|
HC MAC/REGIONAL PER MINUTE
|
Facility
|
IP
|
$14.00
|
|
| Hospital Charge Code |
37000025
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$9.10 |
| Max. Negotiated Rate |
$14.00 |
| Rate for Payer: Aetna Commercial |
$12.60
|
| Rate for Payer: ASR ASR |
$13.58
|
| Rate for Payer: ASR Commercial |
$13.58
|
| Rate for Payer: BCBS Trust/PPO |
$11.41
|
| Rate for Payer: BCN Commercial |
$10.85
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cofinity Commercial |
$13.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.20
|
| Rate for Payer: Healthscope Commercial |
$14.00
|
| Rate for Payer: Healthscope Whirlpool |
$13.58
|
| Rate for Payer: Mclaren Commercial |
$12.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.90
|
| Rate for Payer: Nomi Health Commercial |
$11.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12.32
|
|
|
HC MACROSCOPIC EXAM ARTHROPOD
|
Facility
|
OP
|
$44.94
|
|
|
Service Code
|
CPT 87168
|
| Hospital Charge Code |
30600092
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$2.29 |
| Max. Negotiated Rate |
$60.95 |
| Rate for Payer: Aetna Commercial |
$40.45
|
| Rate for Payer: Aetna Medicare |
$4.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.34
|
| Rate for Payer: ASR ASR |
$43.59
|
| Rate for Payer: ASR Commercial |
$43.59
|
| Rate for Payer: BCBS Complete |
$2.40
|
| Rate for Payer: BCBS MAPPO |
$4.27
|
| Rate for Payer: BCBS Trust/PPO |
$36.80
|
| Rate for Payer: BCN Commercial |
$34.84
|
| Rate for Payer: BCN Medicare Advantage |
$4.27
|
| Rate for Payer: Cash Price |
$35.95
|
| Rate for Payer: Cash Price |
$35.95
|
| Rate for Payer: Cofinity Commercial |
$42.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.27
|
| Rate for Payer: Healthscope Commercial |
$44.94
|
| Rate for Payer: Healthscope Whirlpool |
$43.59
|
| Rate for Payer: Humana Choice PPO Medicare |
$4.27
|
| Rate for Payer: Mclaren Commercial |
$40.45
|
| Rate for Payer: Mclaren Medicaid |
$2.29
|
| Rate for Payer: Mclaren Medicare |
$4.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.48
|
| Rate for Payer: Meridian Medicaid |
$2.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.20
|
| Rate for Payer: Nomi Health Commercial |
$36.85
|
| Rate for Payer: PACE Medicare |
$4.06
|
| Rate for Payer: PACE SWMI |
$4.27
|
| Rate for Payer: PHP Commercial |
$4.70
|
| Rate for Payer: PHP Medicaid |
$2.29
|
| Rate for Payer: PHP Medicare Advantage |
$4.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$60.95
|
| Rate for Payer: Priority Health Medicare |
$4.27
|
| Rate for Payer: Priority Health Narrow Network |
$48.76
|
| Rate for Payer: Railroad Medicare Medicare |
$4.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$39.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.27
|
| Rate for Payer: UHC Exchange |
$6.62
|
| Rate for Payer: UHC Medicare Advantage |
$4.27
|
| Rate for Payer: UHCCP DNSP |
$4.27
|
| Rate for Payer: UHCCP Medicaid |
$2.29
|
| Rate for Payer: VA VA |
$4.27
|
|
|
HC MACROSCOPIC EXAM ARTHROPOD
|
Facility
|
IP
|
$44.94
|
|
|
Service Code
|
CPT 87168
|
| Hospital Charge Code |
30600092
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$29.21 |
| Max. Negotiated Rate |
$44.94 |
| Rate for Payer: Aetna Commercial |
$40.45
|
| Rate for Payer: ASR ASR |
$43.59
|
| Rate for Payer: ASR Commercial |
$43.59
|
| Rate for Payer: BCBS Trust/PPO |
$36.62
|
| Rate for Payer: BCN Commercial |
$34.84
|
| Rate for Payer: Cash Price |
$35.95
|
| Rate for Payer: Cofinity Commercial |
$42.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.95
|
| Rate for Payer: Healthscope Commercial |
$44.94
|
| Rate for Payer: Healthscope Whirlpool |
$43.59
|
| Rate for Payer: Mclaren Commercial |
$40.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.20
|
| Rate for Payer: Nomi Health Commercial |
$36.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$39.55
|
|
|
HC MACROSCOPIC EXAM PARASITE
|
Facility
|
IP
|
$44.06
|
|
|
Service Code
|
CPT 87169
|
| Hospital Charge Code |
30600093
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$28.64 |
| Max. Negotiated Rate |
$44.06 |
| Rate for Payer: Aetna Commercial |
$39.65
|
| Rate for Payer: ASR ASR |
$42.74
|
| Rate for Payer: ASR Commercial |
$42.74
|
| Rate for Payer: BCBS Trust/PPO |
$35.90
|
| Rate for Payer: BCN Commercial |
$34.16
|
| Rate for Payer: Cash Price |
$35.25
|
| Rate for Payer: Cofinity Commercial |
$41.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.25
|
| Rate for Payer: Healthscope Commercial |
$44.06
|
| Rate for Payer: Healthscope Whirlpool |
$42.74
|
| Rate for Payer: Mclaren Commercial |
$39.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.45
|
| Rate for Payer: Nomi Health Commercial |
$36.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$38.77
|
|
|
HC MACROSCOPIC EXAM PARASITE
|
Facility
|
OP
|
$44.06
|
|
|
Service Code
|
CPT 87169
|
| Hospital Charge Code |
30600093
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$2.31 |
| Max. Negotiated Rate |
$48.87 |
| Rate for Payer: Aetna Commercial |
$39.65
|
| Rate for Payer: Aetna Medicare |
$4.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.39
|
| Rate for Payer: ASR ASR |
$42.74
|
| Rate for Payer: ASR Commercial |
$42.74
|
| Rate for Payer: BCBS Complete |
$2.43
|
| Rate for Payer: BCBS MAPPO |
$4.31
|
| Rate for Payer: BCBS Trust/PPO |
$36.08
|
| Rate for Payer: BCN Commercial |
$34.16
|
| Rate for Payer: BCN Medicare Advantage |
$4.31
|
| Rate for Payer: Cash Price |
$35.25
|
| Rate for Payer: Cash Price |
$35.25
|
| Rate for Payer: Cofinity Commercial |
$41.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.31
|
| Rate for Payer: Healthscope Commercial |
$44.06
|
| Rate for Payer: Healthscope Whirlpool |
$42.74
|
| Rate for Payer: Humana Choice PPO Medicare |
$4.31
|
| Rate for Payer: Mclaren Commercial |
$39.65
|
| Rate for Payer: Mclaren Medicaid |
$2.31
|
| Rate for Payer: Mclaren Medicare |
$4.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.53
|
| Rate for Payer: Meridian Medicaid |
$2.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.45
|
| Rate for Payer: Nomi Health Commercial |
$36.13
|
| Rate for Payer: PACE Medicare |
$4.09
|
| Rate for Payer: PACE SWMI |
$4.31
|
| Rate for Payer: PHP Commercial |
$4.74
|
| Rate for Payer: PHP Medicaid |
$2.31
|
| Rate for Payer: PHP Medicare Advantage |
$4.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$48.87
|
| Rate for Payer: Priority Health Medicare |
$4.31
|
| Rate for Payer: Priority Health Narrow Network |
$39.10
|
| Rate for Payer: Railroad Medicare Medicare |
$4.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$38.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.31
|
| Rate for Payer: UHC Exchange |
$6.68
|
| Rate for Payer: UHC Medicare Advantage |
$4.31
|
| Rate for Payer: UHCCP DNSP |
$4.31
|
| Rate for Payer: UHCCP Medicaid |
$2.31
|
| Rate for Payer: VA VA |
$4.31
|
|
|
HC MAG 3 TC 99M PER STUDY
|
Facility
|
IP
|
$975.34
|
|
|
Service Code
|
HCPCS A9562
|
| Hospital Charge Code |
34300016
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$633.97 |
| Max. Negotiated Rate |
$975.34 |
| Rate for Payer: Aetna Commercial |
$877.81
|
| Rate for Payer: ASR ASR |
$946.08
|
| Rate for Payer: ASR Commercial |
$946.08
|
| Rate for Payer: BCBS Trust/PPO |
$794.80
|
| Rate for Payer: BCN Commercial |
$756.18
|
| Rate for Payer: Cash Price |
$780.27
|
| Rate for Payer: Cofinity Commercial |
$916.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$780.27
|
| Rate for Payer: Healthscope Commercial |
$975.34
|
| Rate for Payer: Healthscope Whirlpool |
$946.08
|
| Rate for Payer: Mclaren Commercial |
$877.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$829.04
|
| Rate for Payer: Nomi Health Commercial |
$799.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$633.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$858.30
|
|
|
HC MAG 3 TC 99M PER STUDY
|
Facility
|
OP
|
$975.34
|
|
|
Service Code
|
HCPCS A9562
|
| Hospital Charge Code |
34300016
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$257.38 |
| Max. Negotiated Rate |
$975.34 |
| Rate for Payer: Aetna Commercial |
$877.81
|
| Rate for Payer: Aetna Medicare |
$487.67
|
| Rate for Payer: ASR ASR |
$946.08
|
| Rate for Payer: ASR Commercial |
$946.08
|
| Rate for Payer: BCBS Complete |
$390.14
|
| Rate for Payer: BCBS Trust/PPO |
$798.71
|
| Rate for Payer: BCN Commercial |
$756.18
|
| Rate for Payer: Cash Price |
$780.27
|
| Rate for Payer: Cash Price |
$780.27
|
| Rate for Payer: Cofinity Commercial |
$916.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$780.27
|
| Rate for Payer: Healthscope Commercial |
$975.34
|
| Rate for Payer: Healthscope Whirlpool |
$946.08
|
| Rate for Payer: Mclaren Commercial |
$877.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$829.04
|
| Rate for Payer: Nomi Health Commercial |
$799.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$633.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$321.72
|
| Rate for Payer: Priority Health Narrow Network |
$257.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$858.30
|
|
|
HC MAGGOT THERAPY
|
Facility
|
OP
|
$1,092.42
|
|
| Hospital Charge Code |
27000634
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$436.97 |
| Max. Negotiated Rate |
$1,092.42 |
| Rate for Payer: Aetna Commercial |
$983.18
|
| Rate for Payer: Aetna Medicare |
$546.21
|
| Rate for Payer: ASR ASR |
$1,059.65
|
| Rate for Payer: ASR Commercial |
$1,059.65
|
| Rate for Payer: BCBS Complete |
$436.97
|
| Rate for Payer: BCBS Trust/PPO |
$894.58
|
| Rate for Payer: BCN Commercial |
$846.95
|
| Rate for Payer: Cash Price |
$873.94
|
| Rate for Payer: Cofinity Commercial |
$1,026.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$873.94
|
| Rate for Payer: Healthscope Commercial |
$1,092.42
|
| Rate for Payer: Healthscope Whirlpool |
$1,059.65
|
| Rate for Payer: Mclaren Commercial |
$983.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$928.56
|
| Rate for Payer: Nomi Health Commercial |
$895.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$710.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$957.18
|
| Rate for Payer: Priority Health Narrow Network |
$765.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$961.33
|
|
|
HC MAGGOT THERAPY
|
Facility
|
IP
|
$1,092.42
|
|
| Hospital Charge Code |
27000634
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$710.07 |
| Max. Negotiated Rate |
$1,092.42 |
| Rate for Payer: Aetna Commercial |
$983.18
|
| Rate for Payer: ASR ASR |
$1,059.65
|
| Rate for Payer: ASR Commercial |
$1,059.65
|
| Rate for Payer: BCBS Trust/PPO |
$890.21
|
| Rate for Payer: BCN Commercial |
$846.95
|
| Rate for Payer: Cash Price |
$873.94
|
| Rate for Payer: Cofinity Commercial |
$1,026.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$873.94
|
| Rate for Payer: Healthscope Commercial |
$1,092.42
|
| Rate for Payer: Healthscope Whirlpool |
$1,059.65
|
| Rate for Payer: Mclaren Commercial |
$983.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$928.56
|
| Rate for Payer: Nomi Health Commercial |
$895.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$710.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$961.33
|
|
|
HC MAGNESIUM LEVEL
|
Facility
|
IP
|
$26.01
|
|
|
Service Code
|
CPT 83735
|
| Hospital Charge Code |
30100284
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.91 |
| Max. Negotiated Rate |
$26.01 |
| Rate for Payer: Aetna Commercial |
$23.41
|
| Rate for Payer: ASR ASR |
$25.23
|
| Rate for Payer: ASR Commercial |
$25.23
|
| Rate for Payer: BCBS Trust/PPO |
$21.20
|
| Rate for Payer: BCN Commercial |
$20.17
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$24.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$26.01
|
| Rate for Payer: Healthscope Whirlpool |
$25.23
|
| Rate for Payer: Mclaren Commercial |
$23.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: Nomi Health Commercial |
$21.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.89
|
|
|
HC MAGNESIUM LEVEL
|
Facility
|
OP
|
$26.01
|
|
|
Service Code
|
CPT 83735
|
| Hospital Charge Code |
30100284
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.59 |
| Max. Negotiated Rate |
$36.24 |
| Rate for Payer: Aetna Commercial |
$23.41
|
| Rate for Payer: Aetna Medicare |
$6.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.38
|
| Rate for Payer: ASR ASR |
$25.23
|
| Rate for Payer: ASR Commercial |
$25.23
|
| Rate for Payer: BCBS Complete |
$3.77
|
| Rate for Payer: BCBS MAPPO |
$6.70
|
| Rate for Payer: BCBS Trust/PPO |
$21.30
|
| Rate for Payer: BCN Commercial |
$20.17
|
| Rate for Payer: BCN Medicare Advantage |
$6.70
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$24.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.70
|
| Rate for Payer: Healthscope Commercial |
$26.01
|
| Rate for Payer: Healthscope Whirlpool |
$25.23
|
| Rate for Payer: Humana Choice PPO Medicare |
$6.70
|
| Rate for Payer: Mclaren Commercial |
$23.41
|
| Rate for Payer: Mclaren Medicaid |
$3.59
|
| Rate for Payer: Mclaren Medicare |
$6.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.04
|
| Rate for Payer: Meridian Medicaid |
$3.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: Nomi Health Commercial |
$21.33
|
| Rate for Payer: PACE Medicare |
$6.36
|
| Rate for Payer: PACE SWMI |
$6.70
|
| Rate for Payer: PHP Commercial |
$7.37
|
| Rate for Payer: PHP Medicaid |
$3.59
|
| Rate for Payer: PHP Medicare Advantage |
$6.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$36.24
|
| Rate for Payer: Priority Health Medicare |
$6.70
|
| Rate for Payer: Priority Health Narrow Network |
$28.99
|
| Rate for Payer: Railroad Medicare Medicare |
$6.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.70
|
| Rate for Payer: UHC Exchange |
$10.38
|
| Rate for Payer: UHC Medicare Advantage |
$6.70
|
| Rate for Payer: UHCCP DNSP |
$6.70
|
| Rate for Payer: UHCCP Medicaid |
$3.59
|
| Rate for Payer: VA VA |
$6.70
|
|
|
HC MAKENA 10 MG
|
Facility
|
OP
|
$2.60
|
|
|
Service Code
|
HCPCS J1726
|
| Hospital Charge Code |
63600141
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.69 |
| Max. Negotiated Rate |
$21.42 |
| Rate for Payer: Aetna Commercial |
$2.34
|
| Rate for Payer: Aetna Medicare |
$13.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.28
|
| Rate for Payer: ASR ASR |
$2.52
|
| Rate for Payer: ASR Commercial |
$2.52
|
| Rate for Payer: BCBS Complete |
$7.78
|
| Rate for Payer: BCBS MAPPO |
$13.82
|
| Rate for Payer: BCBS Trust/PPO |
$2.13
|
| Rate for Payer: BCN Commercial |
$2.02
|
| Rate for Payer: BCN Medicare Advantage |
$13.82
|
| Rate for Payer: Cash Price |
$2.08
|
| Rate for Payer: Cash Price |
$2.08
|
| Rate for Payer: Cofinity Commercial |
$2.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.82
|
| Rate for Payer: Healthscope Commercial |
$2.60
|
| Rate for Payer: Healthscope Whirlpool |
$2.52
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.82
|
| Rate for Payer: Mclaren Commercial |
$2.34
|
| Rate for Payer: Mclaren Medicaid |
$7.41
|
| Rate for Payer: Mclaren Medicare |
$13.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.51
|
| Rate for Payer: Meridian Medicaid |
$7.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.21
|
| Rate for Payer: Nomi Health Commercial |
$2.13
|
| Rate for Payer: PACE Medicare |
$13.13
|
| Rate for Payer: PACE SWMI |
$13.82
|
| Rate for Payer: PHP Commercial |
$15.20
|
| Rate for Payer: PHP Medicaid |
$7.41
|
| Rate for Payer: PHP Medicare Advantage |
$13.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20.62
|
| Rate for Payer: Priority Health Medicare |
$13.82
|
| Rate for Payer: Priority Health Narrow Network |
$16.50
|
| Rate for Payer: Railroad Medicare Medicare |
$13.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.82
|
| Rate for Payer: UHC Exchange |
$21.42
|
| Rate for Payer: UHC Medicare Advantage |
$13.82
|
| Rate for Payer: UHCCP DNSP |
$13.82
|
| Rate for Payer: UHCCP Medicaid |
$7.41
|
| Rate for Payer: VA VA |
$13.82
|
|
|
HC MAKENA 10 MG
|
Facility
|
IP
|
$2.60
|
|
|
Service Code
|
HCPCS J1726
|
| Hospital Charge Code |
63600141
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.69 |
| Max. Negotiated Rate |
$2.60 |
| Rate for Payer: Aetna Commercial |
$2.34
|
| Rate for Payer: ASR ASR |
$2.52
|
| Rate for Payer: ASR Commercial |
$2.52
|
| Rate for Payer: BCBS Trust/PPO |
$2.12
|
| Rate for Payer: BCN Commercial |
$2.02
|
| Rate for Payer: Cash Price |
$2.08
|
| Rate for Payer: Cofinity Commercial |
$2.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.08
|
| Rate for Payer: Healthscope Commercial |
$2.60
|
| Rate for Payer: Healthscope Whirlpool |
$2.52
|
| Rate for Payer: Mclaren Commercial |
$2.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.21
|
| Rate for Payer: Nomi Health Commercial |
$2.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2.29
|
|
|
HC MALARIA SMEAR
|
Facility
|
IP
|
$76.91
|
|
|
Service Code
|
CPT 87207
|
| Hospital Charge Code |
30600106
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$49.99 |
| Max. Negotiated Rate |
$76.91 |
| Rate for Payer: Aetna Commercial |
$69.22
|
| Rate for Payer: ASR ASR |
$74.60
|
| Rate for Payer: ASR Commercial |
$74.60
|
| Rate for Payer: BCBS Trust/PPO |
$62.67
|
| Rate for Payer: BCN Commercial |
$59.63
|
| Rate for Payer: Cash Price |
$61.53
|
| Rate for Payer: Cofinity Commercial |
$72.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.53
|
| Rate for Payer: Healthscope Commercial |
$76.91
|
| Rate for Payer: Healthscope Whirlpool |
$74.60
|
| Rate for Payer: Mclaren Commercial |
$69.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.37
|
| Rate for Payer: Nomi Health Commercial |
$63.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$67.68
|
|
|
HC MALARIA SMEAR
|
Facility
|
OP
|
$76.91
|
|
|
Service Code
|
CPT 87207
|
| Hospital Charge Code |
30600106
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$3.21 |
| Max. Negotiated Rate |
$125.17 |
| Rate for Payer: Aetna Commercial |
$69.22
|
| 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 |
$74.60
|
| Rate for Payer: ASR Commercial |
$74.60
|
| Rate for Payer: BCBS Complete |
$3.37
|
| Rate for Payer: BCBS MAPPO |
$5.99
|
| Rate for Payer: BCBS Trust/PPO |
$62.98
|
| Rate for Payer: BCN Commercial |
$59.63
|
| Rate for Payer: BCN Medicare Advantage |
$5.99
|
| Rate for Payer: Cash Price |
$61.53
|
| Rate for Payer: Cash Price |
$61.53
|
| Rate for Payer: Cofinity Commercial |
$72.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.99
|
| Rate for Payer: Healthscope Commercial |
$76.91
|
| Rate for Payer: Healthscope Whirlpool |
$74.60
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.99
|
| Rate for Payer: Mclaren Commercial |
$69.22
|
| Rate for Payer: Mclaren Medicaid |
$3.21
|
| 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 |
$3.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.37
|
| Rate for Payer: Nomi Health Commercial |
$63.07
|
| 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 |
$3.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$125.17
|
| Rate for Payer: Priority Health Medicare |
$5.99
|
| Rate for Payer: Priority Health Narrow Network |
$100.14
|
| Rate for Payer: Railroad Medicare Medicare |
$5.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$67.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.99
|
| Rate for Payer: UHC Exchange |
$9.28
|
| Rate for Payer: UHC Medicare Advantage |
$5.99
|
| Rate for Payer: UHCCP DNSP |
$5.99
|
| Rate for Payer: UHCCP Medicaid |
$3.21
|
| Rate for Payer: VA VA |
$5.99
|
|
|
HC MALONEY/BOUGIE DILATATION
|
Facility
|
IP
|
$1,330.39
|
|
| Hospital Charge Code |
36000074
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$864.75 |
| Max. Negotiated Rate |
$1,330.39 |
| Rate for Payer: Aetna Commercial |
$1,197.35
|
| Rate for Payer: ASR ASR |
$1,290.48
|
| Rate for Payer: ASR Commercial |
$1,290.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,084.13
|
| Rate for Payer: BCN Commercial |
$1,031.45
|
| Rate for Payer: Cash Price |
$1,064.31
|
| Rate for Payer: Cofinity Commercial |
$1,250.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,064.31
|
| Rate for Payer: Healthscope Commercial |
$1,330.39
|
| Rate for Payer: Healthscope Whirlpool |
$1,290.48
|
| Rate for Payer: Mclaren Commercial |
$1,197.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,130.83
|
| Rate for Payer: Nomi Health Commercial |
$1,090.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$864.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,170.74
|
|
|
HC MALONEY/BOUGIE DILATATION
|
Facility
|
OP
|
$1,330.39
|
|
| Hospital Charge Code |
36000074
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$532.16 |
| Max. Negotiated Rate |
$1,330.39 |
| Rate for Payer: Aetna Commercial |
$1,197.35
|
| Rate for Payer: Aetna Medicare |
$665.20
|
| Rate for Payer: ASR ASR |
$1,290.48
|
| Rate for Payer: ASR Commercial |
$1,290.48
|
| Rate for Payer: BCBS Complete |
$532.16
|
| Rate for Payer: BCBS Trust/PPO |
$1,089.46
|
| Rate for Payer: BCN Commercial |
$1,031.45
|
| Rate for Payer: Cash Price |
$1,064.31
|
| Rate for Payer: Cofinity Commercial |
$1,250.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,064.31
|
| Rate for Payer: Healthscope Commercial |
$1,330.39
|
| Rate for Payer: Healthscope Whirlpool |
$1,290.48
|
| Rate for Payer: Mclaren Commercial |
$1,197.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,130.83
|
| Rate for Payer: Nomi Health Commercial |
$1,090.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$864.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,165.69
|
| Rate for Payer: Priority Health Narrow Network |
$932.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,170.74
|
|
|
HC MAMM BILAT DIAGNOSTIC W CAD
|
Facility
|
IP
|
$430.14
|
|
|
Service Code
|
HCPCS 77066
|
| Hospital Charge Code |
40100004
|
|
Hospital Revenue Code
|
401
|
| Min. Negotiated Rate |
$279.59 |
| Max. Negotiated Rate |
$430.14 |
| Rate for Payer: Aetna Commercial |
$387.13
|
| Rate for Payer: ASR ASR |
$417.24
|
| Rate for Payer: ASR Commercial |
$417.24
|
| Rate for Payer: BCBS Trust/PPO |
$350.52
|
| Rate for Payer: BCN Commercial |
$333.49
|
| Rate for Payer: Cash Price |
$344.11
|
| Rate for Payer: Cofinity Commercial |
$404.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$344.11
|
| Rate for Payer: Healthscope Commercial |
$430.14
|
| Rate for Payer: Healthscope Whirlpool |
$417.24
|
| Rate for Payer: Mclaren Commercial |
$387.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$365.62
|
| Rate for Payer: Nomi Health Commercial |
$352.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$279.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$378.52
|
|
|
HC MAMM BILAT DIAGNOSTIC W CAD
|
Facility
|
OP
|
$430.14
|
|
|
Service Code
|
HCPCS 77066
|
| Hospital Charge Code |
40100004
|
|
Hospital Revenue Code
|
401
|
| Min. Negotiated Rate |
$148.01 |
| Max. Negotiated Rate |
$430.14 |
| Rate for Payer: Aetna Commercial |
$387.13
|
| Rate for Payer: Aetna Medicare |
$215.07
|
| Rate for Payer: ASR ASR |
$417.24
|
| Rate for Payer: ASR Commercial |
$417.24
|
| Rate for Payer: BCBS Complete |
$172.06
|
| Rate for Payer: BCBS Trust/PPO |
$352.24
|
| Rate for Payer: BCCCP Commercial |
$148.01
|
| Rate for Payer: BCN Commercial |
$333.49
|
| Rate for Payer: Cash Price |
$344.11
|
| Rate for Payer: Cash Price |
$344.11
|
| Rate for Payer: Cofinity Commercial |
$404.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$344.11
|
| Rate for Payer: Healthscope Commercial |
$430.14
|
| Rate for Payer: Healthscope Whirlpool |
$417.24
|
| Rate for Payer: Mclaren Commercial |
$387.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$365.62
|
| Rate for Payer: Nomi Health Commercial |
$352.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$279.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$376.89
|
| Rate for Payer: Priority Health Narrow Network |
$301.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$378.52
|
|
|
HC MAMM BILAT SCREEN WITH CAD
|
Facility
|
OP
|
$424.41
|
|
|
Service Code
|
HCPCS 77067
|
| Hospital Charge Code |
40300006
|
|
Hospital Revenue Code
|
403
|
| Min. Negotiated Rate |
$119.92 |
| Max. Negotiated Rate |
$424.41 |
| Rate for Payer: Aetna Commercial |
$381.97
|
| Rate for Payer: Aetna Medicare |
$212.20
|
| Rate for Payer: ASR ASR |
$411.68
|
| Rate for Payer: ASR Commercial |
$411.68
|
| Rate for Payer: BCBS Complete |
$169.76
|
| Rate for Payer: BCBS Trust/PPO |
$347.55
|
| Rate for Payer: BCCCP Commercial |
$119.92
|
| Rate for Payer: BCN Commercial |
$329.05
|
| Rate for Payer: Cash Price |
$339.53
|
| Rate for Payer: Cash Price |
$339.53
|
| Rate for Payer: Cofinity Commercial |
$398.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$339.53
|
| Rate for Payer: Healthscope Commercial |
$424.41
|
| Rate for Payer: Healthscope Whirlpool |
$411.68
|
| Rate for Payer: Mclaren Commercial |
$381.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$360.75
|
| Rate for Payer: Nomi Health Commercial |
$348.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$275.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$371.87
|
| Rate for Payer: Priority Health Narrow Network |
$297.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$373.48
|
|
|
HC MAMM BILAT SCREEN WITH CAD
|
Facility
|
IP
|
$424.41
|
|
|
Service Code
|
HCPCS 77067
|
| Hospital Charge Code |
40300006
|
|
Hospital Revenue Code
|
403
|
| Min. Negotiated Rate |
$275.87 |
| Max. Negotiated Rate |
$424.41 |
| Rate for Payer: Aetna Commercial |
$381.97
|
| Rate for Payer: ASR ASR |
$411.68
|
| Rate for Payer: ASR Commercial |
$411.68
|
| Rate for Payer: BCBS Trust/PPO |
$345.85
|
| Rate for Payer: BCN Commercial |
$329.05
|
| Rate for Payer: Cash Price |
$339.53
|
| Rate for Payer: Cofinity Commercial |
$398.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$339.53
|
| Rate for Payer: Healthscope Commercial |
$424.41
|
| Rate for Payer: Healthscope Whirlpool |
$411.68
|
| Rate for Payer: Mclaren Commercial |
$381.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$360.75
|
| Rate for Payer: Nomi Health Commercial |
$348.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$275.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$373.48
|
|
|
HC MAMMO BREAST ASP CYST
|
Facility
|
IP
|
$720.36
|
|
|
Service Code
|
CPT 19000
|
| Hospital Charge Code |
36100008
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$468.23 |
| Max. Negotiated Rate |
$720.36 |
| Rate for Payer: Aetna Commercial |
$648.32
|
| Rate for Payer: ASR ASR |
$698.75
|
| Rate for Payer: ASR Commercial |
$698.75
|
| Rate for Payer: BCBS Trust/PPO |
$587.02
|
| Rate for Payer: BCN Commercial |
$558.50
|
| Rate for Payer: Cash Price |
$576.29
|
| Rate for Payer: Cofinity Commercial |
$677.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$576.29
|
| Rate for Payer: Healthscope Commercial |
$720.36
|
| Rate for Payer: Healthscope Whirlpool |
$698.75
|
| Rate for Payer: Mclaren Commercial |
$648.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$612.31
|
| Rate for Payer: Nomi Health Commercial |
$590.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$468.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$633.92
|
|
|
HC MAMMO BREAST ASP CYST
|
Facility
|
OP
|
$720.36
|
|
|
Service Code
|
CPT 19000
|
| Hospital Charge Code |
36100008
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$92.31 |
| Max. Negotiated Rate |
$1,068.51 |
| Rate for Payer: Aetna Commercial |
$648.32
|
| Rate for Payer: Aetna Medicare |
$689.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$861.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$861.70
|
| Rate for Payer: ASR ASR |
$698.75
|
| Rate for Payer: ASR Commercial |
$698.75
|
| Rate for Payer: BCBS Complete |
$387.97
|
| Rate for Payer: BCBS MAPPO |
$689.36
|
| Rate for Payer: BCBS Trust/PPO |
$589.90
|
| Rate for Payer: BCCCP Commercial |
$92.31
|
| Rate for Payer: BCN Commercial |
$558.50
|
| Rate for Payer: BCN Medicare Advantage |
$689.36
|
| Rate for Payer: Cash Price |
$576.29
|
| Rate for Payer: Cash Price |
$576.29
|
| Rate for Payer: Cofinity Commercial |
$677.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$576.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$689.36
|
| Rate for Payer: Healthscope Commercial |
$720.36
|
| Rate for Payer: Healthscope Whirlpool |
$698.75
|
| Rate for Payer: Humana Choice PPO Medicare |
$689.36
|
| Rate for Payer: Mclaren Commercial |
$648.32
|
| Rate for Payer: Mclaren Medicaid |
$369.50
|
| Rate for Payer: Mclaren Medicare |
$689.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$723.83
|
| Rate for Payer: Meridian Medicaid |
$387.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$792.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$612.31
|
| Rate for Payer: Nomi Health Commercial |
$590.70
|
| Rate for Payer: PACE Medicare |
$654.89
|
| Rate for Payer: PACE SWMI |
$689.36
|
| Rate for Payer: PHP Commercial |
$758.30
|
| Rate for Payer: PHP Medicaid |
$369.50
|
| Rate for Payer: PHP Medicare Advantage |
$689.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$468.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$693.95
|
| Rate for Payer: Priority Health Medicare |
$689.36
|
| Rate for Payer: Priority Health Narrow Network |
$555.16
|
| Rate for Payer: Railroad Medicare Medicare |
$689.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$633.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$689.36
|
| Rate for Payer: UHC Exchange |
$1,068.51
|
| Rate for Payer: UHC Medicare Advantage |
$689.36
|
| Rate for Payer: UHCCP DNSP |
$689.36
|
| Rate for Payer: UHCCP Medicaid |
$369.50
|
| Rate for Payer: VA VA |
$689.36
|
|
|
HC MAMMO BREAST ASP CYST ADD LESION
|
Facility
|
IP
|
$396.58
|
|
|
Service Code
|
CPT 19001
|
| Hospital Charge Code |
36100009
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$257.78 |
| Max. Negotiated Rate |
$396.58 |
| Rate for Payer: Aetna Commercial |
$356.92
|
| Rate for Payer: ASR ASR |
$384.68
|
| Rate for Payer: ASR Commercial |
$384.68
|
| Rate for Payer: BCBS Trust/PPO |
$323.17
|
| Rate for Payer: BCN Commercial |
$307.47
|
| Rate for Payer: Cash Price |
$317.26
|
| Rate for Payer: Cofinity Commercial |
$372.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$317.26
|
| Rate for Payer: Healthscope Commercial |
$396.58
|
| Rate for Payer: Healthscope Whirlpool |
$384.68
|
| Rate for Payer: Mclaren Commercial |
$356.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$337.09
|
| Rate for Payer: Nomi Health Commercial |
$325.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$257.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$348.99
|
|
|
HC MAMMO BREAST ASP CYST ADD LESION
|
Facility
|
OP
|
$396.58
|
|
|
Service Code
|
CPT 19001
|
| Hospital Charge Code |
36100009
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$25.13 |
| Max. Negotiated Rate |
$396.58 |
| Rate for Payer: Aetna Commercial |
$356.92
|
| Rate for Payer: Aetna Medicare |
$198.29
|
| Rate for Payer: ASR ASR |
$384.68
|
| Rate for Payer: ASR Commercial |
$384.68
|
| Rate for Payer: BCBS Complete |
$158.63
|
| Rate for Payer: BCBS Trust/PPO |
$324.76
|
| Rate for Payer: BCCCP Commercial |
$25.13
|
| Rate for Payer: BCN Commercial |
$307.47
|
| Rate for Payer: Cash Price |
$317.26
|
| Rate for Payer: Cash Price |
$317.26
|
| Rate for Payer: Cofinity Commercial |
$372.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$317.26
|
| Rate for Payer: Healthscope Commercial |
$396.58
|
| Rate for Payer: Healthscope Whirlpool |
$384.68
|
| Rate for Payer: Mclaren Commercial |
$356.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$337.09
|
| Rate for Payer: Nomi Health Commercial |
$325.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$257.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$347.48
|
| Rate for Payer: Priority Health Narrow Network |
$278.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$348.99
|
|
