|
HC INJ HYDROCORTISONE NA SUCCINATE, UP TO 100MG
|
Facility
|
OP
|
$42.84
|
|
|
Service Code
|
HCPCS J1720
|
| Hospital Charge Code |
63600241
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$17.09 |
| Max. Negotiated Rate |
$42.84 |
| Rate for Payer: Aetna Commercial |
$38.56
|
| Rate for Payer: Aetna Medicare |
$21.42
|
| Rate for Payer: ASR ASR |
$41.55
|
| Rate for Payer: ASR Commercial |
$41.55
|
| Rate for Payer: BCBS Complete |
$17.14
|
| Rate for Payer: BCBS Trust/PPO |
$35.08
|
| Rate for Payer: BCN Commercial |
$33.21
|
| Rate for Payer: Cash Price |
$34.27
|
| Rate for Payer: Cash Price |
$34.27
|
| Rate for Payer: Cofinity Commercial |
$40.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.27
|
| Rate for Payer: Healthscope Commercial |
$42.84
|
| Rate for Payer: Healthscope Whirlpool |
$41.55
|
| Rate for Payer: Mclaren Commercial |
$38.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.41
|
| Rate for Payer: Nomi Health Commercial |
$35.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.36
|
| Rate for Payer: Priority Health Narrow Network |
$17.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.70
|
|
|
HC INJ HYDROCORTISONE NA SUCCINATE, UP TO 100MG
|
Facility
|
IP
|
$42.84
|
|
|
Service Code
|
HCPCS J1720
|
| Hospital Charge Code |
63600241
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$27.85 |
| Max. Negotiated Rate |
$42.84 |
| Rate for Payer: Aetna Commercial |
$38.56
|
| Rate for Payer: ASR ASR |
$41.55
|
| Rate for Payer: ASR Commercial |
$41.55
|
| Rate for Payer: BCBS Trust/PPO |
$34.91
|
| Rate for Payer: BCN Commercial |
$33.21
|
| Rate for Payer: Cash Price |
$34.27
|
| Rate for Payer: Cofinity Commercial |
$40.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.27
|
| Rate for Payer: Healthscope Commercial |
$42.84
|
| Rate for Payer: Healthscope Whirlpool |
$41.55
|
| Rate for Payer: Mclaren Commercial |
$38.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.41
|
| Rate for Payer: Nomi Health Commercial |
$35.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.70
|
|
|
HC INJ KNEE ARTHROGRAM CT/MRI
|
Facility
|
IP
|
$617.14
|
|
|
Service Code
|
CPT 27369
|
| Hospital Charge Code |
36100562
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$401.14 |
| Max. Negotiated Rate |
$617.14 |
| Rate for Payer: Aetna Commercial |
$555.43
|
| Rate for Payer: ASR ASR |
$598.63
|
| Rate for Payer: ASR Commercial |
$598.63
|
| Rate for Payer: BCBS Trust/PPO |
$502.91
|
| Rate for Payer: BCN Commercial |
$478.47
|
| Rate for Payer: Cash Price |
$493.71
|
| Rate for Payer: Cofinity Commercial |
$580.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$493.71
|
| Rate for Payer: Healthscope Commercial |
$617.14
|
| Rate for Payer: Healthscope Whirlpool |
$598.63
|
| Rate for Payer: Mclaren Commercial |
$555.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$524.57
|
| Rate for Payer: Nomi Health Commercial |
$506.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$401.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$543.08
|
|
|
HC INJ KNEE ARTHROGRAM CT/MRI
|
Facility
|
OP
|
$617.14
|
|
|
Service Code
|
CPT 27369
|
| Hospital Charge Code |
36100562
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$246.86 |
| Max. Negotiated Rate |
$617.14 |
| Rate for Payer: Aetna Commercial |
$555.43
|
| Rate for Payer: Aetna Medicare |
$308.57
|
| Rate for Payer: ASR ASR |
$598.63
|
| Rate for Payer: ASR Commercial |
$598.63
|
| Rate for Payer: BCBS Complete |
$246.86
|
| Rate for Payer: BCBS Trust/PPO |
$505.38
|
| Rate for Payer: BCN Commercial |
$478.47
|
| Rate for Payer: Cash Price |
$493.71
|
| Rate for Payer: Cash Price |
$493.71
|
| Rate for Payer: Cofinity Commercial |
$580.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$493.71
|
| Rate for Payer: Healthscope Commercial |
$617.14
|
| Rate for Payer: Healthscope Whirlpool |
$598.63
|
| Rate for Payer: Mclaren Commercial |
$555.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$524.57
|
| Rate for Payer: Nomi Health Commercial |
$506.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$401.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$396.12
|
| Rate for Payer: Priority Health Narrow Network |
$316.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$543.08
|
|
|
HC INJ LIDOCAINE HYDROCHLORIDE 1 MG
|
Facility
|
OP
|
$1.00
|
|
|
Service Code
|
HCPCS J2003
|
| Hospital Charge Code |
63600262
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$1.00 |
| Rate for Payer: Aetna Commercial |
$0.90
|
| Rate for Payer: Aetna Medicare |
$0.50
|
| Rate for Payer: ASR ASR |
$0.97
|
| Rate for Payer: ASR Commercial |
$0.97
|
| Rate for Payer: BCBS Complete |
$0.40
|
| Rate for Payer: BCBS Trust/PPO |
$0.82
|
| Rate for Payer: BCN Commercial |
$0.78
|
| Rate for Payer: Cash Price |
$0.80
|
| Rate for Payer: Cash Price |
$0.80
|
| Rate for Payer: Cofinity Commercial |
$0.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.80
|
| Rate for Payer: Healthscope Commercial |
$1.00
|
| Rate for Payer: Healthscope Whirlpool |
$0.97
|
| Rate for Payer: Mclaren Commercial |
$0.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.85
|
| Rate for Payer: Nomi Health Commercial |
$0.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$0.01
|
| Rate for Payer: Priority Health Narrow Network |
$0.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$0.88
|
|
|
HC INJ LIDOCAINE HYDROCHLORIDE 1 MG
|
Facility
|
IP
|
$1.00
|
|
|
Service Code
|
HCPCS J2003
|
| Hospital Charge Code |
63600262
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.65 |
| Max. Negotiated Rate |
$1.00 |
| Rate for Payer: Aetna Commercial |
$0.90
|
| Rate for Payer: ASR ASR |
$0.97
|
| Rate for Payer: ASR Commercial |
$0.97
|
| Rate for Payer: BCBS Trust/PPO |
$0.81
|
| Rate for Payer: BCN Commercial |
$0.78
|
| Rate for Payer: Cash Price |
$0.80
|
| Rate for Payer: Cofinity Commercial |
$0.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.80
|
| Rate for Payer: Healthscope Commercial |
$1.00
|
| Rate for Payer: Healthscope Whirlpool |
$0.97
|
| Rate for Payer: Mclaren Commercial |
$0.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.85
|
| Rate for Payer: Nomi Health Commercial |
$0.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$0.88
|
|
|
HC INJ LUMB W MYELO 2+REG SAME MD
|
Facility
|
OP
|
$2,096.95
|
|
|
Service Code
|
CPT 62305
|
| Hospital Charge Code |
36100463
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$414.91 |
| Max. Negotiated Rate |
$2,096.95 |
| Rate for Payer: Aetna Commercial |
$1,887.26
|
| Rate for Payer: Aetna Medicare |
$774.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$967.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$967.60
|
| Rate for Payer: ASR ASR |
$2,034.04
|
| Rate for Payer: ASR Commercial |
$2,034.04
|
| Rate for Payer: BCBS Complete |
$435.65
|
| Rate for Payer: BCBS MAPPO |
$774.08
|
| Rate for Payer: BCBS Trust/PPO |
$1,717.19
|
| Rate for Payer: BCN Commercial |
$1,625.77
|
| Rate for Payer: BCN Medicare Advantage |
$774.08
|
| Rate for Payer: Cash Price |
$1,677.56
|
| Rate for Payer: Cash Price |
$1,677.56
|
| Rate for Payer: Cofinity Commercial |
$1,971.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,677.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$774.08
|
| Rate for Payer: Healthscope Commercial |
$2,096.95
|
| Rate for Payer: Healthscope Whirlpool |
$2,034.04
|
| Rate for Payer: Humana Choice PPO Medicare |
$774.08
|
| Rate for Payer: Mclaren Commercial |
$1,887.26
|
| Rate for Payer: Mclaren Medicaid |
$414.91
|
| Rate for Payer: Mclaren Medicare |
$774.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$812.78
|
| Rate for Payer: Meridian Medicaid |
$435.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$890.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,782.41
|
| Rate for Payer: Nomi Health Commercial |
$1,719.50
|
| Rate for Payer: PACE Medicare |
$735.38
|
| Rate for Payer: PACE SWMI |
$774.08
|
| Rate for Payer: PHP Commercial |
$851.49
|
| Rate for Payer: PHP Medicaid |
$414.91
|
| Rate for Payer: PHP Medicare Advantage |
$774.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$414.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,363.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,837.35
|
| Rate for Payer: Priority Health Medicare |
$774.08
|
| Rate for Payer: Priority Health Narrow Network |
$1,469.96
|
| Rate for Payer: Railroad Medicare Medicare |
$774.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,845.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$774.08
|
| Rate for Payer: UHC Exchange |
$1,199.82
|
| Rate for Payer: UHC Medicare Advantage |
$774.08
|
| Rate for Payer: UHCCP DNSP |
$774.08
|
| Rate for Payer: UHCCP Medicaid |
$414.91
|
| Rate for Payer: VA VA |
$774.08
|
|
|
HC INJ LUMB W MYELO 2+REG SAME MD
|
Facility
|
IP
|
$2,096.95
|
|
|
Service Code
|
CPT 62305
|
| Hospital Charge Code |
36100463
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,363.02 |
| Max. Negotiated Rate |
$2,096.95 |
| Rate for Payer: Aetna Commercial |
$1,887.26
|
| Rate for Payer: ASR ASR |
$2,034.04
|
| Rate for Payer: ASR Commercial |
$2,034.04
|
| Rate for Payer: BCBS Trust/PPO |
$1,708.80
|
| Rate for Payer: BCN Commercial |
$1,625.77
|
| Rate for Payer: Cash Price |
$1,677.56
|
| Rate for Payer: Cofinity Commercial |
$1,971.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,677.56
|
| Rate for Payer: Healthscope Commercial |
$2,096.95
|
| Rate for Payer: Healthscope Whirlpool |
$2,034.04
|
| Rate for Payer: Mclaren Commercial |
$1,887.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,782.41
|
| Rate for Payer: Nomi Health Commercial |
$1,719.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,363.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,845.32
|
|
|
HC INJ LUMB W MYELO CERV SAME MD
|
Facility
|
IP
|
$2,204.53
|
|
|
Service Code
|
CPT 62302
|
| Hospital Charge Code |
36100460
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,432.94 |
| Max. Negotiated Rate |
$2,204.53 |
| Rate for Payer: Aetna Commercial |
$1,984.08
|
| Rate for Payer: ASR ASR |
$2,138.39
|
| Rate for Payer: ASR Commercial |
$2,138.39
|
| Rate for Payer: BCBS Trust/PPO |
$1,796.47
|
| Rate for Payer: BCN Commercial |
$1,709.17
|
| Rate for Payer: Cash Price |
$1,763.62
|
| Rate for Payer: Cofinity Commercial |
$2,072.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,763.62
|
| Rate for Payer: Healthscope Commercial |
$2,204.53
|
| Rate for Payer: Healthscope Whirlpool |
$2,138.39
|
| Rate for Payer: Mclaren Commercial |
$1,984.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,873.85
|
| Rate for Payer: Nomi Health Commercial |
$1,807.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,432.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,939.99
|
|
|
HC INJ LUMB W MYELO CERV SAME MD
|
Facility
|
OP
|
$2,204.53
|
|
|
Service Code
|
CPT 62302
|
| Hospital Charge Code |
36100460
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$414.91 |
| Max. Negotiated Rate |
$2,204.53 |
| Rate for Payer: Aetna Commercial |
$1,984.08
|
| Rate for Payer: Aetna Medicare |
$774.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$967.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$967.60
|
| Rate for Payer: ASR ASR |
$2,138.39
|
| Rate for Payer: ASR Commercial |
$2,138.39
|
| Rate for Payer: BCBS Complete |
$435.65
|
| Rate for Payer: BCBS MAPPO |
$774.08
|
| Rate for Payer: BCBS Trust/PPO |
$1,805.29
|
| Rate for Payer: BCN Commercial |
$1,709.17
|
| Rate for Payer: BCN Medicare Advantage |
$774.08
|
| Rate for Payer: Cash Price |
$1,763.62
|
| Rate for Payer: Cash Price |
$1,763.62
|
| Rate for Payer: Cofinity Commercial |
$2,072.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,763.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$774.08
|
| Rate for Payer: Healthscope Commercial |
$2,204.53
|
| Rate for Payer: Healthscope Whirlpool |
$2,138.39
|
| Rate for Payer: Humana Choice PPO Medicare |
$774.08
|
| Rate for Payer: Mclaren Commercial |
$1,984.08
|
| Rate for Payer: Mclaren Medicaid |
$414.91
|
| Rate for Payer: Mclaren Medicare |
$774.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$812.78
|
| Rate for Payer: Meridian Medicaid |
$435.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$890.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,873.85
|
| Rate for Payer: Nomi Health Commercial |
$1,807.71
|
| Rate for Payer: PACE Medicare |
$735.38
|
| Rate for Payer: PACE SWMI |
$774.08
|
| Rate for Payer: PHP Commercial |
$851.49
|
| Rate for Payer: PHP Medicaid |
$414.91
|
| Rate for Payer: PHP Medicare Advantage |
$774.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$414.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,432.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,931.61
|
| Rate for Payer: Priority Health Medicare |
$774.08
|
| Rate for Payer: Priority Health Narrow Network |
$1,545.38
|
| Rate for Payer: Railroad Medicare Medicare |
$774.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,939.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$774.08
|
| Rate for Payer: UHC Exchange |
$1,199.82
|
| Rate for Payer: UHC Medicare Advantage |
$774.08
|
| Rate for Payer: UHCCP DNSP |
$774.08
|
| Rate for Payer: UHCCP Medicaid |
$414.91
|
| Rate for Payer: VA VA |
$774.08
|
|
|
HC INJ LUMB W MYELO LS SAME MD
|
Facility
|
OP
|
$2,204.53
|
|
|
Service Code
|
CPT 62304
|
| Hospital Charge Code |
36100462
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$414.91 |
| Max. Negotiated Rate |
$2,204.53 |
| Rate for Payer: Aetna Commercial |
$1,984.08
|
| Rate for Payer: Aetna Medicare |
$774.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$967.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$967.60
|
| Rate for Payer: ASR ASR |
$2,138.39
|
| Rate for Payer: ASR Commercial |
$2,138.39
|
| Rate for Payer: BCBS Complete |
$435.65
|
| Rate for Payer: BCBS MAPPO |
$774.08
|
| Rate for Payer: BCBS Trust/PPO |
$1,805.29
|
| Rate for Payer: BCN Commercial |
$1,709.17
|
| Rate for Payer: BCN Medicare Advantage |
$774.08
|
| Rate for Payer: Cash Price |
$1,763.62
|
| Rate for Payer: Cash Price |
$1,763.62
|
| Rate for Payer: Cofinity Commercial |
$2,072.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,763.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$774.08
|
| Rate for Payer: Healthscope Commercial |
$2,204.53
|
| Rate for Payer: Healthscope Whirlpool |
$2,138.39
|
| Rate for Payer: Humana Choice PPO Medicare |
$774.08
|
| Rate for Payer: Mclaren Commercial |
$1,984.08
|
| Rate for Payer: Mclaren Medicaid |
$414.91
|
| Rate for Payer: Mclaren Medicare |
$774.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$812.78
|
| Rate for Payer: Meridian Medicaid |
$435.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$890.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,873.85
|
| Rate for Payer: Nomi Health Commercial |
$1,807.71
|
| Rate for Payer: PACE Medicare |
$735.38
|
| Rate for Payer: PACE SWMI |
$774.08
|
| Rate for Payer: PHP Commercial |
$851.49
|
| Rate for Payer: PHP Medicaid |
$414.91
|
| Rate for Payer: PHP Medicare Advantage |
$774.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$414.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,432.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,931.61
|
| Rate for Payer: Priority Health Medicare |
$774.08
|
| Rate for Payer: Priority Health Narrow Network |
$1,545.38
|
| Rate for Payer: Railroad Medicare Medicare |
$774.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,939.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$774.08
|
| Rate for Payer: UHC Exchange |
$1,199.82
|
| Rate for Payer: UHC Medicare Advantage |
$774.08
|
| Rate for Payer: UHCCP DNSP |
$774.08
|
| Rate for Payer: UHCCP Medicaid |
$414.91
|
| Rate for Payer: VA VA |
$774.08
|
|
|
HC INJ LUMB W MYELO LS SAME MD
|
Facility
|
IP
|
$2,204.53
|
|
|
Service Code
|
CPT 62304
|
| Hospital Charge Code |
36100462
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,432.94 |
| Max. Negotiated Rate |
$2,204.53 |
| Rate for Payer: Aetna Commercial |
$1,984.08
|
| Rate for Payer: ASR ASR |
$2,138.39
|
| Rate for Payer: ASR Commercial |
$2,138.39
|
| Rate for Payer: BCBS Trust/PPO |
$1,796.47
|
| Rate for Payer: BCN Commercial |
$1,709.17
|
| Rate for Payer: Cash Price |
$1,763.62
|
| Rate for Payer: Cofinity Commercial |
$2,072.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,763.62
|
| Rate for Payer: Healthscope Commercial |
$2,204.53
|
| Rate for Payer: Healthscope Whirlpool |
$2,138.39
|
| Rate for Payer: Mclaren Commercial |
$1,984.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,873.85
|
| Rate for Payer: Nomi Health Commercial |
$1,807.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,432.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,939.99
|
|
|
HC INJ LUMB W MYELO THOR SAME MD
|
Facility
|
IP
|
$2,204.53
|
|
|
Service Code
|
CPT 62303
|
| Hospital Charge Code |
36100461
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,432.94 |
| Max. Negotiated Rate |
$2,204.53 |
| Rate for Payer: Aetna Commercial |
$1,984.08
|
| Rate for Payer: ASR ASR |
$2,138.39
|
| Rate for Payer: ASR Commercial |
$2,138.39
|
| Rate for Payer: BCBS Trust/PPO |
$1,796.47
|
| Rate for Payer: BCN Commercial |
$1,709.17
|
| Rate for Payer: Cash Price |
$1,763.62
|
| Rate for Payer: Cofinity Commercial |
$2,072.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,763.62
|
| Rate for Payer: Healthscope Commercial |
$2,204.53
|
| Rate for Payer: Healthscope Whirlpool |
$2,138.39
|
| Rate for Payer: Mclaren Commercial |
$1,984.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,873.85
|
| Rate for Payer: Nomi Health Commercial |
$1,807.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,432.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,939.99
|
|
|
HC INJ LUMB W MYELO THOR SAME MD
|
Facility
|
OP
|
$2,204.53
|
|
|
Service Code
|
CPT 62303
|
| Hospital Charge Code |
36100461
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$414.91 |
| Max. Negotiated Rate |
$2,204.53 |
| Rate for Payer: Aetna Commercial |
$1,984.08
|
| Rate for Payer: Aetna Medicare |
$774.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$967.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$967.60
|
| Rate for Payer: ASR ASR |
$2,138.39
|
| Rate for Payer: ASR Commercial |
$2,138.39
|
| Rate for Payer: BCBS Complete |
$435.65
|
| Rate for Payer: BCBS MAPPO |
$774.08
|
| Rate for Payer: BCBS Trust/PPO |
$1,805.29
|
| Rate for Payer: BCN Commercial |
$1,709.17
|
| Rate for Payer: BCN Medicare Advantage |
$774.08
|
| Rate for Payer: Cash Price |
$1,763.62
|
| Rate for Payer: Cash Price |
$1,763.62
|
| Rate for Payer: Cofinity Commercial |
$2,072.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,763.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$774.08
|
| Rate for Payer: Healthscope Commercial |
$2,204.53
|
| Rate for Payer: Healthscope Whirlpool |
$2,138.39
|
| Rate for Payer: Humana Choice PPO Medicare |
$774.08
|
| Rate for Payer: Mclaren Commercial |
$1,984.08
|
| Rate for Payer: Mclaren Medicaid |
$414.91
|
| Rate for Payer: Mclaren Medicare |
$774.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$812.78
|
| Rate for Payer: Meridian Medicaid |
$435.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$890.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,873.85
|
| Rate for Payer: Nomi Health Commercial |
$1,807.71
|
| Rate for Payer: PACE Medicare |
$735.38
|
| Rate for Payer: PACE SWMI |
$774.08
|
| Rate for Payer: PHP Commercial |
$851.49
|
| Rate for Payer: PHP Medicaid |
$414.91
|
| Rate for Payer: PHP Medicare Advantage |
$774.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$414.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,432.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,931.61
|
| Rate for Payer: Priority Health Medicare |
$774.08
|
| Rate for Payer: Priority Health Narrow Network |
$1,545.38
|
| Rate for Payer: Railroad Medicare Medicare |
$774.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,939.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$774.08
|
| Rate for Payer: UHC Exchange |
$1,199.82
|
| Rate for Payer: UHC Medicare Advantage |
$774.08
|
| Rate for Payer: UHCCP DNSP |
$774.08
|
| Rate for Payer: UHCCP Medicaid |
$414.91
|
| Rate for Payer: VA VA |
$774.08
|
|
|
HC INJ LYMPHANGIOGRAPHY
|
Facility
|
OP
|
$1,305.17
|
|
|
Service Code
|
CPT 38790
|
| Hospital Charge Code |
36100445
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$522.07 |
| Max. Negotiated Rate |
$1,305.17 |
| Rate for Payer: Aetna Commercial |
$1,174.65
|
| Rate for Payer: Aetna Medicare |
$652.58
|
| Rate for Payer: ASR ASR |
$1,266.01
|
| Rate for Payer: ASR Commercial |
$1,266.01
|
| Rate for Payer: BCBS Complete |
$522.07
|
| Rate for Payer: BCBS Trust/PPO |
$1,068.80
|
| Rate for Payer: BCN Commercial |
$1,011.90
|
| Rate for Payer: Cash Price |
$1,044.14
|
| Rate for Payer: Cofinity Commercial |
$1,226.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,044.14
|
| Rate for Payer: Healthscope Commercial |
$1,305.17
|
| Rate for Payer: Healthscope Whirlpool |
$1,266.01
|
| Rate for Payer: Mclaren Commercial |
$1,174.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,109.39
|
| Rate for Payer: Nomi Health Commercial |
$1,070.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$848.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,143.59
|
| Rate for Payer: Priority Health Narrow Network |
$914.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,148.55
|
|
|
HC INJ LYMPHANGIOGRAPHY
|
Facility
|
IP
|
$1,305.17
|
|
|
Service Code
|
CPT 38790
|
| Hospital Charge Code |
36100445
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$848.36 |
| Max. Negotiated Rate |
$1,305.17 |
| Rate for Payer: Aetna Commercial |
$1,174.65
|
| Rate for Payer: ASR ASR |
$1,266.01
|
| Rate for Payer: ASR Commercial |
$1,266.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,063.58
|
| Rate for Payer: BCN Commercial |
$1,011.90
|
| Rate for Payer: Cash Price |
$1,044.14
|
| Rate for Payer: Cofinity Commercial |
$1,226.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,044.14
|
| Rate for Payer: Healthscope Commercial |
$1,305.17
|
| Rate for Payer: Healthscope Whirlpool |
$1,266.01
|
| Rate for Payer: Mclaren Commercial |
$1,174.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,109.39
|
| Rate for Payer: Nomi Health Commercial |
$1,070.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$848.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,148.55
|
|
|
HC INJ, METHYLPREDNISOLONE ACETATE, 1 MG
|
Facility
|
IP
|
$0.52
|
|
|
Service Code
|
HCPCS J1010
|
| Hospital Charge Code |
63600239
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.34 |
| Max. Negotiated Rate |
$0.52 |
| Rate for Payer: Aetna Commercial |
$0.47
|
| Rate for Payer: ASR ASR |
$0.50
|
| Rate for Payer: ASR Commercial |
$0.50
|
| Rate for Payer: BCBS Trust/PPO |
$0.42
|
| Rate for Payer: BCN Commercial |
$0.40
|
| Rate for Payer: Cash Price |
$0.42
|
| Rate for Payer: Cofinity Commercial |
$0.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.42
|
| Rate for Payer: Healthscope Commercial |
$0.52
|
| Rate for Payer: Healthscope Whirlpool |
$0.50
|
| Rate for Payer: Mclaren Commercial |
$0.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.44
|
| Rate for Payer: Nomi Health Commercial |
$0.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$0.46
|
|
|
HC INJ, METHYLPREDNISOLONE ACETATE, 1 MG
|
Facility
|
OP
|
$0.52
|
|
|
Service Code
|
HCPCS J1010
|
| Hospital Charge Code |
63600239
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.06 |
| Max. Negotiated Rate |
$0.52 |
| Rate for Payer: Aetna Commercial |
$0.47
|
| Rate for Payer: Aetna Medicare |
$0.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.15
|
| Rate for Payer: ASR ASR |
$0.50
|
| Rate for Payer: ASR Commercial |
$0.50
|
| Rate for Payer: BCBS Complete |
$0.07
|
| Rate for Payer: BCBS MAPPO |
$0.12
|
| Rate for Payer: BCBS Trust/PPO |
$0.43
|
| Rate for Payer: BCN Commercial |
$0.40
|
| Rate for Payer: BCN Medicare Advantage |
$0.12
|
| Rate for Payer: Cash Price |
$0.42
|
| Rate for Payer: Cash Price |
$0.42
|
| Rate for Payer: Cofinity Commercial |
$0.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.12
|
| Rate for Payer: Healthscope Commercial |
$0.52
|
| Rate for Payer: Healthscope Whirlpool |
$0.50
|
| Rate for Payer: Humana Choice PPO Medicare |
$0.12
|
| Rate for Payer: Mclaren Commercial |
$0.47
|
| Rate for Payer: Mclaren Medicaid |
$0.06
|
| Rate for Payer: Mclaren Medicare |
$0.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.13
|
| Rate for Payer: Meridian Medicaid |
$0.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.44
|
| Rate for Payer: Nomi Health Commercial |
$0.43
|
| Rate for Payer: PACE Medicare |
$0.11
|
| Rate for Payer: PACE SWMI |
$0.12
|
| Rate for Payer: PHP Commercial |
$0.13
|
| Rate for Payer: PHP Medicaid |
$0.06
|
| Rate for Payer: PHP Medicare Advantage |
$0.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$0.11
|
| Rate for Payer: Priority Health Medicare |
$0.12
|
| Rate for Payer: Priority Health Narrow Network |
$0.09
|
| Rate for Payer: Railroad Medicare Medicare |
$0.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$0.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.12
|
| Rate for Payer: UHC Exchange |
$0.19
|
| Rate for Payer: UHC Medicare Advantage |
$0.12
|
| Rate for Payer: UHCCP DNSP |
$0.12
|
| Rate for Payer: UHCCP Medicaid |
$0.06
|
| Rate for Payer: VA VA |
$0.12
|
|
|
HC INJ, METHYLPREDNISOLONE NA SUCCINATE, 5 MG
|
Facility
|
OP
|
$2.60
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
63600240
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.14 |
| Max. Negotiated Rate |
$2.60 |
| Rate for Payer: Aetna Commercial |
$2.34
|
| Rate for Payer: Aetna Medicare |
$0.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.34
|
| Rate for Payer: ASR ASR |
$2.52
|
| Rate for Payer: ASR Commercial |
$2.52
|
| Rate for Payer: BCBS Complete |
$0.15
|
| Rate for Payer: BCBS MAPPO |
$0.27
|
| Rate for Payer: BCBS Trust/PPO |
$2.13
|
| Rate for Payer: BCN Commercial |
$2.02
|
| Rate for Payer: BCN Medicare Advantage |
$0.27
|
| Rate for Payer: Cash Price |
$2.08
|
| Rate for Payer: Cash Price |
$2.08
|
| Rate for Payer: Cofinity Commercial |
$2.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.27
|
| Rate for Payer: Healthscope Commercial |
$2.60
|
| Rate for Payer: Healthscope Whirlpool |
$2.52
|
| Rate for Payer: Humana Choice PPO Medicare |
$0.27
|
| Rate for Payer: Mclaren Commercial |
$2.34
|
| Rate for Payer: Mclaren Medicaid |
$0.14
|
| Rate for Payer: Mclaren Medicare |
$0.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.28
|
| Rate for Payer: Meridian Medicaid |
$0.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.21
|
| Rate for Payer: Nomi Health Commercial |
$2.13
|
| Rate for Payer: PACE Medicare |
$0.26
|
| Rate for Payer: PACE SWMI |
$0.27
|
| Rate for Payer: PHP Commercial |
$0.30
|
| Rate for Payer: PHP Medicaid |
$0.14
|
| Rate for Payer: PHP Medicare Advantage |
$0.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$0.26
|
| Rate for Payer: Priority Health Medicare |
$0.27
|
| Rate for Payer: Priority Health Narrow Network |
$0.21
|
| Rate for Payer: Railroad Medicare Medicare |
$0.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.27
|
| Rate for Payer: UHC Exchange |
$0.42
|
| Rate for Payer: UHC Medicare Advantage |
$0.27
|
| Rate for Payer: UHCCP DNSP |
$0.27
|
| Rate for Payer: UHCCP Medicaid |
$0.14
|
| Rate for Payer: VA VA |
$0.27
|
|
|
HC INJ, METHYLPREDNISOLONE NA SUCCINATE, 5 MG
|
Facility
|
IP
|
$2.60
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
63600240
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.69 |
| Max. Negotiated Rate |
$2.60 |
| Rate for Payer: Aetna Commercial |
$2.34
|
| Rate for Payer: ASR ASR |
$2.52
|
| Rate for Payer: ASR Commercial |
$2.52
|
| Rate for Payer: BCBS Trust/PPO |
$2.12
|
| Rate for Payer: BCN Commercial |
$2.02
|
| Rate for Payer: Cash Price |
$2.08
|
| Rate for Payer: Cofinity Commercial |
$2.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.08
|
| Rate for Payer: Healthscope Commercial |
$2.60
|
| Rate for Payer: Healthscope Whirlpool |
$2.52
|
| Rate for Payer: Mclaren Commercial |
$2.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.21
|
| Rate for Payer: Nomi Health Commercial |
$2.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2.29
|
|
|
HC INJ, METHYLPREDNISOLONE NA SUCCINATE, UP TO 125MG
|
Facility
|
OP
|
$26.01
|
|
|
Service Code
|
CPT J2930
|
| Hospital Charge Code |
63600102
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$10.40 |
| Max. Negotiated Rate |
$26.01 |
| Rate for Payer: Aetna Commercial |
$23.41
|
| Rate for Payer: Aetna Medicare |
$13.00
|
| Rate for Payer: ASR ASR |
$25.23
|
| Rate for Payer: ASR Commercial |
$25.23
|
| Rate for Payer: BCBS Complete |
$10.40
|
| Rate for Payer: BCBS Trust/PPO |
$21.30
|
| Rate for Payer: BCN Commercial |
$20.17
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$24.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$26.01
|
| Rate for Payer: Healthscope Whirlpool |
$25.23
|
| Rate for Payer: Mclaren Commercial |
$23.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: Nomi Health Commercial |
$21.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.79
|
| Rate for Payer: Priority Health Narrow Network |
$18.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.89
|
|
|
HC INJ, METHYLPREDNISOLONE NA SUCCINATE, UP TO 125MG
|
Facility
|
IP
|
$26.01
|
|
|
Service Code
|
CPT J2930
|
| Hospital Charge Code |
63600102
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$16.91 |
| Max. Negotiated Rate |
$26.01 |
| Rate for Payer: Aetna Commercial |
$23.41
|
| Rate for Payer: ASR ASR |
$25.23
|
| Rate for Payer: ASR Commercial |
$25.23
|
| Rate for Payer: BCBS Trust/PPO |
$21.20
|
| Rate for Payer: BCN Commercial |
$20.17
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$24.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$26.01
|
| Rate for Payer: Healthscope Whirlpool |
$25.23
|
| Rate for Payer: Mclaren Commercial |
$23.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: Nomi Health Commercial |
$21.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.89
|
|
|
HC INJ, METHYLPREDNISOLONE NA SUCCINATE, UP TO 40MG
|
Facility
|
IP
|
$20.81
|
|
|
Service Code
|
CPT J2920
|
| Hospital Charge Code |
63600101
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$13.53 |
| Max. Negotiated Rate |
$20.81 |
| Rate for Payer: Aetna Commercial |
$18.73
|
| Rate for Payer: ASR ASR |
$20.19
|
| Rate for Payer: ASR Commercial |
$20.19
|
| Rate for Payer: BCBS Trust/PPO |
$16.96
|
| Rate for Payer: BCN Commercial |
$16.13
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$19.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Healthscope Commercial |
$20.81
|
| Rate for Payer: Healthscope Whirlpool |
$20.19
|
| Rate for Payer: Mclaren Commercial |
$18.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: Nomi Health Commercial |
$17.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.31
|
|
|
HC INJ, METHYLPREDNISOLONE NA SUCCINATE, UP TO 40MG
|
Facility
|
OP
|
$20.81
|
|
|
Service Code
|
CPT J2920
|
| Hospital Charge Code |
63600101
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$8.32 |
| Max. Negotiated Rate |
$20.81 |
| Rate for Payer: Aetna Commercial |
$18.73
|
| Rate for Payer: Aetna Medicare |
$10.40
|
| Rate for Payer: ASR ASR |
$20.19
|
| Rate for Payer: ASR Commercial |
$20.19
|
| Rate for Payer: BCBS Complete |
$8.32
|
| Rate for Payer: BCBS Trust/PPO |
$17.04
|
| Rate for Payer: BCN Commercial |
$16.13
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$19.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Healthscope Commercial |
$20.81
|
| Rate for Payer: Healthscope Whirlpool |
$20.19
|
| Rate for Payer: Mclaren Commercial |
$18.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: Nomi Health Commercial |
$17.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.23
|
| Rate for Payer: Priority Health Narrow Network |
$14.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.31
|
|
|
HC INJ NERV BLOCK GREAT OCCIPTL
|
Facility
|
IP
|
$264.38
|
|
|
Service Code
|
CPT 64405
|
| Hospital Charge Code |
36100545
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$171.85 |
| Max. Negotiated Rate |
$264.38 |
| Rate for Payer: Aetna Commercial |
$237.94
|
| Rate for Payer: ASR ASR |
$256.45
|
| Rate for Payer: ASR Commercial |
$256.45
|
| Rate for Payer: BCBS Trust/PPO |
$215.44
|
| Rate for Payer: BCN Commercial |
$204.97
|
| Rate for Payer: Cash Price |
$211.50
|
| Rate for Payer: Cofinity Commercial |
$248.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$211.50
|
| Rate for Payer: Healthscope Commercial |
$264.38
|
| Rate for Payer: Healthscope Whirlpool |
$256.45
|
| Rate for Payer: Mclaren Commercial |
$237.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$224.72
|
| Rate for Payer: Nomi Health Commercial |
$216.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$171.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$232.65
|
|
