|
HC MICRA VV LEADLESS PACEMAKER
|
Facility
|
OP
|
$17,967.59
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500012
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$6,648.01 |
| Max. Negotiated Rate |
$17,967.59 |
| Rate for Payer: Aetna Commercial |
$16,170.83
|
| Rate for Payer: Aetna Medicare |
$6,648.01
|
| Rate for Payer: ASR ASR |
$17,428.56
|
| Rate for Payer: BCBS Complete |
$7,187.04
|
| Rate for Payer: BCBS Trust/PPO |
$14,814.28
|
| Rate for Payer: BCN Commercial |
$14,814.28
|
| Rate for Payer: Cash Price |
$14,374.07
|
| Rate for Payer: Cofinity Commercial |
$16,889.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,374.07
|
| Rate for Payer: Healthscope Commercial |
$17,428.56
|
| Rate for Payer: Healthscope Whirlpool |
$17,967.59
|
| Rate for Payer: Mclaren Commercial |
$16,170.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,374.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,272.45
|
| Rate for Payer: Nomi Health Commercial |
$14,733.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13,475.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$15,743.20
|
| Rate for Payer: Priority Health Narrow Network |
$12,595.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15,811.48
|
|
|
HC MICRA VV LEADLESS PACEMAKER
|
Facility
|
IP
|
$17,967.59
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500012
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$13,475.69 |
| Max. Negotiated Rate |
$17,967.59 |
| Rate for Payer: Aetna Commercial |
$16,170.83
|
| Rate for Payer: ASR ASR |
$17,428.56
|
| Rate for Payer: BCBS Trust/PPO |
$14,754.98
|
| Rate for Payer: BCN Commercial |
$14,754.98
|
| Rate for Payer: Cash Price |
$14,374.07
|
| Rate for Payer: Cofinity Commercial |
$16,889.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,374.07
|
| Rate for Payer: Healthscope Commercial |
$17,428.56
|
| Rate for Payer: Healthscope Whirlpool |
$17,967.59
|
| Rate for Payer: Mclaren Commercial |
$16,170.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,272.45
|
| Rate for Payer: Nomi Health Commercial |
$14,733.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13,475.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15,811.48
|
|
|
HC MICRO ALBUMIN URINE
|
Facility
|
OP
|
$78.45
|
|
|
Service Code
|
CPT 82043
|
| Hospital Charge Code |
30100075
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.02 |
| Max. Negotiated Rate |
$78.45 |
| Rate for Payer: Aetna Commercial |
$70.61
|
| Rate for Payer: Aetna Medicare |
$5.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.22
|
| Rate for Payer: ASR ASR |
$76.10
|
| Rate for Payer: BCBS Complete |
$3.17
|
| Rate for Payer: BCBS MAPPO |
$5.78
|
| Rate for Payer: BCBS Trust/PPO |
$64.68
|
| Rate for Payer: BCN Commercial |
$64.68
|
| Rate for Payer: BCN Medicare Advantage |
$5.78
|
| Rate for Payer: Cash Price |
$62.76
|
| Rate for Payer: Cash Price |
$62.76
|
| Rate for Payer: Cofinity Commercial |
$73.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.78
|
| Rate for Payer: Healthscope Commercial |
$76.10
|
| Rate for Payer: Healthscope Whirlpool |
$78.45
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.78
|
| Rate for Payer: Mclaren Commercial |
$70.61
|
| Rate for Payer: Mclaren Medicaid |
$5.78
|
| Rate for Payer: Mclaren Medicare |
$5.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.07
|
| Rate for Payer: Meridian Medicaid |
$3.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.68
|
| Rate for Payer: Nomi Health Commercial |
$64.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.84
|
| Rate for Payer: PACE Medicare |
$5.49
|
| Rate for Payer: PACE SWMI |
$5.78
|
| Rate for Payer: PHP Commercial |
$6.36
|
| Rate for Payer: PHP Medicaid |
$3.10
|
| Rate for Payer: PHP Medicare Advantage |
$5.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$59.31
|
| Rate for Payer: Priority Health Medicare |
$5.78
|
| Rate for Payer: Priority Health Narrow Network |
$47.45
|
| Rate for Payer: Railroad Medicare Medicare |
$5.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$69.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.78
|
| Rate for Payer: UHC Exchange |
$8.96
|
| Rate for Payer: UHC Medicaid |
$3.02
|
| Rate for Payer: UHCCP DNSP |
$5.78
|
| Rate for Payer: UHCCP Medicaid |
$3.02
|
| Rate for Payer: VA VA |
$5.78
|
|
|
HC MICRO ALBUMIN URINE
|
Facility
|
IP
|
$78.45
|
|
|
Service Code
|
CPT 82043
|
| Hospital Charge Code |
30100075
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$58.84 |
| Max. Negotiated Rate |
$78.45 |
| Rate for Payer: Aetna Commercial |
$70.61
|
| Rate for Payer: ASR ASR |
$76.10
|
| Rate for Payer: BCBS Trust/PPO |
$64.42
|
| Rate for Payer: BCN Commercial |
$64.42
|
| Rate for Payer: Cash Price |
$62.76
|
| Rate for Payer: Cofinity Commercial |
$73.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.76
|
| Rate for Payer: Healthscope Commercial |
$76.10
|
| Rate for Payer: Healthscope Whirlpool |
$78.45
|
| Rate for Payer: Mclaren Commercial |
$70.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.68
|
| Rate for Payer: Nomi Health Commercial |
$64.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$69.04
|
|
|
HC MICROSPORIDIA DETECTION
|
Facility
|
OP
|
$23.35
|
|
|
Service Code
|
CPT 87015
|
| Hospital Charge Code |
30600070
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$3.49 |
| Max. Negotiated Rate |
$23.35 |
| Rate for Payer: Aetna Commercial |
$21.02
|
| Rate for Payer: Aetna Medicare |
$6.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.35
|
| Rate for Payer: ASR ASR |
$22.65
|
| Rate for Payer: BCBS Complete |
$3.67
|
| Rate for Payer: BCBS MAPPO |
$6.68
|
| Rate for Payer: BCBS Trust/PPO |
$19.25
|
| Rate for Payer: BCN Commercial |
$19.25
|
| Rate for Payer: BCN Medicare Advantage |
$6.68
|
| Rate for Payer: Cash Price |
$18.68
|
| Rate for Payer: Cash Price |
$18.68
|
| Rate for Payer: Cofinity Commercial |
$21.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.68
|
| Rate for Payer: Healthscope Commercial |
$22.65
|
| Rate for Payer: Healthscope Whirlpool |
$23.35
|
| Rate for Payer: Humana Choice PPO Medicare |
$6.68
|
| Rate for Payer: Mclaren Commercial |
$21.02
|
| Rate for Payer: Mclaren Medicaid |
$6.68
|
| Rate for Payer: Mclaren Medicare |
$6.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.01
|
| Rate for Payer: Meridian Medicaid |
$3.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.85
|
| Rate for Payer: Nomi Health Commercial |
$19.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.51
|
| Rate for Payer: PACE Medicare |
$6.35
|
| Rate for Payer: PACE SWMI |
$6.68
|
| Rate for Payer: PHP Commercial |
$7.35
|
| Rate for Payer: PHP Medicaid |
$3.58
|
| Rate for Payer: PHP Medicare Advantage |
$6.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$23.01
|
| Rate for Payer: Priority Health Medicare |
$6.68
|
| Rate for Payer: Priority Health Narrow Network |
$18.40
|
| Rate for Payer: Railroad Medicare Medicare |
$6.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$20.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6.68
|
| Rate for Payer: UHC Exchange |
$10.35
|
| Rate for Payer: UHC Medicaid |
$3.49
|
| Rate for Payer: UHCCP DNSP |
$6.68
|
| Rate for Payer: UHCCP Medicaid |
$3.49
|
| Rate for Payer: VA VA |
$6.68
|
|
|
HC MICROSPORIDIA DETECTION
|
Facility
|
IP
|
$23.35
|
|
|
Service Code
|
CPT 87015
|
| Hospital Charge Code |
30600070
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$17.51 |
| Max. Negotiated Rate |
$23.35 |
| Rate for Payer: Aetna Commercial |
$21.02
|
| Rate for Payer: ASR ASR |
$22.65
|
| Rate for Payer: BCBS Trust/PPO |
$19.18
|
| Rate for Payer: BCN Commercial |
$19.18
|
| Rate for Payer: Cash Price |
$18.68
|
| Rate for Payer: Cofinity Commercial |
$21.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.68
|
| Rate for Payer: Healthscope Commercial |
$22.65
|
| Rate for Payer: Healthscope Whirlpool |
$23.35
|
| Rate for Payer: Mclaren Commercial |
$21.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.85
|
| Rate for Payer: Nomi Health Commercial |
$19.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$20.55
|
|
|
HC MICROSPORIDIA DETECTION CMPT
|
Facility
|
IP
|
$33.29
|
|
|
Service Code
|
CPT 87207
|
| Hospital Charge Code |
30600107
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$24.97 |
| Max. Negotiated Rate |
$33.29 |
| Rate for Payer: Aetna Commercial |
$29.96
|
| Rate for Payer: ASR ASR |
$32.29
|
| Rate for Payer: BCBS Trust/PPO |
$27.34
|
| Rate for Payer: BCN Commercial |
$27.34
|
| Rate for Payer: Cash Price |
$26.63
|
| Rate for Payer: Cofinity Commercial |
$31.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.63
|
| Rate for Payer: Healthscope Commercial |
$32.29
|
| Rate for Payer: Healthscope Whirlpool |
$33.29
|
| Rate for Payer: Mclaren Commercial |
$29.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.30
|
| Rate for Payer: Nomi Health Commercial |
$27.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$29.30
|
|
|
HC MICROSPORIDIA DETECTION CMPT
|
Facility
|
OP
|
$33.29
|
|
|
Service Code
|
CPT 87207
|
| Hospital Charge Code |
30600107
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$3.13 |
| Max. Negotiated Rate |
$138.00 |
| Rate for Payer: Aetna Commercial |
$29.96
|
| Rate for Payer: Aetna Medicare |
$5.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.49
|
| Rate for Payer: ASR ASR |
$32.29
|
| Rate for Payer: BCBS Complete |
$3.29
|
| Rate for Payer: BCBS MAPPO |
$5.99
|
| Rate for Payer: BCBS Trust/PPO |
$27.45
|
| Rate for Payer: BCN Commercial |
$27.45
|
| Rate for Payer: BCN Medicare Advantage |
$5.99
|
| Rate for Payer: Cash Price |
$26.63
|
| Rate for Payer: Cash Price |
$26.63
|
| Rate for Payer: Cofinity Commercial |
$31.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.99
|
| Rate for Payer: Healthscope Commercial |
$32.29
|
| Rate for Payer: Healthscope Whirlpool |
$33.29
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.99
|
| Rate for Payer: Mclaren Commercial |
$29.96
|
| Rate for Payer: Mclaren Medicaid |
$5.99
|
| Rate for Payer: Mclaren Medicare |
$5.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.29
|
| Rate for Payer: Meridian Medicaid |
$3.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.30
|
| Rate for Payer: Nomi Health Commercial |
$27.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.97
|
| Rate for Payer: PACE Medicare |
$5.69
|
| Rate for Payer: PACE SWMI |
$5.99
|
| Rate for Payer: PHP Commercial |
$6.59
|
| Rate for Payer: PHP Medicaid |
$3.21
|
| Rate for Payer: PHP Medicare Advantage |
$5.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$138.00
|
| Rate for Payer: Priority Health Medicare |
$5.99
|
| Rate for Payer: Priority Health Narrow Network |
$110.40
|
| Rate for Payer: Railroad Medicare Medicare |
$5.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$29.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.99
|
| Rate for Payer: UHC Exchange |
$9.28
|
| Rate for Payer: UHC Medicaid |
$3.13
|
| Rate for Payer: UHCCP DNSP |
$5.99
|
| Rate for Payer: UHCCP Medicaid |
$3.13
|
| Rate for Payer: VA VA |
$5.99
|
|
|
HC MICROSPORIDIA PCR
|
Facility
|
OP
|
$382.87
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600285
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.35 |
| Max. Negotiated Rate |
$382.87 |
| Rate for Payer: Aetna Commercial |
$344.58
|
| Rate for Payer: Aetna Medicare |
$35.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: ASR ASR |
$371.38
|
| Rate for Payer: BCBS Complete |
$19.27
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$315.68
|
| Rate for Payer: BCN Commercial |
$315.68
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$306.30
|
| Rate for Payer: Cash Price |
$306.30
|
| Rate for Payer: Cofinity Commercial |
$359.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$306.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$371.38
|
| Rate for Payer: Healthscope Whirlpool |
$382.87
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$344.58
|
| Rate for Payer: Mclaren Medicaid |
$35.09
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$19.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$325.44
|
| Rate for Payer: Nomi Health Commercial |
$313.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$287.15
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$38.60
|
| Rate for Payer: PHP Medicaid |
$18.81
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$335.47
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$268.39
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$336.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$35.09
|
| Rate for Payer: UHC Exchange |
$54.39
|
| Rate for Payer: UHC Medicaid |
$18.35
|
| Rate for Payer: UHCCP DNSP |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$18.35
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC MICROSPORIDIA PCR
|
Facility
|
IP
|
$382.87
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600285
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$287.15 |
| Max. Negotiated Rate |
$382.87 |
| Rate for Payer: Aetna Commercial |
$344.58
|
| Rate for Payer: ASR ASR |
$371.38
|
| Rate for Payer: BCBS Trust/PPO |
$314.41
|
| Rate for Payer: BCN Commercial |
$314.41
|
| Rate for Payer: Cash Price |
$306.30
|
| Rate for Payer: Cofinity Commercial |
$359.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$306.30
|
| Rate for Payer: Healthscope Commercial |
$371.38
|
| Rate for Payer: Healthscope Whirlpool |
$382.87
|
| Rate for Payer: Mclaren Commercial |
$344.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$325.44
|
| Rate for Payer: Nomi Health Commercial |
$313.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$287.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$336.93
|
|
|
HC MICU OBSERVATION PER HOUR
|
Facility
|
IP
|
$204.96
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200005
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$153.72 |
| Max. Negotiated Rate |
$204.96 |
| Rate for Payer: Aetna Commercial |
$184.46
|
| Rate for Payer: ASR ASR |
$198.81
|
| Rate for Payer: BCBS Trust/PPO |
$168.31
|
| Rate for Payer: BCN Commercial |
$168.31
|
| Rate for Payer: Cash Price |
$163.97
|
| Rate for Payer: Cofinity Commercial |
$192.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.97
|
| Rate for Payer: Healthscope Commercial |
$198.81
|
| Rate for Payer: Healthscope Whirlpool |
$204.96
|
| Rate for Payer: Mclaren Commercial |
$184.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$174.22
|
| Rate for Payer: Nomi Health Commercial |
$168.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$153.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$180.36
|
|
|
HC MICU OBSERVATION PER HOUR
|
Facility
|
OP
|
$204.96
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200005
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$54.44 |
| Max. Negotiated Rate |
$1,608.00 |
| Rate for Payer: Aetna Commercial |
$184.46
|
| Rate for Payer: Aetna Medicare |
$75.84
|
| Rate for Payer: ASR ASR |
$198.81
|
| Rate for Payer: BCBS Complete |
$81.98
|
| Rate for Payer: BCBS Trust/PPO |
$168.99
|
| Rate for Payer: BCN Commercial |
$168.99
|
| Rate for Payer: Cash Price |
$163.97
|
| Rate for Payer: Cash Price |
$163.97
|
| Rate for Payer: Cash Price |
$163.97
|
| Rate for Payer: Cofinity Commercial |
$192.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.97
|
| Rate for Payer: Healthscope Commercial |
$198.81
|
| Rate for Payer: Healthscope Whirlpool |
$204.96
|
| Rate for Payer: Mclaren Commercial |
$184.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$163.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$174.22
|
| Rate for Payer: Nomi Health Commercial |
$168.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$153.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$68.05
|
| Rate for Payer: Priority Health Narrow Network |
$54.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$180.36
|
| Rate for Payer: UHC Medicaid |
$1,608.00
|
|
|
HC MILK IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200047
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$25.90 |
| Rate for Payer: Aetna Commercial |
$23.31
|
| 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 |
$25.12
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$21.35
|
| Rate for Payer: BCN Commercial |
$21.35
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$24.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$25.12
|
| Rate for Payer: Healthscope Whirlpool |
$25.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$23.31
|
| Rate for Payer: Mclaren Medicaid |
$5.22
|
| 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 |
$2.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| 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 |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$22.69
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$18.16
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP DNSP |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC MILK IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200047
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.43 |
| Max. Negotiated Rate |
$25.90 |
| Rate for Payer: Aetna Commercial |
$23.31
|
| Rate for Payer: ASR ASR |
$25.12
|
| Rate for Payer: BCBS Trust/PPO |
$21.27
|
| Rate for Payer: BCN Commercial |
$21.27
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$24.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$25.12
|
| Rate for Payer: Healthscope Whirlpool |
$25.90
|
| Rate for Payer: Mclaren Commercial |
$23.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.79
|
|
|
HC MINI BAL PROCEDURE
|
Facility
|
OP
|
$315.45
|
|
|
Service Code
|
CPT 94799
|
| Hospital Charge Code |
41000014
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$67.05 |
| Max. Negotiated Rate |
$315.45 |
| Rate for Payer: Aetna Commercial |
$283.90
|
| Rate for Payer: Aetna Medicare |
$128.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$160.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$160.26
|
| Rate for Payer: ASR ASR |
$305.99
|
| Rate for Payer: BCBS Complete |
$70.41
|
| Rate for Payer: BCBS MAPPO |
$128.21
|
| Rate for Payer: BCBS Trust/PPO |
$260.09
|
| Rate for Payer: BCN Commercial |
$260.09
|
| Rate for Payer: BCN Medicare Advantage |
$128.21
|
| Rate for Payer: Cash Price |
$252.36
|
| Rate for Payer: Cash Price |
$252.36
|
| Rate for Payer: Cofinity Commercial |
$296.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.21
|
| Rate for Payer: Healthscope Commercial |
$305.99
|
| Rate for Payer: Healthscope Whirlpool |
$315.45
|
| Rate for Payer: Humana Choice PPO Medicare |
$128.21
|
| Rate for Payer: Mclaren Commercial |
$283.90
|
| Rate for Payer: Mclaren Medicaid |
$128.21
|
| Rate for Payer: Mclaren Medicare |
$128.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$134.62
|
| Rate for Payer: Meridian Medicaid |
$70.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$147.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$141.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$268.13
|
| Rate for Payer: Nomi Health Commercial |
$258.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$236.59
|
| Rate for Payer: PACE Medicare |
$121.80
|
| Rate for Payer: PACE SWMI |
$128.21
|
| Rate for Payer: PHP Commercial |
$141.03
|
| Rate for Payer: PHP Medicaid |
$68.72
|
| Rate for Payer: PHP Medicare Advantage |
$128.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$98.06
|
| Rate for Payer: Priority Health Medicare |
$128.21
|
| Rate for Payer: Priority Health Narrow Network |
$78.45
|
| Rate for Payer: Railroad Medicare Medicare |
$128.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$277.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$128.21
|
| Rate for Payer: UHC Exchange |
$198.73
|
| Rate for Payer: UHC Medicaid |
$67.05
|
| Rate for Payer: UHCCP DNSP |
$128.21
|
| Rate for Payer: UHCCP Medicaid |
$67.05
|
| Rate for Payer: VA VA |
$128.21
|
|
|
HC MINI BAL PROCEDURE
|
Facility
|
IP
|
$315.45
|
|
|
Service Code
|
CPT 94799
|
| Hospital Charge Code |
41000014
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$236.59 |
| Max. Negotiated Rate |
$315.45 |
| Rate for Payer: Aetna Commercial |
$283.90
|
| Rate for Payer: ASR ASR |
$305.99
|
| Rate for Payer: BCBS Trust/PPO |
$259.05
|
| Rate for Payer: BCN Commercial |
$259.05
|
| Rate for Payer: Cash Price |
$252.36
|
| Rate for Payer: Cofinity Commercial |
$296.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.36
|
| Rate for Payer: Healthscope Commercial |
$305.99
|
| Rate for Payer: Healthscope Whirlpool |
$315.45
|
| Rate for Payer: Mclaren Commercial |
$283.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$268.13
|
| Rate for Payer: Nomi Health Commercial |
$258.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$236.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$277.60
|
|
|
HC MINIMUM BACTERICIDAL CONCENTRA
|
Facility
|
IP
|
$31.21
|
|
|
Service Code
|
CPT 87188
|
| Hospital Charge Code |
30600103
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$23.41 |
| Max. Negotiated Rate |
$31.21 |
| Rate for Payer: Aetna Commercial |
$28.09
|
| Rate for Payer: ASR ASR |
$30.27
|
| Rate for Payer: BCBS Trust/PPO |
$25.63
|
| Rate for Payer: BCN Commercial |
$25.63
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cofinity Commercial |
$29.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.97
|
| Rate for Payer: Healthscope Commercial |
$30.27
|
| Rate for Payer: Healthscope Whirlpool |
$31.21
|
| Rate for Payer: Mclaren Commercial |
$28.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.53
|
| Rate for Payer: Nomi Health Commercial |
$25.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.46
|
|
|
HC MINIMUM BACTERICIDAL CONCENTRA
|
Facility
|
OP
|
$31.21
|
|
|
Service Code
|
CPT 87188
|
| Hospital Charge Code |
30600103
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$3.47 |
| Max. Negotiated Rate |
$31.21 |
| Rate for Payer: Aetna Commercial |
$28.09
|
| Rate for Payer: Aetna Medicare |
$6.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.30
|
| Rate for Payer: ASR ASR |
$30.27
|
| Rate for Payer: BCBS Complete |
$3.65
|
| Rate for Payer: BCBS MAPPO |
$6.64
|
| Rate for Payer: BCBS Trust/PPO |
$25.73
|
| Rate for Payer: BCN Commercial |
$25.73
|
| Rate for Payer: BCN Medicare Advantage |
$6.64
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cofinity Commercial |
$29.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.64
|
| Rate for Payer: Healthscope Commercial |
$30.27
|
| Rate for Payer: Healthscope Whirlpool |
$31.21
|
| Rate for Payer: Humana Choice PPO Medicare |
$6.64
|
| Rate for Payer: Mclaren Commercial |
$28.09
|
| Rate for Payer: Mclaren Medicaid |
$6.64
|
| Rate for Payer: Mclaren Medicare |
$6.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.97
|
| Rate for Payer: Meridian Medicaid |
$3.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.53
|
| Rate for Payer: Nomi Health Commercial |
$25.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.41
|
| Rate for Payer: PACE Medicare |
$6.31
|
| Rate for Payer: PACE SWMI |
$6.64
|
| Rate for Payer: PHP Commercial |
$7.30
|
| Rate for Payer: PHP Medicaid |
$3.56
|
| Rate for Payer: PHP Medicare Advantage |
$6.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$27.35
|
| Rate for Payer: Priority Health Medicare |
$6.64
|
| Rate for Payer: Priority Health Narrow Network |
$21.88
|
| Rate for Payer: Railroad Medicare Medicare |
$6.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6.64
|
| Rate for Payer: UHC Exchange |
$10.29
|
| Rate for Payer: UHC Medicaid |
$3.47
|
| Rate for Payer: UHCCP DNSP |
$6.64
|
| Rate for Payer: UHCCP Medicaid |
$3.47
|
| Rate for Payer: VA VA |
$6.64
|
|
|
HC MINIMUM LETHAL CONCENTRATION (MLC)
|
Facility
|
OP
|
$47.76
|
|
|
Service Code
|
CPT 87187
|
| Hospital Charge Code |
30600102
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$21.01 |
| Max. Negotiated Rate |
$62.26 |
| Rate for Payer: Aetna Commercial |
$42.98
|
| Rate for Payer: Aetna Medicare |
$40.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$50.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$50.21
|
| Rate for Payer: ASR ASR |
$46.33
|
| Rate for Payer: BCBS Complete |
$22.06
|
| Rate for Payer: BCBS MAPPO |
$40.17
|
| Rate for Payer: BCBS Trust/PPO |
$39.38
|
| Rate for Payer: BCN Commercial |
$39.38
|
| Rate for Payer: BCN Medicare Advantage |
$40.17
|
| Rate for Payer: Cash Price |
$38.21
|
| Rate for Payer: Cash Price |
$38.21
|
| Rate for Payer: Cofinity Commercial |
$44.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.17
|
| Rate for Payer: Healthscope Commercial |
$46.33
|
| Rate for Payer: Healthscope Whirlpool |
$47.76
|
| Rate for Payer: Humana Choice PPO Medicare |
$40.17
|
| Rate for Payer: Mclaren Commercial |
$42.98
|
| Rate for Payer: Mclaren Medicaid |
$40.17
|
| Rate for Payer: Mclaren Medicare |
$40.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.18
|
| Rate for Payer: Meridian Medicaid |
$22.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$44.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.60
|
| Rate for Payer: Nomi Health Commercial |
$39.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.82
|
| Rate for Payer: PACE Medicare |
$38.16
|
| Rate for Payer: PACE SWMI |
$40.17
|
| Rate for Payer: PHP Commercial |
$44.19
|
| Rate for Payer: PHP Medicaid |
$21.53
|
| Rate for Payer: PHP Medicare Advantage |
$40.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$41.85
|
| Rate for Payer: Priority Health Medicare |
$40.17
|
| Rate for Payer: Priority Health Narrow Network |
$33.48
|
| Rate for Payer: Railroad Medicare Medicare |
$40.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$42.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$40.17
|
| Rate for Payer: UHC Exchange |
$62.26
|
| Rate for Payer: UHC Medicaid |
$21.01
|
| Rate for Payer: UHCCP DNSP |
$40.17
|
| Rate for Payer: UHCCP Medicaid |
$21.01
|
| Rate for Payer: VA VA |
$40.17
|
|
|
HC MINIMUM LETHAL CONCENTRATION (MLC)
|
Facility
|
IP
|
$47.76
|
|
|
Service Code
|
CPT 87187
|
| Hospital Charge Code |
30600102
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$35.82 |
| Max. Negotiated Rate |
$47.76 |
| Rate for Payer: Aetna Commercial |
$42.98
|
| Rate for Payer: ASR ASR |
$46.33
|
| Rate for Payer: BCBS Trust/PPO |
$39.22
|
| Rate for Payer: BCN Commercial |
$39.22
|
| Rate for Payer: Cash Price |
$38.21
|
| Rate for Payer: Cofinity Commercial |
$44.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.21
|
| Rate for Payer: Healthscope Commercial |
$46.33
|
| Rate for Payer: Healthscope Whirlpool |
$47.76
|
| Rate for Payer: Mclaren Commercial |
$42.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.60
|
| Rate for Payer: Nomi Health Commercial |
$39.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$42.03
|
|
|
HC MINOR PROCEDURE WO SEDATION
|
Facility
|
IP
|
$542.17
|
|
| Hospital Charge Code |
36000076
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$406.63 |
| Max. Negotiated Rate |
$542.17 |
| Rate for Payer: Aetna Commercial |
$487.95
|
| Rate for Payer: ASR ASR |
$525.90
|
| Rate for Payer: BCBS Trust/PPO |
$445.23
|
| Rate for Payer: BCN Commercial |
$445.23
|
| Rate for Payer: Cash Price |
$433.74
|
| Rate for Payer: Cofinity Commercial |
$509.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$433.74
|
| Rate for Payer: Healthscope Commercial |
$525.90
|
| Rate for Payer: Healthscope Whirlpool |
$542.17
|
| Rate for Payer: Mclaren Commercial |
$487.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$460.84
|
| Rate for Payer: Nomi Health Commercial |
$444.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$406.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$477.11
|
|
|
HC MINOR PROCEDURE WO SEDATION
|
Facility
|
OP
|
$542.17
|
|
| Hospital Charge Code |
36000076
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$200.60 |
| Max. Negotiated Rate |
$542.17 |
| Rate for Payer: Aetna Commercial |
$487.95
|
| Rate for Payer: Aetna Medicare |
$200.60
|
| Rate for Payer: ASR ASR |
$525.90
|
| Rate for Payer: BCBS Complete |
$216.87
|
| Rate for Payer: BCBS Trust/PPO |
$447.02
|
| Rate for Payer: BCN Commercial |
$447.02
|
| Rate for Payer: Cash Price |
$433.74
|
| Rate for Payer: Cofinity Commercial |
$509.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$433.74
|
| Rate for Payer: Healthscope Commercial |
$525.90
|
| Rate for Payer: Healthscope Whirlpool |
$542.17
|
| Rate for Payer: Mclaren Commercial |
$487.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$433.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$460.84
|
| Rate for Payer: Nomi Health Commercial |
$444.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$406.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$475.05
|
| Rate for Payer: Priority Health Narrow Network |
$380.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$477.11
|
|
|
HC MINOR PROCEDURE W SEDATION
|
Facility
|
IP
|
$628.24
|
|
| Hospital Charge Code |
36000075
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$471.18 |
| Max. Negotiated Rate |
$628.24 |
| Rate for Payer: Aetna Commercial |
$565.42
|
| Rate for Payer: ASR ASR |
$609.39
|
| Rate for Payer: BCBS Trust/PPO |
$515.91
|
| Rate for Payer: BCN Commercial |
$515.91
|
| Rate for Payer: Cash Price |
$502.59
|
| Rate for Payer: Cofinity Commercial |
$590.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$502.59
|
| Rate for Payer: Healthscope Commercial |
$609.39
|
| Rate for Payer: Healthscope Whirlpool |
$628.24
|
| Rate for Payer: Mclaren Commercial |
$565.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$534.00
|
| Rate for Payer: Nomi Health Commercial |
$515.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$471.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$552.85
|
|
|
HC MINOR PROCEDURE W SEDATION
|
Facility
|
OP
|
$628.24
|
|
| Hospital Charge Code |
36000075
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$232.45 |
| Max. Negotiated Rate |
$628.24 |
| Rate for Payer: Aetna Commercial |
$565.42
|
| Rate for Payer: Aetna Medicare |
$232.45
|
| Rate for Payer: ASR ASR |
$609.39
|
| Rate for Payer: BCBS Complete |
$251.30
|
| Rate for Payer: BCBS Trust/PPO |
$517.98
|
| Rate for Payer: BCN Commercial |
$517.98
|
| Rate for Payer: Cash Price |
$502.59
|
| Rate for Payer: Cofinity Commercial |
$590.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$502.59
|
| Rate for Payer: Healthscope Commercial |
$609.39
|
| Rate for Payer: Healthscope Whirlpool |
$628.24
|
| Rate for Payer: Mclaren Commercial |
$565.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$502.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$534.00
|
| Rate for Payer: Nomi Health Commercial |
$515.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$471.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$550.46
|
| Rate for Payer: Priority Health Narrow Network |
$440.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$552.85
|
|
|
HC MITOTANE (LYSODREN)
|
Facility
|
OP
|
$119.87
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100731
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.75 |
| Max. Negotiated Rate |
$271.17 |
| Rate for Payer: Aetna Commercial |
$107.88
|
| Rate for Payer: Aetna Medicare |
$18.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.30
|
| Rate for Payer: ASR ASR |
$116.27
|
| Rate for Payer: BCBS Complete |
$10.24
|
| Rate for Payer: BCBS MAPPO |
$18.64
|
| Rate for Payer: BCBS Trust/PPO |
$98.83
|
| Rate for Payer: BCN Commercial |
$98.83
|
| Rate for Payer: BCN Medicare Advantage |
$18.64
|
| Rate for Payer: Cash Price |
$95.90
|
| Rate for Payer: Cash Price |
$95.90
|
| Rate for Payer: Cofinity Commercial |
$112.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.64
|
| Rate for Payer: Healthscope Commercial |
$116.27
|
| Rate for Payer: Healthscope Whirlpool |
$119.87
|
| Rate for Payer: Humana Choice PPO Medicare |
$18.64
|
| Rate for Payer: Mclaren Commercial |
$107.88
|
| Rate for Payer: Mclaren Medicaid |
$18.64
|
| Rate for Payer: Mclaren Medicare |
$18.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.57
|
| Rate for Payer: Meridian Medicaid |
$10.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.89
|
| Rate for Payer: Nomi Health Commercial |
$98.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$89.90
|
| Rate for Payer: PACE Medicare |
$17.71
|
| Rate for Payer: PACE SWMI |
$18.64
|
| Rate for Payer: PHP Commercial |
$20.50
|
| Rate for Payer: PHP Medicaid |
$9.99
|
| Rate for Payer: PHP Medicare Advantage |
$18.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$271.17
|
| Rate for Payer: Priority Health Medicare |
$18.64
|
| Rate for Payer: Priority Health Narrow Network |
$216.94
|
| Rate for Payer: Railroad Medicare Medicare |
$18.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$105.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18.64
|
| Rate for Payer: UHC Exchange |
$28.89
|
| Rate for Payer: UHC Medicaid |
$9.75
|
| Rate for Payer: UHCCP DNSP |
$18.64
|
| Rate for Payer: UHCCP Medicaid |
$9.75
|
| Rate for Payer: VA VA |
$18.64
|
|
