|
HC LD RECOVERY 8-10 HRS
|
Facility
|
IP
|
$1,484.78
|
|
| Hospital Charge Code |
71000017
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$1,113.59 |
| Max. Negotiated Rate |
$1,484.78 |
| Rate for Payer: Aetna Commercial |
$1,336.30
|
| Rate for Payer: ASR ASR |
$1,440.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,219.30
|
| Rate for Payer: BCN Commercial |
$1,219.30
|
| Rate for Payer: Cash Price |
$1,187.82
|
| Rate for Payer: Cofinity Commercial |
$1,395.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,187.82
|
| Rate for Payer: Healthscope Commercial |
$1,440.24
|
| Rate for Payer: Healthscope Whirlpool |
$1,484.78
|
| Rate for Payer: Mclaren Commercial |
$1,336.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,262.06
|
| Rate for Payer: Nomi Health Commercial |
$1,217.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,113.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,306.61
|
|
|
HC LD RECOVERY 8-10 HRS
|
Facility
|
OP
|
$1,484.78
|
|
| Hospital Charge Code |
71000017
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$549.37 |
| Max. Negotiated Rate |
$1,484.78 |
| Rate for Payer: Aetna Commercial |
$1,336.30
|
| Rate for Payer: Aetna Medicare |
$549.37
|
| Rate for Payer: ASR ASR |
$1,440.24
|
| Rate for Payer: BCBS Complete |
$593.91
|
| Rate for Payer: BCBS Trust/PPO |
$1,224.20
|
| Rate for Payer: BCN Commercial |
$1,224.20
|
| Rate for Payer: Cash Price |
$1,187.82
|
| Rate for Payer: Cofinity Commercial |
$1,395.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,187.82
|
| Rate for Payer: Healthscope Commercial |
$1,440.24
|
| Rate for Payer: Healthscope Whirlpool |
$1,484.78
|
| Rate for Payer: Mclaren Commercial |
$1,336.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,187.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,262.06
|
| Rate for Payer: Nomi Health Commercial |
$1,217.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,113.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,300.96
|
| Rate for Payer: Priority Health Narrow Network |
$1,040.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,306.61
|
|
|
HC LEAD
|
Facility
|
IP
|
$45.78
|
|
|
Service Code
|
CPT 83655
|
| Hospital Charge Code |
30100275
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$34.34 |
| Max. Negotiated Rate |
$45.78 |
| Rate for Payer: Aetna Commercial |
$41.20
|
| Rate for Payer: ASR ASR |
$44.41
|
| Rate for Payer: BCBS Trust/PPO |
$37.59
|
| Rate for Payer: BCN Commercial |
$37.59
|
| Rate for Payer: Cash Price |
$36.62
|
| Rate for Payer: Cofinity Commercial |
$43.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.62
|
| Rate for Payer: Healthscope Commercial |
$44.41
|
| Rate for Payer: Healthscope Whirlpool |
$45.78
|
| Rate for Payer: Mclaren Commercial |
$41.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.91
|
| Rate for Payer: Nomi Health Commercial |
$37.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.29
|
|
|
HC LEAD
|
Facility
|
OP
|
$45.78
|
|
|
Service Code
|
CPT 83655
|
| Hospital Charge Code |
30100275
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.33 |
| Max. Negotiated Rate |
$46.00 |
| Rate for Payer: Aetna Commercial |
$41.20
|
| Rate for Payer: Aetna Medicare |
$12.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.14
|
| Rate for Payer: ASR ASR |
$44.41
|
| Rate for Payer: BCBS Complete |
$6.65
|
| Rate for Payer: BCBS MAPPO |
$12.11
|
| Rate for Payer: BCBS Trust/PPO |
$37.75
|
| Rate for Payer: BCN Commercial |
$37.75
|
| Rate for Payer: BCN Medicare Advantage |
$12.11
|
| Rate for Payer: Cash Price |
$36.62
|
| Rate for Payer: Cash Price |
$36.62
|
| Rate for Payer: Cofinity Commercial |
$43.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.11
|
| Rate for Payer: Healthscope Commercial |
$44.41
|
| Rate for Payer: Healthscope Whirlpool |
$45.78
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.11
|
| Rate for Payer: Mclaren Commercial |
$41.20
|
| Rate for Payer: Mclaren Medicaid |
$12.11
|
| Rate for Payer: Mclaren Medicare |
$12.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.72
|
| Rate for Payer: Meridian Medicaid |
$6.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.91
|
| Rate for Payer: Nomi Health Commercial |
$37.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.34
|
| Rate for Payer: PACE Medicare |
$11.50
|
| Rate for Payer: PACE SWMI |
$12.11
|
| Rate for Payer: PHP Commercial |
$13.32
|
| Rate for Payer: PHP Medicaid |
$6.49
|
| Rate for Payer: PHP Medicare Advantage |
$12.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$46.00
|
| Rate for Payer: Priority Health Medicare |
$12.11
|
| Rate for Payer: Priority Health Narrow Network |
$36.80
|
| Rate for Payer: Railroad Medicare Medicare |
$12.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.11
|
| Rate for Payer: UHC Exchange |
$18.77
|
| Rate for Payer: UHC Medicaid |
$6.33
|
| Rate for Payer: UHCCP DNSP |
$12.11
|
| Rate for Payer: UHCCP Medicaid |
$6.33
|
| Rate for Payer: VA VA |
$12.11
|
|
|
HC LEAD CARDIOVERTER DEFIB ENDOCARDIAL SINGLE COIL
|
Facility
|
OP
|
$15,033.78
|
|
|
Service Code
|
HCPCS C1777
|
| Hospital Charge Code |
27800088
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,562.50 |
| Max. Negotiated Rate |
$15,033.78 |
| Rate for Payer: Aetna Commercial |
$13,530.40
|
| Rate for Payer: Aetna Medicare |
$5,562.50
|
| Rate for Payer: ASR ASR |
$14,582.77
|
| Rate for Payer: BCBS Complete |
$6,013.51
|
| Rate for Payer: BCBS Trust/PPO |
$12,395.35
|
| Rate for Payer: BCN Commercial |
$12,395.35
|
| Rate for Payer: Cash Price |
$12,027.02
|
| Rate for Payer: Cofinity Commercial |
$14,131.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12,027.02
|
| Rate for Payer: Healthscope Commercial |
$14,582.77
|
| Rate for Payer: Healthscope Whirlpool |
$15,033.78
|
| Rate for Payer: Mclaren Commercial |
$13,530.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,027.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,778.71
|
| Rate for Payer: Nomi Health Commercial |
$12,327.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11,275.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$13,172.60
|
| Rate for Payer: Priority Health Narrow Network |
$10,538.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$13,229.73
|
|
|
HC LEAD CARDIOVERTER DEFIB ENDOCARDIAL SINGLE COIL
|
Facility
|
IP
|
$15,033.78
|
|
|
Service Code
|
HCPCS C1777
|
| Hospital Charge Code |
27800088
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11,275.33 |
| Max. Negotiated Rate |
$15,033.78 |
| Rate for Payer: Aetna Commercial |
$13,530.40
|
| Rate for Payer: ASR ASR |
$14,582.77
|
| Rate for Payer: BCBS Trust/PPO |
$12,345.74
|
| Rate for Payer: BCN Commercial |
$12,345.74
|
| Rate for Payer: Cash Price |
$12,027.02
|
| Rate for Payer: Cofinity Commercial |
$14,131.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12,027.02
|
| Rate for Payer: Healthscope Commercial |
$14,582.77
|
| Rate for Payer: Healthscope Whirlpool |
$15,033.78
|
| Rate for Payer: Mclaren Commercial |
$13,530.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,778.71
|
| Rate for Payer: Nomi Health Commercial |
$12,327.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11,275.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$13,229.73
|
|
|
HC LEAD NEUROSTIM TEST KIT LEVEL 20
|
Facility
|
OP
|
$2,080.80
|
|
|
Service Code
|
HCPCS C1897
|
| Hospital Charge Code |
27800134
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$769.90 |
| Max. Negotiated Rate |
$2,080.80 |
| Rate for Payer: Aetna Commercial |
$1,872.72
|
| Rate for Payer: Aetna Medicare |
$769.90
|
| Rate for Payer: ASR ASR |
$2,018.38
|
| Rate for Payer: BCBS Complete |
$832.32
|
| Rate for Payer: BCBS Trust/PPO |
$1,715.62
|
| Rate for Payer: BCN Commercial |
$1,715.62
|
| Rate for Payer: Cash Price |
$1,664.64
|
| Rate for Payer: Cofinity Commercial |
$1,955.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,664.64
|
| Rate for Payer: Healthscope Commercial |
$2,018.38
|
| Rate for Payer: Healthscope Whirlpool |
$2,080.80
|
| Rate for Payer: Mclaren Commercial |
$1,872.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,664.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,768.68
|
| Rate for Payer: Nomi Health Commercial |
$1,706.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,560.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,823.20
|
| Rate for Payer: Priority Health Narrow Network |
$1,458.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,831.10
|
|
|
HC LEAD NEUROSTIM TEST KIT LEVEL 20
|
Facility
|
IP
|
$2,080.80
|
|
|
Service Code
|
HCPCS C1897
|
| Hospital Charge Code |
27800134
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,560.60 |
| Max. Negotiated Rate |
$2,080.80 |
| Rate for Payer: Aetna Commercial |
$1,872.72
|
| Rate for Payer: ASR ASR |
$2,018.38
|
| Rate for Payer: BCBS Trust/PPO |
$1,708.75
|
| Rate for Payer: BCN Commercial |
$1,708.75
|
| Rate for Payer: Cash Price |
$1,664.64
|
| Rate for Payer: Cofinity Commercial |
$1,955.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,664.64
|
| Rate for Payer: Healthscope Commercial |
$2,018.38
|
| Rate for Payer: Healthscope Whirlpool |
$2,080.80
|
| Rate for Payer: Mclaren Commercial |
$1,872.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,768.68
|
| Rate for Payer: Nomi Health Commercial |
$1,706.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,560.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,831.10
|
|
|
HC LEAD NEUROSTIMULATOR
|
Facility
|
OP
|
$7,965.30
|
|
|
Service Code
|
HCPCS C1778
|
| Hospital Charge Code |
27800017
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,947.16 |
| Max. Negotiated Rate |
$7,965.30 |
| Rate for Payer: Aetna Commercial |
$7,168.77
|
| Rate for Payer: Aetna Medicare |
$2,947.16
|
| Rate for Payer: ASR ASR |
$7,726.34
|
| Rate for Payer: BCBS Complete |
$3,186.12
|
| Rate for Payer: BCBS Trust/PPO |
$6,567.39
|
| Rate for Payer: BCN Commercial |
$6,567.39
|
| Rate for Payer: Cash Price |
$6,372.24
|
| Rate for Payer: Cofinity Commercial |
$7,487.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,372.24
|
| Rate for Payer: Healthscope Commercial |
$7,726.34
|
| Rate for Payer: Healthscope Whirlpool |
$7,965.30
|
| Rate for Payer: Mclaren Commercial |
$7,168.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,372.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,770.51
|
| Rate for Payer: Nomi Health Commercial |
$6,531.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,973.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$6,979.20
|
| Rate for Payer: Priority Health Narrow Network |
$5,583.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,009.46
|
|
|
HC LEAD NEUROSTIMULATOR
|
Facility
|
IP
|
$7,965.30
|
|
|
Service Code
|
HCPCS C1778
|
| Hospital Charge Code |
27800017
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,973.98 |
| Max. Negotiated Rate |
$7,965.30 |
| Rate for Payer: Aetna Commercial |
$7,168.77
|
| Rate for Payer: ASR ASR |
$7,726.34
|
| Rate for Payer: BCBS Trust/PPO |
$6,541.10
|
| Rate for Payer: BCN Commercial |
$6,541.10
|
| Rate for Payer: Cash Price |
$6,372.24
|
| Rate for Payer: Cofinity Commercial |
$7,487.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,372.24
|
| Rate for Payer: Healthscope Commercial |
$7,726.34
|
| Rate for Payer: Healthscope Whirlpool |
$7,965.30
|
| Rate for Payer: Mclaren Commercial |
$7,168.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,770.51
|
| Rate for Payer: Nomi Health Commercial |
$6,531.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,973.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,009.46
|
|
|
HC LEAD NOS LVL 1
|
Facility
|
OP
|
$198.90
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800144
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$73.59 |
| Max. Negotiated Rate |
$198.90 |
| Rate for Payer: Aetna Commercial |
$179.01
|
| Rate for Payer: Aetna Medicare |
$73.59
|
| Rate for Payer: ASR ASR |
$192.93
|
| Rate for Payer: BCBS Complete |
$79.56
|
| Rate for Payer: BCBS Trust/PPO |
$163.99
|
| Rate for Payer: BCN Commercial |
$163.99
|
| Rate for Payer: Cash Price |
$159.12
|
| Rate for Payer: Cofinity Commercial |
$186.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$159.12
|
| Rate for Payer: Healthscope Commercial |
$192.93
|
| Rate for Payer: Healthscope Whirlpool |
$198.90
|
| Rate for Payer: Mclaren Commercial |
$179.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$159.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$169.06
|
| Rate for Payer: Nomi Health Commercial |
$163.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$149.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$174.28
|
| Rate for Payer: Priority Health Narrow Network |
$139.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$175.03
|
|
|
HC LEAD NOS LVL 1
|
Facility
|
IP
|
$198.90
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800144
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$149.18 |
| Max. Negotiated Rate |
$198.90 |
| Rate for Payer: Aetna Commercial |
$179.01
|
| Rate for Payer: ASR ASR |
$192.93
|
| Rate for Payer: BCBS Trust/PPO |
$163.34
|
| Rate for Payer: BCN Commercial |
$163.34
|
| Rate for Payer: Cash Price |
$159.12
|
| Rate for Payer: Cofinity Commercial |
$186.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$159.12
|
| Rate for Payer: Healthscope Commercial |
$192.93
|
| Rate for Payer: Healthscope Whirlpool |
$198.90
|
| Rate for Payer: Mclaren Commercial |
$179.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$169.06
|
| Rate for Payer: Nomi Health Commercial |
$163.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$149.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$175.03
|
|
|
HC LEAD REMOVAL DUAL
|
Facility
|
OP
|
$2,984.04
|
|
|
Service Code
|
CPT 33235
|
| Hospital Charge Code |
36100074
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,947.40 |
| Max. Negotiated Rate |
$5,771.46 |
| Rate for Payer: Aetna Commercial |
$2,685.64
|
| Rate for Payer: Aetna Medicare |
$3,723.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,654.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,654.40
|
| Rate for Payer: ASR ASR |
$2,894.52
|
| Rate for Payer: BCBS Complete |
$2,044.96
|
| Rate for Payer: BCBS MAPPO |
$3,723.52
|
| Rate for Payer: BCBS Trust/PPO |
$2,460.34
|
| Rate for Payer: BCN Commercial |
$2,460.34
|
| Rate for Payer: BCN Medicare Advantage |
$3,723.52
|
| Rate for Payer: Cash Price |
$2,387.23
|
| Rate for Payer: Cash Price |
$2,387.23
|
| Rate for Payer: Cofinity Commercial |
$2,805.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,387.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,723.52
|
| Rate for Payer: Healthscope Commercial |
$2,894.52
|
| Rate for Payer: Healthscope Whirlpool |
$2,984.04
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,723.52
|
| Rate for Payer: Mclaren Commercial |
$2,685.64
|
| Rate for Payer: Mclaren Medicaid |
$3,723.52
|
| Rate for Payer: Mclaren Medicare |
$3,723.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,909.70
|
| Rate for Payer: Meridian Medicaid |
$2,044.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,282.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$4,095.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,536.43
|
| Rate for Payer: Nomi Health Commercial |
$2,446.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,238.03
|
| Rate for Payer: PACE Medicare |
$3,537.34
|
| Rate for Payer: PACE SWMI |
$3,723.52
|
| Rate for Payer: PHP Commercial |
$4,095.87
|
| Rate for Payer: PHP Medicaid |
$1,995.81
|
| Rate for Payer: PHP Medicare Advantage |
$3,723.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,947.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,614.62
|
| Rate for Payer: Priority Health Medicare |
$3,723.52
|
| Rate for Payer: Priority Health Narrow Network |
$2,091.81
|
| Rate for Payer: Railroad Medicare Medicare |
$3,723.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,625.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,723.52
|
| Rate for Payer: UHC Exchange |
$5,771.46
|
| Rate for Payer: UHC Medicaid |
$1,947.40
|
| Rate for Payer: UHCCP DNSP |
$3,723.52
|
| Rate for Payer: UHCCP Medicaid |
$1,947.40
|
| Rate for Payer: VA VA |
$3,723.52
|
|
|
HC LEAD REMOVAL DUAL
|
Facility
|
IP
|
$2,984.04
|
|
|
Service Code
|
CPT 33235
|
| Hospital Charge Code |
36100074
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,238.03 |
| Max. Negotiated Rate |
$2,984.04 |
| Rate for Payer: Aetna Commercial |
$2,685.64
|
| Rate for Payer: ASR ASR |
$2,894.52
|
| Rate for Payer: BCBS Trust/PPO |
$2,450.49
|
| Rate for Payer: BCN Commercial |
$2,450.49
|
| Rate for Payer: Cash Price |
$2,387.23
|
| Rate for Payer: Cofinity Commercial |
$2,805.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,387.23
|
| Rate for Payer: Healthscope Commercial |
$2,894.52
|
| Rate for Payer: Healthscope Whirlpool |
$2,984.04
|
| Rate for Payer: Mclaren Commercial |
$2,685.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,536.43
|
| Rate for Payer: Nomi Health Commercial |
$2,446.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,238.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,625.96
|
|
|
HC LEAD REMOVAL SINGLE
|
Facility
|
OP
|
$3,778.97
|
|
|
Service Code
|
CPT 33234
|
| Hospital Charge Code |
36100073
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,947.40 |
| Max. Negotiated Rate |
$5,771.46 |
| Rate for Payer: Aetna Commercial |
$3,401.07
|
| Rate for Payer: Aetna Medicare |
$3,723.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,654.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,654.40
|
| Rate for Payer: ASR ASR |
$3,665.60
|
| Rate for Payer: BCBS Complete |
$2,044.96
|
| Rate for Payer: BCBS MAPPO |
$3,723.52
|
| Rate for Payer: BCBS Trust/PPO |
$3,115.76
|
| Rate for Payer: BCN Commercial |
$3,115.76
|
| Rate for Payer: BCN Medicare Advantage |
$3,723.52
|
| Rate for Payer: Cash Price |
$3,023.18
|
| Rate for Payer: Cash Price |
$3,023.18
|
| Rate for Payer: Cofinity Commercial |
$3,552.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,023.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,723.52
|
| Rate for Payer: Healthscope Commercial |
$3,665.60
|
| Rate for Payer: Healthscope Whirlpool |
$3,778.97
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,723.52
|
| Rate for Payer: Mclaren Commercial |
$3,401.07
|
| Rate for Payer: Mclaren Medicaid |
$3,723.52
|
| Rate for Payer: Mclaren Medicare |
$3,723.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,909.70
|
| Rate for Payer: Meridian Medicaid |
$2,044.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,282.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$4,095.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,212.12
|
| Rate for Payer: Nomi Health Commercial |
$3,098.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,834.23
|
| Rate for Payer: PACE Medicare |
$3,537.34
|
| Rate for Payer: PACE SWMI |
$3,723.52
|
| Rate for Payer: PHP Commercial |
$4,095.87
|
| Rate for Payer: PHP Medicaid |
$1,995.81
|
| Rate for Payer: PHP Medicare Advantage |
$3,723.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,947.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,311.13
|
| Rate for Payer: Priority Health Medicare |
$3,723.52
|
| Rate for Payer: Priority Health Narrow Network |
$2,649.06
|
| Rate for Payer: Railroad Medicare Medicare |
$3,723.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,325.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,723.52
|
| Rate for Payer: UHC Exchange |
$5,771.46
|
| Rate for Payer: UHC Medicaid |
$1,947.40
|
| Rate for Payer: UHCCP DNSP |
$3,723.52
|
| Rate for Payer: UHCCP Medicaid |
$1,947.40
|
| Rate for Payer: VA VA |
$3,723.52
|
|
|
HC LEAD REMOVAL SINGLE
|
Facility
|
IP
|
$3,778.97
|
|
|
Service Code
|
CPT 33234
|
| Hospital Charge Code |
36100073
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,834.23 |
| Max. Negotiated Rate |
$3,778.97 |
| Rate for Payer: Aetna Commercial |
$3,401.07
|
| Rate for Payer: ASR ASR |
$3,665.60
|
| Rate for Payer: BCBS Trust/PPO |
$3,103.29
|
| Rate for Payer: BCN Commercial |
$3,103.29
|
| Rate for Payer: Cash Price |
$3,023.18
|
| Rate for Payer: Cofinity Commercial |
$3,552.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,023.18
|
| Rate for Payer: Healthscope Commercial |
$3,665.60
|
| Rate for Payer: Healthscope Whirlpool |
$3,778.97
|
| Rate for Payer: Mclaren Commercial |
$3,401.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,212.12
|
| Rate for Payer: Nomi Health Commercial |
$3,098.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,834.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,325.49
|
|
|
HC LECITHIN-SPHINGOMYELIN
|
Facility
|
OP
|
$98.84
|
|
|
Service Code
|
CPT 83661
|
| Hospital Charge Code |
30100634
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.50 |
| Max. Negotiated Rate |
$98.84 |
| Rate for Payer: Aetna Commercial |
$88.96
|
| Rate for Payer: Aetna Medicare |
$21.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27.49
|
| Rate for Payer: ASR ASR |
$95.87
|
| Rate for Payer: BCBS Complete |
$12.08
|
| Rate for Payer: BCBS MAPPO |
$21.99
|
| Rate for Payer: BCBS Trust/PPO |
$81.49
|
| Rate for Payer: BCN Commercial |
$81.49
|
| Rate for Payer: BCN Medicare Advantage |
$21.99
|
| Rate for Payer: Cash Price |
$79.07
|
| Rate for Payer: Cash Price |
$79.07
|
| Rate for Payer: Cofinity Commercial |
$92.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.99
|
| Rate for Payer: Healthscope Commercial |
$95.87
|
| Rate for Payer: Healthscope Whirlpool |
$98.84
|
| Rate for Payer: Humana Choice PPO Medicare |
$21.99
|
| Rate for Payer: Mclaren Commercial |
$88.96
|
| Rate for Payer: Mclaren Medicaid |
$21.99
|
| Rate for Payer: Mclaren Medicare |
$21.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.09
|
| Rate for Payer: Meridian Medicaid |
$12.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$24.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.01
|
| Rate for Payer: Nomi Health Commercial |
$81.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.13
|
| Rate for Payer: PACE Medicare |
$20.89
|
| Rate for Payer: PACE SWMI |
$21.99
|
| Rate for Payer: PHP Commercial |
$24.19
|
| Rate for Payer: PHP Medicaid |
$11.79
|
| Rate for Payer: PHP Medicare Advantage |
$21.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$86.60
|
| Rate for Payer: Priority Health Medicare |
$21.99
|
| Rate for Payer: Priority Health Narrow Network |
$69.29
|
| Rate for Payer: Railroad Medicare Medicare |
$21.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$86.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$21.99
|
| Rate for Payer: UHC Exchange |
$34.08
|
| Rate for Payer: UHC Medicaid |
$11.50
|
| Rate for Payer: UHCCP DNSP |
$21.99
|
| Rate for Payer: UHCCP Medicaid |
$11.50
|
| Rate for Payer: VA VA |
$21.99
|
|
|
HC LECITHIN-SPHINGOMYELIN
|
Facility
|
IP
|
$98.84
|
|
|
Service Code
|
CPT 83661
|
| Hospital Charge Code |
30100634
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$74.13 |
| Max. Negotiated Rate |
$98.84 |
| Rate for Payer: Aetna Commercial |
$88.96
|
| Rate for Payer: ASR ASR |
$95.87
|
| Rate for Payer: BCBS Trust/PPO |
$81.17
|
| Rate for Payer: BCN Commercial |
$81.17
|
| Rate for Payer: Cash Price |
$79.07
|
| Rate for Payer: Cofinity Commercial |
$92.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.07
|
| Rate for Payer: Healthscope Commercial |
$95.87
|
| Rate for Payer: Healthscope Whirlpool |
$98.84
|
| Rate for Payer: Mclaren Commercial |
$88.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.01
|
| Rate for Payer: Nomi Health Commercial |
$81.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$86.98
|
|
|
HC LEFT ATRIAL APPENDAGE CLOS WITH ENDOCARDIAL IMPLANT
|
Facility
|
OP
|
$30,085.25
|
|
|
Service Code
|
CPT 33340
|
| Hospital Charge Code |
48100112
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$11,131.54 |
| Max. Negotiated Rate |
$30,085.25 |
| Rate for Payer: Aetna Commercial |
$27,076.72
|
| Rate for Payer: Aetna Medicare |
$11,131.54
|
| Rate for Payer: ASR ASR |
$29,182.69
|
| Rate for Payer: BCBS Complete |
$12,034.10
|
| Rate for Payer: BCBS Trust/PPO |
$24,805.29
|
| Rate for Payer: BCN Commercial |
$24,805.29
|
| Rate for Payer: Cash Price |
$24,068.20
|
| Rate for Payer: Cofinity Commercial |
$28,280.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24,068.20
|
| Rate for Payer: Healthscope Commercial |
$29,182.69
|
| Rate for Payer: Healthscope Whirlpool |
$30,085.25
|
| Rate for Payer: Mclaren Commercial |
$27,076.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24,068.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,572.46
|
| Rate for Payer: Nomi Health Commercial |
$24,669.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22,563.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$26,360.70
|
| Rate for Payer: Priority Health Narrow Network |
$21,089.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26,475.02
|
|
|
HC LEFT ATRIAL APPENDAGE CLOS WITH ENDOCARDIAL IMPLANT
|
Facility
|
IP
|
$30,085.25
|
|
|
Service Code
|
CPT 33340
|
| Hospital Charge Code |
48100112
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$22,563.94 |
| Max. Negotiated Rate |
$30,085.25 |
| Rate for Payer: Aetna Commercial |
$27,076.72
|
| Rate for Payer: ASR ASR |
$29,182.69
|
| Rate for Payer: BCBS Trust/PPO |
$24,706.01
|
| Rate for Payer: BCN Commercial |
$24,706.01
|
| Rate for Payer: Cash Price |
$24,068.20
|
| Rate for Payer: Cofinity Commercial |
$28,280.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24,068.20
|
| Rate for Payer: Healthscope Commercial |
$29,182.69
|
| Rate for Payer: Healthscope Whirlpool |
$30,085.25
|
| Rate for Payer: Mclaren Commercial |
$27,076.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,572.46
|
| Rate for Payer: Nomi Health Commercial |
$24,669.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22,563.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26,475.02
|
|
|
HC LEFT CATH W INTERVENTION
|
Facility
|
OP
|
$10,051.10
|
|
|
Service Code
|
CPT 93458
|
| Hospital Charge Code |
48100049
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,689.43 |
| Max. Negotiated Rate |
$10,051.10 |
| Rate for Payer: Aetna Commercial |
$9,045.99
|
| Rate for Payer: Aetna Medicare |
$3,230.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,037.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,037.84
|
| Rate for Payer: ASR ASR |
$9,749.57
|
| Rate for Payer: BCBS Complete |
$1,774.06
|
| Rate for Payer: BCBS MAPPO |
$3,230.27
|
| Rate for Payer: BCBS Trust/PPO |
$8,287.13
|
| Rate for Payer: BCN Commercial |
$8,287.13
|
| Rate for Payer: BCN Medicare Advantage |
$3,230.27
|
| Rate for Payer: Cash Price |
$8,040.88
|
| Rate for Payer: Cash Price |
$8,040.88
|
| Rate for Payer: Cofinity Commercial |
$9,448.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,040.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,230.27
|
| Rate for Payer: Healthscope Commercial |
$9,749.57
|
| Rate for Payer: Healthscope Whirlpool |
$10,051.10
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,230.27
|
| Rate for Payer: Mclaren Commercial |
$9,045.99
|
| Rate for Payer: Mclaren Medicaid |
$3,230.27
|
| Rate for Payer: Mclaren Medicare |
$3,230.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,391.78
|
| Rate for Payer: Meridian Medicaid |
$1,774.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,714.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,553.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,543.43
|
| Rate for Payer: Nomi Health Commercial |
$8,241.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,538.32
|
| Rate for Payer: PACE Medicare |
$3,068.76
|
| Rate for Payer: PACE SWMI |
$3,230.27
|
| Rate for Payer: PHP Commercial |
$3,553.30
|
| Rate for Payer: PHP Medicaid |
$1,731.42
|
| Rate for Payer: PHP Medicare Advantage |
$3,230.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,689.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$8,806.77
|
| Rate for Payer: Priority Health Medicare |
$3,230.27
|
| Rate for Payer: Priority Health Narrow Network |
$7,045.82
|
| Rate for Payer: Railroad Medicare Medicare |
$3,230.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8,844.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,230.27
|
| Rate for Payer: UHC Exchange |
$5,006.92
|
| Rate for Payer: UHC Medicaid |
$1,689.43
|
| Rate for Payer: UHCCP DNSP |
$3,230.27
|
| Rate for Payer: UHCCP Medicaid |
$1,689.43
|
| Rate for Payer: VA VA |
$3,230.27
|
|
|
HC LEFT CATH W INTERVENTION
|
Facility
|
IP
|
$10,051.10
|
|
|
Service Code
|
CPT 93458
|
| Hospital Charge Code |
48100049
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$7,538.32 |
| Max. Negotiated Rate |
$10,051.10 |
| Rate for Payer: Aetna Commercial |
$9,045.99
|
| Rate for Payer: ASR ASR |
$9,749.57
|
| Rate for Payer: BCBS Trust/PPO |
$8,253.96
|
| Rate for Payer: BCN Commercial |
$8,253.96
|
| Rate for Payer: Cash Price |
$8,040.88
|
| Rate for Payer: Cofinity Commercial |
$9,448.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,040.88
|
| Rate for Payer: Healthscope Commercial |
$9,749.57
|
| Rate for Payer: Healthscope Whirlpool |
$10,051.10
|
| Rate for Payer: Mclaren Commercial |
$9,045.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,543.43
|
| Rate for Payer: Nomi Health Commercial |
$8,241.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,538.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8,844.97
|
|
|
HC LEGAL BLOOD DRAW KZO CO/STATE/OTHER
|
Facility
|
IP
|
$100.00
|
|
|
Service Code
|
CPT 36415
|
| Hospital Charge Code |
30000049
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$75.00 |
| Max. Negotiated Rate |
$100.00 |
| Rate for Payer: Aetna Commercial |
$90.00
|
| Rate for Payer: ASR ASR |
$97.00
|
| Rate for Payer: BCBS Trust/PPO |
$82.12
|
| Rate for Payer: BCN Commercial |
$82.12
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cofinity Commercial |
$94.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.00
|
| Rate for Payer: Healthscope Commercial |
$97.00
|
| Rate for Payer: Healthscope Whirlpool |
$100.00
|
| Rate for Payer: Mclaren Commercial |
$90.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.00
|
| Rate for Payer: Nomi Health Commercial |
$82.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$75.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$88.00
|
|
|
HC LEGAL BLOOD DRAW KZO CO/STATE/OTHER
|
Facility
|
OP
|
$100.00
|
|
|
Service Code
|
CPT 36415
|
| Hospital Charge Code |
30000049
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.88 |
| Max. Negotiated Rate |
$100.00 |
| Rate for Payer: Aetna Commercial |
$90.00
|
| Rate for Payer: Aetna Medicare |
$9.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.68
|
| Rate for Payer: ASR ASR |
$97.00
|
| Rate for Payer: BCBS Complete |
$5.13
|
| Rate for Payer: BCBS MAPPO |
$9.34
|
| Rate for Payer: BCBS Trust/PPO |
$82.45
|
| Rate for Payer: BCN Commercial |
$82.45
|
| Rate for Payer: BCN Medicare Advantage |
$9.34
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: City of Battle Creek Police Dept Commercial |
$50.00
|
| Rate for Payer: Cofinity Commercial |
$94.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.34
|
| Rate for Payer: Healthscope Commercial |
$97.00
|
| Rate for Payer: Healthscope Whirlpool |
$100.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$9.34
|
| Rate for Payer: Mclaren Commercial |
$90.00
|
| Rate for Payer: Mclaren Medicaid |
$9.34
|
| Rate for Payer: Mclaren Medicare |
$9.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.81
|
| Rate for Payer: Meridian Medicaid |
$5.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.74
|
| Rate for Payer: Michigan State Police Michigan State Police |
$50.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.00
|
| Rate for Payer: Nomi Health Commercial |
$82.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$75.00
|
| Rate for Payer: PACE Medicare |
$8.87
|
| Rate for Payer: PACE SWMI |
$9.34
|
| Rate for Payer: PHP Commercial |
$10.27
|
| Rate for Payer: PHP Medicaid |
$5.01
|
| Rate for Payer: PHP Medicare Advantage |
$9.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$13.92
|
| Rate for Payer: Priority Health Medicare |
$9.34
|
| Rate for Payer: Priority Health Narrow Network |
$11.14
|
| Rate for Payer: Railroad Medicare Medicare |
$9.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$88.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$9.34
|
| Rate for Payer: UHC Exchange |
$14.48
|
| Rate for Payer: UHC Medicaid |
$4.88
|
| Rate for Payer: UHCCP DNSP |
$9.34
|
| Rate for Payer: UHCCP Medicaid |
$4.88
|
| Rate for Payer: VA VA |
$9.34
|
|
|
HC LEGIONELLA
|
Facility
|
IP
|
$52.00
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30600300
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$39.00 |
| Max. Negotiated Rate |
$52.00 |
| Rate for Payer: Aetna Commercial |
$46.80
|
| Rate for Payer: ASR ASR |
$50.44
|
| Rate for Payer: BCBS Trust/PPO |
$42.70
|
| Rate for Payer: BCN Commercial |
$42.70
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Cofinity Commercial |
$48.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.60
|
| Rate for Payer: Healthscope Commercial |
$50.44
|
| Rate for Payer: Healthscope Whirlpool |
$52.00
|
| Rate for Payer: Mclaren Commercial |
$46.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.20
|
| Rate for Payer: Nomi Health Commercial |
$42.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.76
|
|
