commercial |
$1,019.27
|
| Rate for Payer: PHP Medicaid |
$496.66
|
| Rate for Payer: PHP Medicare Advantage |
$926.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$484.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,687.44
|
| Rate for Payer: Priority Health Medicare |
$926.61
|
| Rate for Payer: Priority Health Narrow Network |
$2,149.95
|
| Rate for Payer: Railroad Medicare Medicare |
$926.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,084.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$926.61
|
| Rate for Payer: UHC Exchange |
$1,436.25
|
| Rate for Payer: UHC Medicaid |
$484.62
|
| Rate for Payer: UHCCP DNSP |
$926.61
|
| Rate for Payer: UHCCP Medicaid |
$484.62
|
| Rate for Payer: VA VA |
$926.61
|
|
|
HC IR Z ABSCESS PERIANAL
|
Facility
|
IP
|
$1,232.52
|
|
|
Service Code
|
CPT 46050
|
| Hospital Charge Code |
36100369
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$924.39 |
| Max. Negotiated Rate |
$1,232.52 |
| Rate for Payer: Aetna Commercial |
$1,109.27
|
| Rate for Payer: ASR ASR |
$1,195.54
|
| Rate for Payer: BCBS Trust/PPO |
$1,012.15
|
| Rate for Payer: BCN Commercial |
$1,012.15
|
| Rate for Payer: Cash Price |
$986.02
|
| Rate for Payer: Cofinity Commercial |
$1,158.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$986.02
|
| Rate for Payer: Healthscope Commercial |
$1,195.54
|
| Rate for Payer: Healthscope Whirlpool |
$1,232.52
|
| Rate for Payer: Mclaren Commercial |
$1,109.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,047.64
|
| Rate for Payer: Nomi Health Commercial |
$1,010.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$924.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,084.62
|
|
|
HC ISCHEMIA MODIFIED ALBUMIN
|
Facility
|
IP
|
$164.59
|
|
|
Service Code
|
CPT 82045
|
| Hospital Charge Code |
30100076
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$123.44 |
| Max. Negotiated Rate |
$164.59 |
| Rate for Payer: Aetna Commercial |
$148.13
|
| Rate for Payer: ASR ASR |
$159.65
|
| Rate for Payer: BCBS Trust/PPO |
$135.16
|
| Rate for Payer: BCN Commercial |
$135.16
|
| Rate for Payer: Cash Price |
$131.67
|
| Rate for Payer: Cofinity Commercial |
$154.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$131.67
|
| Rate for Payer: Healthscope Commercial |
$159.65
|
| Rate for Payer: Healthscope Whirlpool |
$164.59
|
| Rate for Payer: Mclaren Commercial |
$148.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$139.90
|
| Rate for Payer: Nomi Health Commercial |
$134.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$123.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$144.84
|
|
|
HC ISCHEMIA MODIFIED ALBUMIN
|
Facility
|
OP
|
$164.59
|
|
|
Service Code
|
CPT 82045
|
| Hospital Charge Code |
30100076
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.75 |
| Max. Negotiated Rate |
$164.59 |
| Rate for Payer: Aetna Commercial |
$148.13
|
| Rate for Payer: Aetna Medicare |
$33.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$42.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$42.42
|
| Rate for Payer: ASR ASR |
$159.65
|
| Rate for Payer: BCBS Complete |
$18.64
|
| Rate for Payer: BCBS MAPPO |
$33.94
|
| Rate for Payer: BCBS Trust/PPO |
$135.70
|
| Rate for Payer: BCN Commercial |
$135.70
|
| Rate for Payer: BCN Medicare Advantage |
$33.94
|
| Rate for Payer: Cash Price |
$131.67
|
| Rate for Payer: Cash Price |
$131.67
|
| Rate for Payer: Cofinity Commercial |
$154.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$131.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.94
|
| Rate for Payer: Healthscope Commercial |
$159.65
|
| Rate for Payer: Healthscope Whirlpool |
$164.59
|
| Rate for Payer: Humana Choice PPO Medicare |
$33.94
|
| Rate for Payer: Mclaren Commercial |
$148.13
|
| Rate for Payer: Mclaren Medicaid |
$33.94
|
| Rate for Payer: Mclaren Medicare |
$33.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.64
|
| Rate for Payer: Meridian Medicaid |
$18.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$39.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$37.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$139.90
|
| Rate for Payer: Nomi Health Commercial |
$134.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$123.44
|
| Rate for Payer: PACE Medicare |
$32.24
|
| Rate for Payer: PACE SWMI |
$33.94
|
| Rate for Payer: PHP Commercial |
$37.33
|
| Rate for Payer: PHP Medicaid |
$18.19
|
| Rate for Payer: PHP Medicare Advantage |
$33.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$144.21
|
| Rate for Payer: Priority Health Medicare |
$33.94
|
| Rate for Payer: Priority Health Narrow Network |
$115.38
|
| Rate for Payer: Railroad Medicare Medicare |
$33.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$144.84
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$33.94
|
| Rate for Payer: UHC Exchange |
$52.61
|
| Rate for Payer: UHC Medicaid |
$17.75
|
| Rate for Payer: UHCCP DNSP |
$33.94
|
| Rate for Payer: UHCCP Medicaid |
$17.75
|
| Rate for Payer: VA VA |
$33.94
|
|
|
HC ISLET ANTIGEN 2 ANTIBODY
|
Facility
|
OP
|
$56.24
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
30200412
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.33 |
| Max. Negotiated Rate |
$56.24 |
| Rate for Payer: Aetna Commercial |
$50.62
|
| Rate for Payer: Aetna Medicare |
$23.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.46
|
| Rate for Payer: ASR ASR |
$54.55
|
| Rate for Payer: BCBS Complete |
$12.94
|
| Rate for Payer: BCBS MAPPO |
$23.57
|
| Rate for Payer: BCBS Trust/PPO |
$46.37
|
| Rate for Payer: BCN Commercial |
$46.37
|
| Rate for Payer: BCN Medicare Advantage |
$23.57
|
| Rate for Payer: Cash Price |
$44.99
|
| Rate for Payer: Cash Price |
$44.99
|
| Rate for Payer: Cofinity Commercial |
$52.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.57
|
| Rate for Payer: Healthscope Commercial |
$54.55
|
| Rate for Payer: Healthscope Whirlpool |
$56.24
|
| Rate for Payer: Humana Choice PPO Medicare |
$23.57
|
| Rate for Payer: Mclaren Commercial |
$50.62
|
| Rate for Payer: Mclaren Medicaid |
$23.57
|
| Rate for Payer: Mclaren Medicare |
$23.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.75
|
| Rate for Payer: Meridian Medicaid |
$12.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$25.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.80
|
| Rate for Payer: Nomi Health Commercial |
$46.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.18
|
| Rate for Payer: PACE Medicare |
$22.39
|
| Rate for Payer: PACE SWMI |
$23.57
|
| Rate for Payer: PHP Commercial |
$25.93
|
| Rate for Payer: PHP Medicaid |
$12.63
|
| Rate for Payer: PHP Medicare Advantage |
$23.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$49.28
|
| Rate for Payer: Priority Health Medicare |
$23.57
|
| Rate for Payer: Priority Health Narrow Network |
$39.42
|
| Rate for Payer: Railroad Medicare Medicare |
$23.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$49.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$23.57
|
| Rate for Payer: UHC Exchange |
$36.53
|
| Rate for Payer: UHC Medicaid |
$12.33
|
| Rate for Payer: UHCCP DNSP |
$23.57
|
| Rate for Payer: UHCCP Medicaid |
$12.33
|
| Rate for Payer: VA VA |
$23.57
|
|
|
HC ISLET ANTIGEN 2 ANTIBODY
|
Facility
|
IP
|
$56.24
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
30200412
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$42.18 |
| Max. Negotiated Rate |
$56.24 |
| Rate for Payer: Aetna Commercial |
$50.62
|
| Rate for Payer: ASR ASR |
$54.55
|
| Rate for Payer: BCBS Trust/PPO |
$46.18
|
| Rate for Payer: BCN Commercial |
$46.18
|
| Rate for Payer: Cash Price |
$44.99
|
| Rate for Payer: Cofinity Commercial |
$52.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.99
|
| Rate for Payer: Healthscope Commercial |
$54.55
|
| Rate for Payer: Healthscope Whirlpool |
$56.24
|
| Rate for Payer: Mclaren Commercial |
$50.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.80
|
| Rate for Payer: Nomi Health Commercial |
$46.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$49.49
|
|
|
HC ISOAGGLUTININ TITER ANTI A
|
Facility
|
OP
|
$111.42
|
|
|
Service Code
|
CPT 86886
|
| Hospital Charge Code |
30200345
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.71 |
| Max. Negotiated Rate |
$111.42 |
| Rate for Payer: Aetna Commercial |
$100.28
|
| Rate for Payer: Aetna Medicare |
$5.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.47
|
| Rate for Payer: ASR ASR |
$108.08
|
| Rate for Payer: BCBS Complete |
$2.84
|
| Rate for Payer: BCBS MAPPO |
$5.18
|
| Rate for Payer: BCBS Trust/PPO |
$91.87
|
| Rate for Payer: BCN Commercial |
$91.87
|
| Rate for Payer: BCN Medicare Advantage |
$5.18
|
| Rate for Payer: Cash Price |
$89.14
|
| Rate for Payer: Cash Price |
$89.14
|
| Rate for Payer: Cofinity Commercial |
$104.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.18
|
| Rate for Payer: Healthscope Commercial |
$108.08
|
| Rate for Payer: Healthscope Whirlpool |
$111.42
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.18
|
| Rate for Payer: Mclaren Commercial |
$100.28
|
| Rate for Payer: Mclaren Medicaid |
$5.18
|
| Rate for Payer: Mclaren Medicare |
$5.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.44
|
| Rate for Payer: Meridian Medicaid |
$2.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.71
|
| Rate for Payer: Nomi Health Commercial |
$91.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$83.56
|
| Rate for Payer: PACE Medicare |
$4.92
|
| Rate for Payer: PACE SWMI |
$5.18
|
| Rate for Payer: PHP Commercial |
$5.70
|
| Rate for Payer: PHP Medicaid |
$2.78
|
| Rate for Payer: PHP Medicare Advantage |
$5.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$97.63
|
| Rate for Payer: Priority Health Medicare |
$5.18
|
| Rate for Payer: Priority Health Narrow Network |
$78.11
|
| Rate for Payer: Railroad Medicare Medicare |
$5.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$98.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.18
|
| Rate for Payer: UHC Exchange |
$8.03
|
| Rate for Payer: UHC Medicaid |
$2.71
|
| Rate for Payer: UHCCP DNSP |
$5.18
|
| Rate for Payer: UHCCP Medicaid |
$2.71
|
| Rate for Payer: VA VA |
$5.18
|
|
|
HC ISOAGGLUTININ TITER ANTI A
|
Facility
|
IP
|
$111.42
|
|
|
Service Code
|
CPT 86886
|
| Hospital Charge Code |
30200345
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$83.56 |
| Max. Negotiated Rate |
$111.42 |
| Rate for Payer: Aetna Commercial |
$100.28
|
| Rate for Payer: ASR ASR |
$108.08
|
| Rate for Payer: BCBS Trust/PPO |
$91.50
|
| Rate for Payer: BCN Commercial |
$91.50
|
| Rate for Payer: Cash Price |
$89.14
|
| Rate for Payer: Cofinity Commercial |
$104.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.14
|
| Rate for Payer: Healthscope Commercial |
$108.08
|
| Rate for Payer: Healthscope Whirlpool |
$111.42
|
| Rate for Payer: Mclaren Commercial |
$100.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.71
|
| Rate for Payer: Nomi Health Commercial |
$91.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$83.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$98.05
|
|
|
HC ISOAGGLUTININ TITER ANTI B
|
Facility
|
OP
|
$111.42
|
|
|
Service Code
|
CPT 86886
|
| Hospital Charge Code |
30200346
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.71 |
| Max. Negotiated Rate |
$111.42 |
| Rate for Payer: Aetna Commercial |
$100.28
|
| Rate for Payer: Aetna Medicare |
$5.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.47
|
| Rate for Payer: ASR ASR |
$108.08
|
| Rate for Payer: BCBS Complete |
$2.84
|
| Rate for Payer: BCBS MAPPO |
$5.18
|
| Rate for Payer: BCBS Trust/PPO |
$91.87
|
| Rate for Payer: BCN Commercial |
$91.87
|
| Rate for Payer: BCN Medicare Advantage |
$5.18
|
| Rate for Payer: Cash Price |
$89.14
|
| Rate for Payer: Cash Price |
$89.14
|
| Rate for Payer: Cofinity Commercial |
$104.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.18
|
| Rate for Payer: Healthscope Commercial |
$108.08
|
| Rate for Payer: Healthscope Whirlpool |
$111.42
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.18
|
| Rate for Payer: Mclaren Commercial |
$100.28
|
| Rate for Payer: Mclaren Medicaid |
$5.18
|
| Rate for Payer: Mclaren Medicare |
$5.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.44
|
| Rate for Payer: Meridian Medicaid |
$2.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.71
|
| Rate for Payer: Nomi Health Commercial |
$91.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$83.56
|
| Rate for Payer: PACE Medicare |
$4.92
|
| Rate for Payer: PACE SWMI |
$5.18
|
| Rate for Payer: PHP Commercial |
$5.70
|
| Rate for Payer: PHP Medicaid |
$2.78
|
| Rate for Payer: PHP Medicare Advantage |
$5.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$97.63
|
| Rate for Payer: Priority Health Medicare |
$5.18
|
| Rate for Payer: Priority Health Narrow Network |
$78.11
|
| Rate for Payer: Railroad Medicare Medicare |
$5.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$98.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.18
|
| Rate for Payer: UHC Exchange |
$8.03
|
| Rate for Payer: UHC Medicaid |
$2.71
|
| Rate for Payer: UHCCP DNSP |
$5.18
|
| Rate for Payer: UHCCP Medicaid |
$2.71
|
| Rate for Payer: VA VA |
$5.18
|
|
|
HC ISOAGGLUTININ TITER ANTI B
|
Facility
|
IP
|
$111.42
|
|
|
Service Code
|
CPT 86886
|
| Hospital Charge Code |
30200346
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$83.56 |
| Max. Negotiated Rate |
$111.42 |
| Rate for Payer: Aetna Commercial |
$100.28
|
| Rate for Payer: ASR ASR |
$108.08
|
| Rate for Payer: BCBS Trust/PPO |
$91.50
|
| Rate for Payer: BCN Commercial |
$91.50
|
| Rate for Payer: Cash Price |
$89.14
|
| Rate for Payer: Cofinity Commercial |
$104.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.14
|
| Rate for Payer: Healthscope Commercial |
$108.08
|
| Rate for Payer: Healthscope Whirlpool |
$111.42
|
| Rate for Payer: Mclaren Commercial |
$100.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.71
|
| Rate for Payer: Nomi Health Commercial |
$91.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$83.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$98.05
|
|
|
HC ISOPROPANOL LVL
|
Facility
|
OP
|
$162.30
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
30100580
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$60.05 |
| Max. Negotiated Rate |
$162.30 |
| Rate for Payer: Aetna Commercial |
$146.07
|
| Rate for Payer: Aetna Medicare |
$60.05
|
| Rate for Payer: ASR ASR |
$157.43
|
| Rate for Payer: BCBS Complete |
$64.92
|
| Rate for Payer: BCBS Trust/PPO |
$133.82
|
| Rate for Payer: BCN Commercial |
$133.82
|
| Rate for Payer: Cash Price |
$129.84
|
| Rate for Payer: Cofinity Commercial |
$152.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.84
|
| Rate for Payer: Healthscope Commercial |
$157.43
|
| Rate for Payer: Healthscope Whirlpool |
$162.30
|
| Rate for Payer: Mclaren Commercial |
$146.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$129.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.96
|
| Rate for Payer: Nomi Health Commercial |
$133.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$121.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$142.21
|
| Rate for Payer: Priority Health Narrow Network |
$113.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$142.82
|
|
|
HC ISOPROPANOL LVL
|
Facility
|
IP
|
$162.30
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
30100580
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$121.72 |
| Max. Negotiated Rate |
$162.30 |
| Rate for Payer: Aetna Commercial |
$146.07
|
| Rate for Payer: ASR ASR |
$157.43
|
| Rate for Payer: BCBS Trust/PPO |
$133.28
|
| Rate for Payer: BCN Commercial |
$133.28
|
| Rate for Payer: Cash Price |
$129.84
|
| Rate for Payer: Cofinity Commercial |
$152.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.84
|
| Rate for Payer: Healthscope Commercial |
$157.43
|
| Rate for Payer: Healthscope Whirlpool |
$162.30
|
| Rate for Payer: Mclaren Commercial |
$146.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.96
|
| Rate for Payer: Nomi Health Commercial |
$133.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$121.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$142.82
|
|
|
HC ISOVUE 200M PER ML
|
Facility
|
OP
|
$2.45
|
|
|
Service Code
|
HCPCS Q9966
|
| Hospital Charge Code |
63600033
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.34 |
| Max. Negotiated Rate |
$2.45 |
| Rate for Payer: Aetna Commercial |
$2.21
|
| Rate for Payer: Aetna Medicare |
$0.91
|
| Rate for Payer: ASR ASR |
$2.38
|
| Rate for Payer: BCBS Complete |
$0.98
|
| Rate for Payer: BCBS Trust/PPO |
$2.02
|
| Rate for Payer: BCN Commercial |
$2.02
|
| Rate for Payer: Cash Price |
$1.96
|
| Rate for Payer: Cash Price |
$1.96
|
| Rate for Payer: Cofinity Commercial |
$2.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.96
|
| Rate for Payer: Healthscope Commercial |
$2.38
|
| Rate for Payer: Healthscope Whirlpool |
$2.45
|
| Rate for Payer: Mclaren Commercial |
$2.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.08
|
| Rate for Payer: Nomi Health Commercial |
$2.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.42
|
| Rate for Payer: Priority Health Narrow Network |
$0.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2.16
|
|
|
HC ISOVUE 200M PER ML
|
Facility
|
IP
|
$2.45
|
|
|
Service Code
|
HCPCS Q9966
|
| Hospital Charge Code |
63600033
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.84 |
| Max. Negotiated Rate |
$2.45 |
| Rate for Payer: Aetna Commercial |
$2.21
|
| Rate for Payer: ASR ASR |
$2.38
|
| Rate for Payer: BCBS Trust/PPO |
$2.01
|
| Rate for Payer: BCN Commercial |
$2.01
|
| Rate for Payer: Cash Price |
$1.96
|
| Rate for Payer: Cofinity Commercial |
$2.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.96
|
| Rate for Payer: Healthscope Commercial |
$2.38
|
| Rate for Payer: Healthscope Whirlpool |
$2.45
|
| Rate for Payer: Mclaren Commercial |
$2.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.08
|
| Rate for Payer: Nomi Health Commercial |
$2.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2.16
|
|
|
HC ISOVUE 200 PER ML
|
Facility
|
OP
|
$4.55
|
|
|
Service Code
|
HCPCS Q9966
|
| Hospital Charge Code |
63600011
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.34 |
| Max. Negotiated Rate |
$4.55 |
| Rate for Payer: Aetna Commercial |
$4.09
|
| Rate for Payer: Aetna Medicare |
$1.68
|
| Rate for Payer: ASR ASR |
$4.41
|
| Rate for Payer: BCBS Complete |
$1.82
|
| Rate for Payer: BCBS Trust/PPO |
$3.75
|
| Rate for Payer: BCN Commercial |
$3.75
|
| Rate for Payer: Cash Price |
$3.64
|
| Rate for Payer: Cash Price |
$3.64
|
| Rate for Payer: Cofinity Commercial |
$4.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.64
|
| Rate for Payer: Healthscope Commercial |
$4.41
|
| Rate for Payer: Healthscope Whirlpool |
$4.55
|
| Rate for Payer: Mclaren Commercial |
$4.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.87
|
| Rate for Payer: Nomi Health Commercial |
$3.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.42
|
| Rate for Payer: Priority Health Narrow Network |
$0.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4.00
|
|
