|
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
|
|
|
HC INJ ONABOTULINUMTOXINA PER 1 UNIT
|
Facility
|
IP
|
$8.16
|
|
|
Service Code
|
HCPCS J0585
|
| Hospital Charge Code |
63600114
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.30 |
| Max. Negotiated Rate |
$8.16 |
| Rate for Payer: Aetna Commercial |
$7.34
|
| Rate for Payer: ASR ASR |
$7.92
|
| Rate for Payer: ASR Commercial |
$7.92
|
| Rate for Payer: BCBS Trust/PPO |
$6.65
|
| Rate for Payer: BCN Commercial |
$6.33
|
| Rate for Payer: Cash Price |
$6.53
|
| Rate for Payer: Cofinity Commercial |
$7.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.53
|
| Rate for Payer: Healthscope Commercial |
$8.16
|
| Rate for Payer: Healthscope Whirlpool |
$7.92
|
| Rate for Payer: Mclaren Commercial |
$7.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.94
|
| Rate for Payer: Nomi Health Commercial |
$6.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7.18
|
|
|
HC INJ ONABOTULINUMTOXINA PER 1 UNIT
|
Facility
|
OP
|
$8.16
|
|
|
Service Code
|
HCPCS J0585
|
| Hospital Charge Code |
63600114
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.47 |
| Max. Negotiated Rate |
$10.03 |
| Rate for Payer: Aetna Commercial |
$7.34
|
| Rate for Payer: Aetna Medicare |
$6.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: ASR ASR |
$7.92
|
| Rate for Payer: ASR Commercial |
$7.92
|
| Rate for Payer: BCBS Complete |
$3.64
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCBS Trust/PPO |
$6.68
|
| Rate for Payer: BCN Commercial |
$6.33
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$6.53
|
| Rate for Payer: Cash Price |
$6.53
|
| Rate for Payer: Cofinity Commercial |
$7.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$8.16
|
| Rate for Payer: Healthscope Whirlpool |
$7.92
|
| Rate for Payer: Humana Choice PPO Medicare |
$6.47
|
| Rate for Payer: Mclaren Commercial |
$7.34
|
| Rate for Payer: Mclaren Medicaid |
$3.47
|
| Rate for Payer: Mclaren Medicare |
$6.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.79
|
| Rate for Payer: Meridian Medicaid |
$3.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.94
|
| Rate for Payer: Nomi Health Commercial |
$6.69
|
| Rate for Payer: PACE Medicare |
$6.15
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$7.12
|
| Rate for Payer: PHP Medicaid |
$3.47
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6.72
|
| Rate for Payer: Priority Health Medicare |
$6.47
|
| Rate for Payer: Priority Health Narrow Network |
$5.38
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.47
|
| Rate for Payer: UHC Exchange |
$10.03
|
| Rate for Payer: UHC Medicare Advantage |
$6.47
|
| Rate for Payer: UHCCP DNSP |
$6.47
|
| Rate for Payer: UHCCP Medicaid |
$3.47
|
| Rate for Payer: VA VA |
$6.47
|
|
|
HC INJ, PENICILLIN G BENZATHINE, 100,000 UNITS
|
Facility
|
OP
|
$17.18
|
|
|
Service Code
|
HCPCS J0561
|
| Hospital Charge Code |
63600162
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$11.17 |
| Max. Negotiated Rate |
$41.57 |
| Rate for Payer: Aetna Commercial |
$15.46
|
| Rate for Payer: Aetna Medicare |
$26.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.52
|
| Rate for Payer: ASR ASR |
$16.66
|
| Rate for Payer: ASR Commercial |
$16.66
|
| Rate for Payer: BCBS Complete |
$15.09
|
| Rate for Payer: BCBS MAPPO |
$26.82
|
| Rate for Payer: BCBS Trust/PPO |
$14.07
|
| Rate for Payer: BCN Commercial |
$13.32
|
| Rate for Payer: BCN Medicare Advantage |
$26.82
|
| Rate for Payer: Cash Price |
$13.74
|
| Rate for Payer: Cash Price |
$13.74
|
| Rate for Payer: Cofinity Commercial |
$16.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.82
|
| Rate for Payer: Healthscope Commercial |
$17.18
|
| Rate for Payer: Healthscope Whirlpool |
$16.66
|
| Rate for Payer: Humana Choice PPO Medicare |
$26.82
|
| Rate for Payer: Mclaren Commercial |
$15.46
|
| Rate for Payer: Mclaren Medicaid |
$14.38
|
| Rate for Payer: Mclaren Medicare |
$26.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.16
|
| Rate for Payer: Meridian Medicaid |
$15.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.60
|
| Rate for Payer: Nomi Health Commercial |
$14.09
|
| Rate for Payer: PACE Medicare |
$25.48
|
| Rate for Payer: PACE SWMI |
$26.82
|
| Rate for Payer: PHP Commercial |
$29.50
|
| Rate for Payer: PHP Medicaid |
$14.38
|
| Rate for Payer: PHP Medicare Advantage |
$26.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$28.00
|
| Rate for Payer: Priority Health Medicare |
$26.82
|
| Rate for Payer: Priority Health Narrow Network |
$22.40
|
| Rate for Payer: Railroad Medicare Medicare |
$26.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.82
|
| Rate for Payer: UHC Exchange |
$41.57
|
| Rate for Payer: UHC Medicare Advantage |
$26.82
|
| Rate for Payer: UHCCP DNSP |
$26.82
|
| Rate for Payer: UHCCP Medicaid |
$14.38
|
| Rate for Payer: VA VA |
$26.82
|
|
|
HC INJ, PENICILLIN G BENZATHINE, 100,000 UNITS
|
Facility
|
IP
|
$17.18
|
|
|
Service Code
|
HCPCS J0561
|
| Hospital Charge Code |
63600162
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$11.17 |
| Max. Negotiated Rate |
$17.18 |
| Rate for Payer: Aetna Commercial |
$15.46
|
| Rate for Payer: ASR ASR |
$16.66
|
| Rate for Payer: ASR Commercial |
$16.66
|
| Rate for Payer: BCBS Trust/PPO |
$14.00
|
| Rate for Payer: BCN Commercial |
$13.32
|
| Rate for Payer: Cash Price |
$13.74
|
| Rate for Payer: Cofinity Commercial |
$16.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.74
|
| Rate for Payer: Healthscope Commercial |
$17.18
|
| Rate for Payer: Healthscope Whirlpool |
$16.66
|
| Rate for Payer: Mclaren Commercial |
$15.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.60
|
| Rate for Payer: Nomi Health Commercial |
$14.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15.12
|
|
|
HC INJ SELECT R VENT/ATRIAL ANGIO HRT CATH
|
Facility
|
IP
|
$683.54
|
|
|
Service Code
|
CPT 93566
|
| Hospital Charge Code |
36000110
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$444.30 |
| Max. Negotiated Rate |
$683.54 |
| Rate for Payer: Aetna Commercial |
$615.19
|
| Rate for Payer: ASR ASR |
$663.03
|
| Rate for Payer: ASR Commercial |
$663.03
|
| Rate for Payer: BCBS Trust/PPO |
$557.02
|
| Rate for Payer: BCN Commercial |
$529.95
|
| Rate for Payer: Cash Price |
$546.83
|
| Rate for Payer: Cofinity Commercial |
$642.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$546.83
|
| Rate for Payer: Healthscope Commercial |
$683.54
|
| Rate for Payer: Healthscope Whirlpool |
$663.03
|
| Rate for Payer: Mclaren Commercial |
$615.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$581.01
|
| Rate for Payer: Nomi Health Commercial |
$560.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$444.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$601.52
|
|
|
HC INJ SELECT R VENT/ATRIAL ANGIO HRT CATH
|
Facility
|
OP
|
$683.54
|
|
|
Service Code
|
CPT 93566
|
| Hospital Charge Code |
36000110
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$273.42 |
| Max. Negotiated Rate |
$683.54 |
| Rate for Payer: Aetna Commercial |
$615.19
|
| Rate for Payer: Aetna Medicare |
$341.77
|
| Rate for Payer: ASR ASR |
$663.03
|
| Rate for Payer: ASR Commercial |
$663.03
|
| Rate for Payer: BCBS Complete |
$273.42
|
| Rate for Payer: BCBS Trust/PPO |
$559.75
|
| Rate for Payer: BCN Commercial |
$529.95
|
| Rate for Payer: Cash Price |
$546.83
|
| Rate for Payer: Cofinity Commercial |
$642.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$546.83
|
| Rate for Payer: Healthscope Commercial |
$683.54
|
| Rate for Payer: Healthscope Whirlpool |
$663.03
|
| Rate for Payer: Mclaren Commercial |
$615.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$581.01
|
| Rate for Payer: Nomi Health Commercial |
$560.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$444.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$598.92
|
| Rate for Payer: Priority Health Narrow Network |
$479.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$601.52
|
|
|
HC INJ TIXAGEVIMAB AND CILGAVIMAB
|
Facility
|
OP
|
$208.08
|
|
|
Service Code
|
HCPCS M0220
|
| Hospital Charge Code |
77100033
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$79.04 |
| Max. Negotiated Rate |
$228.56 |
| Rate for Payer: Aetna Commercial |
$187.27
|
| Rate for Payer: Aetna Medicare |
$147.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$184.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$184.32
|
| Rate for Payer: ASR ASR |
$201.84
|
| Rate for Payer: ASR Commercial |
$201.84
|
| Rate for Payer: BCBS Complete |
$82.99
|
| Rate for Payer: BCBS MAPPO |
$147.46
|
| Rate for Payer: BCBS Trust/PPO |
$170.40
|
| Rate for Payer: BCN Commercial |
$161.32
|
| Rate for Payer: BCN Medicare Advantage |
$147.46
|
| Rate for Payer: Cash Price |
$166.46
|
| Rate for Payer: Cash Price |
$166.46
|
| Rate for Payer: Cofinity Commercial |
$195.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$166.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$147.46
|
| Rate for Payer: Healthscope Commercial |
$208.08
|
| Rate for Payer: Healthscope Whirlpool |
$201.84
|
| Rate for Payer: Humana Choice PPO Medicare |
$147.46
|
| Rate for Payer: Mclaren Commercial |
$187.27
|
| Rate for Payer: Mclaren Medicaid |
$79.04
|
| Rate for Payer: Mclaren Medicare |
$147.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$154.83
|
| Rate for Payer: Meridian Medicaid |
$82.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$169.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$176.87
|
| Rate for Payer: Nomi Health Commercial |
$170.63
|
| Rate for Payer: PACE Medicare |
$140.09
|
| Rate for Payer: PACE SWMI |
$147.46
|
| Rate for Payer: PHP Commercial |
$162.21
|
| Rate for Payer: PHP Medicaid |
$79.04
|
| Rate for Payer: PHP Medicare Advantage |
$147.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$79.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$182.32
|
| Rate for Payer: Priority Health Medicare |
$147.46
|
| Rate for Payer: Priority Health Narrow Network |
$145.86
|
| Rate for Payer: Railroad Medicare Medicare |
$147.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$183.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$147.46
|
| Rate for Payer: UHC Exchange |
$228.56
|
| Rate for Payer: UHC Medicare Advantage |
$147.46
|
| Rate for Payer: UHCCP DNSP |
$147.46
|
| Rate for Payer: UHCCP Medicaid |
$79.04
|
| Rate for Payer: VA VA |
$147.46
|
|
|
HC INJ TIXAGEVIMAB AND CILGAVIMAB
|
Facility
|
IP
|
$208.08
|
|
|
Service Code
|
HCPCS M0220
|
| Hospital Charge Code |
77100033
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$135.25 |
| Max. Negotiated Rate |
$208.08 |
| Rate for Payer: Aetna Commercial |
$187.27
|
| Rate for Payer: ASR ASR |
$201.84
|
| Rate for Payer: ASR Commercial |
$201.84
|
| Rate for Payer: BCBS Trust/PPO |
$169.56
|
| Rate for Payer: BCN Commercial |
$161.32
|
| Rate for Payer: Cash Price |
$166.46
|
| Rate for Payer: Cofinity Commercial |
$195.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$166.46
|
| Rate for Payer: Healthscope Commercial |
$208.08
|
| Rate for Payer: Healthscope Whirlpool |
$201.84
|
| Rate for Payer: Mclaren Commercial |
$187.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$176.87
|
| Rate for Payer: Nomi Health Commercial |
$170.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$183.11
|
|
|
HC INJ, TRIAMCINOLONE ACETONIDE, NOT SPECIFIED, 10 MG
|
Facility
|
IP
|
$10.40
|
|
|
Service Code
|
CPT J3301
|
| Hospital Charge Code |
63600103
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6.76 |
| Max. Negotiated Rate |
$10.40 |
| Rate for Payer: Aetna Commercial |
$9.36
|
| Rate for Payer: ASR ASR |
$10.09
|
| Rate for Payer: ASR Commercial |
$10.09
|
| Rate for Payer: BCBS Trust/PPO |
$8.47
|
| Rate for Payer: BCN Commercial |
$8.06
|
| Rate for Payer: Cash Price |
$8.32
|
| Rate for Payer: Cofinity Commercial |
$9.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.32
|
| Rate for Payer: Healthscope Commercial |
$10.40
|
| Rate for Payer: Healthscope Whirlpool |
$10.09
|
| Rate for Payer: Mclaren Commercial |
$9.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.84
|
| Rate for Payer: Nomi Health Commercial |
$8.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9.15
|
|
|
HC INJ, TRIAMCINOLONE ACETONIDE, NOT SPECIFIED, 10 MG
|
Facility
|
OP
|
$10.40
|
|
|
Service Code
|
CPT J3301
|
| Hospital Charge Code |
63600103
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.72 |
| Max. Negotiated Rate |
$10.40 |
| Rate for Payer: Aetna Commercial |
$9.36
|
| Rate for Payer: Aetna Medicare |
$5.20
|
| Rate for Payer: ASR ASR |
$10.09
|
| Rate for Payer: ASR Commercial |
$10.09
|
| Rate for Payer: BCBS Complete |
$4.16
|
| Rate for Payer: BCBS Trust/PPO |
$8.52
|
| Rate for Payer: BCN Commercial |
$8.06
|
| Rate for Payer: Cash Price |
$8.32
|
| Rate for Payer: Cash Price |
$8.32
|
| Rate for Payer: Cofinity Commercial |
$9.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.32
|
| Rate for Payer: Healthscope Commercial |
$10.40
|
| Rate for Payer: Healthscope Whirlpool |
$10.09
|
| Rate for Payer: Mclaren Commercial |
$9.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.84
|
| Rate for Payer: Nomi Health Commercial |
$8.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$0.90
|
| Rate for Payer: Priority Health Narrow Network |
$0.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9.15
|
|
|
HC INJ, VIT B12 CYANCOBALAMIN, UP TO 1000MCG
|
Facility
|
IP
|
$5.20
|
|
|
Service Code
|
CPT J3420
|
| Hospital Charge Code |
63600104
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.38 |
| Max. Negotiated Rate |
$5.20 |
| Rate for Payer: Aetna Commercial |
$4.68
|
| Rate for Payer: ASR ASR |
$5.04
|
| Rate for Payer: ASR Commercial |
$5.04
|
| Rate for Payer: BCBS Trust/PPO |
$4.24
|
| Rate for Payer: BCN Commercial |
$4.03
|
| Rate for Payer: Cash Price |
$4.16
|
| Rate for Payer: Cofinity Commercial |
$4.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.16
|
| Rate for Payer: Healthscope Commercial |
$5.20
|
| Rate for Payer: Healthscope Whirlpool |
$5.04
|
| Rate for Payer: Mclaren Commercial |
$4.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.42
|
| Rate for Payer: Nomi Health Commercial |
$4.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4.58
|
|
|
HC INJ, VIT B12 CYANCOBALAMIN, UP TO 1000MCG
|
Facility
|
OP
|
$5.20
|
|
|
Service Code
|
CPT J3420
|
| Hospital Charge Code |
63600104
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.55 |
| Max. Negotiated Rate |
$5.20 |
| Rate for Payer: Aetna Commercial |
$4.68
|
| Rate for Payer: Aetna Medicare |
$2.60
|
| Rate for Payer: ASR ASR |
$5.04
|
| Rate for Payer: ASR Commercial |
$5.04
|
| Rate for Payer: BCBS Complete |
$2.08
|
| Rate for Payer: BCBS Trust/PPO |
$4.26
|
| Rate for Payer: BCN Commercial |
$4.03
|
| Rate for Payer: Cash Price |
$4.16
|
| Rate for Payer: Cash Price |
$4.16
|
| Rate for Payer: Cofinity Commercial |
$4.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.16
|
| Rate for Payer: Healthscope Commercial |
$5.20
|
| Rate for Payer: Healthscope Whirlpool |
$5.04
|
| Rate for Payer: Mclaren Commercial |
$4.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.42
|
| Rate for Payer: Nomi Health Commercial |
$4.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$0.69
|
| Rate for Payer: Priority Health Narrow Network |
$0.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4.58
|
|
|
HC INSECT VENOM ALLERGY PANEL
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200115
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$25.39 |
| Rate for Payer: Aetna Commercial |
$22.85
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: ASR ASR |
$24.63
|
| Rate for Payer: ASR Commercial |
$24.63
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$20.79
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$23.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$25.39
|
| Rate for Payer: Healthscope Whirlpool |
$24.63
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$22.85
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$5.74
|
| Rate for Payer: PHP Medicaid |
$2.80
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.25
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$17.80
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP DNSP |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.80
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC INSECT VENOM ALLERGY PANEL
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200115
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$25.39 |
| Rate for Payer: Aetna Commercial |
$22.85
|
| Rate for Payer: ASR ASR |
$24.63
|
| Rate for Payer: ASR Commercial |
$24.63
|
| Rate for Payer: BCBS Trust/PPO |
$20.69
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$23.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$25.39
|
| Rate for Payer: Healthscope Whirlpool |
$24.63
|
| Rate for Payer: Mclaren Commercial |
$22.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.34
|
|
|
HC INSERT CATH COMPLICATED
|
Facility
|
IP
|
$500.32
|
|
|
Service Code
|
CPT 51703
|
| Hospital Charge Code |
45000005
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$325.21 |
| Max. Negotiated Rate |
$500.32 |
| Rate for Payer: Aetna Commercial |
$450.29
|
| Rate for Payer: ASR ASR |
$485.31
|
| Rate for Payer: ASR Commercial |
$485.31
|
| Rate for Payer: BCBS Trust/PPO |
$407.71
|
| Rate for Payer: BCN Commercial |
$387.90
|
| Rate for Payer: Cash Price |
$400.26
|
| Rate for Payer: Cofinity Commercial |
$470.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$400.26
|
| Rate for Payer: Healthscope Commercial |
$500.32
|
| Rate for Payer: Healthscope Whirlpool |
$485.31
|
| Rate for Payer: Mclaren Commercial |
$450.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$425.27
|
| Rate for Payer: Nomi Health Commercial |
$410.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$325.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$440.28
|
|
|
HC INSERT CATH COMPLICATED
|
Facility
|
OP
|
$500.32
|
|
|
Service Code
|
CPT 51703
|
| Hospital Charge Code |
45000005
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$82.17 |
| Max. Negotiated Rate |
$500.32 |
| Rate for Payer: Aetna Commercial |
$450.29
|
| Rate for Payer: Aetna Medicare |
$153.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$191.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$191.62
|
| Rate for Payer: ASR ASR |
$485.31
|
| Rate for Payer: ASR Commercial |
$485.31
|
| Rate for Payer: BCBS Complete |
$86.28
|
| Rate for Payer: BCBS MAPPO |
$153.30
|
| Rate for Payer: BCBS Trust/PPO |
$409.71
|
| Rate for Payer: BCN Commercial |
$387.90
|
| Rate for Payer: BCN Medicare Advantage |
$153.30
|
| Rate for Payer: Cash Price |
$400.26
|
| Rate for Payer: Cash Price |
$400.26
|
| Rate for Payer: Cofinity Commercial |
$470.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$400.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.30
|
| Rate for Payer: Healthscope Commercial |
$500.32
|
| Rate for Payer: Healthscope Whirlpool |
$485.31
|
| Rate for Payer: Humana Choice PPO Medicare |
$153.30
|
| Rate for Payer: Mclaren Commercial |
$450.29
|
| Rate for Payer: Mclaren Medicaid |
$82.17
|
| Rate for Payer: Mclaren Medicare |
$153.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.96
|
| Rate for Payer: Meridian Medicaid |
$86.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$176.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$425.27
|
| Rate for Payer: Nomi Health Commercial |
$410.26
|
| Rate for Payer: PACE Medicare |
$145.64
|
| Rate for Payer: PACE SWMI |
$153.30
|
| Rate for Payer: PHP Commercial |
$168.63
|
| Rate for Payer: PHP Medicaid |
$82.17
|
| Rate for Payer: PHP Medicare Advantage |
$153.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$325.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$438.38
|
| Rate for Payer: Priority Health Medicare |
$153.30
|
| Rate for Payer: Priority Health Narrow Network |
$350.72
|
| Rate for Payer: Railroad Medicare Medicare |
$153.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$440.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.30
|
| Rate for Payer: UHC Exchange |
$237.62
|
| Rate for Payer: UHC Medicare Advantage |
$153.30
|
| Rate for Payer: UHCCP DNSP |
$153.30
|
| Rate for Payer: UHCCP Medicaid |
$82.17
|
| Rate for Payer: VA VA |
$153.30
|
|
|
HC INSERT CERVICAL DILATOR
|
Facility
|
IP
|
$423.24
|
|
|
Service Code
|
CPT 59200
|
| Hospital Charge Code |
36100397
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$275.11 |
| Max. Negotiated Rate |
$423.24 |
| Rate for Payer: Aetna Commercial |
$380.92
|
| Rate for Payer: ASR ASR |
$410.54
|
| Rate for Payer: ASR Commercial |
$410.54
|
| Rate for Payer: BCBS Trust/PPO |
$344.90
|
| Rate for Payer: BCN Commercial |
$328.14
|
| Rate for Payer: Cash Price |
$338.59
|
| Rate for Payer: Cofinity Commercial |
$397.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$338.59
|
| Rate for Payer: Healthscope Commercial |
$423.24
|
| Rate for Payer: Healthscope Whirlpool |
$410.54
|
| Rate for Payer: Mclaren Commercial |
$380.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$359.75
|
| Rate for Payer: Nomi Health Commercial |
$347.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$275.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$372.45
|
|
|
HC INSERT CERVICAL DILATOR
|
Facility
|
OP
|
$423.24
|
|
|
Service Code
|
CPT 59200
|
| Hospital Charge Code |
36100397
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$159.75 |
| Max. Negotiated Rate |
$461.96 |
| Rate for Payer: Aetna Commercial |
$380.92
|
| Rate for Payer: Aetna Medicare |
$298.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$372.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$372.55
|
| Rate for Payer: ASR ASR |
$410.54
|
| Rate for Payer: ASR Commercial |
$410.54
|
| Rate for Payer: BCBS Complete |
$167.74
|
| Rate for Payer: BCBS MAPPO |
$298.04
|
| Rate for Payer: BCBS Trust/PPO |
$346.59
|
| Rate for Payer: BCN Commercial |
$328.14
|
| Rate for Payer: BCN Medicare Advantage |
$298.04
|
| Rate for Payer: Cash Price |
$338.59
|
| Rate for Payer: Cash Price |
$338.59
|
| Rate for Payer: Cofinity Commercial |
$397.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$338.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$298.04
|
| Rate for Payer: Healthscope Commercial |
$423.24
|
| Rate for Payer: Healthscope Whirlpool |
$410.54
|
| Rate for Payer: Humana Choice PPO Medicare |
$298.04
|
| Rate for Payer: Mclaren Commercial |
$380.92
|
| Rate for Payer: Mclaren Medicaid |
$159.75
|
| Rate for Payer: Mclaren Medicare |
$298.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$312.94
|
| Rate for Payer: Meridian Medicaid |
$167.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$342.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$359.75
|
| Rate for Payer: Nomi Health Commercial |
$347.06
|
| Rate for Payer: PACE Medicare |
$283.14
|
| Rate for Payer: PACE SWMI |
$298.04
|
| Rate for Payer: PHP Commercial |
$327.84
|
| Rate for Payer: PHP Medicaid |
$159.75
|
| Rate for Payer: PHP Medicare Advantage |
$298.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$159.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$275.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$247.06
|
| Rate for Payer: Priority Health Medicare |
$298.04
|
| Rate for Payer: Priority Health Narrow Network |
$197.65
|
| Rate for Payer: Railroad Medicare Medicare |
$298.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$372.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$298.04
|
| Rate for Payer: UHC Exchange |
$461.96
|
| Rate for Payer: UHC Medicare Advantage |
$298.04
|
| Rate for Payer: UHCCP DNSP |
$298.04
|
| Rate for Payer: UHCCP Medicaid |
$159.75
|
| Rate for Payer: VA VA |
$298.04
|
|
|
HC INSERT EMERGENCY AIRWAY
|
Facility
|
OP
|
$576.31
|
|
|
Service Code
|
CPT 31500
|
| Hospital Charge Code |
45000012
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$121.95 |
| Max. Negotiated Rate |
$576.31 |
| Rate for Payer: Aetna Commercial |
$518.68
|
| Rate for Payer: Aetna Medicare |
$227.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$284.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$284.40
|
| Rate for Payer: ASR ASR |
$559.02
|
| Rate for Payer: ASR Commercial |
$559.02
|
| Rate for Payer: BCBS Complete |
$128.05
|
| Rate for Payer: BCBS MAPPO |
$227.52
|
| Rate for Payer: BCBS Trust/PPO |
$471.94
|
| Rate for Payer: BCN Commercial |
$446.81
|
| Rate for Payer: BCN Medicare Advantage |
$227.52
|
| Rate for Payer: Cash Price |
$461.05
|
| Rate for Payer: Cash Price |
$461.05
|
| Rate for Payer: Cofinity Commercial |
$541.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$461.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$227.52
|
| Rate for Payer: Healthscope Commercial |
$576.31
|
| Rate for Payer: Healthscope Whirlpool |
$559.02
|
| Rate for Payer: Humana Choice PPO Medicare |
$227.52
|
| Rate for Payer: Mclaren Commercial |
$518.68
|
| Rate for Payer: Mclaren Medicaid |
$121.95
|
| Rate for Payer: Mclaren Medicare |
$227.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$238.90
|
| Rate for Payer: Meridian Medicaid |
$128.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$261.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$489.86
|
| Rate for Payer: Nomi Health Commercial |
$472.57
|
| Rate for Payer: PACE Medicare |
$216.14
|
| Rate for Payer: PACE SWMI |
$227.52
|
| Rate for Payer: PHP Commercial |
$250.27
|
| Rate for Payer: PHP Medicaid |
$121.95
|
| Rate for Payer: PHP Medicare Advantage |
$227.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$121.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$374.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$428.78
|
| Rate for Payer: Priority Health Medicare |
$227.52
|
| Rate for Payer: Priority Health Narrow Network |
$343.02
|
| Rate for Payer: Railroad Medicare Medicare |
$227.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$507.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$227.52
|
| Rate for Payer: UHC Exchange |
$352.66
|
| Rate for Payer: UHC Medicare Advantage |
$227.52
|
| Rate for Payer: UHCCP DNSP |
$227.52
|
| Rate for Payer: UHCCP Medicaid |
$121.95
|
| Rate for Payer: VA VA |
$227.52
|
|
|
HC INSERT EMERGENCY AIRWAY
|
Facility
|
IP
|
$576.31
|
|
|
Service Code
|
CPT 31500
|
| Hospital Charge Code |
45000012
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$374.60 |
| Max. Negotiated Rate |
$576.31 |
| Rate for Payer: Aetna Commercial |
$518.68
|
| Rate for Payer: ASR ASR |
$559.02
|
| Rate for Payer: ASR Commercial |
$559.02
|
| Rate for Payer: BCBS Trust/PPO |
$469.64
|
| Rate for Payer: BCN Commercial |
$446.81
|
| Rate for Payer: Cash Price |
$461.05
|
| Rate for Payer: Cofinity Commercial |
$541.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$461.05
|
| Rate for Payer: Healthscope Commercial |
$576.31
|
| Rate for Payer: Healthscope Whirlpool |
$559.02
|
| Rate for Payer: Mclaren Commercial |
$518.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$489.86
|
| Rate for Payer: Nomi Health Commercial |
$472.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$374.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$507.15
|
|
|
HC INSERT INDWELLING CATH
|
Facility
|
IP
|
$199.25
|
|
|
Service Code
|
CPT 51702
|
| Hospital Charge Code |
45000004
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$129.51 |
| Max. Negotiated Rate |
$199.25 |
| Rate for Payer: Aetna Commercial |
$179.32
|
| Rate for Payer: ASR ASR |
$193.27
|
| Rate for Payer: ASR Commercial |
$193.27
|
| Rate for Payer: BCBS Trust/PPO |
$162.37
|
| Rate for Payer: BCN Commercial |
$154.48
|
| Rate for Payer: Cash Price |
$159.40
|
| Rate for Payer: Cofinity Commercial |
$187.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$159.40
|
| Rate for Payer: Healthscope Commercial |
$199.25
|
| Rate for Payer: Healthscope Whirlpool |
$193.27
|
| Rate for Payer: Mclaren Commercial |
$179.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$169.36
|
| Rate for Payer: Nomi Health Commercial |
$163.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$129.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$175.34
|
|
|
HC INSERT INDWELLING CATH
|
Facility
|
OP
|
$199.25
|
|
|
Service Code
|
CPT 51702
|
| Hospital Charge Code |
45000004
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$67.69 |
| Max. Negotiated Rate |
$199.25 |
| Rate for Payer: Aetna Commercial |
$179.32
|
| Rate for Payer: Aetna Medicare |
$126.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.86
|
| Rate for Payer: ASR ASR |
$193.27
|
| Rate for Payer: ASR Commercial |
$193.27
|
| Rate for Payer: BCBS Complete |
$71.08
|
| Rate for Payer: BCBS MAPPO |
$126.29
|
| Rate for Payer: BCBS Trust/PPO |
$163.17
|
| Rate for Payer: BCN Commercial |
$154.48
|
| Rate for Payer: BCN Medicare Advantage |
$126.29
|
| Rate for Payer: Cash Price |
$159.40
|
| Rate for Payer: Cash Price |
$159.40
|
| Rate for Payer: Cofinity Commercial |
$187.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$159.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.29
|
| Rate for Payer: Healthscope Commercial |
$199.25
|
| Rate for Payer: Healthscope Whirlpool |
$193.27
|
| Rate for Payer: Humana Choice PPO Medicare |
$126.29
|
| Rate for Payer: Mclaren Commercial |
$179.32
|
| Rate for Payer: Mclaren Medicaid |
$67.69
|
| Rate for Payer: Mclaren Medicare |
$126.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.60
|
| Rate for Payer: Meridian Medicaid |
$71.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$145.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$169.36
|
| Rate for Payer: Nomi Health Commercial |
$163.38
|
| Rate for Payer: PACE Medicare |
$119.98
|
| Rate for Payer: PACE SWMI |
$126.29
|
| Rate for Payer: PHP Commercial |
$138.92
|
| Rate for Payer: PHP Medicaid |
$67.69
|
| Rate for Payer: PHP Medicare Advantage |
$126.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$129.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$91.13
|
| Rate for Payer: Priority Health Medicare |
$126.29
|
| Rate for Payer: Priority Health Narrow Network |
$72.90
|
| Rate for Payer: Railroad Medicare Medicare |
$126.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$175.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$126.29
|
| Rate for Payer: UHC Exchange |
$195.75
|
| Rate for Payer: UHC Medicare Advantage |
$126.29
|
| Rate for Payer: UHCCP DNSP |
$126.29
|
| Rate for Payer: UHCCP Medicaid |
$67.69
|
| Rate for Payer: VA VA |
$126.29
|
|
|
HC INSERT INFUSION PUMP
|
Facility
|
OP
|
$1,073.45
|
|
| Hospital Charge Code |
36100438
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$429.38 |
| Max. Negotiated Rate |
$1,073.45 |
| Rate for Payer: Aetna Commercial |
$966.10
|
| Rate for Payer: Aetna Medicare |
$536.72
|
| Rate for Payer: ASR ASR |
$1,041.25
|
| Rate for Payer: ASR Commercial |
$1,041.25
|
| Rate for Payer: BCBS Complete |
$429.38
|
| Rate for Payer: BCBS Trust/PPO |
$879.05
|
| Rate for Payer: BCN Commercial |
$832.25
|
| Rate for Payer: Cash Price |
$858.76
|
| Rate for Payer: Cofinity Commercial |
$1,009.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$858.76
|
| Rate for Payer: Healthscope Commercial |
$1,073.45
|
| Rate for Payer: Healthscope Whirlpool |
$1,041.25
|
| Rate for Payer: Mclaren Commercial |
$966.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$912.43
|
| Rate for Payer: Nomi Health Commercial |
$880.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$697.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$940.56
|
| Rate for Payer: Priority Health Narrow Network |
$752.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$944.64
|
|
|
HC INSERT INFUSION PUMP
|
Facility
|
IP
|
$1,073.45
|
|
| Hospital Charge Code |
36100438
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$697.74 |
| Max. Negotiated Rate |
$1,073.45 |
| Rate for Payer: Aetna Commercial |
$966.10
|
| Rate for Payer: ASR ASR |
$1,041.25
|
| Rate for Payer: ASR Commercial |
$1,041.25
|
| Rate for Payer: BCBS Trust/PPO |
$874.75
|
| Rate for Payer: BCN Commercial |
$832.25
|
| Rate for Payer: Cash Price |
$858.76
|
| Rate for Payer: Cofinity Commercial |
$1,009.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$858.76
|
| Rate for Payer: Healthscope Commercial |
$1,073.45
|
| Rate for Payer: Healthscope Whirlpool |
$1,041.25
|
| Rate for Payer: Mclaren Commercial |
$966.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$912.43
|
| Rate for Payer: Nomi Health Commercial |
$880.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$697.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$944.64
|
|
