|
HC INJECTION TRANSFORAMIN LUMB OR SACR SINGLE LEVEL
|
Facility
|
OP
|
$1,536.98
|
|
|
Service Code
|
CPT 64483
|
| Hospital Charge Code |
36100288
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$467.55 |
| Max. Negotiated Rate |
$1,536.98 |
| Rate for Payer: Aetna Commercial |
$1,383.28
|
| Rate for Payer: Aetna Medicare |
$872.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,090.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,090.36
|
| Rate for Payer: ASR ASR |
$1,490.87
|
| Rate for Payer: ASR Commercial |
$1,490.87
|
| Rate for Payer: BCBS Complete |
$490.92
|
| Rate for Payer: BCBS MAPPO |
$872.29
|
| Rate for Payer: BCBS Trust/PPO |
$1,258.63
|
| Rate for Payer: BCN Commercial |
$1,191.62
|
| Rate for Payer: BCN Medicare Advantage |
$872.29
|
| Rate for Payer: Cash Price |
$1,229.58
|
| Rate for Payer: Cash Price |
$1,229.58
|
| Rate for Payer: Cofinity Commercial |
$1,444.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,229.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$872.29
|
| Rate for Payer: Healthscope Commercial |
$1,536.98
|
| Rate for Payer: Healthscope Whirlpool |
$1,490.87
|
| Rate for Payer: Humana Choice PPO Medicare |
$872.29
|
| Rate for Payer: Mclaren Commercial |
$1,383.28
|
| Rate for Payer: Mclaren Medicaid |
$467.55
|
| Rate for Payer: Mclaren Medicare |
$872.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$915.90
|
| Rate for Payer: Meridian Medicaid |
$490.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,003.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,306.43
|
| Rate for Payer: Nomi Health Commercial |
$1,260.32
|
| Rate for Payer: PACE Medicare |
$828.68
|
| Rate for Payer: PACE SWMI |
$872.29
|
| Rate for Payer: PHP Commercial |
$959.52
|
| Rate for Payer: PHP Medicaid |
$467.55
|
| Rate for Payer: PHP Medicare Advantage |
$872.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$467.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$999.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,346.70
|
| Rate for Payer: Priority Health Medicare |
$872.29
|
| Rate for Payer: Priority Health Narrow Network |
$1,077.42
|
| Rate for Payer: Railroad Medicare Medicare |
$872.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,352.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$872.29
|
| Rate for Payer: UHC Exchange |
$1,352.05
|
| Rate for Payer: UHC Medicare Advantage |
$872.29
|
| Rate for Payer: UHCCP DNSP |
$872.29
|
| Rate for Payer: UHCCP Medicaid |
$467.55
|
| Rate for Payer: VA VA |
$872.29
|
|
|
HC INJECTION TRANSFORAMIN LUMB OR SAC SINGLE LEVEL BIL
|
Facility
|
IP
|
$1,185.25
|
|
|
Service Code
|
CPT 64483
|
| Hospital Charge Code |
36100315
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$770.41 |
| Max. Negotiated Rate |
$1,185.25 |
| Rate for Payer: Aetna Commercial |
$1,066.72
|
| Rate for Payer: ASR ASR |
$1,149.69
|
| Rate for Payer: ASR Commercial |
$1,149.69
|
| Rate for Payer: BCBS Trust/PPO |
$965.86
|
| Rate for Payer: BCN Commercial |
$918.92
|
| Rate for Payer: Cash Price |
$948.20
|
| Rate for Payer: Cofinity Commercial |
$1,114.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$948.20
|
| Rate for Payer: Healthscope Commercial |
$1,185.25
|
| Rate for Payer: Healthscope Whirlpool |
$1,149.69
|
| Rate for Payer: Mclaren Commercial |
$1,066.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,007.46
|
| Rate for Payer: Nomi Health Commercial |
$971.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$770.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,043.02
|
|
|
HC INJECTION TRANSFORAMIN LUMB OR SAC SINGLE LEVEL BIL
|
Facility
|
OP
|
$1,185.25
|
|
|
Service Code
|
CPT 64483
|
| Hospital Charge Code |
36100315
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$467.55 |
| Max. Negotiated Rate |
$1,352.05 |
| Rate for Payer: Aetna Commercial |
$1,066.72
|
| Rate for Payer: Aetna Medicare |
$872.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,090.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,090.36
|
| Rate for Payer: ASR ASR |
$1,149.69
|
| Rate for Payer: ASR Commercial |
$1,149.69
|
| Rate for Payer: BCBS Complete |
$490.92
|
| Rate for Payer: BCBS MAPPO |
$872.29
|
| Rate for Payer: BCBS Trust/PPO |
$970.60
|
| Rate for Payer: BCN Commercial |
$918.92
|
| Rate for Payer: BCN Medicare Advantage |
$872.29
|
| Rate for Payer: Cash Price |
$948.20
|
| Rate for Payer: Cash Price |
$948.20
|
| Rate for Payer: Cofinity Commercial |
$1,114.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$948.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$872.29
|
| Rate for Payer: Healthscope Commercial |
$1,185.25
|
| Rate for Payer: Healthscope Whirlpool |
$1,149.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$872.29
|
| Rate for Payer: Mclaren Commercial |
$1,066.72
|
| Rate for Payer: Mclaren Medicaid |
$467.55
|
| Rate for Payer: Mclaren Medicare |
$872.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$915.90
|
| Rate for Payer: Meridian Medicaid |
$490.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,003.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,007.46
|
| Rate for Payer: Nomi Health Commercial |
$971.90
|
| Rate for Payer: PACE Medicare |
$828.68
|
| Rate for Payer: PACE SWMI |
$872.29
|
| Rate for Payer: PHP Commercial |
$959.52
|
| Rate for Payer: PHP Medicaid |
$467.55
|
| Rate for Payer: PHP Medicare Advantage |
$872.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$467.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$770.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,038.52
|
| Rate for Payer: Priority Health Medicare |
$872.29
|
| Rate for Payer: Priority Health Narrow Network |
$830.86
|
| Rate for Payer: Railroad Medicare Medicare |
$872.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,043.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$872.29
|
| Rate for Payer: UHC Exchange |
$1,352.05
|
| Rate for Payer: UHC Medicare Advantage |
$872.29
|
| Rate for Payer: UHCCP DNSP |
$872.29
|
| Rate for Payer: UHCCP Medicaid |
$467.55
|
| Rate for Payer: VA VA |
$872.29
|
|
|
HC INJECTION TURBINATE THERAPEUTIC
|
Facility
|
OP
|
$1,377.00
|
|
|
Service Code
|
CPT 30200
|
| Hospital Charge Code |
76100450
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$267.44 |
| Max. Negotiated Rate |
$1,377.00 |
| Rate for Payer: Aetna Commercial |
$1,239.30
|
| Rate for Payer: Aetna Medicare |
$498.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$623.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$623.69
|
| Rate for Payer: ASR ASR |
$1,335.69
|
| Rate for Payer: ASR Commercial |
$1,335.69
|
| Rate for Payer: BCBS Complete |
$280.81
|
| Rate for Payer: BCBS MAPPO |
$498.95
|
| Rate for Payer: BCBS Trust/PPO |
$1,127.63
|
| Rate for Payer: BCN Commercial |
$1,067.59
|
| Rate for Payer: BCN Medicare Advantage |
$498.95
|
| Rate for Payer: Cash Price |
$1,101.60
|
| Rate for Payer: Cash Price |
$1,101.60
|
| Rate for Payer: Cofinity Commercial |
$1,294.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,101.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$498.95
|
| Rate for Payer: Healthscope Commercial |
$1,377.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,335.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$498.95
|
| Rate for Payer: Mclaren Commercial |
$1,239.30
|
| Rate for Payer: Mclaren Medicaid |
$267.44
|
| Rate for Payer: Mclaren Medicare |
$498.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$523.90
|
| Rate for Payer: Meridian Medicaid |
$280.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$573.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,170.45
|
| Rate for Payer: Nomi Health Commercial |
$1,129.14
|
| Rate for Payer: PACE Medicare |
$474.00
|
| Rate for Payer: PACE SWMI |
$498.95
|
| Rate for Payer: PHP Commercial |
$548.84
|
| Rate for Payer: PHP Medicaid |
$267.44
|
| Rate for Payer: PHP Medicare Advantage |
$498.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$267.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$895.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,206.53
|
| Rate for Payer: Priority Health Medicare |
$498.95
|
| Rate for Payer: Priority Health Narrow Network |
$965.28
|
| Rate for Payer: Railroad Medicare Medicare |
$498.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,211.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$498.95
|
| Rate for Payer: UHC Exchange |
$773.37
|
| Rate for Payer: UHC Medicare Advantage |
$498.95
|
| Rate for Payer: UHCCP DNSP |
$498.95
|
| Rate for Payer: UHCCP Medicaid |
$267.44
|
| Rate for Payer: VA VA |
$498.95
|
|
|
HC INJECTION TURBINATE THERAPEUTIC
|
Facility
|
IP
|
$1,377.00
|
|
|
Service Code
|
CPT 30200
|
| Hospital Charge Code |
76100450
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$895.05 |
| Max. Negotiated Rate |
$1,377.00 |
| Rate for Payer: Aetna Commercial |
$1,239.30
|
| Rate for Payer: ASR ASR |
$1,335.69
|
| Rate for Payer: ASR Commercial |
$1,335.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,122.12
|
| Rate for Payer: BCN Commercial |
$1,067.59
|
| Rate for Payer: Cash Price |
$1,101.60
|
| Rate for Payer: Cofinity Commercial |
$1,294.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,101.60
|
| Rate for Payer: Healthscope Commercial |
$1,377.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,335.69
|
| Rate for Payer: Mclaren Commercial |
$1,239.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,170.45
|
| Rate for Payer: Nomi Health Commercial |
$1,129.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$895.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,211.76
|
|
|
HC INJECTION VENOGRAM
|
Facility
|
IP
|
$566.97
|
|
|
Service Code
|
CPT 36005
|
| Hospital Charge Code |
36100095
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$368.53 |
| Max. Negotiated Rate |
$566.97 |
| Rate for Payer: Aetna Commercial |
$510.27
|
| Rate for Payer: ASR ASR |
$549.96
|
| Rate for Payer: ASR Commercial |
$549.96
|
| Rate for Payer: BCBS Trust/PPO |
$462.02
|
| Rate for Payer: BCN Commercial |
$439.57
|
| Rate for Payer: Cash Price |
$453.58
|
| Rate for Payer: Cofinity Commercial |
$532.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$453.58
|
| Rate for Payer: Healthscope Commercial |
$566.97
|
| Rate for Payer: Healthscope Whirlpool |
$549.96
|
| Rate for Payer: Mclaren Commercial |
$510.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$481.92
|
| Rate for Payer: Nomi Health Commercial |
$464.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$368.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$498.93
|
|
|
HC INJECTION VENOGRAM
|
Facility
|
OP
|
$566.97
|
|
|
Service Code
|
CPT 36005
|
| Hospital Charge Code |
36100095
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$226.79 |
| Max. Negotiated Rate |
$566.97 |
| Rate for Payer: Aetna Commercial |
$510.27
|
| Rate for Payer: Aetna Medicare |
$283.48
|
| Rate for Payer: ASR ASR |
$549.96
|
| Rate for Payer: ASR Commercial |
$549.96
|
| Rate for Payer: BCBS Complete |
$226.79
|
| Rate for Payer: BCBS Trust/PPO |
$464.29
|
| Rate for Payer: BCN Commercial |
$439.57
|
| Rate for Payer: Cash Price |
$453.58
|
| Rate for Payer: Cofinity Commercial |
$532.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$453.58
|
| Rate for Payer: Healthscope Commercial |
$566.97
|
| Rate for Payer: Healthscope Whirlpool |
$549.96
|
| Rate for Payer: Mclaren Commercial |
$510.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$481.92
|
| Rate for Payer: Nomi Health Commercial |
$464.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$368.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$496.78
|
| Rate for Payer: Priority Health Narrow Network |
$397.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$498.93
|
|
|
HC INJECTION WRIST ARTHROGRAM
|
Facility
|
IP
|
$1,152.20
|
|
|
Service Code
|
CPT 25246
|
| Hospital Charge Code |
36100039
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$748.93 |
| Max. Negotiated Rate |
$1,152.20 |
| Rate for Payer: Aetna Commercial |
$1,036.98
|
| Rate for Payer: ASR ASR |
$1,117.63
|
| Rate for Payer: ASR Commercial |
$1,117.63
|
| Rate for Payer: BCBS Trust/PPO |
$938.93
|
| Rate for Payer: BCN Commercial |
$893.30
|
| Rate for Payer: Cash Price |
$921.76
|
| Rate for Payer: Cofinity Commercial |
$1,083.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$921.76
|
| Rate for Payer: Healthscope Commercial |
$1,152.20
|
| Rate for Payer: Healthscope Whirlpool |
$1,117.63
|
| Rate for Payer: Mclaren Commercial |
$1,036.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$979.37
|
| Rate for Payer: Nomi Health Commercial |
$944.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$748.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,013.94
|
|
|
HC INJECTION WRIST ARTHROGRAM
|
Facility
|
OP
|
$1,152.20
|
|
|
Service Code
|
CPT 25246
|
| Hospital Charge Code |
36100039
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$460.88 |
| Max. Negotiated Rate |
$1,152.20 |
| Rate for Payer: Aetna Commercial |
$1,036.98
|
| Rate for Payer: Aetna Medicare |
$576.10
|
| Rate for Payer: ASR ASR |
$1,117.63
|
| Rate for Payer: ASR Commercial |
$1,117.63
|
| Rate for Payer: BCBS Complete |
$460.88
|
| Rate for Payer: BCBS Trust/PPO |
$943.54
|
| Rate for Payer: BCN Commercial |
$893.30
|
| Rate for Payer: Cash Price |
$921.76
|
| Rate for Payer: Cofinity Commercial |
$1,083.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$921.76
|
| Rate for Payer: Healthscope Commercial |
$1,152.20
|
| Rate for Payer: Healthscope Whirlpool |
$1,117.63
|
| Rate for Payer: Mclaren Commercial |
$1,036.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$979.37
|
| Rate for Payer: Nomi Health Commercial |
$944.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$748.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,009.56
|
| Rate for Payer: Priority Health Narrow Network |
$807.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,013.94
|
|
|
HC INJECT/IRRIGATE CORPORA CAVERNOSA
|
Facility
|
IP
|
$373.37
|
|
| Hospital Charge Code |
45000094
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$242.69 |
| Max. Negotiated Rate |
$373.37 |
| Rate for Payer: Aetna Commercial |
$336.03
|
| Rate for Payer: ASR ASR |
$362.17
|
| Rate for Payer: ASR Commercial |
$362.17
|
| Rate for Payer: BCBS Trust/PPO |
$304.26
|
| Rate for Payer: BCN Commercial |
$289.47
|
| Rate for Payer: Cash Price |
$298.70
|
| Rate for Payer: Cofinity Commercial |
$350.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$298.70
|
| Rate for Payer: Healthscope Commercial |
$373.37
|
| Rate for Payer: Healthscope Whirlpool |
$362.17
|
| Rate for Payer: Mclaren Commercial |
$336.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$317.36
|
| Rate for Payer: Nomi Health Commercial |
$306.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$242.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$328.57
|
|
|
HC INJECT/IRRIGATE CORPORA CAVERNOSA
|
Facility
|
OP
|
$373.37
|
|
| Hospital Charge Code |
45000094
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$149.35 |
| Max. Negotiated Rate |
$373.37 |
| Rate for Payer: Aetna Commercial |
$336.03
|
| Rate for Payer: Aetna Medicare |
$186.68
|
| Rate for Payer: ASR ASR |
$362.17
|
| Rate for Payer: ASR Commercial |
$362.17
|
| Rate for Payer: BCBS Complete |
$149.35
|
| Rate for Payer: BCBS Trust/PPO |
$305.75
|
| Rate for Payer: BCN Commercial |
$289.47
|
| Rate for Payer: Cash Price |
$298.70
|
| Rate for Payer: Cofinity Commercial |
$350.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$298.70
|
| Rate for Payer: Healthscope Commercial |
$373.37
|
| Rate for Payer: Healthscope Whirlpool |
$362.17
|
| Rate for Payer: Mclaren Commercial |
$336.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$317.36
|
| Rate for Payer: Nomi Health Commercial |
$306.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$242.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$327.15
|
| Rate for Payer: Priority Health Narrow Network |
$261.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$328.57
|
|
|
HC INJECT PORTAL VEIN
|
Facility
|
OP
|
$2,780.89
|
|
|
Service Code
|
CPT 36481
|
| Hospital Charge Code |
36100543
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,112.36 |
| Max. Negotiated Rate |
$2,780.89 |
| Rate for Payer: Aetna Commercial |
$2,502.80
|
| Rate for Payer: Aetna Medicare |
$1,390.44
|
| Rate for Payer: ASR ASR |
$2,697.46
|
| Rate for Payer: ASR Commercial |
$2,697.46
|
| Rate for Payer: BCBS Complete |
$1,112.36
|
| Rate for Payer: BCBS Trust/PPO |
$2,277.27
|
| Rate for Payer: BCN Commercial |
$2,156.02
|
| Rate for Payer: Cash Price |
$2,224.71
|
| Rate for Payer: Cofinity Commercial |
$2,614.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,224.71
|
| Rate for Payer: Healthscope Commercial |
$2,780.89
|
| Rate for Payer: Healthscope Whirlpool |
$2,697.46
|
| Rate for Payer: Mclaren Commercial |
$2,502.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,363.76
|
| Rate for Payer: Nomi Health Commercial |
$2,280.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,807.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,436.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,949.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,447.18
|
|
|
HC INJECT PORTAL VEIN
|
Facility
|
IP
|
$2,780.89
|
|
|
Service Code
|
CPT 36481
|
| Hospital Charge Code |
36100543
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,807.58 |
| Max. Negotiated Rate |
$2,780.89 |
| Rate for Payer: Aetna Commercial |
$2,502.80
|
| Rate for Payer: ASR ASR |
$2,697.46
|
| Rate for Payer: ASR Commercial |
$2,697.46
|
| Rate for Payer: BCBS Trust/PPO |
$2,266.15
|
| Rate for Payer: BCN Commercial |
$2,156.02
|
| Rate for Payer: Cash Price |
$2,224.71
|
| Rate for Payer: Cofinity Commercial |
$2,614.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,224.71
|
| Rate for Payer: Healthscope Commercial |
$2,780.89
|
| Rate for Payer: Healthscope Whirlpool |
$2,697.46
|
| Rate for Payer: Mclaren Commercial |
$2,502.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,363.76
|
| Rate for Payer: Nomi Health Commercial |
$2,280.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,807.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,447.18
|
|
|
HC INJECT PROC PENILE PLAQUE
|
Facility
|
IP
|
$361.15
|
|
|
Service Code
|
CPT 54200
|
| Hospital Charge Code |
76100199
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$234.75 |
| Max. Negotiated Rate |
$361.15 |
| Rate for Payer: Aetna Commercial |
$325.04
|
| Rate for Payer: ASR ASR |
$350.32
|
| Rate for Payer: ASR Commercial |
$350.32
|
| Rate for Payer: BCBS Trust/PPO |
$294.30
|
| Rate for Payer: BCN Commercial |
$280.00
|
| Rate for Payer: Cash Price |
$288.92
|
| Rate for Payer: Cofinity Commercial |
$339.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$288.92
|
| Rate for Payer: Healthscope Commercial |
$361.15
|
| Rate for Payer: Healthscope Whirlpool |
$350.32
|
| Rate for Payer: Mclaren Commercial |
$325.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$306.98
|
| Rate for Payer: Nomi Health Commercial |
$296.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$234.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$317.81
|
|
|
HC INJECT PROC PENILE PLAQUE
|
Facility
|
OP
|
$361.15
|
|
|
Service Code
|
CPT 54200
|
| Hospital Charge Code |
76100199
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$127.72 |
| Max. Negotiated Rate |
$369.35 |
| Rate for Payer: Aetna Commercial |
$325.04
|
| Rate for Payer: Aetna Medicare |
$238.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$297.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$297.86
|
| Rate for Payer: ASR ASR |
$350.32
|
| Rate for Payer: ASR Commercial |
$350.32
|
| Rate for Payer: BCBS Complete |
$134.11
|
| Rate for Payer: BCBS MAPPO |
$238.29
|
| Rate for Payer: BCBS Trust/PPO |
$295.75
|
| Rate for Payer: BCN Commercial |
$280.00
|
| Rate for Payer: BCN Medicare Advantage |
$238.29
|
| Rate for Payer: Cash Price |
$288.92
|
| Rate for Payer: Cash Price |
$288.92
|
| Rate for Payer: Cofinity Commercial |
$339.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$288.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$238.29
|
| Rate for Payer: Healthscope Commercial |
$361.15
|
| Rate for Payer: Healthscope Whirlpool |
$350.32
|
| Rate for Payer: Humana Choice PPO Medicare |
$238.29
|
| Rate for Payer: Mclaren Commercial |
$325.04
|
| Rate for Payer: Mclaren Medicaid |
$127.72
|
| Rate for Payer: Mclaren Medicare |
$238.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$250.20
|
| Rate for Payer: Meridian Medicaid |
$134.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$274.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$306.98
|
| Rate for Payer: Nomi Health Commercial |
$296.14
|
| Rate for Payer: PACE Medicare |
$226.38
|
| Rate for Payer: PACE SWMI |
$238.29
|
| Rate for Payer: PHP Commercial |
$262.12
|
| Rate for Payer: PHP Medicaid |
$127.72
|
| Rate for Payer: PHP Medicare Advantage |
$238.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$127.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$234.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$316.44
|
| Rate for Payer: Priority Health Medicare |
$238.29
|
| Rate for Payer: Priority Health Narrow Network |
$253.17
|
| Rate for Payer: Railroad Medicare Medicare |
$238.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$317.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$238.29
|
| Rate for Payer: UHC Exchange |
$369.35
|
| Rate for Payer: UHC Medicare Advantage |
$238.29
|
| Rate for Payer: UHCCP DNSP |
$238.29
|
| Rate for Payer: UHCCP Medicaid |
$127.72
|
| Rate for Payer: VA VA |
$238.29
|
|
|
HC INJECT SING OR MULTI TRIGGER PTS 1 OR 2 MUSCLES
|
Facility
|
OP
|
$374.14
|
|
|
Service Code
|
CPT 20552
|
| Hospital Charge Code |
36100399
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$155.02 |
| Max. Negotiated Rate |
$448.29 |
| Rate for Payer: Aetna Commercial |
$336.73
|
| Rate for Payer: Aetna Medicare |
$289.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$361.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$361.52
|
| Rate for Payer: ASR ASR |
$362.92
|
| Rate for Payer: ASR Commercial |
$362.92
|
| Rate for Payer: BCBS Complete |
$162.77
|
| Rate for Payer: BCBS MAPPO |
$289.22
|
| Rate for Payer: BCBS Trust/PPO |
$306.38
|
| Rate for Payer: BCN Commercial |
$290.07
|
| Rate for Payer: BCN Medicare Advantage |
$289.22
|
| Rate for Payer: Cash Price |
$299.31
|
| Rate for Payer: Cash Price |
$299.31
|
| Rate for Payer: Cofinity Commercial |
$351.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$299.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$289.22
|
| Rate for Payer: Healthscope Commercial |
$374.14
|
| Rate for Payer: Healthscope Whirlpool |
$362.92
|
| Rate for Payer: Humana Choice PPO Medicare |
$289.22
|
| Rate for Payer: Mclaren Commercial |
$336.73
|
| Rate for Payer: Mclaren Medicaid |
$155.02
|
| Rate for Payer: Mclaren Medicare |
$289.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$303.68
|
| Rate for Payer: Meridian Medicaid |
$162.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$332.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$318.02
|
| Rate for Payer: Nomi Health Commercial |
$306.79
|
| Rate for Payer: PACE Medicare |
$274.76
|
| Rate for Payer: PACE SWMI |
$289.22
|
| Rate for Payer: PHP Commercial |
$318.14
|
| Rate for Payer: PHP Medicaid |
$155.02
|
| Rate for Payer: PHP Medicare Advantage |
$289.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$155.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$243.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$404.07
|
| Rate for Payer: Priority Health Medicare |
$289.22
|
| Rate for Payer: Priority Health Narrow Network |
$323.26
|
| Rate for Payer: Railroad Medicare Medicare |
$289.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$329.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$289.22
|
| Rate for Payer: UHC Exchange |
$448.29
|
| Rate for Payer: UHC Medicare Advantage |
$289.22
|
| Rate for Payer: UHCCP DNSP |
$289.22
|
| Rate for Payer: UHCCP Medicaid |
$155.02
|
| Rate for Payer: VA VA |
$289.22
|
|
|
HC INJECT SING OR MULTI TRIGGER PTS 1 OR 2 MUSCLES
|
Facility
|
IP
|
$374.14
|
|
|
Service Code
|
CPT 20552
|
| Hospital Charge Code |
36100399
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$243.19 |
| Max. Negotiated Rate |
$374.14 |
| Rate for Payer: Aetna Commercial |
$336.73
|
| Rate for Payer: ASR ASR |
$362.92
|
| Rate for Payer: ASR Commercial |
$362.92
|
| Rate for Payer: BCBS Trust/PPO |
$304.89
|
| Rate for Payer: BCN Commercial |
$290.07
|
| Rate for Payer: Cash Price |
$299.31
|
| Rate for Payer: Cofinity Commercial |
$351.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$299.31
|
| Rate for Payer: Healthscope Commercial |
$374.14
|
| Rate for Payer: Healthscope Whirlpool |
$362.92
|
| Rate for Payer: Mclaren Commercial |
$336.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$318.02
|
| Rate for Payer: Nomi Health Commercial |
$306.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$243.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$329.24
|
|
|
HC INJECT SING OR MULTI TRIGGER PTS 3 OR MORE MUSCLES
|
Facility
|
IP
|
$487.67
|
|
|
Service Code
|
CPT 20553
|
| Hospital Charge Code |
36100400
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$316.99 |
| Max. Negotiated Rate |
$487.67 |
| Rate for Payer: Aetna Commercial |
$438.90
|
| Rate for Payer: ASR ASR |
$473.04
|
| Rate for Payer: ASR Commercial |
$473.04
|
| Rate for Payer: BCBS Trust/PPO |
$397.40
|
| Rate for Payer: BCN Commercial |
$378.09
|
| Rate for Payer: Cash Price |
$390.14
|
| Rate for Payer: Cofinity Commercial |
$458.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$390.14
|
| Rate for Payer: Healthscope Commercial |
$487.67
|
| Rate for Payer: Healthscope Whirlpool |
$473.04
|
| Rate for Payer: Mclaren Commercial |
$438.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$414.52
|
| Rate for Payer: Nomi Health Commercial |
$399.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$316.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$429.15
|
|
|
HC INJECT SING OR MULTI TRIGGER PTS 3 OR MORE MUSCLES
|
Facility
|
OP
|
$487.67
|
|
|
Service Code
|
CPT 20553
|
| Hospital Charge Code |
36100400
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$155.02 |
| Max. Negotiated Rate |
$487.67 |
| Rate for Payer: Aetna Commercial |
$438.90
|
| Rate for Payer: Aetna Medicare |
$289.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$361.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$361.52
|
| Rate for Payer: ASR ASR |
$473.04
|
| Rate for Payer: ASR Commercial |
$473.04
|
| Rate for Payer: BCBS Complete |
$162.77
|
| Rate for Payer: BCBS MAPPO |
$289.22
|
| Rate for Payer: BCBS Trust/PPO |
$399.35
|
| Rate for Payer: BCN Commercial |
$378.09
|
| Rate for Payer: BCN Medicare Advantage |
$289.22
|
| Rate for Payer: Cash Price |
$390.14
|
| Rate for Payer: Cash Price |
$390.14
|
| Rate for Payer: Cofinity Commercial |
$458.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$390.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$289.22
|
| Rate for Payer: Healthscope Commercial |
$487.67
|
| Rate for Payer: Healthscope Whirlpool |
$473.04
|
| Rate for Payer: Humana Choice PPO Medicare |
$289.22
|
| Rate for Payer: Mclaren Commercial |
$438.90
|
| Rate for Payer: Mclaren Medicaid |
$155.02
|
| Rate for Payer: Mclaren Medicare |
$289.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$303.68
|
| Rate for Payer: Meridian Medicaid |
$162.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$332.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$414.52
|
| Rate for Payer: Nomi Health Commercial |
$399.89
|
| Rate for Payer: PACE Medicare |
$274.76
|
| Rate for Payer: PACE SWMI |
$289.22
|
| Rate for Payer: PHP Commercial |
$318.14
|
| Rate for Payer: PHP Medicaid |
$155.02
|
| Rate for Payer: PHP Medicare Advantage |
$289.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$155.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$316.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$427.30
|
| Rate for Payer: Priority Health Medicare |
$289.22
|
| Rate for Payer: Priority Health Narrow Network |
$341.86
|
| Rate for Payer: Railroad Medicare Medicare |
$289.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$429.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$289.22
|
| Rate for Payer: UHC Exchange |
$448.29
|
| Rate for Payer: UHC Medicare Advantage |
$289.22
|
| Rate for Payer: UHCCP DNSP |
$289.22
|
| Rate for Payer: UHCCP Medicaid |
$155.02
|
| Rate for Payer: VA VA |
$289.22
|
|
|
HC INJ ENOXAPARIN SODIUM PER 10 MG
|
Facility
|
IP
|
$15.61
|
|
|
Service Code
|
HCPCS J1650
|
| Hospital Charge Code |
63600151
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$10.15 |
| Max. Negotiated Rate |
$15.61 |
| Rate for Payer: Aetna Commercial |
$14.05
|
| Rate for Payer: ASR ASR |
$15.14
|
| Rate for Payer: ASR Commercial |
$15.14
|
| Rate for Payer: BCBS Trust/PPO |
$12.72
|
| Rate for Payer: BCN Commercial |
$12.10
|
| Rate for Payer: Cash Price |
$12.49
|
| Rate for Payer: Cofinity Commercial |
$14.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.49
|
| Rate for Payer: Healthscope Commercial |
$15.61
|
| Rate for Payer: Healthscope Whirlpool |
$15.14
|
| Rate for Payer: Mclaren Commercial |
$14.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.27
|
| Rate for Payer: Nomi Health Commercial |
$12.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$13.74
|
|
|
HC INJ ENOXAPARIN SODIUM PER 10 MG
|
Facility
|
OP
|
$15.61
|
|
|
Service Code
|
HCPCS J1650
|
| Hospital Charge Code |
63600151
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.43 |
| Max. Negotiated Rate |
$15.61 |
| Rate for Payer: Aetna Commercial |
$14.05
|
| Rate for Payer: Aetna Medicare |
$7.80
|
| Rate for Payer: ASR ASR |
$15.14
|
| Rate for Payer: ASR Commercial |
$15.14
|
| Rate for Payer: BCBS Complete |
$6.24
|
| Rate for Payer: BCBS Trust/PPO |
$12.78
|
| Rate for Payer: BCN Commercial |
$12.10
|
| Rate for Payer: Cash Price |
$12.49
|
| Rate for Payer: Cash Price |
$12.49
|
| Rate for Payer: Cofinity Commercial |
$14.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.49
|
| Rate for Payer: Healthscope Commercial |
$15.61
|
| Rate for Payer: Healthscope Whirlpool |
$15.14
|
| Rate for Payer: Mclaren Commercial |
$14.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.27
|
| Rate for Payer: Nomi Health Commercial |
$12.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$0.54
|
| Rate for Payer: Priority Health Narrow Network |
$0.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$13.74
|
|
|
HC INJ ENZYME PALMAR FASCIAL CORD
|
Facility
|
IP
|
$339.65
|
|
|
Service Code
|
CPT 20527
|
| Hospital Charge Code |
76100305
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$220.77 |
| Max. Negotiated Rate |
$339.65 |
| Rate for Payer: Aetna Commercial |
$305.68
|
| Rate for Payer: ASR ASR |
$329.46
|
| Rate for Payer: ASR Commercial |
$329.46
|
| Rate for Payer: BCBS Trust/PPO |
$276.78
|
| Rate for Payer: BCN Commercial |
$263.33
|
| Rate for Payer: Cash Price |
$271.72
|
| Rate for Payer: Cofinity Commercial |
$319.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$271.72
|
| Rate for Payer: Healthscope Commercial |
$339.65
|
| Rate for Payer: Healthscope Whirlpool |
$329.46
|
| Rate for Payer: Mclaren Commercial |
$305.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$288.70
|
| Rate for Payer: Nomi Health Commercial |
$278.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$220.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$298.89
|
|
|
HC INJ ENZYME PALMAR FASCIAL CORD
|
Facility
|
OP
|
$339.65
|
|
|
Service Code
|
CPT 20527
|
| Hospital Charge Code |
76100305
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$155.02 |
| Max. Negotiated Rate |
$448.29 |
| Rate for Payer: Aetna Commercial |
$305.68
|
| Rate for Payer: Aetna Medicare |
$289.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$361.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$361.52
|
| Rate for Payer: ASR ASR |
$329.46
|
| Rate for Payer: ASR Commercial |
$329.46
|
| Rate for Payer: BCBS Complete |
$162.77
|
| Rate for Payer: BCBS MAPPO |
$289.22
|
| Rate for Payer: BCBS Trust/PPO |
$278.14
|
| Rate for Payer: BCN Commercial |
$263.33
|
| Rate for Payer: BCN Medicare Advantage |
$289.22
|
| Rate for Payer: Cash Price |
$271.72
|
| Rate for Payer: Cash Price |
$271.72
|
| Rate for Payer: Cofinity Commercial |
$319.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$271.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$289.22
|
| Rate for Payer: Healthscope Commercial |
$339.65
|
| Rate for Payer: Healthscope Whirlpool |
$329.46
|
| Rate for Payer: Humana Choice PPO Medicare |
$289.22
|
| Rate for Payer: Mclaren Commercial |
$305.68
|
| Rate for Payer: Mclaren Medicaid |
$155.02
|
| Rate for Payer: Mclaren Medicare |
$289.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$303.68
|
| Rate for Payer: Meridian Medicaid |
$162.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$332.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$288.70
|
| Rate for Payer: Nomi Health Commercial |
$278.51
|
| Rate for Payer: PACE Medicare |
$274.76
|
| Rate for Payer: PACE SWMI |
$289.22
|
| Rate for Payer: PHP Commercial |
$318.14
|
| Rate for Payer: PHP Medicaid |
$155.02
|
| Rate for Payer: PHP Medicare Advantage |
$289.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$155.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$220.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$297.60
|
| Rate for Payer: Priority Health Medicare |
$289.22
|
| Rate for Payer: Priority Health Narrow Network |
$238.09
|
| Rate for Payer: Railroad Medicare Medicare |
$289.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$298.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$289.22
|
| Rate for Payer: UHC Exchange |
$448.29
|
| Rate for Payer: UHC Medicare Advantage |
$289.22
|
| Rate for Payer: UHCCP DNSP |
$289.22
|
| Rate for Payer: UHCCP Medicaid |
$155.02
|
| Rate for Payer: VA VA |
$289.22
|
|
|
HC INJ HEPARIN SODIUM PER 1000U
|
Facility
|
OP
|
$1.04
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
63600140
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.18 |
| Max. Negotiated Rate |
$1.04 |
| Rate for Payer: Aetna Commercial |
$0.94
|
| Rate for Payer: Aetna Medicare |
$0.52
|
| Rate for Payer: ASR ASR |
$1.01
|
| Rate for Payer: ASR Commercial |
$1.01
|
| Rate for Payer: BCBS Complete |
$0.42
|
| Rate for Payer: BCBS Trust/PPO |
$0.85
|
| Rate for Payer: BCN Commercial |
$0.81
|
| Rate for Payer: Cash Price |
$0.83
|
| Rate for Payer: Cash Price |
$0.83
|
| Rate for Payer: Cofinity Commercial |
$0.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.83
|
| Rate for Payer: Healthscope Commercial |
$1.04
|
| Rate for Payer: Healthscope Whirlpool |
$1.01
|
| Rate for Payer: Mclaren Commercial |
$0.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.88
|
| Rate for Payer: Nomi Health Commercial |
$0.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$0.23
|
| Rate for Payer: Priority Health Narrow Network |
$0.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$0.92
|
|
|
HC INJ HEPARIN SODIUM PER 1000U
|
Facility
|
IP
|
$1.04
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
63600140
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.68 |
| Max. Negotiated Rate |
$1.04 |
| Rate for Payer: Aetna Commercial |
$0.94
|
| Rate for Payer: ASR ASR |
$1.01
|
| Rate for Payer: ASR Commercial |
$1.01
|
| Rate for Payer: BCBS Trust/PPO |
$0.85
|
| Rate for Payer: BCN Commercial |
$0.81
|
| Rate for Payer: Cash Price |
$0.83
|
| Rate for Payer: Cofinity Commercial |
$0.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.83
|
| Rate for Payer: Healthscope Commercial |
$1.04
|
| Rate for Payer: Healthscope Whirlpool |
$1.01
|
| Rate for Payer: Mclaren Commercial |
$0.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.88
|
| Rate for Payer: Nomi Health Commercial |
$0.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$0.92
|
|
