|
HC LABOR CAT (5) 12-17HRS
|
Facility
|
IP
|
$4,589.55
|
|
| Hospital Charge Code |
72000007
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$2,983.21 |
| Max. Negotiated Rate |
$4,589.55 |
| Rate for Payer: Aetna Commercial |
$4,130.60
|
| Rate for Payer: ASR ASR |
$4,451.86
|
| Rate for Payer: ASR Commercial |
$4,451.86
|
| Rate for Payer: BCBS Trust/PPO |
$3,740.02
|
| Rate for Payer: BCN Commercial |
$3,558.28
|
| Rate for Payer: Cash Price |
$3,671.64
|
| Rate for Payer: Cofinity Commercial |
$4,314.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,671.64
|
| Rate for Payer: Healthscope Commercial |
$4,589.55
|
| Rate for Payer: Healthscope Whirlpool |
$4,451.86
|
| Rate for Payer: Mclaren Commercial |
$4,130.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,901.12
|
| Rate for Payer: Nomi Health Commercial |
$3,763.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,983.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,038.80
|
|
|
HC LABOR CAT (6) 17 OR MORE HRS
|
Facility
|
IP
|
$6,790.05
|
|
| Hospital Charge Code |
72000008
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$4,413.53 |
| Max. Negotiated Rate |
$6,790.05 |
| Rate for Payer: Aetna Commercial |
$6,111.05
|
| Rate for Payer: ASR ASR |
$6,586.35
|
| Rate for Payer: ASR Commercial |
$6,586.35
|
| Rate for Payer: BCBS Trust/PPO |
$5,533.21
|
| Rate for Payer: BCN Commercial |
$5,264.33
|
| Rate for Payer: Cash Price |
$5,432.04
|
| Rate for Payer: Cofinity Commercial |
$6,382.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,432.04
|
| Rate for Payer: Healthscope Commercial |
$6,790.05
|
| Rate for Payer: Healthscope Whirlpool |
$6,586.35
|
| Rate for Payer: Mclaren Commercial |
$6,111.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,771.54
|
| Rate for Payer: Nomi Health Commercial |
$5,567.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,413.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,975.24
|
|
|
HC LABOR CAT (6) 17 OR MORE HRS
|
Facility
|
OP
|
$6,790.05
|
|
| Hospital Charge Code |
72000008
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$2,716.02 |
| Max. Negotiated Rate |
$6,790.05 |
| Rate for Payer: Aetna Commercial |
$6,111.05
|
| Rate for Payer: Aetna Medicare |
$3,395.03
|
| Rate for Payer: ASR ASR |
$6,586.35
|
| Rate for Payer: ASR Commercial |
$6,586.35
|
| Rate for Payer: BCBS Complete |
$2,716.02
|
| Rate for Payer: BCBS Trust/PPO |
$5,560.37
|
| Rate for Payer: BCN Commercial |
$5,264.33
|
| Rate for Payer: Cash Price |
$5,432.04
|
| Rate for Payer: Cofinity Commercial |
$6,382.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,432.04
|
| Rate for Payer: Healthscope Commercial |
$6,790.05
|
| Rate for Payer: Healthscope Whirlpool |
$6,586.35
|
| Rate for Payer: Mclaren Commercial |
$6,111.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,771.54
|
| Rate for Payer: Nomi Health Commercial |
$5,567.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,413.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,949.44
|
| Rate for Payer: Priority Health Narrow Network |
$4,759.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,975.24
|
|
|
HC LABYRINTHOTOMY TRANSCANAL
|
Facility
|
IP
|
$4,015.74
|
|
|
Service Code
|
CPT 69801
|
| Hospital Charge Code |
76100487
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,610.23 |
| Max. Negotiated Rate |
$4,015.74 |
| Rate for Payer: Aetna Commercial |
$3,614.17
|
| Rate for Payer: ASR ASR |
$3,895.27
|
| Rate for Payer: ASR Commercial |
$3,895.27
|
| Rate for Payer: BCBS Trust/PPO |
$3,272.43
|
| Rate for Payer: BCN Commercial |
$3,113.40
|
| Rate for Payer: Cash Price |
$3,212.59
|
| Rate for Payer: Cofinity Commercial |
$3,774.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,212.59
|
| Rate for Payer: Healthscope Commercial |
$4,015.74
|
| Rate for Payer: Healthscope Whirlpool |
$3,895.27
|
| Rate for Payer: Mclaren Commercial |
$3,614.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,413.38
|
| Rate for Payer: Nomi Health Commercial |
$3,292.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,610.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,533.85
|
|
|
HC LABYRINTHOTOMY TRANSCANAL
|
Facility
|
OP
|
$4,015.74
|
|
|
Service Code
|
CPT 69801
|
| Hospital Charge Code |
76100487
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$774.34 |
| Max. Negotiated Rate |
$4,015.74 |
| Rate for Payer: Aetna Commercial |
$3,614.17
|
| Rate for Payer: Aetna Medicare |
$1,444.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,805.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,805.83
|
| Rate for Payer: ASR ASR |
$3,895.27
|
| Rate for Payer: ASR Commercial |
$3,895.27
|
| Rate for Payer: BCBS Complete |
$813.05
|
| Rate for Payer: BCBS MAPPO |
$1,444.66
|
| Rate for Payer: BCBS Trust/PPO |
$3,288.49
|
| Rate for Payer: BCN Commercial |
$3,113.40
|
| Rate for Payer: BCN Medicare Advantage |
$1,444.66
|
| Rate for Payer: Cash Price |
$3,212.59
|
| Rate for Payer: Cash Price |
$3,212.59
|
| Rate for Payer: Cofinity Commercial |
$3,774.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,212.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,444.66
|
| Rate for Payer: Healthscope Commercial |
$4,015.74
|
| Rate for Payer: Healthscope Whirlpool |
$3,895.27
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,444.66
|
| Rate for Payer: Mclaren Commercial |
$3,614.17
|
| Rate for Payer: Mclaren Medicaid |
$774.34
|
| Rate for Payer: Mclaren Medicare |
$1,444.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,516.89
|
| Rate for Payer: Meridian Medicaid |
$813.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,661.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,413.38
|
| Rate for Payer: Nomi Health Commercial |
$3,292.91
|
| Rate for Payer: PACE Medicare |
$1,372.43
|
| Rate for Payer: PACE SWMI |
$1,444.66
|
| Rate for Payer: PHP Commercial |
$1,589.13
|
| Rate for Payer: PHP Medicaid |
$774.34
|
| Rate for Payer: PHP Medicare Advantage |
$1,444.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$774.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,610.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,518.59
|
| Rate for Payer: Priority Health Medicare |
$1,444.66
|
| Rate for Payer: Priority Health Narrow Network |
$2,815.03
|
| Rate for Payer: Railroad Medicare Medicare |
$1,444.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,533.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,444.66
|
| Rate for Payer: UHC Exchange |
$2,239.22
|
| Rate for Payer: UHC Medicare Advantage |
$1,444.66
|
| Rate for Payer: UHCCP DNSP |
$1,444.66
|
| Rate for Payer: UHCCP Medicaid |
$774.34
|
| Rate for Payer: VA VA |
$1,444.66
|
|
|
HC LA/CS PACING + RECORDING
|
Facility
|
OP
|
$1,555.91
|
|
|
Service Code
|
CPT 93621
|
| Hospital Charge Code |
48100038
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$622.36 |
| Max. Negotiated Rate |
$1,555.91 |
| Rate for Payer: Aetna Commercial |
$1,400.32
|
| Rate for Payer: Aetna Medicare |
$777.96
|
| Rate for Payer: ASR ASR |
$1,509.23
|
| Rate for Payer: ASR Commercial |
$1,509.23
|
| Rate for Payer: BCBS Complete |
$622.36
|
| Rate for Payer: BCBS Trust/PPO |
$1,274.13
|
| Rate for Payer: BCN Commercial |
$1,206.30
|
| Rate for Payer: Cash Price |
$1,244.73
|
| Rate for Payer: Cofinity Commercial |
$1,462.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,244.73
|
| Rate for Payer: Healthscope Commercial |
$1,555.91
|
| Rate for Payer: Healthscope Whirlpool |
$1,509.23
|
| Rate for Payer: Mclaren Commercial |
$1,400.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,322.52
|
| Rate for Payer: Nomi Health Commercial |
$1,275.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,011.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,363.29
|
| Rate for Payer: Priority Health Narrow Network |
$1,090.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,369.20
|
|
|
HC LA/CS PACING + RECORDING
|
Facility
|
IP
|
$1,555.91
|
|
|
Service Code
|
CPT 93621
|
| Hospital Charge Code |
48100038
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,011.34 |
| Max. Negotiated Rate |
$1,555.91 |
| Rate for Payer: Aetna Commercial |
$1,400.32
|
| Rate for Payer: ASR ASR |
$1,509.23
|
| Rate for Payer: ASR Commercial |
$1,509.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,267.91
|
| Rate for Payer: BCN Commercial |
$1,206.30
|
| Rate for Payer: Cash Price |
$1,244.73
|
| Rate for Payer: Cofinity Commercial |
$1,462.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,244.73
|
| Rate for Payer: Healthscope Commercial |
$1,555.91
|
| Rate for Payer: Healthscope Whirlpool |
$1,509.23
|
| Rate for Payer: Mclaren Commercial |
$1,400.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,322.52
|
| Rate for Payer: Nomi Health Commercial |
$1,275.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,011.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,369.20
|
|
|
HC LACTATE DEHYDROGENASE
|
Facility
|
OP
|
$22.20
|
|
|
Service Code
|
CPT 83615
|
| Hospital Charge Code |
30100272
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.24 |
| Max. Negotiated Rate |
$22.20 |
| Rate for Payer: Aetna Commercial |
$19.98
|
| Rate for Payer: Aetna Medicare |
$6.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.55
|
| Rate for Payer: ASR ASR |
$21.53
|
| Rate for Payer: ASR Commercial |
$21.53
|
| Rate for Payer: BCBS Complete |
$3.40
|
| Rate for Payer: BCBS MAPPO |
$6.04
|
| Rate for Payer: BCBS Trust/PPO |
$18.18
|
| Rate for Payer: BCN Commercial |
$17.21
|
| Rate for Payer: BCN Medicare Advantage |
$6.04
|
| Rate for Payer: Cash Price |
$17.76
|
| Rate for Payer: Cash Price |
$17.76
|
| Rate for Payer: Cofinity Commercial |
$20.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.04
|
| Rate for Payer: Healthscope Commercial |
$22.20
|
| Rate for Payer: Healthscope Whirlpool |
$21.53
|
| Rate for Payer: Humana Choice PPO Medicare |
$6.04
|
| Rate for Payer: Mclaren Commercial |
$19.98
|
| Rate for Payer: Mclaren Medicaid |
$3.24
|
| Rate for Payer: Mclaren Medicare |
$6.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.34
|
| Rate for Payer: Meridian Medicaid |
$3.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.87
|
| Rate for Payer: Nomi Health Commercial |
$18.20
|
| Rate for Payer: PACE Medicare |
$5.74
|
| Rate for Payer: PACE SWMI |
$6.04
|
| Rate for Payer: PHP Commercial |
$6.64
|
| Rate for Payer: PHP Medicaid |
$3.24
|
| Rate for Payer: PHP Medicare Advantage |
$6.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19.45
|
| Rate for Payer: Priority Health Medicare |
$6.04
|
| Rate for Payer: Priority Health Narrow Network |
$15.56
|
| Rate for Payer: Railroad Medicare Medicare |
$6.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.04
|
| Rate for Payer: UHC Exchange |
$9.36
|
| Rate for Payer: UHC Medicare Advantage |
$6.04
|
| Rate for Payer: UHCCP DNSP |
$6.04
|
| Rate for Payer: UHCCP Medicaid |
$3.24
|
| Rate for Payer: VA VA |
$6.04
|
|
|
HC LACTATE DEHYDROGENASE
|
Facility
|
IP
|
$22.20
|
|
|
Service Code
|
CPT 83615
|
| Hospital Charge Code |
30100272
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.43 |
| Max. Negotiated Rate |
$22.20 |
| Rate for Payer: Aetna Commercial |
$19.98
|
| Rate for Payer: ASR ASR |
$21.53
|
| Rate for Payer: ASR Commercial |
$21.53
|
| Rate for Payer: BCBS Trust/PPO |
$18.09
|
| Rate for Payer: BCN Commercial |
$17.21
|
| Rate for Payer: Cash Price |
$17.76
|
| Rate for Payer: Cofinity Commercial |
$20.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.76
|
| Rate for Payer: Healthscope Commercial |
$22.20
|
| Rate for Payer: Healthscope Whirlpool |
$21.53
|
| Rate for Payer: Mclaren Commercial |
$19.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.87
|
| Rate for Payer: Nomi Health Commercial |
$18.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19.54
|
|
|
HC LACTATE LACTIC ACID
|
Facility
|
IP
|
$59.30
|
|
|
Service Code
|
CPT 83605
|
| Hospital Charge Code |
30100270
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$38.55 |
| Max. Negotiated Rate |
$59.30 |
| Rate for Payer: Aetna Commercial |
$53.37
|
| Rate for Payer: ASR ASR |
$57.52
|
| Rate for Payer: ASR Commercial |
$57.52
|
| Rate for Payer: BCBS Trust/PPO |
$48.32
|
| Rate for Payer: BCN Commercial |
$45.98
|
| Rate for Payer: Cash Price |
$47.44
|
| Rate for Payer: Cofinity Commercial |
$55.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.44
|
| Rate for Payer: Healthscope Commercial |
$59.30
|
| Rate for Payer: Healthscope Whirlpool |
$57.52
|
| Rate for Payer: Mclaren Commercial |
$53.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.41
|
| Rate for Payer: Nomi Health Commercial |
$48.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$52.18
|
|
|
HC LACTATE LACTIC ACID
|
Facility
|
OP
|
$59.30
|
|
|
Service Code
|
CPT 83605
|
| Hospital Charge Code |
30100270
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.20 |
| Max. Negotiated Rate |
$59.30 |
| Rate for Payer: Aetna Commercial |
$53.37
|
| Rate for Payer: Aetna Medicare |
$11.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.46
|
| Rate for Payer: ASR ASR |
$57.52
|
| Rate for Payer: ASR Commercial |
$57.52
|
| Rate for Payer: BCBS Complete |
$6.51
|
| Rate for Payer: BCBS MAPPO |
$11.57
|
| Rate for Payer: BCBS Trust/PPO |
$48.56
|
| Rate for Payer: BCN Commercial |
$45.98
|
| Rate for Payer: BCN Medicare Advantage |
$11.57
|
| Rate for Payer: Cash Price |
$47.44
|
| Rate for Payer: Cash Price |
$47.44
|
| Rate for Payer: Cofinity Commercial |
$55.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.57
|
| Rate for Payer: Healthscope Commercial |
$59.30
|
| Rate for Payer: Healthscope Whirlpool |
$57.52
|
| Rate for Payer: Humana Choice PPO Medicare |
$11.57
|
| Rate for Payer: Mclaren Commercial |
$53.37
|
| Rate for Payer: Mclaren Medicaid |
$6.20
|
| Rate for Payer: Mclaren Medicare |
$11.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.15
|
| Rate for Payer: Meridian Medicaid |
$6.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.41
|
| Rate for Payer: Nomi Health Commercial |
$48.63
|
| Rate for Payer: PACE Medicare |
$10.99
|
| Rate for Payer: PACE SWMI |
$11.57
|
| Rate for Payer: PHP Commercial |
$12.73
|
| Rate for Payer: PHP Medicaid |
$6.20
|
| Rate for Payer: PHP Medicare Advantage |
$11.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$51.96
|
| Rate for Payer: Priority Health Medicare |
$11.57
|
| Rate for Payer: Priority Health Narrow Network |
$41.57
|
| Rate for Payer: Railroad Medicare Medicare |
$11.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$52.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.57
|
| Rate for Payer: UHC Exchange |
$17.93
|
| Rate for Payer: UHC Medicare Advantage |
$11.57
|
| Rate for Payer: UHCCP DNSP |
$11.57
|
| Rate for Payer: UHCCP Medicaid |
$6.20
|
| Rate for Payer: VA VA |
$11.57
|
|
|
HC LACTOSE TOLERANCE
|
Facility
|
IP
|
$94.05
|
|
|
Service Code
|
CPT 82951
|
| Hospital Charge Code |
30100226
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$61.13 |
| Max. Negotiated Rate |
$94.05 |
| Rate for Payer: Aetna Commercial |
$84.64
|
| Rate for Payer: ASR ASR |
$91.23
|
| Rate for Payer: ASR Commercial |
$91.23
|
| Rate for Payer: BCBS Trust/PPO |
$76.64
|
| Rate for Payer: BCN Commercial |
$72.92
|
| Rate for Payer: Cash Price |
$75.24
|
| Rate for Payer: Cofinity Commercial |
$88.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.24
|
| Rate for Payer: Healthscope Commercial |
$94.05
|
| Rate for Payer: Healthscope Whirlpool |
$91.23
|
| Rate for Payer: Mclaren Commercial |
$84.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.94
|
| Rate for Payer: Nomi Health Commercial |
$77.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$82.76
|
|
|
HC LACTOSE TOLERANCE
|
Facility
|
OP
|
$94.05
|
|
|
Service Code
|
CPT 82951
|
| Hospital Charge Code |
30100226
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$94.05 |
| Rate for Payer: Aetna Commercial |
$84.64
|
| Rate for Payer: Aetna Medicare |
$12.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.09
|
| Rate for Payer: ASR ASR |
$91.23
|
| Rate for Payer: ASR Commercial |
$91.23
|
| Rate for Payer: BCBS Complete |
$7.24
|
| Rate for Payer: BCBS MAPPO |
$12.87
|
| Rate for Payer: BCBS Trust/PPO |
$77.02
|
| Rate for Payer: BCN Commercial |
$72.92
|
| Rate for Payer: BCN Medicare Advantage |
$12.87
|
| Rate for Payer: Cash Price |
$75.24
|
| Rate for Payer: Cash Price |
$75.24
|
| Rate for Payer: Cofinity Commercial |
$88.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.87
|
| Rate for Payer: Healthscope Commercial |
$94.05
|
| Rate for Payer: Healthscope Whirlpool |
$91.23
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.87
|
| Rate for Payer: Mclaren Commercial |
$84.64
|
| Rate for Payer: Mclaren Medicaid |
$6.90
|
| Rate for Payer: Mclaren Medicare |
$12.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.51
|
| Rate for Payer: Meridian Medicaid |
$7.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.94
|
| Rate for Payer: Nomi Health Commercial |
$77.12
|
| Rate for Payer: PACE Medicare |
$12.23
|
| Rate for Payer: PACE SWMI |
$12.87
|
| Rate for Payer: PHP Commercial |
$14.16
|
| Rate for Payer: PHP Medicaid |
$6.90
|
| Rate for Payer: PHP Medicare Advantage |
$12.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$82.41
|
| Rate for Payer: Priority Health Medicare |
$12.87
|
| Rate for Payer: Priority Health Narrow Network |
$65.93
|
| Rate for Payer: Railroad Medicare Medicare |
$12.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$82.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.87
|
| Rate for Payer: UHC Exchange |
$19.95
|
| Rate for Payer: UHC Medicare Advantage |
$12.87
|
| Rate for Payer: UHCCP DNSP |
$12.87
|
| Rate for Payer: UHCCP Medicaid |
$6.90
|
| Rate for Payer: VA VA |
$12.87
|
|
|
HC LAMBDA FREE LIGHT CHAIN SERUM
|
Facility
|
IP
|
$77.42
|
|
|
Service Code
|
CPT 83521
|
| Hospital Charge Code |
30100308
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$50.32 |
| Max. Negotiated Rate |
$77.42 |
| Rate for Payer: Aetna Commercial |
$69.68
|
| Rate for Payer: ASR ASR |
$75.10
|
| Rate for Payer: ASR Commercial |
$75.10
|
| Rate for Payer: BCBS Trust/PPO |
$63.09
|
| Rate for Payer: BCN Commercial |
$60.02
|
| Rate for Payer: Cash Price |
$61.94
|
| Rate for Payer: Cofinity Commercial |
$72.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.94
|
| Rate for Payer: Healthscope Commercial |
$77.42
|
| Rate for Payer: Healthscope Whirlpool |
$75.10
|
| Rate for Payer: Mclaren Commercial |
$69.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.81
|
| Rate for Payer: Nomi Health Commercial |
$63.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$68.13
|
|
|
HC LAMBDA FREE LIGHT CHAIN SERUM
|
Facility
|
OP
|
$77.42
|
|
|
Service Code
|
CPT 83521
|
| Hospital Charge Code |
30100308
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.26 |
| Max. Negotiated Rate |
$77.42 |
| Rate for Payer: Aetna Commercial |
$69.68
|
| Rate for Payer: Aetna Medicare |
$17.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.59
|
| Rate for Payer: ASR ASR |
$75.10
|
| Rate for Payer: ASR Commercial |
$75.10
|
| Rate for Payer: BCBS Complete |
$9.72
|
| Rate for Payer: BCBS MAPPO |
$17.27
|
| Rate for Payer: BCBS Trust/PPO |
$63.40
|
| Rate for Payer: BCN Commercial |
$60.02
|
| Rate for Payer: BCN Medicare Advantage |
$17.27
|
| Rate for Payer: Cash Price |
$61.94
|
| Rate for Payer: Cash Price |
$61.94
|
| Rate for Payer: Cofinity Commercial |
$72.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.27
|
| Rate for Payer: Healthscope Commercial |
$77.42
|
| Rate for Payer: Healthscope Whirlpool |
$75.10
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.27
|
| Rate for Payer: Mclaren Commercial |
$69.68
|
| Rate for Payer: Mclaren Medicaid |
$9.26
|
| Rate for Payer: Mclaren Medicare |
$17.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.13
|
| Rate for Payer: Meridian Medicaid |
$9.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.81
|
| Rate for Payer: Nomi Health Commercial |
$63.48
|
| Rate for Payer: PACE Medicare |
$16.41
|
| Rate for Payer: PACE SWMI |
$17.27
|
| Rate for Payer: PHP Commercial |
$19.00
|
| Rate for Payer: PHP Medicaid |
$9.26
|
| Rate for Payer: PHP Medicare Advantage |
$17.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$67.84
|
| Rate for Payer: Priority Health Medicare |
$17.27
|
| Rate for Payer: Priority Health Narrow Network |
$54.27
|
| Rate for Payer: Railroad Medicare Medicare |
$17.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$68.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.27
|
| Rate for Payer: UHC Exchange |
$26.77
|
| Rate for Payer: UHC Medicare Advantage |
$17.27
|
| Rate for Payer: UHCCP DNSP |
$17.27
|
| Rate for Payer: UHCCP Medicaid |
$9.26
|
| Rate for Payer: VA VA |
$17.27
|
|
|
HC LAMBS QUARTERS IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200091
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$25.39 |
| Rate for Payer: Aetna Commercial |
$22.85
|
| Rate for Payer: ASR ASR |
$24.63
|
| Rate for Payer: ASR Commercial |
$24.63
|
| Rate for Payer: BCBS Trust/PPO |
$20.69
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$23.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$25.39
|
| Rate for Payer: Healthscope Whirlpool |
$24.63
|
| Rate for Payer: Mclaren Commercial |
$22.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.34
|
|
|
HC LAMBS QUARTERS IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200091
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$25.39 |
| Rate for Payer: Aetna Commercial |
$22.85
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: ASR ASR |
$24.63
|
| Rate for Payer: ASR Commercial |
$24.63
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$20.79
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$23.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$25.39
|
| Rate for Payer: Healthscope Whirlpool |
$24.63
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$22.85
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$5.74
|
| Rate for Payer: PHP Medicaid |
$2.80
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.25
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$17.80
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP DNSP |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.80
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC LAMELLAR BODY COUNT AMNIOTIC
|
Facility
|
IP
|
$71.40
|
|
|
Service Code
|
CPT 83664
|
| Hospital Charge Code |
30100278
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$46.41 |
| Max. Negotiated Rate |
$71.40 |
| Rate for Payer: Aetna Commercial |
$64.26
|
| Rate for Payer: ASR ASR |
$69.26
|
| Rate for Payer: ASR Commercial |
$69.26
|
| Rate for Payer: BCBS Trust/PPO |
$58.18
|
| Rate for Payer: BCN Commercial |
$55.36
|
| Rate for Payer: Cash Price |
$57.12
|
| Rate for Payer: Cofinity Commercial |
$67.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.12
|
| Rate for Payer: Healthscope Commercial |
$71.40
|
| Rate for Payer: Healthscope Whirlpool |
$69.26
|
| Rate for Payer: Mclaren Commercial |
$64.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.69
|
| Rate for Payer: Nomi Health Commercial |
$58.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$62.83
|
|
|
HC LAMELLAR BODY COUNT AMNIOTIC
|
Facility
|
OP
|
$71.40
|
|
|
Service Code
|
CPT 83664
|
| Hospital Charge Code |
30100278
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.36 |
| Max. Negotiated Rate |
$71.40 |
| Rate for Payer: Aetna Commercial |
$64.26
|
| Rate for Payer: Aetna Medicare |
$19.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.15
|
| Rate for Payer: ASR ASR |
$69.26
|
| Rate for Payer: ASR Commercial |
$69.26
|
| Rate for Payer: BCBS Complete |
$10.87
|
| Rate for Payer: BCBS MAPPO |
$19.32
|
| Rate for Payer: BCBS Trust/PPO |
$58.47
|
| Rate for Payer: BCN Commercial |
$55.36
|
| Rate for Payer: BCN Medicare Advantage |
$19.32
|
| Rate for Payer: Cash Price |
$57.12
|
| Rate for Payer: Cash Price |
$57.12
|
| Rate for Payer: Cofinity Commercial |
$67.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.32
|
| Rate for Payer: Healthscope Commercial |
$71.40
|
| Rate for Payer: Healthscope Whirlpool |
$69.26
|
| Rate for Payer: Humana Choice PPO Medicare |
$19.32
|
| Rate for Payer: Mclaren Commercial |
$64.26
|
| Rate for Payer: Mclaren Medicaid |
$10.36
|
| Rate for Payer: Mclaren Medicare |
$19.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.29
|
| Rate for Payer: Meridian Medicaid |
$10.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.69
|
| Rate for Payer: Nomi Health Commercial |
$58.55
|
| Rate for Payer: PACE Medicare |
$18.35
|
| Rate for Payer: PACE SWMI |
$19.32
|
| Rate for Payer: PHP Commercial |
$21.25
|
| Rate for Payer: PHP Medicaid |
$10.36
|
| Rate for Payer: PHP Medicare Advantage |
$19.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$62.56
|
| Rate for Payer: Priority Health Medicare |
$19.32
|
| Rate for Payer: Priority Health Narrow Network |
$50.05
|
| Rate for Payer: Railroad Medicare Medicare |
$19.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$62.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.32
|
| Rate for Payer: UHC Exchange |
$29.95
|
| Rate for Payer: UHC Medicare Advantage |
$19.32
|
| Rate for Payer: UHCCP DNSP |
$19.32
|
| Rate for Payer: UHCCP Medicaid |
$10.36
|
| Rate for Payer: VA VA |
$19.32
|
|
|
HC LAMICTAL LEVEL
|
Facility
|
OP
|
$54.10
|
|
|
Service Code
|
CPT 80175
|
| Hospital Charge Code |
30100054
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.10 |
| Max. Negotiated Rate |
$54.10 |
| Rate for Payer: Aetna Commercial |
$48.69
|
| Rate for Payer: Aetna Medicare |
$13.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.56
|
| Rate for Payer: ASR ASR |
$52.48
|
| Rate for Payer: ASR Commercial |
$52.48
|
| Rate for Payer: BCBS Complete |
$7.46
|
| Rate for Payer: BCBS MAPPO |
$13.25
|
| Rate for Payer: BCBS Trust/PPO |
$44.30
|
| Rate for Payer: BCN Commercial |
$41.94
|
| Rate for Payer: BCN Medicare Advantage |
$13.25
|
| Rate for Payer: Cash Price |
$43.28
|
| Rate for Payer: Cash Price |
$43.28
|
| Rate for Payer: Cofinity Commercial |
$50.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.25
|
| Rate for Payer: Healthscope Commercial |
$54.10
|
| Rate for Payer: Healthscope Whirlpool |
$52.48
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.25
|
| Rate for Payer: Mclaren Commercial |
$48.69
|
| Rate for Payer: Mclaren Medicaid |
$7.10
|
| Rate for Payer: Mclaren Medicare |
$13.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.91
|
| Rate for Payer: Meridian Medicaid |
$7.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.98
|
| Rate for Payer: Nomi Health Commercial |
$44.36
|
| Rate for Payer: PACE Medicare |
$12.59
|
| Rate for Payer: PACE SWMI |
$13.25
|
| Rate for Payer: PHP Commercial |
$14.57
|
| Rate for Payer: PHP Medicaid |
$7.10
|
| Rate for Payer: PHP Medicare Advantage |
$13.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$47.40
|
| Rate for Payer: Priority Health Medicare |
$13.25
|
| Rate for Payer: Priority Health Narrow Network |
$37.92
|
| Rate for Payer: Railroad Medicare Medicare |
$13.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$47.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.25
|
| Rate for Payer: UHC Exchange |
$20.54
|
| Rate for Payer: UHC Medicare Advantage |
$13.25
|
| Rate for Payer: UHCCP DNSP |
$13.25
|
| Rate for Payer: UHCCP Medicaid |
$7.10
|
| Rate for Payer: VA VA |
$13.25
|
|
|
HC LAMICTAL LEVEL
|
Facility
|
IP
|
$54.10
|
|
|
Service Code
|
CPT 80175
|
| Hospital Charge Code |
30100054
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$35.16 |
| Max. Negotiated Rate |
$54.10 |
| Rate for Payer: Aetna Commercial |
$48.69
|
| Rate for Payer: ASR ASR |
$52.48
|
| Rate for Payer: ASR Commercial |
$52.48
|
| Rate for Payer: BCBS Trust/PPO |
$44.09
|
| Rate for Payer: BCN Commercial |
$41.94
|
| Rate for Payer: Cash Price |
$43.28
|
| Rate for Payer: Cofinity Commercial |
$50.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.28
|
| Rate for Payer: Healthscope Commercial |
$54.10
|
| Rate for Payer: Healthscope Whirlpool |
$52.48
|
| Rate for Payer: Mclaren Commercial |
$48.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.98
|
| Rate for Payer: Nomi Health Commercial |
$44.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$47.61
|
|
|
HC LARGSC W/NJX VOCAL CORD THER W/MICRO/TELESCOPE
|
Facility
|
OP
|
$10,480.00
|
|
|
Service Code
|
CPT 31571
|
| Hospital Charge Code |
76100432
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,927.35 |
| Max. Negotiated Rate |
$10,480.00 |
| Rate for Payer: Aetna Commercial |
$9,432.00
|
| Rate for Payer: Aetna Medicare |
$3,595.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,494.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,494.76
|
| Rate for Payer: ASR ASR |
$10,165.60
|
| Rate for Payer: ASR Commercial |
$10,165.60
|
| Rate for Payer: BCBS Complete |
$2,023.72
|
| Rate for Payer: BCBS MAPPO |
$3,595.81
|
| Rate for Payer: BCBS Trust/PPO |
$8,582.07
|
| Rate for Payer: BCN Commercial |
$8,125.14
|
| Rate for Payer: BCN Medicare Advantage |
$3,595.81
|
| Rate for Payer: Cash Price |
$8,384.00
|
| Rate for Payer: Cash Price |
$8,384.00
|
| Rate for Payer: Cofinity Commercial |
$9,851.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,384.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,595.81
|
| Rate for Payer: Healthscope Commercial |
$10,480.00
|
| Rate for Payer: Healthscope Whirlpool |
$10,165.60
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,595.81
|
| Rate for Payer: Mclaren Commercial |
$9,432.00
|
| Rate for Payer: Mclaren Medicaid |
$1,927.35
|
| Rate for Payer: Mclaren Medicare |
$3,595.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,775.60
|
| Rate for Payer: Meridian Medicaid |
$2,023.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,135.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,908.00
|
| Rate for Payer: Nomi Health Commercial |
$8,593.60
|
| Rate for Payer: PACE Medicare |
$3,416.02
|
| Rate for Payer: PACE SWMI |
$3,595.81
|
| Rate for Payer: PHP Commercial |
$3,955.39
|
| Rate for Payer: PHP Medicaid |
$1,927.35
|
| Rate for Payer: PHP Medicare Advantage |
$3,595.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,927.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,812.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,182.58
|
| Rate for Payer: Priority Health Medicare |
$3,595.81
|
| Rate for Payer: Priority Health Narrow Network |
$7,346.48
|
| Rate for Payer: Railroad Medicare Medicare |
$3,595.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9,222.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,595.81
|
| Rate for Payer: UHC Exchange |
$5,573.51
|
| Rate for Payer: UHC Medicare Advantage |
$3,595.81
|
| Rate for Payer: UHCCP DNSP |
$3,595.81
|
| Rate for Payer: UHCCP Medicaid |
$1,927.35
|
| Rate for Payer: VA VA |
$3,595.81
|
|
|
HC LARGSC W/NJX VOCAL CORD THER W/MICRO/TELESCOPE
|
Facility
|
IP
|
$10,480.00
|
|
|
Service Code
|
CPT 31571
|
| Hospital Charge Code |
76100432
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$6,812.00 |
| Max. Negotiated Rate |
$10,480.00 |
| Rate for Payer: Aetna Commercial |
$9,432.00
|
| Rate for Payer: ASR ASR |
$10,165.60
|
| Rate for Payer: ASR Commercial |
$10,165.60
|
| Rate for Payer: BCBS Trust/PPO |
$8,540.15
|
| Rate for Payer: BCN Commercial |
$8,125.14
|
| Rate for Payer: Cash Price |
$8,384.00
|
| Rate for Payer: Cofinity Commercial |
$9,851.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,384.00
|
| Rate for Payer: Healthscope Commercial |
$10,480.00
|
| Rate for Payer: Healthscope Whirlpool |
$10,165.60
|
| Rate for Payer: Mclaren Commercial |
$9,432.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,908.00
|
| Rate for Payer: Nomi Health Commercial |
$8,593.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,812.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9,222.40
|
|
|
HC LA RO SSB SJOGRENS AB
|
Facility
|
OP
|
$35.17
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200160
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.61 |
| Max. Negotiated Rate |
$35.17 |
| Rate for Payer: Aetna Commercial |
$31.65
|
| Rate for Payer: Aetna Medicare |
$17.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.41
|
| Rate for Payer: ASR ASR |
$34.11
|
| Rate for Payer: ASR Commercial |
$34.11
|
| Rate for Payer: BCBS Complete |
$10.09
|
| Rate for Payer: BCBS MAPPO |
$17.93
|
| Rate for Payer: BCBS Trust/PPO |
$28.80
|
| Rate for Payer: BCN Commercial |
$27.27
|
| Rate for Payer: BCN Medicare Advantage |
$17.93
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cofinity Commercial |
$33.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.93
|
| Rate for Payer: Healthscope Commercial |
$35.17
|
| Rate for Payer: Healthscope Whirlpool |
$34.11
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.93
|
| Rate for Payer: Mclaren Commercial |
$31.65
|
| Rate for Payer: Mclaren Medicaid |
$9.61
|
| Rate for Payer: Mclaren Medicare |
$17.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.83
|
| Rate for Payer: Meridian Medicaid |
$10.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.89
|
| Rate for Payer: Nomi Health Commercial |
$28.84
|
| Rate for Payer: PACE Medicare |
$17.03
|
| Rate for Payer: PACE SWMI |
$17.93
|
| Rate for Payer: PHP Commercial |
$19.72
|
| Rate for Payer: PHP Medicaid |
$9.61
|
| Rate for Payer: PHP Medicare Advantage |
$17.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30.82
|
| Rate for Payer: Priority Health Medicare |
$17.93
|
| Rate for Payer: Priority Health Narrow Network |
$24.65
|
| Rate for Payer: Railroad Medicare Medicare |
$17.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$30.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.93
|
| Rate for Payer: UHC Exchange |
$27.79
|
| Rate for Payer: UHC Medicare Advantage |
$17.93
|
| Rate for Payer: UHCCP DNSP |
$17.93
|
| Rate for Payer: UHCCP Medicaid |
$9.61
|
| Rate for Payer: VA VA |
$17.93
|
|
|
HC LA RO SSB SJOGRENS AB
|
Facility
|
IP
|
$35.17
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200160
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$22.86 |
| Max. Negotiated Rate |
$35.17 |
| Rate for Payer: Aetna Commercial |
$31.65
|
| Rate for Payer: ASR ASR |
$34.11
|
| Rate for Payer: ASR Commercial |
$34.11
|
| Rate for Payer: BCBS Trust/PPO |
$28.66
|
| Rate for Payer: BCN Commercial |
$27.27
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cofinity Commercial |
$33.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.14
|
| Rate for Payer: Healthscope Commercial |
$35.17
|
| Rate for Payer: Healthscope Whirlpool |
$34.11
|
| Rate for Payer: Mclaren Commercial |
$31.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.89
|
| Rate for Payer: Nomi Health Commercial |
$28.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$30.95
|
|
