|
HC LP (A) CHOLESTEROL LMPP
|
Facility
|
IP
|
$24.41
|
|
|
Service Code
|
CPT 83700
|
| Hospital Charge Code |
30100636
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.31 |
| Max. Negotiated Rate |
$24.41 |
| Rate for Payer: Aetna Commercial |
$21.97
|
| Rate for Payer: ASR ASR |
$23.68
|
| Rate for Payer: BCBS Trust/PPO |
$20.05
|
| Rate for Payer: BCN Commercial |
$20.05
|
| Rate for Payer: Cash Price |
$19.53
|
| Rate for Payer: Cofinity Commercial |
$22.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.53
|
| Rate for Payer: Healthscope Commercial |
$23.68
|
| Rate for Payer: Healthscope Whirlpool |
$24.41
|
| Rate for Payer: Mclaren Commercial |
$21.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.75
|
| Rate for Payer: Nomi Health Commercial |
$20.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.48
|
|
|
HC LP (A) CHOLESTEROL LMPP
|
Facility
|
OP
|
$24.41
|
|
|
Service Code
|
CPT 83700
|
| Hospital Charge Code |
30100636
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.89 |
| Max. Negotiated Rate |
$175.53 |
| Rate for Payer: Aetna Commercial |
$21.97
|
| Rate for Payer: Aetna Medicare |
$11.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.07
|
| Rate for Payer: ASR ASR |
$23.68
|
| Rate for Payer: BCBS Complete |
$6.18
|
| Rate for Payer: BCBS MAPPO |
$11.26
|
| Rate for Payer: BCBS Trust/PPO |
$20.13
|
| Rate for Payer: BCN Commercial |
$20.13
|
| Rate for Payer: BCN Medicare Advantage |
$11.26
|
| Rate for Payer: Cash Price |
$19.53
|
| Rate for Payer: Cash Price |
$19.53
|
| Rate for Payer: Cofinity Commercial |
$22.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.26
|
| Rate for Payer: Healthscope Commercial |
$23.68
|
| Rate for Payer: Healthscope Whirlpool |
$24.41
|
| Rate for Payer: Humana Choice PPO Medicare |
$11.26
|
| Rate for Payer: Mclaren Commercial |
$21.97
|
| Rate for Payer: Mclaren Medicaid |
$11.26
|
| Rate for Payer: Mclaren Medicare |
$11.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.82
|
| Rate for Payer: Meridian Medicaid |
$6.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.75
|
| Rate for Payer: Nomi Health Commercial |
$20.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.31
|
| Rate for Payer: PACE Medicare |
$10.70
|
| Rate for Payer: PACE SWMI |
$11.26
|
| Rate for Payer: PHP Commercial |
$12.39
|
| Rate for Payer: PHP Medicaid |
$6.04
|
| Rate for Payer: PHP Medicare Advantage |
$11.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$175.53
|
| Rate for Payer: Priority Health Medicare |
$11.26
|
| Rate for Payer: Priority Health Narrow Network |
$140.42
|
| Rate for Payer: Railroad Medicare Medicare |
$11.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11.26
|
| Rate for Payer: UHC Exchange |
$17.45
|
| Rate for Payer: UHC Medicaid |
$5.89
|
| Rate for Payer: UHCCP DNSP |
$11.26
|
| Rate for Payer: UHCCP Medicaid |
$5.89
|
| Rate for Payer: VA VA |
$11.26
|
|
|
HC LTC ROOM AND BOARD
|
Facility
|
IP
|
$377.40
|
|
| Hospital Charge Code |
11000003
|
|
Hospital Revenue Code
|
110
|
| Min. Negotiated Rate |
$283.05 |
| Max. Negotiated Rate |
$377.40 |
| Rate for Payer: Aetna Commercial |
$339.66
|
| Rate for Payer: ASR ASR |
$366.08
|
| Rate for Payer: BCBS Trust/PPO |
$309.92
|
| Rate for Payer: BCN Commercial |
$309.92
|
| Rate for Payer: Cash Price |
$301.92
|
| Rate for Payer: Cofinity Commercial |
$354.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$301.92
|
| Rate for Payer: Healthscope Commercial |
$366.08
|
| Rate for Payer: Healthscope Whirlpool |
$377.40
|
| Rate for Payer: Mclaren Commercial |
$339.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$320.79
|
| Rate for Payer: Nomi Health Commercial |
$309.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$283.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$332.11
|
|
|
HC LT/RT/C'S/CABG'S W INTERVENTION
|
Facility
|
OP
|
$12,605.08
|
|
|
Service Code
|
CPT 93461
|
| Hospital Charge Code |
48100051
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,689.43 |
| Max. Negotiated Rate |
$12,605.08 |
| Rate for Payer: Aetna Commercial |
$11,344.57
|
| 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 |
$12,226.93
|
| Rate for Payer: BCBS Complete |
$1,774.06
|
| Rate for Payer: BCBS MAPPO |
$3,230.27
|
| Rate for Payer: BCBS Trust/PPO |
$10,392.89
|
| Rate for Payer: BCN Commercial |
$10,392.89
|
| Rate for Payer: BCN Medicare Advantage |
$3,230.27
|
| Rate for Payer: Cash Price |
$10,084.06
|
| Rate for Payer: Cash Price |
$10,084.06
|
| Rate for Payer: Cofinity Commercial |
$11,848.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,084.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,230.27
|
| Rate for Payer: Healthscope Commercial |
$12,226.93
|
| Rate for Payer: Healthscope Whirlpool |
$12,605.08
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,230.27
|
| Rate for Payer: Mclaren Commercial |
$11,344.57
|
| 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 |
$10,714.32
|
| Rate for Payer: Nomi Health Commercial |
$10,336.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,453.81
|
| 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 |
$11,044.57
|
| Rate for Payer: Priority Health Medicare |
$3,230.27
|
| Rate for Payer: Priority Health Narrow Network |
$8,836.16
|
| Rate for Payer: Railroad Medicare Medicare |
$3,230.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11,092.47
|
| 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 LT/RT/C'S/CABG'S W INTERVENTION
|
Facility
|
IP
|
$12,605.08
|
|
|
Service Code
|
CPT 93461
|
| Hospital Charge Code |
48100051
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$9,453.81 |
| Max. Negotiated Rate |
$12,605.08 |
| Rate for Payer: Aetna Commercial |
$11,344.57
|
| Rate for Payer: ASR ASR |
$12,226.93
|
| Rate for Payer: BCBS Trust/PPO |
$10,351.29
|
| Rate for Payer: BCN Commercial |
$10,351.29
|
| Rate for Payer: Cash Price |
$10,084.06
|
| Rate for Payer: Cofinity Commercial |
$11,848.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,084.06
|
| Rate for Payer: Healthscope Commercial |
$12,226.93
|
| Rate for Payer: Healthscope Whirlpool |
$12,605.08
|
| Rate for Payer: Mclaren Commercial |
$11,344.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,714.32
|
| Rate for Payer: Nomi Health Commercial |
$10,336.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,453.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11,092.47
|
|
|
HC LUMASON PER ML
|
Facility
|
OP
|
$81.09
|
|
|
Service Code
|
HCPCS Q9950
|
| Hospital Charge Code |
63600066
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$15.08 |
| Max. Negotiated Rate |
$81.09 |
| Rate for Payer: Aetna Commercial |
$72.98
|
| Rate for Payer: Aetna Medicare |
$30.00
|
| Rate for Payer: ASR ASR |
$78.66
|
| Rate for Payer: BCBS Complete |
$32.44
|
| Rate for Payer: BCBS Trust/PPO |
$66.86
|
| Rate for Payer: BCN Commercial |
$66.86
|
| Rate for Payer: Cash Price |
$64.87
|
| Rate for Payer: Cash Price |
$64.87
|
| Rate for Payer: Cofinity Commercial |
$76.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.87
|
| Rate for Payer: Healthscope Commercial |
$78.66
|
| Rate for Payer: Healthscope Whirlpool |
$81.09
|
| Rate for Payer: Mclaren Commercial |
$72.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$64.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.93
|
| Rate for Payer: Nomi Health Commercial |
$66.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$60.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$18.85
|
| Rate for Payer: Priority Health Narrow Network |
$15.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$71.36
|
|
|
HC LUMASON PER ML
|
Facility
|
IP
|
$81.09
|
|
|
Service Code
|
HCPCS Q9950
|
| Hospital Charge Code |
63600066
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$60.82 |
| Max. Negotiated Rate |
$81.09 |
| Rate for Payer: Aetna Commercial |
$72.98
|
| Rate for Payer: ASR ASR |
$78.66
|
| Rate for Payer: BCBS Trust/PPO |
$66.59
|
| Rate for Payer: BCN Commercial |
$66.59
|
| Rate for Payer: Cash Price |
$64.87
|
| Rate for Payer: Cofinity Commercial |
$76.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.87
|
| Rate for Payer: Healthscope Commercial |
$78.66
|
| Rate for Payer: Healthscope Whirlpool |
$81.09
|
| Rate for Payer: Mclaren Commercial |
$72.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.93
|
| Rate for Payer: Nomi Health Commercial |
$66.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$60.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$71.36
|
|
|
HC LUMBAR PUNCTURE
|
Facility
|
IP
|
$763.51
|
|
| Hospital Charge Code |
45000046
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$572.63 |
| Max. Negotiated Rate |
$763.51 |
| Rate for Payer: Aetna Commercial |
$687.16
|
| Rate for Payer: ASR ASR |
$740.60
|
| Rate for Payer: BCBS Trust/PPO |
$626.99
|
| Rate for Payer: BCN Commercial |
$626.99
|
| Rate for Payer: Cash Price |
$610.81
|
| Rate for Payer: Cofinity Commercial |
$717.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$610.81
|
| Rate for Payer: Healthscope Commercial |
$740.60
|
| Rate for Payer: Healthscope Whirlpool |
$763.51
|
| Rate for Payer: Mclaren Commercial |
$687.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$648.98
|
| Rate for Payer: Nomi Health Commercial |
$626.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$572.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$671.89
|
|
|
HC LUMBAR PUNCTURE
|
Facility
|
OP
|
$763.51
|
|
| Hospital Charge Code |
45000046
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$282.50 |
| Max. Negotiated Rate |
$763.51 |
| Rate for Payer: Aetna Commercial |
$687.16
|
| Rate for Payer: Aetna Medicare |
$282.50
|
| Rate for Payer: ASR ASR |
$740.60
|
| Rate for Payer: BCBS Complete |
$305.40
|
| Rate for Payer: BCBS Trust/PPO |
$629.51
|
| Rate for Payer: BCN Commercial |
$629.51
|
| Rate for Payer: Cash Price |
$610.81
|
| Rate for Payer: Cofinity Commercial |
$717.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$610.81
|
| Rate for Payer: Healthscope Commercial |
$740.60
|
| Rate for Payer: Healthscope Whirlpool |
$763.51
|
| Rate for Payer: Mclaren Commercial |
$687.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$610.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$648.98
|
| Rate for Payer: Nomi Health Commercial |
$626.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$572.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$668.99
|
| Rate for Payer: Priority Health Narrow Network |
$535.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$671.89
|
|
|
HC LUMBAR PUNCTURE DIAGNOSTIC
|
Facility
|
IP
|
$934.71
|
|
|
Service Code
|
CPT 62270
|
| Hospital Charge Code |
36100278
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$701.03 |
| Max. Negotiated Rate |
$934.71 |
| Rate for Payer: Aetna Commercial |
$841.24
|
| Rate for Payer: ASR ASR |
$906.67
|
| Rate for Payer: BCBS Trust/PPO |
$767.58
|
| Rate for Payer: BCN Commercial |
$767.58
|
| Rate for Payer: Cash Price |
$747.77
|
| Rate for Payer: Cofinity Commercial |
$878.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$747.77
|
| Rate for Payer: Healthscope Commercial |
$906.67
|
| Rate for Payer: Healthscope Whirlpool |
$934.71
|
| Rate for Payer: Mclaren Commercial |
$841.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$794.50
|
| Rate for Payer: Nomi Health Commercial |
$766.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$701.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$822.54
|
|
|
HC LUMBAR PUNCTURE DIAGNOSTIC
|
Facility
|
OP
|
$934.71
|
|
|
Service Code
|
CPT 62270
|
| Hospital Charge Code |
36100278
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$367.85 |
| Max. Negotiated Rate |
$1,090.18 |
| Rate for Payer: Aetna Commercial |
$841.24
|
| Rate for Payer: Aetna Medicare |
$703.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$879.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$879.17
|
| Rate for Payer: ASR ASR |
$906.67
|
| Rate for Payer: BCBS Complete |
$386.27
|
| Rate for Payer: BCBS MAPPO |
$703.34
|
| Rate for Payer: BCBS Trust/PPO |
$770.67
|
| Rate for Payer: BCN Commercial |
$770.67
|
| Rate for Payer: BCN Medicare Advantage |
$703.34
|
| Rate for Payer: Cash Price |
$747.77
|
| Rate for Payer: Cash Price |
$747.77
|
| Rate for Payer: Cofinity Commercial |
$878.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$747.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$703.34
|
| Rate for Payer: Healthscope Commercial |
$906.67
|
| Rate for Payer: Healthscope Whirlpool |
$934.71
|
| Rate for Payer: Humana Choice PPO Medicare |
$703.34
|
| Rate for Payer: Mclaren Commercial |
$841.24
|
| Rate for Payer: Mclaren Medicaid |
$703.34
|
| Rate for Payer: Mclaren Medicare |
$703.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$738.51
|
| Rate for Payer: Meridian Medicaid |
$386.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$808.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$773.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$794.50
|
| Rate for Payer: Nomi Health Commercial |
$766.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$701.03
|
| Rate for Payer: PACE Medicare |
$668.17
|
| Rate for Payer: PACE SWMI |
$703.34
|
| Rate for Payer: PHP Commercial |
$773.67
|
| Rate for Payer: PHP Medicaid |
$376.99
|
| Rate for Payer: PHP Medicare Advantage |
$703.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$647.65
|
| Rate for Payer: Priority Health Medicare |
$703.34
|
| Rate for Payer: Priority Health Narrow Network |
$518.12
|
| Rate for Payer: Railroad Medicare Medicare |
$703.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$822.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$703.34
|
| Rate for Payer: UHC Exchange |
$1,090.18
|
| Rate for Payer: UHC Medicaid |
$367.85
|
| Rate for Payer: UHCCP DNSP |
$703.34
|
| Rate for Payer: UHCCP Medicaid |
$367.85
|
| Rate for Payer: VA VA |
$703.34
|
|
|
HC LUMBAR PUNCTURE THERAPEUTIC
|
Facility
|
OP
|
$786.42
|
|
|
Service Code
|
CPT 62272
|
| Hospital Charge Code |
36100279
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$367.85 |
| Max. Negotiated Rate |
$1,090.18 |
| Rate for Payer: Aetna Commercial |
$707.78
|
| Rate for Payer: Aetna Medicare |
$703.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$879.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$879.17
|
| Rate for Payer: ASR ASR |
$762.83
|
| Rate for Payer: BCBS Complete |
$386.27
|
| Rate for Payer: BCBS MAPPO |
$703.34
|
| Rate for Payer: BCBS Trust/PPO |
$648.40
|
| Rate for Payer: BCN Commercial |
$648.40
|
| Rate for Payer: BCN Medicare Advantage |
$703.34
|
| Rate for Payer: Cash Price |
$629.14
|
| Rate for Payer: Cash Price |
$629.14
|
| Rate for Payer: Cofinity Commercial |
$739.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$629.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$703.34
|
| Rate for Payer: Healthscope Commercial |
$762.83
|
| Rate for Payer: Healthscope Whirlpool |
$786.42
|
| Rate for Payer: Humana Choice PPO Medicare |
$703.34
|
| Rate for Payer: Mclaren Commercial |
$707.78
|
| Rate for Payer: Mclaren Medicaid |
$703.34
|
| Rate for Payer: Mclaren Medicare |
$703.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$738.51
|
| Rate for Payer: Meridian Medicaid |
$386.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$808.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$773.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$668.46
|
| Rate for Payer: Nomi Health Commercial |
$644.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$589.82
|
| Rate for Payer: PACE Medicare |
$668.17
|
| Rate for Payer: PACE SWMI |
$703.34
|
| Rate for Payer: PHP Commercial |
$773.67
|
| Rate for Payer: PHP Medicaid |
$376.99
|
| Rate for Payer: PHP Medicare Advantage |
$703.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$689.06
|
| Rate for Payer: Priority Health Medicare |
$703.34
|
| Rate for Payer: Priority Health Narrow Network |
$551.28
|
| Rate for Payer: Railroad Medicare Medicare |
$703.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$692.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$703.34
|
| Rate for Payer: UHC Exchange |
$1,090.18
|
| Rate for Payer: UHC Medicaid |
$367.85
|
| Rate for Payer: UHCCP DNSP |
$703.34
|
| Rate for Payer: UHCCP Medicaid |
$367.85
|
| Rate for Payer: VA VA |
$703.34
|
|
|
HC LUMBAR PUNCTURE THERAPEUTIC
|
Facility
|
IP
|
$786.42
|
|
|
Service Code
|
CPT 62272
|
| Hospital Charge Code |
36100279
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$589.82 |
| Max. Negotiated Rate |
$786.42 |
| Rate for Payer: Aetna Commercial |
$707.78
|
| Rate for Payer: ASR ASR |
$762.83
|
| Rate for Payer: BCBS Trust/PPO |
$645.81
|
| Rate for Payer: BCN Commercial |
$645.81
|
| Rate for Payer: Cash Price |
$629.14
|
| Rate for Payer: Cofinity Commercial |
$739.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$629.14
|
| Rate for Payer: Healthscope Commercial |
$762.83
|
| Rate for Payer: Healthscope Whirlpool |
$786.42
|
| Rate for Payer: Mclaren Commercial |
$707.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$668.46
|
| Rate for Payer: Nomi Health Commercial |
$644.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$589.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$692.05
|
|
|
HC LUNG/MED BIOPSY
|
Facility
|
OP
|
$2,150.09
|
|
|
Service Code
|
CPT 32408
|
| Hospital Charge Code |
36100609
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$860.68 |
| Max. Negotiated Rate |
$2,550.77 |
| Rate for Payer: Aetna Commercial |
$1,935.08
|
| Rate for Payer: Aetna Medicare |
$1,645.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: ASR ASR |
$2,085.59
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,772.75
|
| Rate for Payer: BCN Commercial |
$1,772.75
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$1,720.07
|
| Rate for Payer: Cash Price |
$1,720.07
|
| Rate for Payer: Cofinity Commercial |
$2,021.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,720.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$2,085.59
|
| Rate for Payer: Healthscope Whirlpool |
$2,150.09
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,645.66
|
| Rate for Payer: Mclaren Commercial |
$1,935.08
|
| Rate for Payer: Mclaren Medicaid |
$1,645.66
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$903.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,827.58
|
| Rate for Payer: Nomi Health Commercial |
$1,763.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,612.57
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$1,810.23
|
| Rate for Payer: PHP Medicaid |
$882.07
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,883.91
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health Narrow Network |
$1,507.21
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,892.08
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Exchange |
$2,550.77
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP DNSP |
$1,645.66
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
HC LUNG/MED BIOPSY
|
Facility
|
IP
|
$2,150.09
|
|
|
Service Code
|
CPT 32408
|
| Hospital Charge Code |
36100609
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,612.57 |
| Max. Negotiated Rate |
$2,150.09 |
| Rate for Payer: Aetna Commercial |
$1,935.08
|
| Rate for Payer: ASR ASR |
$2,085.59
|
| Rate for Payer: BCBS Trust/PPO |
$1,765.65
|
| Rate for Payer: BCN Commercial |
$1,765.65
|
| Rate for Payer: Cash Price |
$1,720.07
|
| Rate for Payer: Cofinity Commercial |
$2,021.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,720.07
|
| Rate for Payer: Healthscope Commercial |
$2,085.59
|
| Rate for Payer: Healthscope Whirlpool |
$2,150.09
|
| Rate for Payer: Mclaren Commercial |
$1,935.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,827.58
|
| Rate for Payer: Nomi Health Commercial |
$1,763.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,612.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,892.08
|
|
|
HC LUPUS ANTICOAGULANT HEX PHASE
|
Facility
|
IP
|
$166.46
|
|
|
Service Code
|
CPT 85598
|
| Hospital Charge Code |
30500057
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$124.84 |
| Max. Negotiated Rate |
$166.46 |
| Rate for Payer: Aetna Commercial |
$149.81
|
| Rate for Payer: ASR ASR |
$161.47
|
| Rate for Payer: BCBS Trust/PPO |
$136.70
|
| Rate for Payer: BCN Commercial |
$136.70
|
| Rate for Payer: Cash Price |
$133.17
|
| Rate for Payer: Cofinity Commercial |
$156.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$133.17
|
| Rate for Payer: Healthscope Commercial |
$161.47
|
| Rate for Payer: Healthscope Whirlpool |
$166.46
|
| Rate for Payer: Mclaren Commercial |
$149.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$141.49
|
| Rate for Payer: Nomi Health Commercial |
$136.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$124.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$146.48
|
|
|
HC LUPUS ANTICOAGULANT HEX PHASE
|
Facility
|
OP
|
$166.46
|
|
|
Service Code
|
CPT 85598
|
| Hospital Charge Code |
30500057
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$9.40 |
| Max. Negotiated Rate |
$166.46 |
| Rate for Payer: Aetna Commercial |
$149.81
|
| Rate for Payer: Aetna Medicare |
$17.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.48
|
| Rate for Payer: ASR ASR |
$161.47
|
| Rate for Payer: BCBS Complete |
$9.87
|
| Rate for Payer: BCBS MAPPO |
$17.98
|
| Rate for Payer: BCBS Trust/PPO |
$137.25
|
| Rate for Payer: BCN Commercial |
$137.25
|
| Rate for Payer: BCN Medicare Advantage |
$17.98
|
| Rate for Payer: Cash Price |
$133.17
|
| Rate for Payer: Cash Price |
$133.17
|
| Rate for Payer: Cofinity Commercial |
$156.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$133.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.98
|
| Rate for Payer: Healthscope Commercial |
$161.47
|
| Rate for Payer: Healthscope Whirlpool |
$166.46
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.98
|
| Rate for Payer: Mclaren Commercial |
$149.81
|
| Rate for Payer: Mclaren Medicaid |
$17.98
|
| Rate for Payer: Mclaren Medicare |
$17.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.88
|
| Rate for Payer: Meridian Medicaid |
$9.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$141.49
|
| Rate for Payer: Nomi Health Commercial |
$136.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$124.84
|
| Rate for Payer: PACE Medicare |
$17.08
|
| Rate for Payer: PACE SWMI |
$17.98
|
| Rate for Payer: PHP Commercial |
$19.78
|
| Rate for Payer: PHP Medicaid |
$9.64
|
| Rate for Payer: PHP Medicare Advantage |
$17.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$145.85
|
| Rate for Payer: Priority Health Medicare |
$17.98
|
| Rate for Payer: Priority Health Narrow Network |
$116.69
|
| Rate for Payer: Railroad Medicare Medicare |
$17.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$146.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17.98
|
| Rate for Payer: UHC Exchange |
$27.87
|
| Rate for Payer: UHC Medicaid |
$9.40
|
| Rate for Payer: UHCCP DNSP |
$17.98
|
| Rate for Payer: UHCCP Medicaid |
$9.40
|
| Rate for Payer: VA VA |
$17.98
|
|
|
HC LUTETIUM LU 177 VIPIVOTIDE TETRAXETAN, 1 MILLICURIE
|
Facility
|
OP
|
$325.00
|
|
|
Service Code
|
HCPCS A9607
|
| Hospital Charge Code |
34300040
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$135.77 |
| Max. Negotiated Rate |
$402.38 |
| Rate for Payer: Aetna Commercial |
$292.50
|
| Rate for Payer: Aetna Medicare |
$259.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$324.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$324.50
|
| Rate for Payer: ASR ASR |
$315.25
|
| Rate for Payer: BCBS Complete |
$142.57
|
| Rate for Payer: BCBS MAPPO |
$259.60
|
| Rate for Payer: BCBS Trust/PPO |
$267.96
|
| Rate for Payer: BCN Commercial |
$267.96
|
| Rate for Payer: BCN Medicare Advantage |
$259.60
|
| Rate for Payer: Cash Price |
$260.00
|
| Rate for Payer: Cash Price |
$260.00
|
| Rate for Payer: Cofinity Commercial |
$305.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$260.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$259.60
|
| Rate for Payer: Healthscope Commercial |
$315.25
|
| Rate for Payer: Healthscope Whirlpool |
$325.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$259.60
|
| Rate for Payer: Mclaren Commercial |
$292.50
|
| Rate for Payer: Mclaren Medicaid |
$259.60
|
| Rate for Payer: Mclaren Medicare |
$259.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$272.58
|
| Rate for Payer: Meridian Medicaid |
$142.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$298.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$285.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$276.25
|
| Rate for Payer: Nomi Health Commercial |
$266.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$243.75
|
| Rate for Payer: PACE Medicare |
$246.62
|
| Rate for Payer: PACE SWMI |
$259.60
|
| Rate for Payer: PHP Commercial |
$285.56
|
| Rate for Payer: PHP Medicaid |
$139.15
|
| Rate for Payer: PHP Medicare Advantage |
$259.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$135.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$260.96
|
| Rate for Payer: Priority Health Medicare |
$259.60
|
| Rate for Payer: Priority Health Narrow Network |
$208.77
|
| Rate for Payer: Railroad Medicare Medicare |
$259.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$286.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$259.60
|
| Rate for Payer: UHC Exchange |
$402.38
|
| Rate for Payer: UHC Medicaid |
$135.77
|
| Rate for Payer: UHCCP DNSP |
$259.60
|
| Rate for Payer: UHCCP Medicaid |
$135.77
|
| Rate for Payer: VA VA |
$259.60
|
|
|
HC LUTETIUM LU 177 VIPIVOTIDE TETRAXETAN, 1 MILLICURIE
|
Facility
|
IP
|
$325.00
|
|
|
Service Code
|
HCPCS A9607
|
| Hospital Charge Code |
34300040
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$243.75 |
| Max. Negotiated Rate |
$325.00 |
| Rate for Payer: Aetna Commercial |
$292.50
|
| Rate for Payer: ASR ASR |
$315.25
|
| Rate for Payer: BCBS Trust/PPO |
$266.89
|
| Rate for Payer: BCN Commercial |
$266.89
|
| Rate for Payer: Cash Price |
$260.00
|
| Rate for Payer: Cofinity Commercial |
$305.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$260.00
|
| Rate for Payer: Healthscope Commercial |
$315.25
|
| Rate for Payer: Healthscope Whirlpool |
$325.00
|
| Rate for Payer: Mclaren Commercial |
$292.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$276.25
|
| Rate for Payer: Nomi Health Commercial |
$266.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$243.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$286.00
|
|
|
HC LV4RP GROSS_MICRO (BILL ONLY)
|
Facility
|
OP
|
$317.32
|
|
|
Service Code
|
CPT 88305
|
| Hospital Charge Code |
31000087
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$27.15 |
| Max. Negotiated Rate |
$317.32 |
| Rate for Payer: Aetna Commercial |
$285.59
|
| Rate for Payer: Aetna Medicare |
$51.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$64.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$64.90
|
| Rate for Payer: ASR ASR |
$307.80
|
| Rate for Payer: BCBS Complete |
$28.51
|
| Rate for Payer: BCBS MAPPO |
$51.92
|
| Rate for Payer: BCBS Trust/PPO |
$261.63
|
| Rate for Payer: BCCCP Commercial |
$67.27
|
| Rate for Payer: BCN Commercial |
$261.63
|
| Rate for Payer: BCN Medicare Advantage |
$51.92
|
| Rate for Payer: Cash Price |
$253.86
|
| Rate for Payer: Cash Price |
$253.86
|
| Rate for Payer: Cofinity Commercial |
$298.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$253.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.92
|
| Rate for Payer: Healthscope Commercial |
$307.80
|
| Rate for Payer: Healthscope Whirlpool |
$317.32
|
| Rate for Payer: Humana Choice PPO Medicare |
$51.92
|
| Rate for Payer: Mclaren Commercial |
$285.59
|
| Rate for Payer: Mclaren Medicaid |
$51.92
|
| Rate for Payer: Mclaren Medicare |
$51.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$54.52
|
| Rate for Payer: Meridian Medicaid |
$28.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$57.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$269.72
|
| Rate for Payer: Nomi Health Commercial |
$260.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$237.99
|
| Rate for Payer: PACE Medicare |
$49.32
|
| Rate for Payer: PACE SWMI |
$51.92
|
| Rate for Payer: PHP Commercial |
$57.11
|
| Rate for Payer: PHP Medicaid |
$27.83
|
| Rate for Payer: PHP Medicare Advantage |
$51.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$183.99
|
| Rate for Payer: Priority Health Medicare |
$51.92
|
| Rate for Payer: Priority Health Narrow Network |
$147.19
|
| Rate for Payer: Railroad Medicare Medicare |
$51.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$279.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$51.92
|
| Rate for Payer: UHC Exchange |
$80.48
|
| Rate for Payer: UHC Medicaid |
$27.15
|
| Rate for Payer: UHCCP DNSP |
$51.92
|
| Rate for Payer: UHCCP Medicaid |
$27.15
|
| Rate for Payer: VA VA |
$51.92
|
|
|
HC LV4RP GROSS_MICRO (BILL ONLY)
|
Facility
|
IP
|
$317.32
|
|
|
Service Code
|
CPT 88305
|
| Hospital Charge Code |
31000087
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$237.99 |
| Max. Negotiated Rate |
$317.32 |
| Rate for Payer: Aetna Commercial |
$285.59
|
| Rate for Payer: ASR ASR |
$307.80
|
| Rate for Payer: BCBS Trust/PPO |
$260.58
|
| Rate for Payer: BCN Commercial |
$260.58
|
| Rate for Payer: Cash Price |
$253.86
|
| Rate for Payer: Cofinity Commercial |
$298.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$253.86
|
| Rate for Payer: Healthscope Commercial |
$307.80
|
| Rate for Payer: Healthscope Whirlpool |
$317.32
|
| Rate for Payer: Mclaren Commercial |
$285.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$269.72
|
| Rate for Payer: Nomi Health Commercial |
$260.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$237.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$279.24
|
|
|
HC LVAD INSERTION
|
Facility
|
IP
|
$3,288.11
|
|
|
Service Code
|
CPT 33990
|
| Hospital Charge Code |
36100084
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,466.08 |
| Max. Negotiated Rate |
$3,288.11 |
| Rate for Payer: Aetna Commercial |
$2,959.30
|
| Rate for Payer: ASR ASR |
$3,189.47
|
| Rate for Payer: BCBS Trust/PPO |
$2,700.20
|
| Rate for Payer: BCN Commercial |
$2,700.20
|
| Rate for Payer: Cash Price |
$2,630.49
|
| Rate for Payer: Cofinity Commercial |
$3,090.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,630.49
|
| Rate for Payer: Healthscope Commercial |
$3,189.47
|
| Rate for Payer: Healthscope Whirlpool |
$3,288.11
|
| Rate for Payer: Mclaren Commercial |
$2,959.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,794.89
|
| Rate for Payer: Nomi Health Commercial |
$2,696.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,466.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,893.54
|
|
|
HC LVAD INSERTION
|
Facility
|
OP
|
$3,288.11
|
|
|
Service Code
|
CPT 33990
|
| Hospital Charge Code |
36100084
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$3,288.11 |
| Rate for Payer: Aetna Commercial |
$2,959.30
|
| Rate for Payer: Aetna Medicare |
$1,216.60
|
| Rate for Payer: ASR ASR |
$3,189.47
|
| Rate for Payer: BCBS Complete |
$1,315.24
|
| Rate for Payer: BCBS Trust/PPO |
$2,711.05
|
| Rate for Payer: BCN Commercial |
$2,711.05
|
| Rate for Payer: Cash Price |
$2,630.49
|
| Rate for Payer: Cash Price |
$2,630.49
|
| Rate for Payer: Cofinity Commercial |
$3,090.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,630.49
|
| Rate for Payer: Healthscope Commercial |
$3,189.47
|
| Rate for Payer: Healthscope Whirlpool |
$3,288.11
|
| Rate for Payer: Mclaren Commercial |
$2,959.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,630.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,794.89
|
| Rate for Payer: Nomi Health Commercial |
$2,696.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,466.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.01
|
| Rate for Payer: Priority Health Narrow Network |
$0.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,893.54
|
|
|
HC LVDS PLT PER LEUKO RED IRRAD
|
Facility
|
IP
|
$2,889.46
|
|
|
Service Code
|
HCPCS P9037
|
| Hospital Charge Code |
39000088
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$2,167.09 |
| Max. Negotiated Rate |
$2,889.46 |
| Rate for Payer: Aetna Commercial |
$2,600.51
|
| Rate for Payer: ASR ASR |
$2,802.78
|
| Rate for Payer: BCBS Trust/PPO |
$2,372.82
|
| Rate for Payer: BCN Commercial |
$2,372.82
|
| Rate for Payer: Cash Price |
$2,311.57
|
| Rate for Payer: Cofinity Commercial |
$2,716.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,311.57
|
| Rate for Payer: Healthscope Commercial |
$2,802.78
|
| Rate for Payer: Healthscope Whirlpool |
$2,889.46
|
| Rate for Payer: Mclaren Commercial |
$2,600.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,456.04
|
| Rate for Payer: Nomi Health Commercial |
$2,369.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,167.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,542.72
|
|
|
HC LVDS PLT PER LEUKO RED IRRAD
|
Facility
|
OP
|
$2,889.46
|
|
|
Service Code
|
HCPCS P9037
|
| Hospital Charge Code |
39000088
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$347.16 |
| Max. Negotiated Rate |
$2,889.46 |
| Rate for Payer: Aetna Commercial |
$2,600.51
|
| Rate for Payer: Aetna Medicare |
$663.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$829.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$829.74
|
| Rate for Payer: ASR ASR |
$2,802.78
|
| Rate for Payer: BCBS Complete |
$364.55
|
| Rate for Payer: BCBS MAPPO |
$663.79
|
| Rate for Payer: BCBS Trust/PPO |
$2,382.36
|
| Rate for Payer: BCN Commercial |
$2,382.36
|
| Rate for Payer: BCN Medicare Advantage |
$663.79
|
| Rate for Payer: Cash Price |
$2,311.57
|
| Rate for Payer: Cash Price |
$2,311.57
|
| Rate for Payer: Cofinity Commercial |
$2,716.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,311.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$663.79
|
| Rate for Payer: Healthscope Commercial |
$2,802.78
|
| Rate for Payer: Healthscope Whirlpool |
$2,889.46
|
| Rate for Payer: Humana Choice PPO Medicare |
$663.79
|
| Rate for Payer: Mclaren Commercial |
$2,600.51
|
| Rate for Payer: Mclaren Medicaid |
$663.79
|
| Rate for Payer: Mclaren Medicare |
$663.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$696.98
|
| Rate for Payer: Meridian Medicaid |
$364.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$763.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$730.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,456.04
|
| Rate for Payer: Nomi Health Commercial |
$2,369.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,167.09
|
| Rate for Payer: PACE Medicare |
$630.60
|
| Rate for Payer: PACE SWMI |
$663.79
|
| Rate for Payer: PHP Commercial |
$730.17
|
| Rate for Payer: PHP Medicaid |
$355.79
|
| Rate for Payer: PHP Medicare Advantage |
$663.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$347.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,587.03
|
| Rate for Payer: Priority Health Medicare |
$663.79
|
| Rate for Payer: Priority Health Narrow Network |
$1,269.63
|
| Rate for Payer: Railroad Medicare Medicare |
$663.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,542.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$663.79
|
| Rate for Payer: UHC Exchange |
$1,028.87
|
| Rate for Payer: UHC Medicaid |
$347.16
|
| Rate for Payer: UHCCP DNSP |
$663.79
|
| Rate for Payer: UHCCP Medicaid |
$347.16
|
| Rate for Payer: VA VA |
$663.79
|
|
