|
HC INSERT STRAIGHT CATH
|
Facility
|
IP
|
$185.30
|
|
|
Service Code
|
CPT 51701
|
| Hospital Charge Code |
45000003
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$120.44 |
| Max. Negotiated Rate |
$185.30 |
| Rate for Payer: Aetna Commercial |
$166.77
|
| Rate for Payer: ASR ASR |
$179.74
|
| Rate for Payer: ASR Commercial |
$179.74
|
| Rate for Payer: BCBS Trust/PPO |
$151.00
|
| Rate for Payer: BCN Commercial |
$143.66
|
| Rate for Payer: Cash Price |
$148.24
|
| Rate for Payer: Cofinity Commercial |
$174.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$148.24
|
| Rate for Payer: Healthscope Commercial |
$185.30
|
| Rate for Payer: Healthscope Whirlpool |
$179.74
|
| Rate for Payer: Mclaren Commercial |
$166.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$157.50
|
| Rate for Payer: Nomi Health Commercial |
$151.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$120.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$163.06
|
|
|
HC INSERT TUNNELED CENTRAL LINE WO PORT OR PUMP ABOVE 5 YRS AGE
|
Facility
|
OP
|
$4,076.99
|
|
|
Service Code
|
CPT 36558
|
| Hospital Charge Code |
36100123
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,645.35 |
| Max. Negotiated Rate |
$4,758.02 |
| Rate for Payer: Aetna Commercial |
$3,669.29
|
| Rate for Payer: Aetna Medicare |
$3,069.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,837.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,837.11
|
| Rate for Payer: ASR ASR |
$3,954.68
|
| Rate for Payer: ASR Commercial |
$3,954.68
|
| Rate for Payer: BCBS Complete |
$1,727.62
|
| Rate for Payer: BCBS MAPPO |
$3,069.69
|
| Rate for Payer: BCBS Trust/PPO |
$3,338.65
|
| Rate for Payer: BCN Commercial |
$3,160.89
|
| Rate for Payer: BCN Medicare Advantage |
$3,069.69
|
| Rate for Payer: Cash Price |
$3,261.59
|
| Rate for Payer: Cash Price |
$3,261.59
|
| Rate for Payer: Cofinity Commercial |
$3,832.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,261.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,069.69
|
| Rate for Payer: Healthscope Commercial |
$4,076.99
|
| Rate for Payer: Healthscope Whirlpool |
$3,954.68
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,069.69
|
| Rate for Payer: Mclaren Commercial |
$3,669.29
|
| Rate for Payer: Mclaren Medicaid |
$1,645.35
|
| Rate for Payer: Mclaren Medicare |
$3,069.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,223.17
|
| Rate for Payer: Meridian Medicaid |
$1,727.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,530.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,465.44
|
| Rate for Payer: Nomi Health Commercial |
$3,343.13
|
| Rate for Payer: PACE Medicare |
$2,916.21
|
| Rate for Payer: PACE SWMI |
$3,069.69
|
| Rate for Payer: PHP Commercial |
$3,376.66
|
| Rate for Payer: PHP Medicaid |
$1,645.35
|
| Rate for Payer: PHP Medicare Advantage |
$3,069.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,650.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,572.26
|
| Rate for Payer: Priority Health Medicare |
$3,069.69
|
| Rate for Payer: Priority Health Narrow Network |
$2,857.97
|
| Rate for Payer: Railroad Medicare Medicare |
$3,069.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,587.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,069.69
|
| Rate for Payer: UHC Exchange |
$4,758.02
|
| Rate for Payer: UHC Medicare Advantage |
$3,069.69
|
| Rate for Payer: UHCCP DNSP |
$3,069.69
|
| Rate for Payer: UHCCP Medicaid |
$1,645.35
|
| Rate for Payer: VA VA |
$3,069.69
|
|
|
HC INSERT TUNNELED CENTRAL LINE WO PORT OR PUMP ABOVE 5 YRS AGE
|
Facility
|
IP
|
$4,076.99
|
|
|
Service Code
|
CPT 36558
|
| Hospital Charge Code |
36100123
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,650.04 |
| Max. Negotiated Rate |
$4,076.99 |
| Rate for Payer: Aetna Commercial |
$3,669.29
|
| Rate for Payer: ASR ASR |
$3,954.68
|
| Rate for Payer: ASR Commercial |
$3,954.68
|
| Rate for Payer: BCBS Trust/PPO |
$3,322.34
|
| Rate for Payer: BCN Commercial |
$3,160.89
|
| Rate for Payer: Cash Price |
$3,261.59
|
| Rate for Payer: Cofinity Commercial |
$3,832.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,261.59
|
| Rate for Payer: Healthscope Commercial |
$4,076.99
|
| Rate for Payer: Healthscope Whirlpool |
$3,954.68
|
| Rate for Payer: Mclaren Commercial |
$3,669.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,465.44
|
| Rate for Payer: Nomi Health Commercial |
$3,343.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,650.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,587.75
|
|
|
HC INSERT TUNNELED CENTRAL LINE WO PORT OR PUMP LESS THAN 5 YRS AGE
|
Facility
|
IP
|
$4,139.56
|
|
|
Service Code
|
CPT 36557
|
| Hospital Charge Code |
36100122
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,690.71 |
| Max. Negotiated Rate |
$4,139.56 |
| Rate for Payer: Aetna Commercial |
$3,725.60
|
| Rate for Payer: ASR ASR |
$4,015.37
|
| Rate for Payer: ASR Commercial |
$4,015.37
|
| Rate for Payer: BCBS Trust/PPO |
$3,373.33
|
| Rate for Payer: BCN Commercial |
$3,209.40
|
| Rate for Payer: Cash Price |
$3,311.65
|
| Rate for Payer: Cofinity Commercial |
$3,891.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,311.65
|
| Rate for Payer: Healthscope Commercial |
$4,139.56
|
| Rate for Payer: Healthscope Whirlpool |
$4,015.37
|
| Rate for Payer: Mclaren Commercial |
$3,725.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,518.63
|
| Rate for Payer: Nomi Health Commercial |
$3,394.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,690.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,642.81
|
|
|
HC INSERT TUNNELED CENTRAL LINE WO PORT OR PUMP LESS THAN 5 YRS AGE
|
Facility
|
OP
|
$4,139.56
|
|
|
Service Code
|
CPT 36557
|
| Hospital Charge Code |
36100122
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,690.71 |
| Max. Negotiated Rate |
$8,171.71 |
| Rate for Payer: Aetna Commercial |
$3,725.60
|
| Rate for Payer: Aetna Medicare |
$5,272.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,590.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,590.09
|
| Rate for Payer: ASR ASR |
$4,015.37
|
| Rate for Payer: ASR Commercial |
$4,015.37
|
| Rate for Payer: BCBS Complete |
$2,967.12
|
| Rate for Payer: BCBS MAPPO |
$5,272.07
|
| Rate for Payer: BCBS Trust/PPO |
$3,389.89
|
| Rate for Payer: BCN Commercial |
$3,209.40
|
| Rate for Payer: BCN Medicare Advantage |
$5,272.07
|
| Rate for Payer: Cash Price |
$3,311.65
|
| Rate for Payer: Cash Price |
$3,311.65
|
| Rate for Payer: Cofinity Commercial |
$3,891.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,311.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,272.07
|
| Rate for Payer: Healthscope Commercial |
$4,139.56
|
| Rate for Payer: Healthscope Whirlpool |
$4,015.37
|
| Rate for Payer: Humana Choice PPO Medicare |
$5,272.07
|
| Rate for Payer: Mclaren Commercial |
$3,725.60
|
| Rate for Payer: Mclaren Medicaid |
$2,825.83
|
| Rate for Payer: Mclaren Medicare |
$5,272.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,535.67
|
| Rate for Payer: Meridian Medicaid |
$2,967.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,062.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,518.63
|
| Rate for Payer: Nomi Health Commercial |
$3,394.44
|
| Rate for Payer: PACE Medicare |
$5,008.47
|
| Rate for Payer: PACE SWMI |
$5,272.07
|
| Rate for Payer: PHP Commercial |
$5,799.28
|
| Rate for Payer: PHP Medicaid |
$2,825.83
|
| Rate for Payer: PHP Medicare Advantage |
$5,272.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,825.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,690.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,627.08
|
| Rate for Payer: Priority Health Medicare |
$5,272.07
|
| Rate for Payer: Priority Health Narrow Network |
$2,901.83
|
| Rate for Payer: Railroad Medicare Medicare |
$5,272.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,642.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,272.07
|
| Rate for Payer: UHC Exchange |
$8,171.71
|
| Rate for Payer: UHC Medicare Advantage |
$5,272.07
|
| Rate for Payer: UHCCP DNSP |
$5,272.07
|
| Rate for Payer: UHCCP Medicaid |
$2,825.83
|
| Rate for Payer: VA VA |
$5,272.07
|
|
|
HC IN SITU HYBRID EA ADDL PROBE STAIN PER SPECIMEN
|
Facility
|
IP
|
$265.10
|
|
|
Service Code
|
CPT 88364
|
| Hospital Charge Code |
31000120
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$172.31 |
| Max. Negotiated Rate |
$265.10 |
| Rate for Payer: Aetna Commercial |
$238.59
|
| Rate for Payer: ASR ASR |
$257.15
|
| Rate for Payer: ASR Commercial |
$257.15
|
| Rate for Payer: BCBS Trust/PPO |
$216.03
|
| Rate for Payer: BCN Commercial |
$205.53
|
| Rate for Payer: Cash Price |
$212.08
|
| Rate for Payer: Cofinity Commercial |
$249.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$212.08
|
| Rate for Payer: Healthscope Commercial |
$265.10
|
| Rate for Payer: Healthscope Whirlpool |
$257.15
|
| Rate for Payer: Mclaren Commercial |
$238.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$225.34
|
| Rate for Payer: Nomi Health Commercial |
$217.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$172.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$233.29
|
|
|
HC IN SITU HYBRID EA ADDL PROBE STAIN PER SPECIMEN
|
Facility
|
OP
|
$265.10
|
|
|
Service Code
|
CPT 88364
|
| Hospital Charge Code |
31000120
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$106.04 |
| Max. Negotiated Rate |
$265.10 |
| Rate for Payer: Aetna Commercial |
$238.59
|
| Rate for Payer: Aetna Medicare |
$132.55
|
| Rate for Payer: ASR ASR |
$257.15
|
| Rate for Payer: ASR Commercial |
$257.15
|
| Rate for Payer: BCBS Complete |
$106.04
|
| Rate for Payer: BCBS Trust/PPO |
$217.09
|
| Rate for Payer: BCN Commercial |
$205.53
|
| Rate for Payer: Cash Price |
$212.08
|
| Rate for Payer: Cofinity Commercial |
$249.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$212.08
|
| Rate for Payer: Healthscope Commercial |
$265.10
|
| Rate for Payer: Healthscope Whirlpool |
$257.15
|
| Rate for Payer: Mclaren Commercial |
$238.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$225.34
|
| Rate for Payer: Nomi Health Commercial |
$217.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$172.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$232.28
|
| Rate for Payer: Priority Health Narrow Network |
$185.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$233.29
|
|
|
HC IN SITU HYBRID MULTIPLX MRPH QUANT OR SEMI-QUANT
|
Facility
|
OP
|
$655.45
|
|
|
Service Code
|
CPT 88377
|
| Hospital Charge Code |
31000119
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$89.58 |
| Max. Negotiated Rate |
$655.45 |
| Rate for Payer: Aetna Commercial |
$589.90
|
| Rate for Payer: Aetna Medicare |
$167.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$208.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$208.90
|
| Rate for Payer: ASR ASR |
$635.79
|
| Rate for Payer: ASR Commercial |
$635.79
|
| Rate for Payer: BCBS Complete |
$94.06
|
| Rate for Payer: BCBS MAPPO |
$167.12
|
| Rate for Payer: BCBS Trust/PPO |
$536.75
|
| Rate for Payer: BCN Commercial |
$508.17
|
| Rate for Payer: BCN Medicare Advantage |
$167.12
|
| Rate for Payer: Cash Price |
$524.36
|
| Rate for Payer: Cash Price |
$524.36
|
| Rate for Payer: Cofinity Commercial |
$616.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$524.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$167.12
|
| Rate for Payer: Healthscope Commercial |
$655.45
|
| Rate for Payer: Healthscope Whirlpool |
$635.79
|
| Rate for Payer: Humana Choice PPO Medicare |
$167.12
|
| Rate for Payer: Mclaren Commercial |
$589.90
|
| Rate for Payer: Mclaren Medicaid |
$89.58
|
| Rate for Payer: Mclaren Medicare |
$167.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$175.48
|
| Rate for Payer: Meridian Medicaid |
$94.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$192.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$557.13
|
| Rate for Payer: Nomi Health Commercial |
$537.47
|
| Rate for Payer: PACE Medicare |
$158.76
|
| Rate for Payer: PACE SWMI |
$167.12
|
| Rate for Payer: PHP Commercial |
$183.83
|
| Rate for Payer: PHP Medicaid |
$89.58
|
| Rate for Payer: PHP Medicare Advantage |
$167.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$426.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$574.31
|
| Rate for Payer: Priority Health Medicare |
$167.12
|
| Rate for Payer: Priority Health Narrow Network |
$459.47
|
| Rate for Payer: Railroad Medicare Medicare |
$167.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$576.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$167.12
|
| Rate for Payer: UHC Exchange |
$259.04
|
| Rate for Payer: UHC Medicare Advantage |
$167.12
|
| Rate for Payer: UHCCP DNSP |
$167.12
|
| Rate for Payer: UHCCP Medicaid |
$89.58
|
| Rate for Payer: VA VA |
$167.12
|
|
|
HC IN SITU HYBRID MULTIPLX MRPH QUANT OR SEMI-QUANT
|
Facility
|
IP
|
$655.45
|
|
|
Service Code
|
CPT 88377
|
| Hospital Charge Code |
31000119
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$426.04 |
| Max. Negotiated Rate |
$655.45 |
| Rate for Payer: Aetna Commercial |
$589.90
|
| Rate for Payer: ASR ASR |
$635.79
|
| Rate for Payer: ASR Commercial |
$635.79
|
| Rate for Payer: BCBS Trust/PPO |
$534.13
|
| Rate for Payer: BCN Commercial |
$508.17
|
| Rate for Payer: Cash Price |
$524.36
|
| Rate for Payer: Cofinity Commercial |
$616.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$524.36
|
| Rate for Payer: Healthscope Commercial |
$655.45
|
| Rate for Payer: Healthscope Whirlpool |
$635.79
|
| Rate for Payer: Mclaren Commercial |
$589.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$557.13
|
| Rate for Payer: Nomi Health Commercial |
$537.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$426.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$576.80
|
|
|
HC INSTILL ANTICARCIN BLADDER
|
Facility
|
IP
|
$746.53
|
|
|
Service Code
|
CPT 51720
|
| Hospital Charge Code |
36100449
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$485.24 |
| Max. Negotiated Rate |
$746.53 |
| Rate for Payer: Aetna Commercial |
$671.88
|
| Rate for Payer: ASR ASR |
$724.13
|
| Rate for Payer: ASR Commercial |
$724.13
|
| Rate for Payer: BCBS Trust/PPO |
$608.35
|
| Rate for Payer: BCN Commercial |
$578.78
|
| Rate for Payer: Cash Price |
$597.22
|
| Rate for Payer: Cofinity Commercial |
$701.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$597.22
|
| Rate for Payer: Healthscope Commercial |
$746.53
|
| Rate for Payer: Healthscope Whirlpool |
$724.13
|
| Rate for Payer: Mclaren Commercial |
$671.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$634.55
|
| Rate for Payer: Nomi Health Commercial |
$612.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$485.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$656.95
|
|
|
HC INSTILL ANTICARCIN BLADDER
|
Facility
|
OP
|
$746.53
|
|
|
Service Code
|
CPT 51720
|
| Hospital Charge Code |
36100449
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$348.92 |
| Max. Negotiated Rate |
$1,009.00 |
| Rate for Payer: Aetna Commercial |
$671.88
|
| Rate for Payer: Aetna Medicare |
$650.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$813.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$813.71
|
| Rate for Payer: ASR ASR |
$724.13
|
| Rate for Payer: ASR Commercial |
$724.13
|
| Rate for Payer: BCBS Complete |
$366.37
|
| Rate for Payer: BCBS MAPPO |
$650.97
|
| Rate for Payer: BCBS Trust/PPO |
$611.33
|
| Rate for Payer: BCN Commercial |
$578.78
|
| Rate for Payer: BCN Medicare Advantage |
$650.97
|
| Rate for Payer: Cash Price |
$597.22
|
| Rate for Payer: Cash Price |
$597.22
|
| Rate for Payer: Cofinity Commercial |
$701.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$597.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$650.97
|
| Rate for Payer: Healthscope Commercial |
$746.53
|
| Rate for Payer: Healthscope Whirlpool |
$724.13
|
| Rate for Payer: Humana Choice PPO Medicare |
$650.97
|
| Rate for Payer: Mclaren Commercial |
$671.88
|
| Rate for Payer: Mclaren Medicaid |
$348.92
|
| Rate for Payer: Mclaren Medicare |
$650.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$683.52
|
| Rate for Payer: Meridian Medicaid |
$366.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$748.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$634.55
|
| Rate for Payer: Nomi Health Commercial |
$612.15
|
| Rate for Payer: PACE Medicare |
$618.42
|
| Rate for Payer: PACE SWMI |
$650.97
|
| Rate for Payer: PHP Commercial |
$716.07
|
| Rate for Payer: PHP Medicaid |
$348.92
|
| Rate for Payer: PHP Medicare Advantage |
$650.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$348.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$485.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$654.11
|
| Rate for Payer: Priority Health Medicare |
$650.97
|
| Rate for Payer: Priority Health Narrow Network |
$523.32
|
| Rate for Payer: Railroad Medicare Medicare |
$650.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$656.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$650.97
|
| Rate for Payer: UHC Exchange |
$1,009.00
|
| Rate for Payer: UHC Medicare Advantage |
$650.97
|
| Rate for Payer: UHCCP DNSP |
$650.97
|
| Rate for Payer: UHCCP Medicaid |
$348.92
|
| Rate for Payer: VA VA |
$650.97
|
|
|
HC INST THER AGENT RENAL PELVIS/URETER VIA TUB
|
Facility
|
OP
|
$666.90
|
|
|
Service Code
|
CPT 50391
|
| Hospital Charge Code |
36100571
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$127.14 |
| Max. Negotiated Rate |
$666.90 |
| Rate for Payer: Aetna Commercial |
$600.21
|
| Rate for Payer: Aetna Medicare |
$237.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$296.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$296.50
|
| Rate for Payer: ASR ASR |
$646.89
|
| Rate for Payer: ASR Commercial |
$646.89
|
| Rate for Payer: BCBS Complete |
$133.50
|
| Rate for Payer: BCBS MAPPO |
$237.20
|
| Rate for Payer: BCBS Trust/PPO |
$546.12
|
| Rate for Payer: BCN Commercial |
$517.05
|
| Rate for Payer: BCN Medicare Advantage |
$237.20
|
| Rate for Payer: Cash Price |
$533.52
|
| Rate for Payer: Cash Price |
$533.52
|
| Rate for Payer: Cofinity Commercial |
$626.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$533.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.20
|
| Rate for Payer: Healthscope Commercial |
$666.90
|
| Rate for Payer: Healthscope Whirlpool |
$646.89
|
| Rate for Payer: Humana Choice PPO Medicare |
$237.20
|
| Rate for Payer: Mclaren Commercial |
$600.21
|
| Rate for Payer: Mclaren Medicaid |
$127.14
|
| Rate for Payer: Mclaren Medicare |
$237.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.06
|
| Rate for Payer: Meridian Medicaid |
$133.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$272.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$566.87
|
| Rate for Payer: Nomi Health Commercial |
$546.86
|
| Rate for Payer: PACE Medicare |
$225.34
|
| Rate for Payer: PACE SWMI |
$237.20
|
| Rate for Payer: PHP Commercial |
$260.92
|
| Rate for Payer: PHP Medicaid |
$127.14
|
| Rate for Payer: PHP Medicare Advantage |
$237.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$127.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$433.49
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$584.34
|
| Rate for Payer: Priority Health Medicare |
$237.20
|
| Rate for Payer: Priority Health Narrow Network |
$467.50
|
| Rate for Payer: Railroad Medicare Medicare |
$237.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$586.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$237.20
|
| Rate for Payer: UHC Exchange |
$367.66
|
| Rate for Payer: UHC Medicare Advantage |
$237.20
|
| Rate for Payer: UHCCP DNSP |
$237.20
|
| Rate for Payer: UHCCP Medicaid |
$127.14
|
| Rate for Payer: VA VA |
$237.20
|
|
|
HC INST THER AGENT RENAL PELVIS/URETER VIA TUB
|
Facility
|
IP
|
$666.90
|
|
|
Service Code
|
CPT 50391
|
| Hospital Charge Code |
36100571
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$433.49 |
| Max. Negotiated Rate |
$666.90 |
| Rate for Payer: Aetna Commercial |
$600.21
|
| Rate for Payer: ASR ASR |
$646.89
|
| Rate for Payer: ASR Commercial |
$646.89
|
| Rate for Payer: BCBS Trust/PPO |
$543.46
|
| Rate for Payer: BCN Commercial |
$517.05
|
| Rate for Payer: Cash Price |
$533.52
|
| Rate for Payer: Cofinity Commercial |
$626.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$533.52
|
| Rate for Payer: Healthscope Commercial |
$666.90
|
| Rate for Payer: Healthscope Whirlpool |
$646.89
|
| Rate for Payer: Mclaren Commercial |
$600.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$566.87
|
| Rate for Payer: Nomi Health Commercial |
$546.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$433.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$586.87
|
|
|
HC INSULIN
|
Facility
|
OP
|
$99.96
|
|
|
Service Code
|
CPT 83525
|
| Hospital Charge Code |
30100266
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.13 |
| Max. Negotiated Rate |
$99.96 |
| Rate for Payer: Aetna Commercial |
$89.96
|
| Rate for Payer: Aetna Medicare |
$11.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.29
|
| Rate for Payer: ASR ASR |
$96.96
|
| Rate for Payer: ASR Commercial |
$96.96
|
| Rate for Payer: BCBS Complete |
$6.43
|
| Rate for Payer: BCBS MAPPO |
$11.43
|
| Rate for Payer: BCBS Trust/PPO |
$81.86
|
| Rate for Payer: BCN Commercial |
$77.50
|
| Rate for Payer: BCN Medicare Advantage |
$11.43
|
| Rate for Payer: Cash Price |
$79.97
|
| Rate for Payer: Cash Price |
$79.97
|
| Rate for Payer: Cofinity Commercial |
$93.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.43
|
| Rate for Payer: Healthscope Commercial |
$99.96
|
| Rate for Payer: Healthscope Whirlpool |
$96.96
|
| Rate for Payer: Humana Choice PPO Medicare |
$11.43
|
| Rate for Payer: Mclaren Commercial |
$89.96
|
| Rate for Payer: Mclaren Medicaid |
$6.13
|
| Rate for Payer: Mclaren Medicare |
$11.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.00
|
| Rate for Payer: Meridian Medicaid |
$6.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.97
|
| Rate for Payer: Nomi Health Commercial |
$81.97
|
| Rate for Payer: PACE Medicare |
$10.86
|
| Rate for Payer: PACE SWMI |
$11.43
|
| Rate for Payer: PHP Commercial |
$12.57
|
| Rate for Payer: PHP Medicaid |
$6.13
|
| Rate for Payer: PHP Medicare Advantage |
$11.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$87.58
|
| Rate for Payer: Priority Health Medicare |
$11.43
|
| Rate for Payer: Priority Health Narrow Network |
$70.07
|
| Rate for Payer: Railroad Medicare Medicare |
$11.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$87.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.43
|
| Rate for Payer: UHC Exchange |
$17.72
|
| Rate for Payer: UHC Medicare Advantage |
$11.43
|
| Rate for Payer: UHCCP DNSP |
$11.43
|
| Rate for Payer: UHCCP Medicaid |
$6.13
|
| Rate for Payer: VA VA |
$11.43
|
|
|
HC INSULIN
|
Facility
|
IP
|
$99.96
|
|
|
Service Code
|
CPT 83525
|
| Hospital Charge Code |
30100266
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$64.97 |
| Max. Negotiated Rate |
$99.96 |
| Rate for Payer: Aetna Commercial |
$89.96
|
| Rate for Payer: ASR ASR |
$96.96
|
| Rate for Payer: ASR Commercial |
$96.96
|
| Rate for Payer: BCBS Trust/PPO |
$81.46
|
| Rate for Payer: BCN Commercial |
$77.50
|
| Rate for Payer: Cash Price |
$79.97
|
| Rate for Payer: Cofinity Commercial |
$93.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.97
|
| Rate for Payer: Healthscope Commercial |
$99.96
|
| Rate for Payer: Healthscope Whirlpool |
$96.96
|
| Rate for Payer: Mclaren Commercial |
$89.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.97
|
| Rate for Payer: Nomi Health Commercial |
$81.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$87.96
|
|
|
HC INSULIN ANTIBODIES
|
Facility
|
OP
|
$69.36
|
|
|
Service Code
|
CPT 86337
|
| Hospital Charge Code |
30200199
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.48 |
| Max. Negotiated Rate |
$69.36 |
| Rate for Payer: Aetna Commercial |
$62.42
|
| Rate for Payer: Aetna Medicare |
$21.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.76
|
| Rate for Payer: ASR ASR |
$67.28
|
| Rate for Payer: ASR Commercial |
$67.28
|
| Rate for Payer: BCBS Complete |
$12.05
|
| Rate for Payer: BCBS MAPPO |
$21.41
|
| Rate for Payer: BCBS Trust/PPO |
$56.80
|
| Rate for Payer: BCN Commercial |
$53.77
|
| Rate for Payer: BCN Medicare Advantage |
$21.41
|
| Rate for Payer: Cash Price |
$55.49
|
| Rate for Payer: Cash Price |
$55.49
|
| Rate for Payer: Cofinity Commercial |
$65.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.41
|
| Rate for Payer: Healthscope Commercial |
$69.36
|
| Rate for Payer: Healthscope Whirlpool |
$67.28
|
| Rate for Payer: Humana Choice PPO Medicare |
$21.41
|
| Rate for Payer: Mclaren Commercial |
$62.42
|
| Rate for Payer: Mclaren Medicaid |
$11.48
|
| Rate for Payer: Mclaren Medicare |
$21.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.48
|
| Rate for Payer: Meridian Medicaid |
$12.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.96
|
| Rate for Payer: Nomi Health Commercial |
$56.88
|
| Rate for Payer: PACE Medicare |
$20.34
|
| Rate for Payer: PACE SWMI |
$21.41
|
| Rate for Payer: PHP Commercial |
$23.55
|
| Rate for Payer: PHP Medicaid |
$11.48
|
| Rate for Payer: PHP Medicare Advantage |
$21.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$60.77
|
| Rate for Payer: Priority Health Medicare |
$21.41
|
| Rate for Payer: Priority Health Narrow Network |
$48.62
|
| Rate for Payer: Railroad Medicare Medicare |
$21.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$61.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.41
|
| Rate for Payer: UHC Exchange |
$33.19
|
| Rate for Payer: UHC Medicare Advantage |
$21.41
|
| Rate for Payer: UHCCP DNSP |
$21.41
|
| Rate for Payer: UHCCP Medicaid |
$11.48
|
| Rate for Payer: VA VA |
$21.41
|
|
|
HC INSULIN ANTIBODIES
|
Facility
|
IP
|
$69.36
|
|
|
Service Code
|
CPT 86337
|
| Hospital Charge Code |
30200199
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$45.08 |
| Max. Negotiated Rate |
$69.36 |
| Rate for Payer: Aetna Commercial |
$62.42
|
| Rate for Payer: ASR ASR |
$67.28
|
| Rate for Payer: ASR Commercial |
$67.28
|
| Rate for Payer: BCBS Trust/PPO |
$56.52
|
| Rate for Payer: BCN Commercial |
$53.77
|
| Rate for Payer: Cash Price |
$55.49
|
| Rate for Payer: Cofinity Commercial |
$65.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.49
|
| Rate for Payer: Healthscope Commercial |
$69.36
|
| Rate for Payer: Healthscope Whirlpool |
$67.28
|
| Rate for Payer: Mclaren Commercial |
$62.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.96
|
| Rate for Payer: Nomi Health Commercial |
$56.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$61.04
|
|
|
HC INSULIN LIKE GROWTH FACTOR BP3
|
Facility
|
OP
|
$49.94
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100258
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.26 |
| Max. Negotiated Rate |
$49.94 |
| Rate for Payer: Aetna Commercial |
$44.95
|
| 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 |
$48.44
|
| Rate for Payer: ASR Commercial |
$48.44
|
| Rate for Payer: BCBS Complete |
$9.72
|
| Rate for Payer: BCBS MAPPO |
$17.27
|
| Rate for Payer: BCBS Trust/PPO |
$40.90
|
| Rate for Payer: BCN Commercial |
$38.72
|
| Rate for Payer: BCN Medicare Advantage |
$17.27
|
| Rate for Payer: Cash Price |
$39.95
|
| Rate for Payer: Cash Price |
$39.95
|
| Rate for Payer: Cofinity Commercial |
$46.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.27
|
| Rate for Payer: Healthscope Commercial |
$49.94
|
| Rate for Payer: Healthscope Whirlpool |
$48.44
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.27
|
| Rate for Payer: Mclaren Commercial |
$44.95
|
| Rate for Payer: Mclaren Medicaid |
$9.26
|
| 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 |
$9.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.45
|
| Rate for Payer: Nomi Health Commercial |
$40.95
|
| 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 |
$9.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$43.76
|
| Rate for Payer: Priority Health Medicare |
$17.27
|
| Rate for Payer: Priority Health Narrow Network |
$35.01
|
| Rate for Payer: Railroad Medicare Medicare |
$17.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$43.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.27
|
| Rate for Payer: UHC Exchange |
$26.77
|
| Rate for Payer: UHC Medicare Advantage |
$17.27
|
| Rate for Payer: UHCCP DNSP |
$17.27
|
| Rate for Payer: UHCCP Medicaid |
$9.26
|
| Rate for Payer: VA VA |
$17.27
|
|
|
HC INSULIN LIKE GROWTH FACTOR BP3
|
Facility
|
IP
|
$49.94
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100258
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$32.46 |
| Max. Negotiated Rate |
$49.94 |
| Rate for Payer: Aetna Commercial |
$44.95
|
| Rate for Payer: ASR ASR |
$48.44
|
| Rate for Payer: ASR Commercial |
$48.44
|
| Rate for Payer: BCBS Trust/PPO |
$40.70
|
| Rate for Payer: BCN Commercial |
$38.72
|
| Rate for Payer: Cash Price |
$39.95
|
| Rate for Payer: Cofinity Commercial |
$46.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.95
|
| Rate for Payer: Healthscope Commercial |
$49.94
|
| Rate for Payer: Healthscope Whirlpool |
$48.44
|
| Rate for Payer: Mclaren Commercial |
$44.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.45
|
| Rate for Payer: Nomi Health Commercial |
$40.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$43.95
|
|
|
HC INTENSIVE CARE OBS OVERFLOW PER HR
|
Facility
|
OP
|
$189.78
|
|
| Hospital Charge Code |
76900004
|
|
Hospital Revenue Code
|
769
|
| Min. Negotiated Rate |
$75.91 |
| Max. Negotiated Rate |
$189.78 |
| Rate for Payer: Aetna Commercial |
$170.80
|
| Rate for Payer: Aetna Medicare |
$94.89
|
| Rate for Payer: ASR ASR |
$184.09
|
| Rate for Payer: ASR Commercial |
$184.09
|
| Rate for Payer: BCBS Complete |
$75.91
|
| Rate for Payer: BCBS Trust/PPO |
$155.41
|
| Rate for Payer: BCN Commercial |
$147.14
|
| Rate for Payer: Cash Price |
$151.82
|
| Rate for Payer: Cofinity Commercial |
$178.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$151.82
|
| Rate for Payer: Healthscope Commercial |
$189.78
|
| Rate for Payer: Healthscope Whirlpool |
$184.09
|
| Rate for Payer: Mclaren Commercial |
$170.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$161.31
|
| Rate for Payer: Nomi Health Commercial |
$155.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$123.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$166.29
|
| Rate for Payer: Priority Health Narrow Network |
$133.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$167.01
|
|
|
HC INTENSIVE CARE OBS OVERFLOW PER HR
|
Facility
|
IP
|
$189.78
|
|
| Hospital Charge Code |
76900004
|
|
Hospital Revenue Code
|
769
|
| Min. Negotiated Rate |
$123.36 |
| Max. Negotiated Rate |
$189.78 |
| Rate for Payer: Aetna Commercial |
$170.80
|
| Rate for Payer: ASR ASR |
$184.09
|
| Rate for Payer: ASR Commercial |
$184.09
|
| Rate for Payer: BCBS Trust/PPO |
$154.65
|
| Rate for Payer: BCN Commercial |
$147.14
|
| Rate for Payer: Cash Price |
$151.82
|
| Rate for Payer: Cofinity Commercial |
$178.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$151.82
|
| Rate for Payer: Healthscope Commercial |
$189.78
|
| Rate for Payer: Healthscope Whirlpool |
$184.09
|
| Rate for Payer: Mclaren Commercial |
$170.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$161.31
|
| Rate for Payer: Nomi Health Commercial |
$155.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$123.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$167.01
|
|
|
HC INTERCEDE ANTIADHESIVE
|
Facility
|
OP
|
$1,185.64
|
|
| Hospital Charge Code |
27200134
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$474.26 |
| Max. Negotiated Rate |
$1,185.64 |
| Rate for Payer: Aetna Commercial |
$1,067.08
|
| Rate for Payer: Aetna Medicare |
$592.82
|
| Rate for Payer: ASR ASR |
$1,150.07
|
| Rate for Payer: ASR Commercial |
$1,150.07
|
| Rate for Payer: BCBS Complete |
$474.26
|
| Rate for Payer: BCBS Trust/PPO |
$970.92
|
| Rate for Payer: BCN Commercial |
$919.23
|
| Rate for Payer: Cash Price |
$948.51
|
| Rate for Payer: Cofinity Commercial |
$1,114.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$948.51
|
| Rate for Payer: Healthscope Commercial |
$1,185.64
|
| Rate for Payer: Healthscope Whirlpool |
$1,150.07
|
| Rate for Payer: Mclaren Commercial |
$1,067.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,007.79
|
| Rate for Payer: Nomi Health Commercial |
$972.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$770.67
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,038.86
|
| Rate for Payer: Priority Health Narrow Network |
$831.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,043.36
|
|
|
HC INTERCEDE ANTIADHESIVE
|
Facility
|
IP
|
$1,185.64
|
|
| Hospital Charge Code |
27200134
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$770.67 |
| Max. Negotiated Rate |
$1,185.64 |
| Rate for Payer: Aetna Commercial |
$1,067.08
|
| Rate for Payer: ASR ASR |
$1,150.07
|
| Rate for Payer: ASR Commercial |
$1,150.07
|
| Rate for Payer: BCBS Trust/PPO |
$966.18
|
| Rate for Payer: BCN Commercial |
$919.23
|
| Rate for Payer: Cash Price |
$948.51
|
| Rate for Payer: Cofinity Commercial |
$1,114.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$948.51
|
| Rate for Payer: Healthscope Commercial |
$1,185.64
|
| Rate for Payer: Healthscope Whirlpool |
$1,150.07
|
| Rate for Payer: Mclaren Commercial |
$1,067.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,007.79
|
| Rate for Payer: Nomi Health Commercial |
$972.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$770.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,043.36
|
|
|
HC INTERLEUKIN 6, PLASMA
|
Facility
|
OP
|
$131.58
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100710
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.26 |
| Max. Negotiated Rate |
$131.58 |
| Rate for Payer: Aetna Commercial |
$118.42
|
| 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 |
$127.63
|
| Rate for Payer: ASR Commercial |
$127.63
|
| Rate for Payer: BCBS Complete |
$9.72
|
| Rate for Payer: BCBS MAPPO |
$17.27
|
| Rate for Payer: BCBS Trust/PPO |
$107.75
|
| Rate for Payer: BCN Commercial |
$102.01
|
| Rate for Payer: BCN Medicare Advantage |
$17.27
|
| Rate for Payer: Cash Price |
$105.26
|
| Rate for Payer: Cash Price |
$105.26
|
| Rate for Payer: Cofinity Commercial |
$123.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.27
|
| Rate for Payer: Healthscope Commercial |
$131.58
|
| Rate for Payer: Healthscope Whirlpool |
$127.63
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.27
|
| Rate for Payer: Mclaren Commercial |
$118.42
|
| Rate for Payer: Mclaren Medicaid |
$9.26
|
| 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 |
$9.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.84
|
| Rate for Payer: Nomi Health Commercial |
$107.90
|
| 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 |
$9.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$115.29
|
| Rate for Payer: Priority Health Medicare |
$17.27
|
| Rate for Payer: Priority Health Narrow Network |
$92.24
|
| Rate for Payer: Railroad Medicare Medicare |
$17.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$115.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.27
|
| Rate for Payer: UHC Exchange |
$26.77
|
| Rate for Payer: UHC Medicare Advantage |
$17.27
|
| Rate for Payer: UHCCP DNSP |
$17.27
|
| Rate for Payer: UHCCP Medicaid |
$9.26
|
| Rate for Payer: VA VA |
$17.27
|
|
|
HC INTERLEUKIN 6, PLASMA
|
Facility
|
IP
|
$131.58
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100710
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$85.53 |
| Max. Negotiated Rate |
$131.58 |
| Rate for Payer: Aetna Commercial |
$118.42
|
| Rate for Payer: ASR ASR |
$127.63
|
| Rate for Payer: ASR Commercial |
$127.63
|
| Rate for Payer: BCBS Trust/PPO |
$107.22
|
| Rate for Payer: BCN Commercial |
$102.01
|
| Rate for Payer: Cash Price |
$105.26
|
| Rate for Payer: Cofinity Commercial |
$123.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.26
|
| Rate for Payer: Healthscope Commercial |
$131.58
|
| Rate for Payer: Healthscope Whirlpool |
$127.63
|
| Rate for Payer: Mclaren Commercial |
$118.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.84
|
| Rate for Payer: Nomi Health Commercial |
$107.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$115.79
|
|
