|
HC IR VASCULAR UNLISTED PROCEDURE
|
Facility
|
OP
|
$490.40
|
|
|
Service Code
|
CPT 36299
|
| Hospital Charge Code |
36100114
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$196.16 |
| Max. Negotiated Rate |
$490.40 |
| Rate for Payer: Aetna Commercial |
$441.36
|
| Rate for Payer: Aetna Medicare |
$245.20
|
| Rate for Payer: ASR ASR |
$475.69
|
| Rate for Payer: ASR Commercial |
$475.69
|
| Rate for Payer: BCBS Complete |
$196.16
|
| Rate for Payer: BCBS Trust/PPO |
$401.59
|
| Rate for Payer: BCN Commercial |
$380.21
|
| Rate for Payer: Cash Price |
$392.32
|
| Rate for Payer: Cofinity Commercial |
$460.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$392.32
|
| Rate for Payer: Healthscope Commercial |
$490.40
|
| Rate for Payer: Healthscope Whirlpool |
$475.69
|
| Rate for Payer: Mclaren Commercial |
$441.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$416.84
|
| Rate for Payer: Nomi Health Commercial |
$402.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$318.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$429.69
|
| Rate for Payer: Priority Health Narrow Network |
$343.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$431.55
|
|
|
HC IR VASCULAR UNLISTED PROCEDURE
|
Facility
|
IP
|
$490.40
|
|
|
Service Code
|
CPT 36299
|
| Hospital Charge Code |
36100114
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$318.76 |
| Max. Negotiated Rate |
$490.40 |
| Rate for Payer: Aetna Commercial |
$441.36
|
| Rate for Payer: ASR ASR |
$475.69
|
| Rate for Payer: ASR Commercial |
$475.69
|
| Rate for Payer: BCBS Trust/PPO |
$399.63
|
| Rate for Payer: BCN Commercial |
$380.21
|
| Rate for Payer: Cash Price |
$392.32
|
| Rate for Payer: Cofinity Commercial |
$460.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$392.32
|
| Rate for Payer: Healthscope Commercial |
$490.40
|
| Rate for Payer: Healthscope Whirlpool |
$475.69
|
| Rate for Payer: Mclaren Commercial |
$441.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$416.84
|
| Rate for Payer: Nomi Health Commercial |
$402.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$318.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$431.55
|
|
|
HC IR VENOGRAM
|
Facility
|
IP
|
$1,122.69
|
|
|
Service Code
|
CPT 75820
|
| Hospital Charge Code |
32000203
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$729.75 |
| Max. Negotiated Rate |
$1,122.69 |
| Rate for Payer: Aetna Commercial |
$1,010.42
|
| Rate for Payer: ASR ASR |
$1,089.01
|
| Rate for Payer: ASR Commercial |
$1,089.01
|
| Rate for Payer: BCBS Trust/PPO |
$914.88
|
| Rate for Payer: BCN Commercial |
$870.42
|
| Rate for Payer: Cash Price |
$898.15
|
| Rate for Payer: Cofinity Commercial |
$1,055.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$898.15
|
| Rate for Payer: Healthscope Commercial |
$1,122.69
|
| Rate for Payer: Healthscope Whirlpool |
$1,089.01
|
| Rate for Payer: Mclaren Commercial |
$1,010.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$954.29
|
| Rate for Payer: Nomi Health Commercial |
$920.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$729.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$987.97
|
|
|
HC IR VENOGRAM
|
Facility
|
OP
|
$1,122.69
|
|
|
Service Code
|
CPT 75820
|
| Hospital Charge Code |
32000203
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$729.75 |
| Max. Negotiated Rate |
$2,359.15 |
| Rate for Payer: Aetna Commercial |
$1,010.42
|
| Rate for Payer: Aetna Medicare |
$1,522.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,902.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,902.54
|
| Rate for Payer: ASR ASR |
$1,089.01
|
| Rate for Payer: ASR Commercial |
$1,089.01
|
| Rate for Payer: BCBS Complete |
$856.60
|
| Rate for Payer: BCBS MAPPO |
$1,522.03
|
| Rate for Payer: BCBS Trust/PPO |
$919.37
|
| Rate for Payer: BCN Commercial |
$870.42
|
| Rate for Payer: BCN Medicare Advantage |
$1,522.03
|
| Rate for Payer: Cash Price |
$898.15
|
| Rate for Payer: Cash Price |
$898.15
|
| Rate for Payer: Cofinity Commercial |
$1,055.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$898.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,522.03
|
| Rate for Payer: Healthscope Commercial |
$1,122.69
|
| Rate for Payer: Healthscope Whirlpool |
$1,089.01
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,522.03
|
| Rate for Payer: Mclaren Commercial |
$1,010.42
|
| Rate for Payer: Mclaren Medicaid |
$815.81
|
| Rate for Payer: Mclaren Medicare |
$1,522.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,598.13
|
| Rate for Payer: Meridian Medicaid |
$856.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,750.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$954.29
|
| Rate for Payer: Nomi Health Commercial |
$920.61
|
| Rate for Payer: PACE Medicare |
$1,445.93
|
| Rate for Payer: PACE SWMI |
$1,522.03
|
| Rate for Payer: PHP Commercial |
$1,674.23
|
| Rate for Payer: PHP Medicaid |
$815.81
|
| Rate for Payer: PHP Medicare Advantage |
$1,522.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$815.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$729.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$983.70
|
| Rate for Payer: Priority Health Medicare |
$1,522.03
|
| Rate for Payer: Priority Health Narrow Network |
$787.01
|
| Rate for Payer: Railroad Medicare Medicare |
$1,522.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$987.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,522.03
|
| Rate for Payer: UHC Exchange |
$2,359.15
|
| Rate for Payer: UHC Medicare Advantage |
$1,522.03
|
| Rate for Payer: UHCCP DNSP |
$1,522.03
|
| Rate for Payer: UHCCP Medicaid |
$815.81
|
| Rate for Payer: VA VA |
$1,522.03
|
|
|
HC IR VENOGRAM BIL
|
Facility
|
IP
|
$1,428.85
|
|
|
Service Code
|
CPT 75822
|
| Hospital Charge Code |
32000204
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$928.75 |
| Max. Negotiated Rate |
$1,428.85 |
| Rate for Payer: Aetna Commercial |
$1,285.96
|
| Rate for Payer: ASR ASR |
$1,385.98
|
| Rate for Payer: ASR Commercial |
$1,385.98
|
| Rate for Payer: BCBS Trust/PPO |
$1,164.37
|
| Rate for Payer: BCN Commercial |
$1,107.79
|
| Rate for Payer: Cash Price |
$1,143.08
|
| Rate for Payer: Cofinity Commercial |
$1,343.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,143.08
|
| Rate for Payer: Healthscope Commercial |
$1,428.85
|
| Rate for Payer: Healthscope Whirlpool |
$1,385.98
|
| Rate for Payer: Mclaren Commercial |
$1,285.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,214.52
|
| Rate for Payer: Nomi Health Commercial |
$1,171.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$928.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,257.39
|
|
|
HC IR VENOGRAM BIL
|
Facility
|
OP
|
$1,428.85
|
|
|
Service Code
|
CPT 75822
|
| Hospital Charge Code |
32000204
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$815.81 |
| Max. Negotiated Rate |
$2,359.15 |
| Rate for Payer: Aetna Commercial |
$1,285.96
|
| Rate for Payer: Aetna Medicare |
$1,522.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,902.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,902.54
|
| Rate for Payer: ASR ASR |
$1,385.98
|
| Rate for Payer: ASR Commercial |
$1,385.98
|
| Rate for Payer: BCBS Complete |
$856.60
|
| Rate for Payer: BCBS MAPPO |
$1,522.03
|
| Rate for Payer: BCBS Trust/PPO |
$1,170.09
|
| Rate for Payer: BCN Commercial |
$1,107.79
|
| Rate for Payer: BCN Medicare Advantage |
$1,522.03
|
| Rate for Payer: Cash Price |
$1,143.08
|
| Rate for Payer: Cash Price |
$1,143.08
|
| Rate for Payer: Cofinity Commercial |
$1,343.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,143.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,522.03
|
| Rate for Payer: Healthscope Commercial |
$1,428.85
|
| Rate for Payer: Healthscope Whirlpool |
$1,385.98
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,522.03
|
| Rate for Payer: Mclaren Commercial |
$1,285.96
|
| Rate for Payer: Mclaren Medicaid |
$815.81
|
| Rate for Payer: Mclaren Medicare |
$1,522.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,598.13
|
| Rate for Payer: Meridian Medicaid |
$856.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,750.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,214.52
|
| Rate for Payer: Nomi Health Commercial |
$1,171.66
|
| Rate for Payer: PACE Medicare |
$1,445.93
|
| Rate for Payer: PACE SWMI |
$1,522.03
|
| Rate for Payer: PHP Commercial |
$1,674.23
|
| Rate for Payer: PHP Medicaid |
$815.81
|
| Rate for Payer: PHP Medicare Advantage |
$1,522.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$815.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$928.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,251.96
|
| Rate for Payer: Priority Health Medicare |
$1,522.03
|
| Rate for Payer: Priority Health Narrow Network |
$1,001.62
|
| Rate for Payer: Railroad Medicare Medicare |
$1,522.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,257.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,522.03
|
| Rate for Payer: UHC Exchange |
$2,359.15
|
| Rate for Payer: UHC Medicare Advantage |
$1,522.03
|
| Rate for Payer: UHCCP DNSP |
$1,522.03
|
| Rate for Payer: UHCCP Medicaid |
$815.81
|
| Rate for Payer: VA VA |
$1,522.03
|
|
|
HC IR VENOGRAM RENAL BILAT SELECT
|
Facility
|
IP
|
$3,801.67
|
|
|
Service Code
|
CPT 75833
|
| Hospital Charge Code |
32000207
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,471.09 |
| Max. Negotiated Rate |
$3,801.67 |
| Rate for Payer: Aetna Commercial |
$3,421.50
|
| Rate for Payer: ASR ASR |
$3,687.62
|
| Rate for Payer: ASR Commercial |
$3,687.62
|
| Rate for Payer: BCBS Trust/PPO |
$3,097.98
|
| Rate for Payer: BCN Commercial |
$2,947.43
|
| Rate for Payer: Cash Price |
$3,041.34
|
| Rate for Payer: Cofinity Commercial |
$3,573.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,041.34
|
| Rate for Payer: Healthscope Commercial |
$3,801.67
|
| Rate for Payer: Healthscope Whirlpool |
$3,687.62
|
| Rate for Payer: Mclaren Commercial |
$3,421.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,231.42
|
| Rate for Payer: Nomi Health Commercial |
$3,117.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,471.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,345.47
|
|
|
HC IR VENOGRAM RENAL BILAT SELECT
|
Facility
|
OP
|
$3,801.67
|
|
|
Service Code
|
CPT 75833
|
| Hospital Charge Code |
32000207
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,652.95 |
| Max. Negotiated Rate |
$4,779.98 |
| Rate for Payer: Aetna Commercial |
$3,421.50
|
| Rate for Payer: Aetna Medicare |
$3,083.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,854.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,854.82
|
| Rate for Payer: ASR ASR |
$3,687.62
|
| Rate for Payer: ASR Commercial |
$3,687.62
|
| Rate for Payer: BCBS Complete |
$1,735.60
|
| Rate for Payer: BCBS MAPPO |
$3,083.86
|
| Rate for Payer: BCBS Trust/PPO |
$3,113.19
|
| Rate for Payer: BCN Commercial |
$2,947.43
|
| Rate for Payer: BCN Medicare Advantage |
$3,083.86
|
| Rate for Payer: Cash Price |
$3,041.34
|
| Rate for Payer: Cash Price |
$3,041.34
|
| Rate for Payer: Cofinity Commercial |
$3,573.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,041.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,083.86
|
| Rate for Payer: Healthscope Commercial |
$3,801.67
|
| Rate for Payer: Healthscope Whirlpool |
$3,687.62
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,083.86
|
| Rate for Payer: Mclaren Commercial |
$3,421.50
|
| Rate for Payer: Mclaren Medicaid |
$1,652.95
|
| Rate for Payer: Mclaren Medicare |
$3,083.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,238.05
|
| Rate for Payer: Meridian Medicaid |
$1,735.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,546.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,231.42
|
| Rate for Payer: Nomi Health Commercial |
$3,117.37
|
| Rate for Payer: PACE Medicare |
$2,929.67
|
| Rate for Payer: PACE SWMI |
$3,083.86
|
| Rate for Payer: PHP Commercial |
$3,392.25
|
| Rate for Payer: PHP Medicaid |
$1,652.95
|
| Rate for Payer: PHP Medicare Advantage |
$3,083.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,652.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,471.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,331.02
|
| Rate for Payer: Priority Health Medicare |
$3,083.86
|
| Rate for Payer: Priority Health Narrow Network |
$2,664.97
|
| Rate for Payer: Railroad Medicare Medicare |
$3,083.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,345.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,083.86
|
| Rate for Payer: UHC Exchange |
$4,779.98
|
| Rate for Payer: UHC Medicare Advantage |
$3,083.86
|
| Rate for Payer: UHCCP DNSP |
$3,083.86
|
| Rate for Payer: UHCCP Medicaid |
$1,652.95
|
| Rate for Payer: VA VA |
$3,083.86
|
|
|
HC IR VENOGRAM RENAL UNI SELECT
|
Facility
|
OP
|
$3,570.17
|
|
|
Service Code
|
CPT 75831
|
| Hospital Charge Code |
32000322
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,652.95 |
| Max. Negotiated Rate |
$4,779.98 |
| Rate for Payer: Aetna Commercial |
$3,213.15
|
| Rate for Payer: Aetna Medicare |
$3,083.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,854.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,854.82
|
| Rate for Payer: ASR ASR |
$3,463.06
|
| Rate for Payer: ASR Commercial |
$3,463.06
|
| Rate for Payer: BCBS Complete |
$1,735.60
|
| Rate for Payer: BCBS MAPPO |
$3,083.86
|
| Rate for Payer: BCBS Trust/PPO |
$2,923.61
|
| Rate for Payer: BCN Commercial |
$2,767.95
|
| Rate for Payer: BCN Medicare Advantage |
$3,083.86
|
| Rate for Payer: Cash Price |
$2,856.14
|
| Rate for Payer: Cash Price |
$2,856.14
|
| Rate for Payer: Cofinity Commercial |
$3,355.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,856.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,083.86
|
| Rate for Payer: Healthscope Commercial |
$3,570.17
|
| Rate for Payer: Healthscope Whirlpool |
$3,463.06
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,083.86
|
| Rate for Payer: Mclaren Commercial |
$3,213.15
|
| Rate for Payer: Mclaren Medicaid |
$1,652.95
|
| Rate for Payer: Mclaren Medicare |
$3,083.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,238.05
|
| Rate for Payer: Meridian Medicaid |
$1,735.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,546.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,034.64
|
| Rate for Payer: Nomi Health Commercial |
$2,927.54
|
| Rate for Payer: PACE Medicare |
$2,929.67
|
| Rate for Payer: PACE SWMI |
$3,083.86
|
| Rate for Payer: PHP Commercial |
$3,392.25
|
| Rate for Payer: PHP Medicaid |
$1,652.95
|
| Rate for Payer: PHP Medicare Advantage |
$3,083.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,652.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,320.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,128.18
|
| Rate for Payer: Priority Health Medicare |
$3,083.86
|
| Rate for Payer: Priority Health Narrow Network |
$2,502.69
|
| Rate for Payer: Railroad Medicare Medicare |
$3,083.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,141.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,083.86
|
| Rate for Payer: UHC Exchange |
$4,779.98
|
| Rate for Payer: UHC Medicare Advantage |
$3,083.86
|
| Rate for Payer: UHCCP DNSP |
$3,083.86
|
| Rate for Payer: UHCCP Medicaid |
$1,652.95
|
| Rate for Payer: VA VA |
$3,083.86
|
|
|
HC IR VENOGRAM RENAL UNI SELECT
|
Facility
|
IP
|
$3,570.17
|
|
|
Service Code
|
CPT 75831
|
| Hospital Charge Code |
32000322
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,320.61 |
| Max. Negotiated Rate |
$3,570.17 |
| Rate for Payer: Aetna Commercial |
$3,213.15
|
| Rate for Payer: ASR ASR |
$3,463.06
|
| Rate for Payer: ASR Commercial |
$3,463.06
|
| Rate for Payer: BCBS Trust/PPO |
$2,909.33
|
| Rate for Payer: BCN Commercial |
$2,767.95
|
| Rate for Payer: Cash Price |
$2,856.14
|
| Rate for Payer: Cofinity Commercial |
$3,355.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,856.14
|
| Rate for Payer: Healthscope Commercial |
$3,570.17
|
| Rate for Payer: Healthscope Whirlpool |
$3,463.06
|
| Rate for Payer: Mclaren Commercial |
$3,213.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,034.64
|
| Rate for Payer: Nomi Health Commercial |
$2,927.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,320.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,141.75
|
|
|
HC IR Z ABSCESS PERIANAL
|
Facility
|
IP
|
$1,208.35
|
|
|
Service Code
|
CPT 46050
|
| Hospital Charge Code |
36100369
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$785.43 |
| Max. Negotiated Rate |
$1,208.35 |
| Rate for Payer: Aetna Commercial |
$1,087.52
|
| Rate for Payer: ASR ASR |
$1,172.10
|
| Rate for Payer: ASR Commercial |
$1,172.10
|
| Rate for Payer: BCBS Trust/PPO |
$984.68
|
| Rate for Payer: BCN Commercial |
$936.83
|
| Rate for Payer: Cash Price |
$966.68
|
| Rate for Payer: Cofinity Commercial |
$1,135.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$966.68
|
| Rate for Payer: Healthscope Commercial |
$1,208.35
|
| Rate for Payer: Healthscope Whirlpool |
$1,172.10
|
| Rate for Payer: Mclaren Commercial |
$1,087.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,027.10
|
| Rate for Payer: Nomi Health Commercial |
$990.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$785.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,063.35
|
|
|
HC IR Z ABSCESS PERIANAL
|
Facility
|
OP
|
$1,208.35
|
|
|
Service Code
|
CPT 46050
|
| Hospital Charge Code |
36100369
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$478.80 |
| Max. Negotiated Rate |
$2,437.59 |
| Rate for Payer: Aetna Commercial |
$1,087.52
|
| Rate for Payer: Aetna Medicare |
$893.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,116.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,116.60
|
| Rate for Payer: ASR ASR |
$1,172.10
|
| Rate for Payer: ASR Commercial |
$1,172.10
|
| Rate for Payer: BCBS Complete |
$502.74
|
| Rate for Payer: BCBS MAPPO |
$893.28
|
| Rate for Payer: BCBS Trust/PPO |
$989.52
|
| Rate for Payer: BCN Commercial |
$936.83
|
| Rate for Payer: BCN Medicare Advantage |
$893.28
|
| Rate for Payer: Cash Price |
$966.68
|
| Rate for Payer: Cash Price |
$966.68
|
| Rate for Payer: Cofinity Commercial |
$1,135.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$966.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$893.28
|
| Rate for Payer: Healthscope Commercial |
$1,208.35
|
| Rate for Payer: Healthscope Whirlpool |
$1,172.10
|
| Rate for Payer: Humana Choice PPO Medicare |
$893.28
|
| Rate for Payer: Mclaren Commercial |
$1,087.52
|
| Rate for Payer: Mclaren Medicaid |
$478.80
|
| Rate for Payer: Mclaren Medicare |
$893.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$937.94
|
| Rate for Payer: Meridian Medicaid |
$502.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,027.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,027.10
|
| Rate for Payer: Nomi Health Commercial |
$990.85
|
| Rate for Payer: PACE Medicare |
$848.62
|
| Rate for Payer: PACE SWMI |
$893.28
|
| Rate for Payer: PHP Commercial |
$982.61
|
| Rate for Payer: PHP Medicaid |
$478.80
|
| Rate for Payer: PHP Medicare Advantage |
$893.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$478.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$785.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,437.59
|
| Rate for Payer: Priority Health Medicare |
$893.28
|
| Rate for Payer: Priority Health Narrow Network |
$1,950.07
|
| Rate for Payer: Railroad Medicare Medicare |
$893.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,063.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$893.28
|
| Rate for Payer: UHC Exchange |
$1,384.58
|
| Rate for Payer: UHC Medicare Advantage |
$893.28
|
| Rate for Payer: UHCCP DNSP |
$893.28
|
| Rate for Payer: UHCCP Medicaid |
$478.80
|
| Rate for Payer: VA VA |
$893.28
|
|
|
HC ISCHEMIA MODIFIED ALBUMIN
|
Facility
|
IP
|
$161.36
|
|
|
Service Code
|
CPT 82045
|
| Hospital Charge Code |
30100076
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$104.88 |
| Max. Negotiated Rate |
$161.36 |
| Rate for Payer: Aetna Commercial |
$145.22
|
| Rate for Payer: ASR ASR |
$156.52
|
| Rate for Payer: ASR Commercial |
$156.52
|
| Rate for Payer: BCBS Trust/PPO |
$131.49
|
| Rate for Payer: BCN Commercial |
$125.10
|
| Rate for Payer: Cash Price |
$129.09
|
| Rate for Payer: Cofinity Commercial |
$151.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.09
|
| Rate for Payer: Healthscope Commercial |
$161.36
|
| Rate for Payer: Healthscope Whirlpool |
$156.52
|
| Rate for Payer: Mclaren Commercial |
$145.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.16
|
| Rate for Payer: Nomi Health Commercial |
$132.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$142.00
|
|
|
HC ISCHEMIA MODIFIED ALBUMIN
|
Facility
|
OP
|
$161.36
|
|
|
Service Code
|
CPT 82045
|
| Hospital Charge Code |
30100076
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.19 |
| Max. Negotiated Rate |
$161.36 |
| Rate for Payer: Aetna Commercial |
$145.22
|
| Rate for Payer: Aetna Medicare |
$33.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$42.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$42.42
|
| Rate for Payer: ASR ASR |
$156.52
|
| Rate for Payer: ASR Commercial |
$156.52
|
| Rate for Payer: BCBS Complete |
$19.10
|
| Rate for Payer: BCBS MAPPO |
$33.94
|
| Rate for Payer: BCBS Trust/PPO |
$132.14
|
| Rate for Payer: BCN Commercial |
$125.10
|
| Rate for Payer: BCN Medicare Advantage |
$33.94
|
| Rate for Payer: Cash Price |
$129.09
|
| Rate for Payer: Cash Price |
$129.09
|
| Rate for Payer: Cofinity Commercial |
$151.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.94
|
| Rate for Payer: Healthscope Commercial |
$161.36
|
| Rate for Payer: Healthscope Whirlpool |
$156.52
|
| Rate for Payer: Humana Choice PPO Medicare |
$33.94
|
| Rate for Payer: Mclaren Commercial |
$145.22
|
| Rate for Payer: Mclaren Medicaid |
$18.19
|
| Rate for Payer: Mclaren Medicare |
$33.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.64
|
| Rate for Payer: Meridian Medicaid |
$19.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$39.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.16
|
| Rate for Payer: Nomi Health Commercial |
$132.32
|
| Rate for Payer: PACE Medicare |
$32.24
|
| Rate for Payer: PACE SWMI |
$33.94
|
| Rate for Payer: PHP Commercial |
$37.33
|
| Rate for Payer: PHP Medicaid |
$18.19
|
| Rate for Payer: PHP Medicare Advantage |
$33.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$141.38
|
| Rate for Payer: Priority Health Medicare |
$33.94
|
| Rate for Payer: Priority Health Narrow Network |
$113.11
|
| Rate for Payer: Railroad Medicare Medicare |
$33.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$142.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.94
|
| Rate for Payer: UHC Exchange |
$52.61
|
| Rate for Payer: UHC Medicare Advantage |
$33.94
|
| Rate for Payer: UHCCP DNSP |
$33.94
|
| Rate for Payer: UHCCP Medicaid |
$18.19
|
| Rate for Payer: VA VA |
$33.94
|
|
|
HC ISLET ANTIGEN 2 ANTIBODY
|
Facility
|
OP
|
$55.14
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
30200412
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.63 |
| Max. Negotiated Rate |
$55.14 |
| Rate for Payer: Aetna Commercial |
$49.63
|
| Rate for Payer: Aetna Medicare |
$23.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.46
|
| Rate for Payer: ASR ASR |
$53.49
|
| Rate for Payer: ASR Commercial |
$53.49
|
| Rate for Payer: BCBS Complete |
$13.27
|
| Rate for Payer: BCBS MAPPO |
$23.57
|
| Rate for Payer: BCBS Trust/PPO |
$45.15
|
| Rate for Payer: BCN Commercial |
$42.75
|
| Rate for Payer: BCN Medicare Advantage |
$23.57
|
| Rate for Payer: Cash Price |
$44.11
|
| Rate for Payer: Cash Price |
$44.11
|
| Rate for Payer: Cofinity Commercial |
$51.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.57
|
| Rate for Payer: Healthscope Commercial |
$55.14
|
| Rate for Payer: Healthscope Whirlpool |
$53.49
|
| Rate for Payer: Humana Choice PPO Medicare |
$23.57
|
| Rate for Payer: Mclaren Commercial |
$49.63
|
| Rate for Payer: Mclaren Medicaid |
$12.63
|
| Rate for Payer: Mclaren Medicare |
$23.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.75
|
| Rate for Payer: Meridian Medicaid |
$13.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.87
|
| Rate for Payer: Nomi Health Commercial |
$45.21
|
| Rate for Payer: PACE Medicare |
$22.39
|
| Rate for Payer: PACE SWMI |
$23.57
|
| Rate for Payer: PHP Commercial |
$25.93
|
| Rate for Payer: PHP Medicaid |
$12.63
|
| Rate for Payer: PHP Medicare Advantage |
$23.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$48.31
|
| Rate for Payer: Priority Health Medicare |
$23.57
|
| Rate for Payer: Priority Health Narrow Network |
$38.65
|
| Rate for Payer: Railroad Medicare Medicare |
$23.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$48.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.57
|
| Rate for Payer: UHC Exchange |
$36.53
|
| Rate for Payer: UHC Medicare Advantage |
$23.57
|
| Rate for Payer: UHCCP DNSP |
$23.57
|
| Rate for Payer: UHCCP Medicaid |
$12.63
|
| Rate for Payer: VA VA |
$23.57
|
|
|
HC ISLET ANTIGEN 2 ANTIBODY
|
Facility
|
IP
|
$55.14
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
30200412
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$35.84 |
| Max. Negotiated Rate |
$55.14 |
| Rate for Payer: Aetna Commercial |
$49.63
|
| Rate for Payer: ASR ASR |
$53.49
|
| Rate for Payer: ASR Commercial |
$53.49
|
| Rate for Payer: BCBS Trust/PPO |
$44.93
|
| Rate for Payer: BCN Commercial |
$42.75
|
| Rate for Payer: Cash Price |
$44.11
|
| Rate for Payer: Cofinity Commercial |
$51.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.11
|
| Rate for Payer: Healthscope Commercial |
$55.14
|
| Rate for Payer: Healthscope Whirlpool |
$53.49
|
| Rate for Payer: Mclaren Commercial |
$49.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.87
|
| Rate for Payer: Nomi Health Commercial |
$45.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$48.52
|
|
|
HC ISOAGGLUTININ TITER ANTI A
|
Facility
|
OP
|
$109.24
|
|
|
Service Code
|
CPT 86886
|
| Hospital Charge Code |
30200345
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$71.01 |
| Max. Negotiated Rate |
$260.24 |
| Rate for Payer: Aetna Commercial |
$98.32
|
| Rate for Payer: Aetna Medicare |
$167.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$209.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$209.88
|
| Rate for Payer: ASR ASR |
$105.96
|
| Rate for Payer: ASR Commercial |
$105.96
|
| Rate for Payer: BCBS Complete |
$94.49
|
| Rate for Payer: BCBS MAPPO |
$167.90
|
| Rate for Payer: BCBS Trust/PPO |
$89.46
|
| Rate for Payer: BCN Commercial |
$84.69
|
| Rate for Payer: BCN Medicare Advantage |
$167.90
|
| Rate for Payer: Cash Price |
$87.39
|
| Rate for Payer: Cash Price |
$87.39
|
| Rate for Payer: Cofinity Commercial |
$102.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$167.90
|
| Rate for Payer: Healthscope Commercial |
$109.24
|
| Rate for Payer: Healthscope Whirlpool |
$105.96
|
| Rate for Payer: Humana Choice PPO Medicare |
$167.90
|
| Rate for Payer: Mclaren Commercial |
$98.32
|
| Rate for Payer: Mclaren Medicaid |
$89.99
|
| Rate for Payer: Mclaren Medicare |
$167.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$176.30
|
| Rate for Payer: Meridian Medicaid |
$94.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$193.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$92.85
|
| Rate for Payer: Nomi Health Commercial |
$89.58
|
| Rate for Payer: PACE Medicare |
$159.50
|
| Rate for Payer: PACE SWMI |
$167.90
|
| Rate for Payer: PHP Commercial |
$184.69
|
| Rate for Payer: PHP Medicaid |
$89.99
|
| Rate for Payer: PHP Medicare Advantage |
$167.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.01
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$95.72
|
| Rate for Payer: Priority Health Medicare |
$167.90
|
| Rate for Payer: Priority Health Narrow Network |
$76.58
|
| Rate for Payer: Railroad Medicare Medicare |
$167.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$96.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$167.90
|
| Rate for Payer: UHC Exchange |
$260.24
|
| Rate for Payer: UHC Medicare Advantage |
$167.90
|
| Rate for Payer: UHCCP DNSP |
$167.90
|
| Rate for Payer: UHCCP Medicaid |
$89.99
|
| Rate for Payer: VA VA |
$167.90
|
|
|
HC ISOAGGLUTININ TITER ANTI A
|
Facility
|
IP
|
$109.24
|
|
|
Service Code
|
CPT 86886
|
| Hospital Charge Code |
30200345
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$71.01 |
| Max. Negotiated Rate |
$109.24 |
| Rate for Payer: Aetna Commercial |
$98.32
|
| Rate for Payer: ASR ASR |
$105.96
|
| Rate for Payer: ASR Commercial |
$105.96
|
| Rate for Payer: BCBS Trust/PPO |
$89.02
|
| Rate for Payer: BCN Commercial |
$84.69
|
| Rate for Payer: Cash Price |
$87.39
|
| Rate for Payer: Cofinity Commercial |
$102.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.39
|
| Rate for Payer: Healthscope Commercial |
$109.24
|
| Rate for Payer: Healthscope Whirlpool |
$105.96
|
| Rate for Payer: Mclaren Commercial |
$98.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$92.85
|
| Rate for Payer: Nomi Health Commercial |
$89.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$96.13
|
|
|
HC ISOAGGLUTININ TITER ANTI B
|
Facility
|
OP
|
$109.24
|
|
|
Service Code
|
CPT 86886
|
| Hospital Charge Code |
30200346
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$71.01 |
| Max. Negotiated Rate |
$260.24 |
| Rate for Payer: Aetna Commercial |
$98.32
|
| Rate for Payer: Aetna Medicare |
$167.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$209.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$209.88
|
| Rate for Payer: ASR ASR |
$105.96
|
| Rate for Payer: ASR Commercial |
$105.96
|
| Rate for Payer: BCBS Complete |
$94.49
|
| Rate for Payer: BCBS MAPPO |
$167.90
|
| Rate for Payer: BCBS Trust/PPO |
$89.46
|
| Rate for Payer: BCN Commercial |
$84.69
|
| Rate for Payer: BCN Medicare Advantage |
$167.90
|
| Rate for Payer: Cash Price |
$87.39
|
| Rate for Payer: Cash Price |
$87.39
|
| Rate for Payer: Cofinity Commercial |
$102.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$167.90
|
| Rate for Payer: Healthscope Commercial |
$109.24
|
| Rate for Payer: Healthscope Whirlpool |
$105.96
|
| Rate for Payer: Humana Choice PPO Medicare |
$167.90
|
| Rate for Payer: Mclaren Commercial |
$98.32
|
| Rate for Payer: Mclaren Medicaid |
$89.99
|
| Rate for Payer: Mclaren Medicare |
$167.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$176.30
|
| Rate for Payer: Meridian Medicaid |
$94.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$193.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$92.85
|
| Rate for Payer: Nomi Health Commercial |
$89.58
|
| Rate for Payer: PACE Medicare |
$159.50
|
| Rate for Payer: PACE SWMI |
$167.90
|
| Rate for Payer: PHP Commercial |
$184.69
|
| Rate for Payer: PHP Medicaid |
$89.99
|
| Rate for Payer: PHP Medicare Advantage |
$167.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.01
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$95.72
|
| Rate for Payer: Priority Health Medicare |
$167.90
|
| Rate for Payer: Priority Health Narrow Network |
$76.58
|
| Rate for Payer: Railroad Medicare Medicare |
$167.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$96.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$167.90
|
| Rate for Payer: UHC Exchange |
$260.24
|
| Rate for Payer: UHC Medicare Advantage |
$167.90
|
| Rate for Payer: UHCCP DNSP |
$167.90
|
| Rate for Payer: UHCCP Medicaid |
$89.99
|
| Rate for Payer: VA VA |
$167.90
|
|
|
HC ISOAGGLUTININ TITER ANTI B
|
Facility
|
IP
|
$109.24
|
|
|
Service Code
|
CPT 86886
|
| Hospital Charge Code |
30200346
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$71.01 |
| Max. Negotiated Rate |
$109.24 |
| Rate for Payer: Aetna Commercial |
$98.32
|
| Rate for Payer: ASR ASR |
$105.96
|
| Rate for Payer: ASR Commercial |
$105.96
|
| Rate for Payer: BCBS Trust/PPO |
$89.02
|
| Rate for Payer: BCN Commercial |
$84.69
|
| Rate for Payer: Cash Price |
$87.39
|
| Rate for Payer: Cofinity Commercial |
$102.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.39
|
| Rate for Payer: Healthscope Commercial |
$109.24
|
| Rate for Payer: Healthscope Whirlpool |
$105.96
|
| Rate for Payer: Mclaren Commercial |
$98.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$92.85
|
| Rate for Payer: Nomi Health Commercial |
$89.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$96.13
|
|
|
HC ISOPROPANOL LVL
|
Facility
|
OP
|
$159.12
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
30100580
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$63.65 |
| Max. Negotiated Rate |
$159.12 |
| Rate for Payer: Aetna Commercial |
$143.21
|
| Rate for Payer: Aetna Medicare |
$79.56
|
| Rate for Payer: ASR ASR |
$154.35
|
| Rate for Payer: ASR Commercial |
$154.35
|
| Rate for Payer: BCBS Complete |
$63.65
|
| Rate for Payer: BCBS Trust/PPO |
$130.30
|
| Rate for Payer: BCN Commercial |
$123.37
|
| Rate for Payer: Cash Price |
$127.30
|
| Rate for Payer: Cofinity Commercial |
$149.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$127.30
|
| Rate for Payer: Healthscope Commercial |
$159.12
|
| Rate for Payer: Healthscope Whirlpool |
$154.35
|
| Rate for Payer: Mclaren Commercial |
$143.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$135.25
|
| Rate for Payer: Nomi Health Commercial |
$130.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$103.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$139.42
|
| Rate for Payer: Priority Health Narrow Network |
$111.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$140.03
|
|
|
HC ISOPROPANOL LVL
|
Facility
|
IP
|
$159.12
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
30100580
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$103.43 |
| Max. Negotiated Rate |
$159.12 |
| Rate for Payer: Aetna Commercial |
$143.21
|
| Rate for Payer: ASR ASR |
$154.35
|
| Rate for Payer: ASR Commercial |
$154.35
|
| Rate for Payer: BCBS Trust/PPO |
$129.67
|
| Rate for Payer: BCN Commercial |
$123.37
|
| Rate for Payer: Cash Price |
$127.30
|
| Rate for Payer: Cofinity Commercial |
$149.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$127.30
|
| Rate for Payer: Healthscope Commercial |
$159.12
|
| Rate for Payer: Healthscope Whirlpool |
$154.35
|
| Rate for Payer: Mclaren Commercial |
$143.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$135.25
|
| Rate for Payer: Nomi Health Commercial |
$130.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$103.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$140.03
|
|
|
HC ISOVUE 200M PER ML
|
Facility
|
OP
|
$2.40
|
|
|
Service Code
|
HCPCS Q9966
|
| Hospital Charge Code |
63600033
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.34 |
| Max. Negotiated Rate |
$2.40 |
| Rate for Payer: Aetna Commercial |
$2.16
|
| Rate for Payer: Aetna Medicare |
$1.20
|
| Rate for Payer: ASR ASR |
$2.33
|
| Rate for Payer: ASR Commercial |
$2.33
|
| Rate for Payer: BCBS Complete |
$0.96
|
| Rate for Payer: BCBS Trust/PPO |
$1.97
|
| Rate for Payer: BCN Commercial |
$1.86
|
| Rate for Payer: Cash Price |
$1.92
|
| Rate for Payer: Cash Price |
$1.92
|
| Rate for Payer: Cofinity Commercial |
$2.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.92
|
| Rate for Payer: Healthscope Commercial |
$2.40
|
| Rate for Payer: Healthscope Whirlpool |
$2.33
|
| Rate for Payer: Mclaren Commercial |
$2.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.04
|
| Rate for Payer: Nomi Health Commercial |
$1.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$0.42
|
| Rate for Payer: Priority Health Narrow Network |
$0.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2.11
|
|
|
HC ISOVUE 200M PER ML
|
Facility
|
IP
|
$2.40
|
|
|
Service Code
|
HCPCS Q9966
|
| Hospital Charge Code |
63600033
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.56 |
| Max. Negotiated Rate |
$2.40 |
| Rate for Payer: Aetna Commercial |
$2.16
|
| Rate for Payer: ASR ASR |
$2.33
|
| Rate for Payer: ASR Commercial |
$2.33
|
| Rate for Payer: BCBS Trust/PPO |
$1.96
|
| Rate for Payer: BCN Commercial |
$1.86
|
| Rate for Payer: Cash Price |
$1.92
|
| Rate for Payer: Cofinity Commercial |
$2.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.92
|
| Rate for Payer: Healthscope Commercial |
$2.40
|
| Rate for Payer: Healthscope Whirlpool |
$2.33
|
| Rate for Payer: Mclaren Commercial |
$2.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.04
|
| Rate for Payer: Nomi Health Commercial |
$1.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2.11
|
|
|
HC ISOVUE 200 PER ML
|
Facility
|
IP
|
$4.46
|
|
|
Service Code
|
HCPCS Q9966
|
| Hospital Charge Code |
63600011
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.90 |
| Max. Negotiated Rate |
$4.46 |
| Rate for Payer: Aetna Commercial |
$4.01
|
| Rate for Payer: ASR ASR |
$4.33
|
| Rate for Payer: ASR Commercial |
$4.33
|
| Rate for Payer: BCBS Trust/PPO |
$3.63
|
| Rate for Payer: BCN Commercial |
$3.46
|
| Rate for Payer: Cash Price |
$3.57
|
| Rate for Payer: Cofinity Commercial |
$4.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.57
|
| Rate for Payer: Healthscope Commercial |
$4.46
|
| Rate for Payer: Healthscope Whirlpool |
$4.33
|
| Rate for Payer: Mclaren Commercial |
$4.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.79
|
| Rate for Payer: Nomi Health Commercial |
$3.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3.92
|
|
