|
HC LA/CS PACING + RECORDING
|
Facility
|
OP
|
$1,587.03
|
|
|
Service Code
|
CPT 93621
|
| Hospital Charge Code |
48100038
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$587.20 |
| Max. Negotiated Rate |
$1,587.03 |
| Rate for Payer: Aetna Commercial |
$1,428.33
|
| Rate for Payer: Aetna Medicare |
$587.20
|
| Rate for Payer: ASR ASR |
$1,539.42
|
| Rate for Payer: BCBS Complete |
$634.81
|
| Rate for Payer: BCBS Trust/PPO |
$1,308.51
|
| Rate for Payer: BCN Commercial |
$1,308.51
|
| Rate for Payer: Cash Price |
$1,269.62
|
| Rate for Payer: Cofinity Commercial |
$1,491.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,269.62
|
| Rate for Payer: Healthscope Commercial |
$1,539.42
|
| Rate for Payer: Healthscope Whirlpool |
$1,587.03
|
| Rate for Payer: Mclaren Commercial |
$1,428.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,269.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,348.98
|
| Rate for Payer: Nomi Health Commercial |
$1,301.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,190.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,390.56
|
| Rate for Payer: Priority Health Narrow Network |
$1,112.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,396.59
|
|
|
HC LA/CS PACING + RECORDING
|
Facility
|
IP
|
$1,587.03
|
|
|
Service Code
|
CPT 93621
|
| Hospital Charge Code |
48100038
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,190.27 |
| Max. Negotiated Rate |
$1,587.03 |
| Rate for Payer: Aetna Commercial |
$1,428.33
|
| Rate for Payer: ASR ASR |
$1,539.42
|
| Rate for Payer: BCBS Trust/PPO |
$1,303.27
|
| Rate for Payer: BCN Commercial |
$1,303.27
|
| Rate for Payer: Cash Price |
$1,269.62
|
| Rate for Payer: Cofinity Commercial |
$1,491.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,269.62
|
| Rate for Payer: Healthscope Commercial |
$1,539.42
|
| Rate for Payer: Healthscope Whirlpool |
$1,587.03
|
| Rate for Payer: Mclaren Commercial |
$1,428.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,348.98
|
| Rate for Payer: Nomi Health Commercial |
$1,301.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,190.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,396.59
|
|
|
HC LACTATE DEHYDROGENASE
|
Facility
|
IP
|
$22.64
|
|
|
Service Code
|
CPT 83615
|
| Hospital Charge Code |
30100272
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.98 |
| Max. Negotiated Rate |
$22.64 |
| Rate for Payer: Aetna Commercial |
$20.38
|
| Rate for Payer: ASR ASR |
$21.96
|
| Rate for Payer: BCBS Trust/PPO |
$18.59
|
| Rate for Payer: BCN Commercial |
$18.59
|
| Rate for Payer: Cash Price |
$18.11
|
| Rate for Payer: Cofinity Commercial |
$21.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.11
|
| Rate for Payer: Healthscope Commercial |
$21.96
|
| Rate for Payer: Healthscope Whirlpool |
$22.64
|
| Rate for Payer: Mclaren Commercial |
$20.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.24
|
| Rate for Payer: Nomi Health Commercial |
$18.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19.92
|
|
|
HC LACTATE DEHYDROGENASE
|
Facility
|
OP
|
$22.64
|
|
|
Service Code
|
CPT 83615
|
| Hospital Charge Code |
30100272
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.16 |
| Max. Negotiated Rate |
$22.64 |
| Rate for Payer: Aetna Commercial |
$20.38
|
| Rate for Payer: Aetna Medicare |
$6.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.55
|
| Rate for Payer: ASR ASR |
$21.96
|
| Rate for Payer: BCBS Complete |
$3.32
|
| Rate for Payer: BCBS MAPPO |
$6.04
|
| Rate for Payer: BCBS Trust/PPO |
$18.67
|
| Rate for Payer: BCN Commercial |
$18.67
|
| Rate for Payer: BCN Medicare Advantage |
$6.04
|
| Rate for Payer: Cash Price |
$18.11
|
| Rate for Payer: Cash Price |
$18.11
|
| Rate for Payer: Cofinity Commercial |
$21.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.04
|
| Rate for Payer: Healthscope Commercial |
$21.96
|
| Rate for Payer: Healthscope Whirlpool |
$22.64
|
| Rate for Payer: Humana Choice PPO Medicare |
$6.04
|
| Rate for Payer: Mclaren Commercial |
$20.38
|
| Rate for Payer: Mclaren Medicaid |
$6.04
|
| Rate for Payer: Mclaren Medicare |
$6.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.34
|
| Rate for Payer: Meridian Medicaid |
$3.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.24
|
| Rate for Payer: Nomi Health Commercial |
$18.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.98
|
| Rate for Payer: PACE Medicare |
$5.74
|
| Rate for Payer: PACE SWMI |
$6.04
|
| Rate for Payer: PHP Commercial |
$6.64
|
| Rate for Payer: PHP Medicaid |
$3.24
|
| Rate for Payer: PHP Medicare Advantage |
$6.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$22.40
|
| Rate for Payer: Priority Health Medicare |
$6.04
|
| Rate for Payer: Priority Health Narrow Network |
$17.92
|
| Rate for Payer: Railroad Medicare Medicare |
$6.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6.04
|
| Rate for Payer: UHC Exchange |
$9.36
|
| Rate for Payer: UHC Medicaid |
$3.16
|
| Rate for Payer: UHCCP DNSP |
$6.04
|
| Rate for Payer: UHCCP Medicaid |
$3.16
|
| Rate for Payer: VA VA |
$6.04
|
|
|
HC LACTATE LACTIC ACID
|
Facility
|
OP
|
$60.49
|
|
|
Service Code
|
CPT 83605
|
| Hospital Charge Code |
30100270
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.05 |
| Max. Negotiated Rate |
$76.27 |
| Rate for Payer: Aetna Commercial |
$54.44
|
| Rate for Payer: Aetna Medicare |
$11.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.46
|
| Rate for Payer: ASR ASR |
$58.68
|
| Rate for Payer: BCBS Complete |
$6.35
|
| Rate for Payer: BCBS MAPPO |
$11.57
|
| Rate for Payer: BCBS Trust/PPO |
$49.87
|
| Rate for Payer: BCN Commercial |
$49.87
|
| Rate for Payer: BCN Medicare Advantage |
$11.57
|
| Rate for Payer: Cash Price |
$48.39
|
| Rate for Payer: Cash Price |
$48.39
|
| Rate for Payer: Cofinity Commercial |
$56.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.57
|
| Rate for Payer: Healthscope Commercial |
$58.68
|
| Rate for Payer: Healthscope Whirlpool |
$60.49
|
| Rate for Payer: Humana Choice PPO Medicare |
$11.57
|
| Rate for Payer: Mclaren Commercial |
$54.44
|
| Rate for Payer: Mclaren Medicaid |
$11.57
|
| Rate for Payer: Mclaren Medicare |
$11.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.15
|
| Rate for Payer: Meridian Medicaid |
$6.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51.42
|
| Rate for Payer: Nomi Health Commercial |
$49.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$45.37
|
| Rate for Payer: PACE Medicare |
$10.99
|
| Rate for Payer: PACE SWMI |
$11.57
|
| Rate for Payer: PHP Commercial |
$12.73
|
| Rate for Payer: PHP Medicaid |
$6.20
|
| Rate for Payer: PHP Medicare Advantage |
$11.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$76.27
|
| Rate for Payer: Priority Health Medicare |
$11.57
|
| Rate for Payer: Priority Health Narrow Network |
$61.02
|
| Rate for Payer: Railroad Medicare Medicare |
$11.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$53.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11.57
|
| Rate for Payer: UHC Exchange |
$17.93
|
| Rate for Payer: UHC Medicaid |
$6.05
|
| Rate for Payer: UHCCP DNSP |
$11.57
|
| Rate for Payer: UHCCP Medicaid |
$6.05
|
| Rate for Payer: VA VA |
$11.57
|
|
|
HC LACTATE LACTIC ACID
|
Facility
|
IP
|
$60.49
|
|
|
Service Code
|
CPT 83605
|
| Hospital Charge Code |
30100270
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$45.37 |
| Max. Negotiated Rate |
$60.49 |
| Rate for Payer: Aetna Commercial |
$54.44
|
| Rate for Payer: ASR ASR |
$58.68
|
| Rate for Payer: BCBS Trust/PPO |
$49.67
|
| Rate for Payer: BCN Commercial |
$49.67
|
| Rate for Payer: Cash Price |
$48.39
|
| Rate for Payer: Cofinity Commercial |
$56.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.39
|
| Rate for Payer: Healthscope Commercial |
$58.68
|
| Rate for Payer: Healthscope Whirlpool |
$60.49
|
| Rate for Payer: Mclaren Commercial |
$54.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51.42
|
| Rate for Payer: Nomi Health Commercial |
$49.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$45.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$53.23
|
|
|
HC LACTOSE TOLERANCE
|
Facility
|
IP
|
$95.93
|
|
|
Service Code
|
CPT 82951
|
| Hospital Charge Code |
30100226
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$71.95 |
| Max. Negotiated Rate |
$95.93 |
| Rate for Payer: Aetna Commercial |
$86.34
|
| Rate for Payer: ASR ASR |
$93.05
|
| Rate for Payer: BCBS Trust/PPO |
$78.78
|
| Rate for Payer: BCN Commercial |
$78.78
|
| Rate for Payer: Cash Price |
$76.74
|
| Rate for Payer: Cofinity Commercial |
$90.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.74
|
| Rate for Payer: Healthscope Commercial |
$93.05
|
| Rate for Payer: Healthscope Whirlpool |
$95.93
|
| Rate for Payer: Mclaren Commercial |
$86.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.54
|
| Rate for Payer: Nomi Health Commercial |
$78.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$71.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$84.42
|
|
|
HC LACTOSE TOLERANCE
|
Facility
|
OP
|
$95.93
|
|
|
Service Code
|
CPT 82951
|
| Hospital Charge Code |
30100226
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.73 |
| Max. Negotiated Rate |
$95.93 |
| Rate for Payer: Aetna Commercial |
$86.34
|
| Rate for Payer: Aetna Medicare |
$12.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.09
|
| Rate for Payer: ASR ASR |
$93.05
|
| Rate for Payer: BCBS Complete |
$7.07
|
| Rate for Payer: BCBS MAPPO |
$12.87
|
| Rate for Payer: BCBS Trust/PPO |
$79.09
|
| Rate for Payer: BCN Commercial |
$79.09
|
| Rate for Payer: BCN Medicare Advantage |
$12.87
|
| Rate for Payer: Cash Price |
$76.74
|
| Rate for Payer: Cash Price |
$76.74
|
| Rate for Payer: Cofinity Commercial |
$90.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.87
|
| Rate for Payer: Healthscope Commercial |
$93.05
|
| Rate for Payer: Healthscope Whirlpool |
$95.93
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.87
|
| Rate for Payer: Mclaren Commercial |
$86.34
|
| Rate for Payer: Mclaren Medicaid |
$12.87
|
| Rate for Payer: Mclaren Medicare |
$12.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.51
|
| Rate for Payer: Meridian Medicaid |
$7.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.54
|
| Rate for Payer: Nomi Health Commercial |
$78.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$71.95
|
| Rate for Payer: PACE Medicare |
$12.23
|
| Rate for Payer: PACE SWMI |
$12.87
|
| Rate for Payer: PHP Commercial |
$14.16
|
| Rate for Payer: PHP Medicaid |
$6.90
|
| Rate for Payer: PHP Medicare Advantage |
$12.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$46.00
|
| Rate for Payer: Priority Health Medicare |
$12.87
|
| Rate for Payer: Priority Health Narrow Network |
$36.80
|
| Rate for Payer: Railroad Medicare Medicare |
$12.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$84.42
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.87
|
| Rate for Payer: UHC Exchange |
$19.95
|
| Rate for Payer: UHC Medicaid |
$6.73
|
| Rate for Payer: UHCCP DNSP |
$12.87
|
| Rate for Payer: UHCCP Medicaid |
$6.73
|
| Rate for Payer: VA VA |
$12.87
|
|
|
HC LAMBDA FREE LIGHT CHAIN SERUM
|
Facility
|
IP
|
$78.97
|
|
|
Service Code
|
CPT 83521
|
| Hospital Charge Code |
30100308
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$59.23 |
| Max. Negotiated Rate |
$78.97 |
| Rate for Payer: Aetna Commercial |
$71.07
|
| Rate for Payer: ASR ASR |
$76.60
|
| Rate for Payer: BCBS Trust/PPO |
$64.85
|
| Rate for Payer: BCN Commercial |
$64.85
|
| Rate for Payer: Cash Price |
$63.18
|
| Rate for Payer: Cofinity Commercial |
$74.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.18
|
| Rate for Payer: Healthscope Commercial |
$76.60
|
| Rate for Payer: Healthscope Whirlpool |
$78.97
|
| Rate for Payer: Mclaren Commercial |
$71.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.12
|
| Rate for Payer: Nomi Health Commercial |
$64.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$69.49
|
|
|
HC LAMBDA FREE LIGHT CHAIN SERUM
|
Facility
|
OP
|
$78.97
|
|
|
Service Code
|
CPT 83521
|
| Hospital Charge Code |
30100308
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.03 |
| Max. Negotiated Rate |
$78.97 |
| Rate for Payer: Aetna Commercial |
$71.07
|
| Rate for Payer: Aetna Medicare |
$17.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.59
|
| Rate for Payer: ASR ASR |
$76.60
|
| Rate for Payer: BCBS Complete |
$9.48
|
| Rate for Payer: BCBS MAPPO |
$17.27
|
| Rate for Payer: BCBS Trust/PPO |
$65.11
|
| Rate for Payer: BCN Commercial |
$65.11
|
| Rate for Payer: BCN Medicare Advantage |
$17.27
|
| Rate for Payer: Cash Price |
$63.18
|
| Rate for Payer: Cash Price |
$63.18
|
| Rate for Payer: Cofinity Commercial |
$74.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.27
|
| Rate for Payer: Healthscope Commercial |
$76.60
|
| Rate for Payer: Healthscope Whirlpool |
$78.97
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.27
|
| Rate for Payer: Mclaren Commercial |
$71.07
|
| Rate for Payer: Mclaren Medicaid |
$17.27
|
| Rate for Payer: Mclaren Medicare |
$17.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.13
|
| Rate for Payer: Meridian Medicaid |
$9.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.12
|
| Rate for Payer: Nomi Health Commercial |
$64.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.23
|
| Rate for Payer: PACE Medicare |
$16.41
|
| Rate for Payer: PACE SWMI |
$17.27
|
| Rate for Payer: PHP Commercial |
$19.00
|
| Rate for Payer: PHP Medicaid |
$9.26
|
| Rate for Payer: PHP Medicare Advantage |
$17.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$69.19
|
| Rate for Payer: Priority Health Medicare |
$17.27
|
| Rate for Payer: Priority Health Narrow Network |
$55.36
|
| Rate for Payer: Railroad Medicare Medicare |
$17.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$69.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17.27
|
| Rate for Payer: UHC Exchange |
$26.77
|
| Rate for Payer: UHC Medicaid |
$9.03
|
| Rate for Payer: UHCCP DNSP |
$17.27
|
| Rate for Payer: UHCCP Medicaid |
$9.03
|
| Rate for Payer: VA VA |
$17.27
|
|
|
HC LAMBS QUARTERS IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200091
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$25.90 |
| Rate for Payer: Aetna Commercial |
$23.31
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: ASR ASR |
$25.12
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$21.35
|
| Rate for Payer: BCN Commercial |
$21.35
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$24.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$25.12
|
| Rate for Payer: Healthscope Whirlpool |
$25.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$23.31
|
| Rate for Payer: Mclaren Medicaid |
$5.22
|
| 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 |
$2.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| 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 |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$22.69
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$18.16
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP DNSP |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC LAMBS QUARTERS IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200091
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.43 |
| Max. Negotiated Rate |
$25.90 |
| Rate for Payer: Aetna Commercial |
$23.31
|
| Rate for Payer: ASR ASR |
$25.12
|
| Rate for Payer: BCBS Trust/PPO |
$21.27
|
| Rate for Payer: BCN Commercial |
$21.27
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$24.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$25.12
|
| Rate for Payer: Healthscope Whirlpool |
$25.90
|
| Rate for Payer: Mclaren Commercial |
$23.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.79
|
|
|
HC LAMELLAR BODY COUNT AMNIOTIC
|
Facility
|
OP
|
$72.83
|
|
|
Service Code
|
CPT 83664
|
| Hospital Charge Code |
30100278
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.10 |
| Max. Negotiated Rate |
$72.83 |
| Rate for Payer: Aetna Commercial |
$65.55
|
| Rate for Payer: Aetna Medicare |
$19.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.15
|
| Rate for Payer: ASR ASR |
$70.65
|
| Rate for Payer: BCBS Complete |
$10.61
|
| Rate for Payer: BCBS MAPPO |
$19.32
|
| Rate for Payer: BCBS Trust/PPO |
$60.05
|
| Rate for Payer: BCN Commercial |
$60.05
|
| Rate for Payer: BCN Medicare Advantage |
$19.32
|
| Rate for Payer: Cash Price |
$58.26
|
| Rate for Payer: Cash Price |
$58.26
|
| Rate for Payer: Cofinity Commercial |
$68.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.32
|
| Rate for Payer: Healthscope Commercial |
$70.65
|
| Rate for Payer: Healthscope Whirlpool |
$72.83
|
| Rate for Payer: Humana Choice PPO Medicare |
$19.32
|
| Rate for Payer: Mclaren Commercial |
$65.55
|
| Rate for Payer: Mclaren Medicaid |
$19.32
|
| Rate for Payer: Mclaren Medicare |
$19.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.29
|
| Rate for Payer: Meridian Medicaid |
$10.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$21.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.91
|
| Rate for Payer: Nomi Health Commercial |
$59.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.62
|
| Rate for Payer: PACE Medicare |
$18.35
|
| Rate for Payer: PACE SWMI |
$19.32
|
| Rate for Payer: PHP Commercial |
$21.25
|
| Rate for Payer: PHP Medicaid |
$10.36
|
| Rate for Payer: PHP Medicare Advantage |
$19.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$63.81
|
| Rate for Payer: Priority Health Medicare |
$19.32
|
| Rate for Payer: Priority Health Narrow Network |
$51.05
|
| Rate for Payer: Railroad Medicare Medicare |
$19.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$64.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$19.32
|
| Rate for Payer: UHC Exchange |
$29.95
|
| Rate for Payer: UHC Medicaid |
$10.10
|
| Rate for Payer: UHCCP DNSP |
$19.32
|
| Rate for Payer: UHCCP Medicaid |
$10.10
|
| Rate for Payer: VA VA |
$19.32
|
|
|
HC LAMELLAR BODY COUNT AMNIOTIC
|
Facility
|
IP
|
$72.83
|
|
|
Service Code
|
CPT 83664
|
| Hospital Charge Code |
30100278
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$54.62 |
| Max. Negotiated Rate |
$72.83 |
| Rate for Payer: Aetna Commercial |
$65.55
|
| Rate for Payer: ASR ASR |
$70.65
|
| Rate for Payer: BCBS Trust/PPO |
$59.81
|
| Rate for Payer: BCN Commercial |
$59.81
|
| Rate for Payer: Cash Price |
$58.26
|
| Rate for Payer: Cofinity Commercial |
$68.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.26
|
| Rate for Payer: Healthscope Commercial |
$70.65
|
| Rate for Payer: Healthscope Whirlpool |
$72.83
|
| Rate for Payer: Mclaren Commercial |
$65.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.91
|
| Rate for Payer: Nomi Health Commercial |
$59.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$64.09
|
|
|
HC LAMICTAL LEVEL
|
Facility
|
OP
|
$55.18
|
|
|
Service Code
|
CPT 80175
|
| Hospital Charge Code |
30100054
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.93 |
| Max. Negotiated Rate |
$55.18 |
| Rate for Payer: Aetna Commercial |
$49.66
|
| Rate for Payer: Aetna Medicare |
$13.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.56
|
| Rate for Payer: ASR ASR |
$53.52
|
| Rate for Payer: BCBS Complete |
$7.28
|
| Rate for Payer: BCBS MAPPO |
$13.25
|
| Rate for Payer: BCBS Trust/PPO |
$45.50
|
| Rate for Payer: BCN Commercial |
$45.50
|
| Rate for Payer: BCN Medicare Advantage |
$13.25
|
| Rate for Payer: Cash Price |
$44.14
|
| Rate for Payer: Cash Price |
$44.14
|
| Rate for Payer: Cofinity Commercial |
$51.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.25
|
| Rate for Payer: Healthscope Commercial |
$53.52
|
| Rate for Payer: Healthscope Whirlpool |
$55.18
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.25
|
| Rate for Payer: Mclaren Commercial |
$49.66
|
| Rate for Payer: Mclaren Medicaid |
$13.25
|
| Rate for Payer: Mclaren Medicare |
$13.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.91
|
| Rate for Payer: Meridian Medicaid |
$7.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.90
|
| Rate for Payer: Nomi Health Commercial |
$45.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.38
|
| Rate for Payer: PACE Medicare |
$12.59
|
| Rate for Payer: PACE SWMI |
$13.25
|
| Rate for Payer: PHP Commercial |
$14.57
|
| Rate for Payer: PHP Medicaid |
$7.10
|
| Rate for Payer: PHP Medicare Advantage |
$13.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$22.85
|
| Rate for Payer: Priority Health Medicare |
$13.25
|
| Rate for Payer: Priority Health Narrow Network |
$18.28
|
| Rate for Payer: Railroad Medicare Medicare |
$13.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$48.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.25
|
| Rate for Payer: UHC Exchange |
$20.54
|
| Rate for Payer: UHC Medicaid |
$6.93
|
| Rate for Payer: UHCCP DNSP |
$13.25
|
| Rate for Payer: UHCCP Medicaid |
$6.93
|
| Rate for Payer: VA VA |
$13.25
|
|
|
HC LAMICTAL LEVEL
|
Facility
|
IP
|
$55.18
|
|
|
Service Code
|
CPT 80175
|
| Hospital Charge Code |
30100054
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$41.38 |
| Max. Negotiated Rate |
$55.18 |
| Rate for Payer: Aetna Commercial |
$49.66
|
| Rate for Payer: ASR ASR |
$53.52
|
| Rate for Payer: BCBS Trust/PPO |
$45.31
|
| Rate for Payer: BCN Commercial |
$45.31
|
| Rate for Payer: Cash Price |
$44.14
|
| Rate for Payer: Cofinity Commercial |
$51.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.14
|
| Rate for Payer: Healthscope Commercial |
$53.52
|
| Rate for Payer: Healthscope Whirlpool |
$55.18
|
| Rate for Payer: Mclaren Commercial |
$49.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.90
|
| Rate for Payer: Nomi Health Commercial |
$45.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$48.56
|
|
|
HC LARGSC W/NJX VOCAL CORD THER W/MICRO/TELESCOPE
|
Facility
|
IP
|
$10,689.60
|
|
|
Service Code
|
CPT 31571
|
| Hospital Charge Code |
76100432
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$8,017.20 |
| Max. Negotiated Rate |
$10,689.60 |
| Rate for Payer: Aetna Commercial |
$9,620.64
|
| Rate for Payer: ASR ASR |
$10,368.91
|
| Rate for Payer: BCBS Trust/PPO |
$8,778.30
|
| Rate for Payer: BCN Commercial |
$8,778.30
|
| Rate for Payer: Cash Price |
$8,551.68
|
| Rate for Payer: Cofinity Commercial |
$10,048.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,551.68
|
| Rate for Payer: Healthscope Commercial |
$10,368.91
|
| Rate for Payer: Healthscope Whirlpool |
$10,689.60
|
| Rate for Payer: Mclaren Commercial |
$9,620.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,086.16
|
| Rate for Payer: Nomi Health Commercial |
$8,765.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,017.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9,406.85
|
|
|
HC LARGSC W/NJX VOCAL CORD THER W/MICRO/TELESCOPE
|
Facility
|
OP
|
$10,689.60
|
|
|
Service Code
|
CPT 31571
|
| Hospital Charge Code |
76100432
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,942.91 |
| Max. Negotiated Rate |
$10,689.60 |
| Rate for Payer: Aetna Commercial |
$9,620.64
|
| Rate for Payer: Aetna Medicare |
$3,714.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,643.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,643.68
|
| Rate for Payer: ASR ASR |
$10,368.91
|
| Rate for Payer: BCBS Complete |
$2,040.25
|
| Rate for Payer: BCBS MAPPO |
$3,714.94
|
| Rate for Payer: BCBS Trust/PPO |
$8,813.58
|
| Rate for Payer: BCN Commercial |
$8,813.58
|
| Rate for Payer: BCN Medicare Advantage |
$3,714.94
|
| Rate for Payer: Cash Price |
$8,551.68
|
| Rate for Payer: Cash Price |
$8,551.68
|
| Rate for Payer: Cofinity Commercial |
$10,048.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,551.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,714.94
|
| Rate for Payer: Healthscope Commercial |
$10,368.91
|
| Rate for Payer: Healthscope Whirlpool |
$10,689.60
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,714.94
|
| Rate for Payer: Mclaren Commercial |
$9,620.64
|
| Rate for Payer: Mclaren Medicaid |
$3,714.94
|
| Rate for Payer: Mclaren Medicare |
$3,714.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,900.69
|
| Rate for Payer: Meridian Medicaid |
$2,040.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,272.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$4,086.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,086.16
|
| Rate for Payer: Nomi Health Commercial |
$8,765.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,017.20
|
| Rate for Payer: PACE Medicare |
$3,529.19
|
| Rate for Payer: PACE SWMI |
$3,714.94
|
| Rate for Payer: PHP Commercial |
$4,086.43
|
| Rate for Payer: PHP Medicaid |
$1,991.21
|
| Rate for Payer: PHP Medicare Advantage |
$3,714.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,942.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$9,366.23
|
| Rate for Payer: Priority Health Medicare |
$3,714.94
|
| Rate for Payer: Priority Health Narrow Network |
$7,493.41
|
| Rate for Payer: Railroad Medicare Medicare |
$3,714.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9,406.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,714.94
|
| Rate for Payer: UHC Exchange |
$5,758.16
|
| Rate for Payer: UHC Medicaid |
$1,942.91
|
| Rate for Payer: UHCCP DNSP |
$3,714.94
|
| Rate for Payer: UHCCP Medicaid |
$1,942.91
|
| Rate for Payer: VA VA |
$3,714.94
|
|
|
HC LA RO SSB SJOGRENS AB
|
Facility
|
IP
|
$35.87
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200160
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$26.90 |
| Max. Negotiated Rate |
$35.87 |
| Rate for Payer: Aetna Commercial |
$32.28
|
| Rate for Payer: ASR ASR |
$34.79
|
| Rate for Payer: BCBS Trust/PPO |
$29.46
|
| Rate for Payer: BCN Commercial |
$29.46
|
| Rate for Payer: Cash Price |
$28.70
|
| Rate for Payer: Cofinity Commercial |
$33.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.70
|
| Rate for Payer: Healthscope Commercial |
$34.79
|
| Rate for Payer: Healthscope Whirlpool |
$35.87
|
| Rate for Payer: Mclaren Commercial |
$32.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.49
|
| Rate for Payer: Nomi Health Commercial |
$29.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$31.57
|
|
|
HC LA RO SSB SJOGRENS AB
|
Facility
|
OP
|
$35.87
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200160
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.38 |
| Max. Negotiated Rate |
$169.49 |
| Rate for Payer: Aetna Commercial |
$32.28
|
| Rate for Payer: Aetna Medicare |
$17.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.41
|
| Rate for Payer: ASR ASR |
$34.79
|
| Rate for Payer: BCBS Complete |
$9.85
|
| Rate for Payer: BCBS MAPPO |
$17.93
|
| Rate for Payer: BCBS Trust/PPO |
$29.57
|
| Rate for Payer: BCN Commercial |
$29.57
|
| Rate for Payer: BCN Medicare Advantage |
$17.93
|
| Rate for Payer: Cash Price |
$28.70
|
| Rate for Payer: Cash Price |
$28.70
|
| Rate for Payer: Cofinity Commercial |
$33.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.93
|
| Rate for Payer: Healthscope Commercial |
$34.79
|
| Rate for Payer: Healthscope Whirlpool |
$35.87
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.93
|
| Rate for Payer: Mclaren Commercial |
$32.28
|
| Rate for Payer: Mclaren Medicaid |
$17.93
|
| Rate for Payer: Mclaren Medicare |
$17.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.83
|
| Rate for Payer: Meridian Medicaid |
$9.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.49
|
| Rate for Payer: Nomi Health Commercial |
$29.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.90
|
| Rate for Payer: PACE Medicare |
$17.03
|
| Rate for Payer: PACE SWMI |
$17.93
|
| Rate for Payer: PHP Commercial |
$19.72
|
| Rate for Payer: PHP Medicaid |
$9.61
|
| Rate for Payer: PHP Medicare Advantage |
$17.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$169.49
|
| Rate for Payer: Priority Health Medicare |
$17.93
|
| Rate for Payer: Priority Health Narrow Network |
$135.59
|
| Rate for Payer: Railroad Medicare Medicare |
$17.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$31.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17.93
|
| Rate for Payer: UHC Exchange |
$27.79
|
| Rate for Payer: UHC Medicaid |
$9.38
|
| Rate for Payer: UHCCP DNSP |
$17.93
|
| Rate for Payer: UHCCP Medicaid |
$9.38
|
| Rate for Payer: VA VA |
$17.93
|
|
|
HC LARYNGOSCOPY
|
Facility
|
IP
|
$2,616.10
|
|
| Hospital Charge Code |
36000113
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,962.08 |
| Max. Negotiated Rate |
$2,616.10 |
| Rate for Payer: Aetna Commercial |
$2,354.49
|
| Rate for Payer: ASR ASR |
$2,537.62
|
| Rate for Payer: BCBS Trust/PPO |
$2,148.34
|
| Rate for Payer: BCN Commercial |
$2,148.34
|
| Rate for Payer: Cash Price |
$2,092.88
|
| Rate for Payer: Cofinity Commercial |
$2,459.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,092.88
|
| Rate for Payer: Healthscope Commercial |
$2,537.62
|
| Rate for Payer: Healthscope Whirlpool |
$2,616.10
|
| Rate for Payer: Mclaren Commercial |
$2,354.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,223.68
|
| Rate for Payer: Nomi Health Commercial |
$2,145.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,962.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,302.17
|
|
|
HC LARYNGOSCOPY
|
Facility
|
OP
|
$2,616.10
|
|
| Hospital Charge Code |
36000113
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$967.96 |
| Max. Negotiated Rate |
$2,616.10 |
| Rate for Payer: Aetna Commercial |
$2,354.49
|
| Rate for Payer: Aetna Medicare |
$967.96
|
| Rate for Payer: ASR ASR |
$2,537.62
|
| Rate for Payer: BCBS Complete |
$1,046.44
|
| Rate for Payer: BCBS Trust/PPO |
$2,156.97
|
| Rate for Payer: BCN Commercial |
$2,156.97
|
| Rate for Payer: Cash Price |
$2,092.88
|
| Rate for Payer: Cofinity Commercial |
$2,459.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,092.88
|
| Rate for Payer: Healthscope Commercial |
$2,537.62
|
| Rate for Payer: Healthscope Whirlpool |
$2,616.10
|
| Rate for Payer: Mclaren Commercial |
$2,354.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,092.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,223.68
|
| Rate for Payer: Nomi Health Commercial |
$2,145.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,962.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,292.23
|
| Rate for Payer: Priority Health Narrow Network |
$1,833.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,302.17
|
|
|
HC LARYNGOSCOPY DIRECT OPERATIVE W BIOPSY
|
Facility
|
OP
|
$4,890.90
|
|
|
Service Code
|
CPT 31235
|
| Hospital Charge Code |
76100522
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$927.54 |
| Max. Negotiated Rate |
$4,890.90 |
| Rate for Payer: Aetna Commercial |
$4,401.81
|
| Rate for Payer: Aetna Medicare |
$1,773.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,216.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,216.88
|
| Rate for Payer: ASR ASR |
$4,744.17
|
| Rate for Payer: BCBS Complete |
$974.01
|
| Rate for Payer: BCBS MAPPO |
$1,773.50
|
| Rate for Payer: BCBS Trust/PPO |
$4,032.55
|
| Rate for Payer: BCN Commercial |
$4,032.55
|
| Rate for Payer: BCN Medicare Advantage |
$1,773.50
|
| Rate for Payer: Cash Price |
$3,912.72
|
| Rate for Payer: Cash Price |
$3,912.72
|
| Rate for Payer: Cofinity Commercial |
$4,597.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,912.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,773.50
|
| Rate for Payer: Healthscope Commercial |
$4,744.17
|
| Rate for Payer: Healthscope Whirlpool |
$4,890.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,773.50
|
| Rate for Payer: Mclaren Commercial |
$4,401.81
|
| Rate for Payer: Mclaren Medicaid |
$1,773.50
|
| Rate for Payer: Mclaren Medicare |
$1,773.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,862.17
|
| Rate for Payer: Meridian Medicaid |
$974.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,039.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,950.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,157.27
|
| Rate for Payer: Nomi Health Commercial |
$4,010.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,668.18
|
| Rate for Payer: PACE Medicare |
$1,684.83
|
| Rate for Payer: PACE SWMI |
$1,773.50
|
| Rate for Payer: PHP Commercial |
$1,950.85
|
| Rate for Payer: PHP Medicaid |
$950.60
|
| Rate for Payer: PHP Medicare Advantage |
$1,773.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$927.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4,285.41
|
| Rate for Payer: Priority Health Medicare |
$1,773.50
|
| Rate for Payer: Priority Health Narrow Network |
$3,428.52
|
| Rate for Payer: Railroad Medicare Medicare |
$1,773.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,303.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,773.50
|
| Rate for Payer: UHC Exchange |
$2,748.93
|
| Rate for Payer: UHC Medicaid |
$927.54
|
| Rate for Payer: UHCCP DNSP |
$1,773.50
|
| Rate for Payer: UHCCP Medicaid |
$927.54
|
| Rate for Payer: VA VA |
$1,773.50
|
|
|
HC LARYNGOSCOPY DIRECT OPERATIVE W BIOPSY
|
Facility
|
IP
|
$4,890.90
|
|
|
Service Code
|
CPT 31235
|
| Hospital Charge Code |
76100522
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,668.18 |
| Max. Negotiated Rate |
$4,890.90 |
| Rate for Payer: Aetna Commercial |
$4,401.81
|
| Rate for Payer: ASR ASR |
$4,744.17
|
| Rate for Payer: BCBS Trust/PPO |
$4,016.41
|
| Rate for Payer: BCN Commercial |
$4,016.41
|
| Rate for Payer: Cash Price |
$3,912.72
|
| Rate for Payer: Cofinity Commercial |
$4,597.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,912.72
|
| Rate for Payer: Healthscope Commercial |
$4,744.17
|
| Rate for Payer: Healthscope Whirlpool |
$4,890.90
|
| Rate for Payer: Mclaren Commercial |
$4,401.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,157.27
|
| Rate for Payer: Nomi Health Commercial |
$4,010.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,668.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,303.99
|
|
|
HC LARYNGOSCOPY FIBEROPTIC
|
Facility
|
OP
|
$379.73
|
|
|
Service Code
|
CPT 31575
|
| Hospital Charge Code |
36100443
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$104.02 |
| Max. Negotiated Rate |
$379.73 |
| Rate for Payer: Aetna Commercial |
$341.76
|
| Rate for Payer: Aetna Medicare |
$198.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$248.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$248.61
|
| Rate for Payer: ASR ASR |
$368.34
|
| Rate for Payer: BCBS Complete |
$109.23
|
| Rate for Payer: BCBS MAPPO |
$198.89
|
| Rate for Payer: BCBS Trust/PPO |
$313.09
|
| Rate for Payer: BCN Commercial |
$313.09
|
| Rate for Payer: BCN Medicare Advantage |
$198.89
|
| Rate for Payer: Cash Price |
$303.78
|
| Rate for Payer: Cash Price |
$303.78
|
| Rate for Payer: Cofinity Commercial |
$356.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$303.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$198.89
|
| Rate for Payer: Healthscope Commercial |
$368.34
|
| Rate for Payer: Healthscope Whirlpool |
$379.73
|
| Rate for Payer: Humana Choice PPO Medicare |
$198.89
|
| Rate for Payer: Mclaren Commercial |
$341.76
|
| Rate for Payer: Mclaren Medicaid |
$198.89
|
| Rate for Payer: Mclaren Medicare |
$198.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$208.83
|
| Rate for Payer: Meridian Medicaid |
$109.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$228.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$218.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$322.77
|
| Rate for Payer: Nomi Health Commercial |
$311.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$284.80
|
| Rate for Payer: PACE Medicare |
$188.95
|
| Rate for Payer: PACE SWMI |
$198.89
|
| Rate for Payer: PHP Commercial |
$218.78
|
| Rate for Payer: PHP Medicaid |
$106.61
|
| Rate for Payer: PHP Medicare Advantage |
$198.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$332.72
|
| Rate for Payer: Priority Health Medicare |
$198.89
|
| Rate for Payer: Priority Health Narrow Network |
$266.19
|
| Rate for Payer: Railroad Medicare Medicare |
$198.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$334.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$198.89
|
| Rate for Payer: UHC Exchange |
$308.28
|
| Rate for Payer: UHC Medicaid |
$104.02
|
| Rate for Payer: UHCCP DNSP |
$198.89
|
| Rate for Payer: UHCCP Medicaid |
$104.02
|
| Rate for Payer: VA VA |
$198.89
|
|
