|
HC RADXF UNL NM ENDOCR 78099
|
Facility
|
OP
|
$787.76
|
|
|
Service Code
|
CPT 78099
|
| Hospital Charge Code |
34100008
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$200.54 |
| Max. Negotiated Rate |
$787.76 |
| Rate for Payer: Aetna Commercial |
$708.98
|
| Rate for Payer: Aetna Medicare |
$366.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$458.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$458.26
|
| Rate for Payer: ASR ASR |
$764.13
|
| Rate for Payer: BCBS Complete |
$210.58
|
| Rate for Payer: BCBS MAPPO |
$366.61
|
| Rate for Payer: BCBS Trust/PPO |
$610.75
|
| Rate for Payer: BCN Commercial |
$610.75
|
| Rate for Payer: BCN Medicare Advantage |
$366.61
|
| Rate for Payer: Cash Price |
$630.21
|
| Rate for Payer: Cash Price |
$630.21
|
| Rate for Payer: Cofinity Commercial |
$740.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$630.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$366.61
|
| Rate for Payer: Healthscope Commercial |
$787.76
|
| Rate for Payer: Healthscope Whirlpool |
$764.13
|
| Rate for Payer: Humana Choice PPO Medicare |
$366.61
|
| Rate for Payer: Mclaren Commercial |
$708.98
|
| Rate for Payer: Mclaren Medicaid |
$200.54
|
| Rate for Payer: Mclaren Medicare |
$366.61
|
| Rate for Payer: Meridian Medicaid |
$210.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$384.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$421.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$669.60
|
| Rate for Payer: PACE Medicare |
$348.28
|
| Rate for Payer: PACE SWMI |
$366.61
|
| Rate for Payer: PHP Commercial |
$403.27
|
| Rate for Payer: PHP Medicaid |
$200.54
|
| Rate for Payer: PHP Medicare Advantage |
$366.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$200.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$551.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$716.86
|
| Rate for Payer: Priority Health Medicare |
$366.61
|
| Rate for Payer: Priority Health Narrow Network |
$559.31
|
| Rate for Payer: Railroad Medicare Medicare |
$366.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$693.23
|
| Rate for Payer: UHC Medicare Advantage |
$377.61
|
| Rate for Payer: VA VA |
$366.61
|
|
|
HC RADXF UNL NM ENDOCR 78099
|
Facility
|
IP
|
$787.76
|
|
|
Service Code
|
CPT 78099
|
| Hospital Charge Code |
34100008
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$551.43 |
| Max. Negotiated Rate |
$787.76 |
| Rate for Payer: Aetna Commercial |
$708.98
|
| Rate for Payer: ASR ASR |
$764.13
|
| Rate for Payer: BCBS Trust/PPO |
$610.75
|
| Rate for Payer: BCN Commercial |
$610.75
|
| Rate for Payer: Cash Price |
$630.21
|
| Rate for Payer: Cofinity Commercial |
$740.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$630.21
|
| Rate for Payer: Healthscope Commercial |
$787.76
|
| Rate for Payer: Healthscope Whirlpool |
$764.13
|
| Rate for Payer: Mclaren Commercial |
$708.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$669.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$551.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$693.23
|
|
|
HC RADXF UNL NM GI PROC 78299
|
Facility
|
OP
|
$787.76
|
|
|
Service Code
|
CPT 78299
|
| Hospital Charge Code |
34100022
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$200.54 |
| Max. Negotiated Rate |
$787.76 |
| Rate for Payer: Aetna Commercial |
$708.98
|
| Rate for Payer: Aetna Medicare |
$366.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$458.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$458.26
|
| Rate for Payer: ASR ASR |
$764.13
|
| Rate for Payer: BCBS Complete |
$210.58
|
| Rate for Payer: BCBS MAPPO |
$366.61
|
| Rate for Payer: BCBS Trust/PPO |
$610.75
|
| Rate for Payer: BCN Commercial |
$610.75
|
| Rate for Payer: BCN Medicare Advantage |
$366.61
|
| Rate for Payer: Cash Price |
$630.21
|
| Rate for Payer: Cash Price |
$630.21
|
| Rate for Payer: Cofinity Commercial |
$740.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$630.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$366.61
|
| Rate for Payer: Healthscope Commercial |
$787.76
|
| Rate for Payer: Healthscope Whirlpool |
$764.13
|
| Rate for Payer: Humana Choice PPO Medicare |
$366.61
|
| Rate for Payer: Mclaren Commercial |
$708.98
|
| Rate for Payer: Mclaren Medicaid |
$200.54
|
| Rate for Payer: Mclaren Medicare |
$366.61
|
| Rate for Payer: Meridian Medicaid |
$210.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$384.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$421.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$669.60
|
| Rate for Payer: PACE Medicare |
$348.28
|
| Rate for Payer: PACE SWMI |
$366.61
|
| Rate for Payer: PHP Commercial |
$403.27
|
| Rate for Payer: PHP Medicaid |
$200.54
|
| Rate for Payer: PHP Medicare Advantage |
$366.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$200.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$551.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$716.86
|
| Rate for Payer: Priority Health Medicare |
$366.61
|
| Rate for Payer: Priority Health Narrow Network |
$559.31
|
| Rate for Payer: Railroad Medicare Medicare |
$366.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$693.23
|
| Rate for Payer: UHC Medicare Advantage |
$377.61
|
| Rate for Payer: VA VA |
$366.61
|
|
|
HC RADXF UNL NM GI PROC 78299
|
Facility
|
IP
|
$787.76
|
|
|
Service Code
|
CPT 78299
|
| Hospital Charge Code |
34100022
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$551.43 |
| Max. Negotiated Rate |
$787.76 |
| Rate for Payer: Aetna Commercial |
$708.98
|
| Rate for Payer: ASR ASR |
$764.13
|
| Rate for Payer: BCBS Trust/PPO |
$610.75
|
| Rate for Payer: BCN Commercial |
$610.75
|
| Rate for Payer: Cash Price |
$630.21
|
| Rate for Payer: Cofinity Commercial |
$740.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$630.21
|
| Rate for Payer: Healthscope Commercial |
$787.76
|
| Rate for Payer: Healthscope Whirlpool |
$764.13
|
| Rate for Payer: Mclaren Commercial |
$708.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$669.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$551.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$693.23
|
|
|
HC RADXF UNL NM GU 78799
|
Facility
|
OP
|
$787.76
|
|
|
Service Code
|
CPT 78799
|
| Hospital Charge Code |
34100051
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$200.54 |
| Max. Negotiated Rate |
$787.76 |
| Rate for Payer: Aetna Commercial |
$708.98
|
| Rate for Payer: Aetna Medicare |
$366.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$458.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$458.26
|
| Rate for Payer: ASR ASR |
$764.13
|
| Rate for Payer: BCBS Complete |
$210.58
|
| Rate for Payer: BCBS MAPPO |
$366.61
|
| Rate for Payer: BCBS Trust/PPO |
$610.75
|
| Rate for Payer: BCN Commercial |
$610.75
|
| Rate for Payer: BCN Medicare Advantage |
$366.61
|
| Rate for Payer: Cash Price |
$630.21
|
| Rate for Payer: Cash Price |
$630.21
|
| Rate for Payer: Cofinity Commercial |
$740.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$630.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$366.61
|
| Rate for Payer: Healthscope Commercial |
$787.76
|
| Rate for Payer: Healthscope Whirlpool |
$764.13
|
| Rate for Payer: Humana Choice PPO Medicare |
$366.61
|
| Rate for Payer: Mclaren Commercial |
$708.98
|
| Rate for Payer: Mclaren Medicaid |
$200.54
|
| Rate for Payer: Mclaren Medicare |
$366.61
|
| Rate for Payer: Meridian Medicaid |
$210.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$384.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$421.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$669.60
|
| Rate for Payer: PACE Medicare |
$348.28
|
| Rate for Payer: PACE SWMI |
$366.61
|
| Rate for Payer: PHP Commercial |
$403.27
|
| Rate for Payer: PHP Medicaid |
$200.54
|
| Rate for Payer: PHP Medicare Advantage |
$366.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$200.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$551.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$716.86
|
| Rate for Payer: Priority Health Medicare |
$366.61
|
| Rate for Payer: Priority Health Narrow Network |
$559.31
|
| Rate for Payer: Railroad Medicare Medicare |
$366.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$693.23
|
| Rate for Payer: UHC Medicare Advantage |
$377.61
|
| Rate for Payer: VA VA |
$366.61
|
|
|
HC RADXF UNL NM GU 78799
|
Facility
|
IP
|
$787.76
|
|
|
Service Code
|
CPT 78799
|
| Hospital Charge Code |
34100051
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$551.43 |
| Max. Negotiated Rate |
$787.76 |
| Rate for Payer: Aetna Commercial |
$708.98
|
| Rate for Payer: ASR ASR |
$764.13
|
| Rate for Payer: BCBS Trust/PPO |
$610.75
|
| Rate for Payer: BCN Commercial |
$610.75
|
| Rate for Payer: Cash Price |
$630.21
|
| Rate for Payer: Cofinity Commercial |
$740.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$630.21
|
| Rate for Payer: Healthscope Commercial |
$787.76
|
| Rate for Payer: Healthscope Whirlpool |
$764.13
|
| Rate for Payer: Mclaren Commercial |
$708.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$669.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$551.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$693.23
|
|
|
HC RADXF UNL NM H R L 78199
|
Facility
|
IP
|
$735.63
|
|
|
Service Code
|
CPT 78199
|
| Hospital Charge Code |
34100013
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$514.94 |
| Max. Negotiated Rate |
$735.63 |
| Rate for Payer: Aetna Commercial |
$662.07
|
| Rate for Payer: ASR ASR |
$713.56
|
| Rate for Payer: BCBS Trust/PPO |
$570.33
|
| Rate for Payer: BCN Commercial |
$570.33
|
| Rate for Payer: Cash Price |
$588.50
|
| Rate for Payer: Cofinity Commercial |
$691.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$588.50
|
| Rate for Payer: Healthscope Commercial |
$735.63
|
| Rate for Payer: Healthscope Whirlpool |
$713.56
|
| Rate for Payer: Mclaren Commercial |
$662.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$625.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$514.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$647.35
|
|
|
HC RADXF UNL NM H R L 78199
|
Facility
|
OP
|
$735.63
|
|
|
Service Code
|
CPT 78199
|
| Hospital Charge Code |
34100013
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$200.54 |
| Max. Negotiated Rate |
$735.63 |
| Rate for Payer: Aetna Commercial |
$662.07
|
| Rate for Payer: Aetna Medicare |
$366.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$458.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$458.26
|
| Rate for Payer: ASR ASR |
$713.56
|
| Rate for Payer: BCBS Complete |
$210.58
|
| Rate for Payer: BCBS MAPPO |
$366.61
|
| Rate for Payer: BCBS Trust/PPO |
$570.33
|
| Rate for Payer: BCN Commercial |
$570.33
|
| Rate for Payer: BCN Medicare Advantage |
$366.61
|
| Rate for Payer: Cash Price |
$588.50
|
| Rate for Payer: Cash Price |
$588.50
|
| Rate for Payer: Cofinity Commercial |
$691.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$588.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$366.61
|
| Rate for Payer: Healthscope Commercial |
$735.63
|
| Rate for Payer: Healthscope Whirlpool |
$713.56
|
| Rate for Payer: Humana Choice PPO Medicare |
$366.61
|
| Rate for Payer: Mclaren Commercial |
$662.07
|
| Rate for Payer: Mclaren Medicaid |
$200.54
|
| Rate for Payer: Mclaren Medicare |
$366.61
|
| Rate for Payer: Meridian Medicaid |
$210.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$384.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$421.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$625.29
|
| Rate for Payer: PACE Medicare |
$348.28
|
| Rate for Payer: PACE SWMI |
$366.61
|
| Rate for Payer: PHP Commercial |
$403.27
|
| Rate for Payer: PHP Medicaid |
$200.54
|
| Rate for Payer: PHP Medicare Advantage |
$366.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$200.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$514.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$669.42
|
| Rate for Payer: Priority Health Medicare |
$366.61
|
| Rate for Payer: Priority Health Narrow Network |
$522.30
|
| Rate for Payer: Railroad Medicare Medicare |
$366.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$647.35
|
| Rate for Payer: UHC Medicare Advantage |
$377.61
|
| Rate for Payer: VA VA |
$366.61
|
|
|
HC RADXF UNL NM MUSCSKL 78399
|
Facility
|
OP
|
$1,885.39
|
|
|
Service Code
|
CPT 78399
|
| Hospital Charge Code |
34100028
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$200.54 |
| Max. Negotiated Rate |
$1,885.39 |
| Rate for Payer: Aetna Commercial |
$1,696.85
|
| Rate for Payer: Aetna Medicare |
$366.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$458.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$458.26
|
| Rate for Payer: ASR ASR |
$1,828.83
|
| Rate for Payer: BCBS Complete |
$210.58
|
| Rate for Payer: BCBS MAPPO |
$366.61
|
| Rate for Payer: BCBS Trust/PPO |
$1,461.74
|
| Rate for Payer: BCN Commercial |
$1,461.74
|
| Rate for Payer: BCN Medicare Advantage |
$366.61
|
| Rate for Payer: Cash Price |
$1,508.31
|
| Rate for Payer: Cash Price |
$1,508.31
|
| Rate for Payer: Cofinity Commercial |
$1,772.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,508.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$366.61
|
| Rate for Payer: Healthscope Commercial |
$1,885.39
|
| Rate for Payer: Healthscope Whirlpool |
$1,828.83
|
| Rate for Payer: Humana Choice PPO Medicare |
$366.61
|
| Rate for Payer: Mclaren Commercial |
$1,696.85
|
| Rate for Payer: Mclaren Medicaid |
$200.54
|
| Rate for Payer: Mclaren Medicare |
$366.61
|
| Rate for Payer: Meridian Medicaid |
$210.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$384.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$421.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,602.58
|
| Rate for Payer: PACE Medicare |
$348.28
|
| Rate for Payer: PACE SWMI |
$366.61
|
| Rate for Payer: PHP Commercial |
$403.27
|
| Rate for Payer: PHP Medicaid |
$200.54
|
| Rate for Payer: PHP Medicare Advantage |
$366.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$200.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,319.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,715.70
|
| Rate for Payer: Priority Health Medicare |
$366.61
|
| Rate for Payer: Priority Health Narrow Network |
$1,338.63
|
| Rate for Payer: Railroad Medicare Medicare |
$366.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,659.14
|
| Rate for Payer: UHC Medicare Advantage |
$377.61
|
| Rate for Payer: VA VA |
$366.61
|
|
|
HC RADXF UNL NM MUSCSKL 78399
|
Facility
|
IP
|
$1,885.39
|
|
|
Service Code
|
CPT 78399
|
| Hospital Charge Code |
34100028
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$1,319.77 |
| Max. Negotiated Rate |
$1,885.39 |
| Rate for Payer: Aetna Commercial |
$1,696.85
|
| Rate for Payer: ASR ASR |
$1,828.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,461.74
|
| Rate for Payer: BCN Commercial |
$1,461.74
|
| Rate for Payer: Cash Price |
$1,508.31
|
| Rate for Payer: Cofinity Commercial |
$1,772.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,508.31
|
| Rate for Payer: Healthscope Commercial |
$1,885.39
|
| Rate for Payer: Healthscope Whirlpool |
$1,828.83
|
| Rate for Payer: Mclaren Commercial |
$1,696.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,602.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,319.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,659.14
|
|
|
HC RADXF UNL NM PROC MISC 78999
|
Facility
|
IP
|
$787.76
|
|
|
Service Code
|
CPT 78999
|
| Hospital Charge Code |
34100061
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$551.43 |
| Max. Negotiated Rate |
$787.76 |
| Rate for Payer: Aetna Commercial |
$708.98
|
| Rate for Payer: ASR ASR |
$764.13
|
| Rate for Payer: BCBS Trust/PPO |
$610.75
|
| Rate for Payer: BCN Commercial |
$610.75
|
| Rate for Payer: Cash Price |
$630.21
|
| Rate for Payer: Cofinity Commercial |
$740.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$630.21
|
| Rate for Payer: Healthscope Commercial |
$787.76
|
| Rate for Payer: Healthscope Whirlpool |
$764.13
|
| Rate for Payer: Mclaren Commercial |
$708.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$669.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$551.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$693.23
|
|
|
HC RADXF UNL NM PROC MISC 78999
|
Facility
|
OP
|
$787.76
|
|
|
Service Code
|
CPT 78999
|
| Hospital Charge Code |
34100061
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$200.54 |
| Max. Negotiated Rate |
$787.76 |
| Rate for Payer: Aetna Commercial |
$708.98
|
| Rate for Payer: Aetna Medicare |
$366.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$458.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$458.26
|
| Rate for Payer: ASR ASR |
$764.13
|
| Rate for Payer: BCBS Complete |
$210.58
|
| Rate for Payer: BCBS MAPPO |
$366.61
|
| Rate for Payer: BCBS Trust/PPO |
$610.75
|
| Rate for Payer: BCN Commercial |
$610.75
|
| Rate for Payer: BCN Medicare Advantage |
$366.61
|
| Rate for Payer: Cash Price |
$630.21
|
| Rate for Payer: Cash Price |
$630.21
|
| Rate for Payer: Cofinity Commercial |
$740.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$630.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$366.61
|
| Rate for Payer: Healthscope Commercial |
$787.76
|
| Rate for Payer: Healthscope Whirlpool |
$764.13
|
| Rate for Payer: Humana Choice PPO Medicare |
$366.61
|
| Rate for Payer: Mclaren Commercial |
$708.98
|
| Rate for Payer: Mclaren Medicaid |
$200.54
|
| Rate for Payer: Mclaren Medicare |
$366.61
|
| Rate for Payer: Meridian Medicaid |
$210.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$384.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$421.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$669.60
|
| Rate for Payer: PACE Medicare |
$348.28
|
| Rate for Payer: PACE SWMI |
$366.61
|
| Rate for Payer: PHP Commercial |
$403.27
|
| Rate for Payer: PHP Medicaid |
$200.54
|
| Rate for Payer: PHP Medicare Advantage |
$366.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$200.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$551.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$716.86
|
| Rate for Payer: Priority Health Medicare |
$366.61
|
| Rate for Payer: Priority Health Narrow Network |
$559.31
|
| Rate for Payer: Railroad Medicare Medicare |
$366.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$693.23
|
| Rate for Payer: UHC Medicare Advantage |
$377.61
|
| Rate for Payer: VA VA |
$366.61
|
|
|
HC RADXF UNL NM RADPHARM THER 799
|
Facility
|
IP
|
$787.76
|
|
|
Service Code
|
CPT 79999
|
| Hospital Charge Code |
34100066
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$551.43 |
| Max. Negotiated Rate |
$787.76 |
| Rate for Payer: Aetna Commercial |
$708.98
|
| Rate for Payer: ASR ASR |
$764.13
|
| Rate for Payer: BCBS Trust/PPO |
$610.75
|
| Rate for Payer: BCN Commercial |
$610.75
|
| Rate for Payer: Cash Price |
$630.21
|
| Rate for Payer: Cofinity Commercial |
$740.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$630.21
|
| Rate for Payer: Healthscope Commercial |
$787.76
|
| Rate for Payer: Healthscope Whirlpool |
$764.13
|
| Rate for Payer: Mclaren Commercial |
$708.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$669.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$551.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$693.23
|
|
|
HC RADXF UNL NM RADPHARM THER 799
|
Facility
|
OP
|
$787.76
|
|
|
Service Code
|
CPT 79999
|
| Hospital Charge Code |
34100066
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$120.96 |
| Max. Negotiated Rate |
$787.76 |
| Rate for Payer: Aetna Commercial |
$708.98
|
| Rate for Payer: Aetna Medicare |
$221.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$276.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$276.42
|
| Rate for Payer: ASR ASR |
$764.13
|
| Rate for Payer: BCBS Complete |
$127.02
|
| Rate for Payer: BCBS MAPPO |
$221.14
|
| Rate for Payer: BCBS Trust/PPO |
$610.75
|
| Rate for Payer: BCN Commercial |
$610.75
|
| Rate for Payer: BCN Medicare Advantage |
$221.14
|
| Rate for Payer: Cash Price |
$630.21
|
| Rate for Payer: Cash Price |
$630.21
|
| Rate for Payer: Cofinity Commercial |
$740.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$630.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$221.14
|
| Rate for Payer: Healthscope Commercial |
$787.76
|
| Rate for Payer: Healthscope Whirlpool |
$764.13
|
| Rate for Payer: Humana Choice PPO Medicare |
$221.14
|
| Rate for Payer: Mclaren Commercial |
$708.98
|
| Rate for Payer: Mclaren Medicaid |
$120.96
|
| Rate for Payer: Mclaren Medicare |
$221.14
|
| Rate for Payer: Meridian Medicaid |
$127.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$232.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$254.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$669.60
|
| Rate for Payer: PACE Medicare |
$210.08
|
| Rate for Payer: PACE SWMI |
$221.14
|
| Rate for Payer: PHP Commercial |
$243.25
|
| Rate for Payer: PHP Medicaid |
$120.96
|
| Rate for Payer: PHP Medicare Advantage |
$221.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$120.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$551.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$716.86
|
| Rate for Payer: Priority Health Medicare |
$221.14
|
| Rate for Payer: Priority Health Narrow Network |
$559.31
|
| Rate for Payer: Railroad Medicare Medicare |
$221.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$693.23
|
| Rate for Payer: UHC Medicare Advantage |
$227.77
|
| Rate for Payer: VA VA |
$221.14
|
|
|
HC RADXF UNL NM RESP 78599
|
Facility
|
OP
|
$787.76
|
|
|
Service Code
|
CPT 78599
|
| Hospital Charge Code |
34100036
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$200.54 |
| Max. Negotiated Rate |
$787.76 |
| Rate for Payer: Aetna Commercial |
$708.98
|
| Rate for Payer: Aetna Medicare |
$366.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$458.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$458.26
|
| Rate for Payer: ASR ASR |
$764.13
|
| Rate for Payer: BCBS Complete |
$210.58
|
| Rate for Payer: BCBS MAPPO |
$366.61
|
| Rate for Payer: BCBS Trust/PPO |
$610.75
|
| Rate for Payer: BCN Commercial |
$610.75
|
| Rate for Payer: BCN Medicare Advantage |
$366.61
|
| Rate for Payer: Cash Price |
$630.21
|
| Rate for Payer: Cash Price |
$630.21
|
| Rate for Payer: Cofinity Commercial |
$740.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$630.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$366.61
|
| Rate for Payer: Healthscope Commercial |
$787.76
|
| Rate for Payer: Healthscope Whirlpool |
$764.13
|
| Rate for Payer: Humana Choice PPO Medicare |
$366.61
|
| Rate for Payer: Mclaren Commercial |
$708.98
|
| Rate for Payer: Mclaren Medicaid |
$200.54
|
| Rate for Payer: Mclaren Medicare |
$366.61
|
| Rate for Payer: Meridian Medicaid |
$210.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$384.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$421.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$669.60
|
| Rate for Payer: PACE Medicare |
$348.28
|
| Rate for Payer: PACE SWMI |
$366.61
|
| Rate for Payer: PHP Commercial |
$403.27
|
| Rate for Payer: PHP Medicaid |
$200.54
|
| Rate for Payer: PHP Medicare Advantage |
$366.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$200.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$551.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$716.86
|
| Rate for Payer: Priority Health Medicare |
$366.61
|
| Rate for Payer: Priority Health Narrow Network |
$559.31
|
| Rate for Payer: Railroad Medicare Medicare |
$366.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$693.23
|
| Rate for Payer: UHC Medicare Advantage |
$377.61
|
| Rate for Payer: VA VA |
$366.61
|
|
|
HC RADXF UNL NM RESP 78599
|
Facility
|
IP
|
$787.76
|
|
|
Service Code
|
CPT 78599
|
| Hospital Charge Code |
34100036
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$551.43 |
| Max. Negotiated Rate |
$787.76 |
| Rate for Payer: Aetna Commercial |
$708.98
|
| Rate for Payer: ASR ASR |
$764.13
|
| Rate for Payer: BCBS Trust/PPO |
$610.75
|
| Rate for Payer: BCN Commercial |
$610.75
|
| Rate for Payer: Cash Price |
$630.21
|
| Rate for Payer: Cofinity Commercial |
$740.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$630.21
|
| Rate for Payer: Healthscope Commercial |
$787.76
|
| Rate for Payer: Healthscope Whirlpool |
$764.13
|
| Rate for Payer: Mclaren Commercial |
$708.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$669.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$551.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$693.23
|
|
|
HC RADXF UNL ULTRASOUND 76999
|
Facility
|
IP
|
$213.00
|
|
|
Service Code
|
CPT 76999
|
| Hospital Charge Code |
40200051
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$149.10 |
| Max. Negotiated Rate |
$213.00 |
| Rate for Payer: Aetna Commercial |
$191.70
|
| Rate for Payer: ASR ASR |
$206.61
|
| Rate for Payer: BCBS Trust/PPO |
$165.14
|
| Rate for Payer: BCN Commercial |
$165.14
|
| Rate for Payer: Cash Price |
$170.40
|
| Rate for Payer: Cofinity Commercial |
$200.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$170.40
|
| Rate for Payer: Healthscope Commercial |
$213.00
|
| Rate for Payer: Healthscope Whirlpool |
$206.61
|
| Rate for Payer: Mclaren Commercial |
$191.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$181.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$149.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$187.44
|
|
|
HC RADXF UNL ULTRASOUND 76999
|
Facility
|
OP
|
$213.00
|
|
|
Service Code
|
CPT 76999
|
| Hospital Charge Code |
40200051
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$44.18 |
| Max. Negotiated Rate |
$369.94 |
| Rate for Payer: Aetna Commercial |
$191.70
|
| Rate for Payer: Aetna Medicare |
$80.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$100.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$100.96
|
| Rate for Payer: ASR ASR |
$206.61
|
| Rate for Payer: BCBS Complete |
$46.39
|
| Rate for Payer: BCBS MAPPO |
$80.77
|
| Rate for Payer: BCBS Trust/PPO |
$165.14
|
| Rate for Payer: BCN Commercial |
$165.14
|
| Rate for Payer: BCN Medicare Advantage |
$80.77
|
| Rate for Payer: Cash Price |
$170.40
|
| Rate for Payer: Cash Price |
$170.40
|
| Rate for Payer: Cofinity Commercial |
$200.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$170.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.77
|
| Rate for Payer: Healthscope Commercial |
$213.00
|
| Rate for Payer: Healthscope Whirlpool |
$206.61
|
| Rate for Payer: Humana Choice PPO Medicare |
$80.77
|
| Rate for Payer: Mclaren Commercial |
$191.70
|
| Rate for Payer: Mclaren Medicaid |
$44.18
|
| Rate for Payer: Mclaren Medicare |
$80.77
|
| Rate for Payer: Meridian Medicaid |
$46.39
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$84.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$92.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$181.05
|
| Rate for Payer: PACE Medicare |
$76.73
|
| Rate for Payer: PACE SWMI |
$80.77
|
| Rate for Payer: PHP Commercial |
$88.85
|
| Rate for Payer: PHP Medicaid |
$44.18
|
| Rate for Payer: PHP Medicare Advantage |
$80.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$149.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$369.94
|
| Rate for Payer: Priority Health Medicare |
$80.77
|
| Rate for Payer: Priority Health Narrow Network |
$295.95
|
| Rate for Payer: Railroad Medicare Medicare |
$80.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$187.44
|
| Rate for Payer: UHC Medicare Advantage |
$83.19
|
| Rate for Payer: VA VA |
$80.77
|
|
|
HC RAGWEED SHORT IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200056
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$17.42 |
| Max. Negotiated Rate |
$24.89 |
| Rate for Payer: Aetna Commercial |
$22.40
|
| Rate for Payer: ASR ASR |
$24.14
|
| Rate for Payer: BCBS Trust/PPO |
$19.30
|
| Rate for Payer: BCN Commercial |
$19.30
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$23.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$24.89
|
| Rate for Payer: Healthscope Whirlpool |
$24.14
|
| Rate for Payer: Mclaren Commercial |
$22.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.90
|
|
|
HC RAGWEED SHORT IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200056
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.86 |
| Max. Negotiated Rate |
$24.89 |
| Rate for Payer: Aetna Commercial |
$22.40
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: ASR ASR |
$24.14
|
| Rate for Payer: BCBS Complete |
$3.00
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.30
|
| Rate for Payer: BCN Commercial |
$19.30
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$23.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$24.89
|
| Rate for Payer: Healthscope Whirlpool |
$24.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$22.40
|
| Rate for Payer: Mclaren Medicaid |
$2.86
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Medicaid |
$3.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| 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 |
$2.86
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.65
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$17.67
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.90
|
| Rate for Payer: UHC Medicare Advantage |
$5.38
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC RAJI CELL ASSAY
|
Facility
|
IP
|
$148.00
|
|
|
Service Code
|
CPT 86332
|
| Hospital Charge Code |
30200192
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$103.60 |
| Max. Negotiated Rate |
$148.00 |
| Rate for Payer: Aetna Commercial |
$133.20
|
| Rate for Payer: ASR ASR |
$143.56
|
| Rate for Payer: BCBS Trust/PPO |
$114.74
|
| Rate for Payer: BCN Commercial |
$114.74
|
| Rate for Payer: Cash Price |
$118.40
|
| Rate for Payer: Cofinity Commercial |
$139.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$118.40
|
| Rate for Payer: Healthscope Commercial |
$148.00
|
| Rate for Payer: Healthscope Whirlpool |
$143.56
|
| Rate for Payer: Mclaren Commercial |
$133.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$125.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$103.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$130.24
|
|
|
HC RAJI CELL ASSAY
|
Facility
|
OP
|
$148.00
|
|
|
Service Code
|
CPT 86332
|
| Hospital Charge Code |
30200192
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.33 |
| Max. Negotiated Rate |
$148.00 |
| Rate for Payer: Aetna Commercial |
$133.20
|
| Rate for Payer: Aetna Medicare |
$24.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.46
|
| Rate for Payer: ASR ASR |
$143.56
|
| Rate for Payer: BCBS Complete |
$14.00
|
| Rate for Payer: BCBS MAPPO |
$24.37
|
| Rate for Payer: BCBS Trust/PPO |
$114.74
|
| Rate for Payer: BCN Commercial |
$114.74
|
| Rate for Payer: BCN Medicare Advantage |
$24.37
|
| Rate for Payer: Cash Price |
$118.40
|
| Rate for Payer: Cash Price |
$118.40
|
| Rate for Payer: Cofinity Commercial |
$139.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$118.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.37
|
| Rate for Payer: Healthscope Commercial |
$148.00
|
| Rate for Payer: Healthscope Whirlpool |
$143.56
|
| Rate for Payer: Humana Choice PPO Medicare |
$24.37
|
| Rate for Payer: Mclaren Commercial |
$133.20
|
| Rate for Payer: Mclaren Medicaid |
$13.33
|
| Rate for Payer: Mclaren Medicare |
$24.37
|
| Rate for Payer: Meridian Medicaid |
$14.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$25.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$125.80
|
| Rate for Payer: PACE Medicare |
$23.15
|
| Rate for Payer: PACE SWMI |
$24.37
|
| Rate for Payer: PHP Commercial |
$26.81
|
| Rate for Payer: PHP Medicaid |
$13.33
|
| Rate for Payer: PHP Medicare Advantage |
$24.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$103.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$134.68
|
| Rate for Payer: Priority Health Medicare |
$24.37
|
| Rate for Payer: Priority Health Narrow Network |
$105.08
|
| Rate for Payer: Railroad Medicare Medicare |
$24.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$130.24
|
| Rate for Payer: UHC Medicare Advantage |
$25.10
|
| Rate for Payer: VA VA |
$24.37
|
|
|
HC RAPID DESENSITIZATION PROC EA HOUR
|
Facility
|
OP
|
$530.15
|
|
|
Service Code
|
CPT 95180
|
| Hospital Charge Code |
76100075
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$193.73 |
| Max. Negotiated Rate |
$530.15 |
| Rate for Payer: Aetna Commercial |
$477.14
|
| Rate for Payer: Aetna Medicare |
$354.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$442.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$442.70
|
| Rate for Payer: ASR ASR |
$514.25
|
| Rate for Payer: BCBS Complete |
$203.43
|
| Rate for Payer: BCBS MAPPO |
$354.16
|
| Rate for Payer: BCBS Trust/PPO |
$411.03
|
| Rate for Payer: BCN Commercial |
$411.03
|
| Rate for Payer: BCN Medicare Advantage |
$354.16
|
| Rate for Payer: Cash Price |
$424.12
|
| Rate for Payer: Cash Price |
$424.12
|
| Rate for Payer: Cofinity Commercial |
$498.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$424.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$354.16
|
| Rate for Payer: Healthscope Commercial |
$530.15
|
| Rate for Payer: Healthscope Whirlpool |
$514.25
|
| Rate for Payer: Humana Choice PPO Medicare |
$354.16
|
| Rate for Payer: Mclaren Commercial |
$477.14
|
| Rate for Payer: Mclaren Medicaid |
$193.73
|
| Rate for Payer: Mclaren Medicare |
$354.16
|
| Rate for Payer: Meridian Medicaid |
$203.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$371.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$407.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$450.63
|
| Rate for Payer: PACE Medicare |
$336.45
|
| Rate for Payer: PACE SWMI |
$354.16
|
| Rate for Payer: PHP Commercial |
$389.58
|
| Rate for Payer: PHP Medicaid |
$193.73
|
| Rate for Payer: PHP Medicare Advantage |
$354.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$193.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$371.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$482.44
|
| Rate for Payer: Priority Health Medicare |
$354.16
|
| Rate for Payer: Priority Health Narrow Network |
$376.41
|
| Rate for Payer: Railroad Medicare Medicare |
$354.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$466.53
|
| Rate for Payer: UHC Medicare Advantage |
$364.78
|
| Rate for Payer: VA VA |
$354.16
|
|
|
HC RAPID DESENSITIZATION PROC EA HOUR
|
Facility
|
IP
|
$530.15
|
|
|
Service Code
|
CPT 95180
|
| Hospital Charge Code |
76100075
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$371.10 |
| Max. Negotiated Rate |
$530.15 |
| Rate for Payer: Aetna Commercial |
$477.14
|
| Rate for Payer: ASR ASR |
$514.25
|
| Rate for Payer: BCBS Trust/PPO |
$411.03
|
| Rate for Payer: BCN Commercial |
$411.03
|
| Rate for Payer: Cash Price |
$424.12
|
| Rate for Payer: Cofinity Commercial |
$498.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$424.12
|
| Rate for Payer: Healthscope Commercial |
$530.15
|
| Rate for Payer: Healthscope Whirlpool |
$514.25
|
| Rate for Payer: Mclaren Commercial |
$477.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$450.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$371.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$466.53
|
|
|
HC RAPID HIV ANTIBODY
|
Facility
|
OP
|
$150.70
|
|
|
Service Code
|
CPT 86701
|
| Hospital Charge Code |
30200290
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.86 |
| Max. Negotiated Rate |
$150.70 |
| Rate for Payer: Aetna Commercial |
$135.63
|
| Rate for Payer: Aetna Medicare |
$8.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.11
|
| Rate for Payer: ASR ASR |
$146.18
|
| Rate for Payer: BCBS Complete |
$5.11
|
| Rate for Payer: BCBS MAPPO |
$8.89
|
| Rate for Payer: BCBS Trust/PPO |
$116.84
|
| Rate for Payer: BCN Commercial |
$116.84
|
| Rate for Payer: BCN Medicare Advantage |
$8.89
|
| Rate for Payer: Cash Price |
$120.56
|
| Rate for Payer: Cash Price |
$120.56
|
| Rate for Payer: Cofinity Commercial |
$141.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.89
|
| Rate for Payer: Healthscope Commercial |
$150.70
|
| Rate for Payer: Healthscope Whirlpool |
$146.18
|
| Rate for Payer: Humana Choice PPO Medicare |
$8.89
|
| Rate for Payer: Mclaren Commercial |
$135.63
|
| Rate for Payer: Mclaren Medicaid |
$4.86
|
| Rate for Payer: Mclaren Medicare |
$8.89
|
| Rate for Payer: Meridian Medicaid |
$5.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$128.10
|
| Rate for Payer: PACE Medicare |
$8.45
|
| Rate for Payer: PACE SWMI |
$8.89
|
| Rate for Payer: PHP Commercial |
$9.78
|
| Rate for Payer: PHP Medicaid |
$4.86
|
| Rate for Payer: PHP Medicare Advantage |
$8.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.49
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$137.14
|
| Rate for Payer: Priority Health Medicare |
$8.89
|
| Rate for Payer: Priority Health Narrow Network |
$107.00
|
| Rate for Payer: Railroad Medicare Medicare |
$8.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$132.62
|
| Rate for Payer: UHC Medicare Advantage |
$9.16
|
| Rate for Payer: VA VA |
$8.89
|
|
