|
HC LYMPHOCYTE PROLIFERATION, MITOGENS CMPT
|
Facility
|
IP
|
$280.09
|
|
|
Service Code
|
CPT 86353
|
| Hospital Charge Code |
30200474
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$182.06 |
| Max. Negotiated Rate |
$280.09 |
| Rate for Payer: Aetna Commercial |
$252.08
|
| Rate for Payer: ASR ASR |
$271.69
|
| Rate for Payer: ASR Commercial |
$271.69
|
| Rate for Payer: BCBS Trust/PPO |
$228.25
|
| Rate for Payer: BCN Commercial |
$217.15
|
| Rate for Payer: Cash Price |
$224.07
|
| Rate for Payer: Cofinity Commercial |
$263.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$224.07
|
| Rate for Payer: Healthscope Commercial |
$280.09
|
| Rate for Payer: Healthscope Whirlpool |
$271.69
|
| Rate for Payer: Mclaren Commercial |
$252.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$238.08
|
| Rate for Payer: Nomi Health Commercial |
$229.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$182.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$246.48
|
|
|
HC LYMPHOCYTE PROLIFERATION, MITOGENS CMPT
|
Facility
|
OP
|
$280.09
|
|
|
Service Code
|
CPT 86353
|
| Hospital Charge Code |
30200474
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$26.28 |
| Max. Negotiated Rate |
$280.09 |
| Rate for Payer: Aetna Commercial |
$252.08
|
| Rate for Payer: Aetna Medicare |
$49.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$61.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$61.29
|
| Rate for Payer: ASR ASR |
$271.69
|
| Rate for Payer: ASR Commercial |
$271.69
|
| Rate for Payer: BCBS Complete |
$27.59
|
| Rate for Payer: BCBS MAPPO |
$49.03
|
| Rate for Payer: BCBS Trust/PPO |
$229.37
|
| Rate for Payer: BCN Commercial |
$217.15
|
| Rate for Payer: BCN Medicare Advantage |
$49.03
|
| Rate for Payer: Cash Price |
$224.07
|
| Rate for Payer: Cash Price |
$224.07
|
| Rate for Payer: Cofinity Commercial |
$263.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$224.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.03
|
| Rate for Payer: Healthscope Commercial |
$280.09
|
| Rate for Payer: Healthscope Whirlpool |
$271.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$49.03
|
| Rate for Payer: Mclaren Commercial |
$252.08
|
| Rate for Payer: Mclaren Medicaid |
$26.28
|
| Rate for Payer: Mclaren Medicare |
$49.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$51.48
|
| Rate for Payer: Meridian Medicaid |
$27.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$56.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$238.08
|
| Rate for Payer: Nomi Health Commercial |
$229.67
|
| Rate for Payer: PACE Medicare |
$46.58
|
| Rate for Payer: PACE SWMI |
$49.03
|
| Rate for Payer: PHP Commercial |
$53.93
|
| Rate for Payer: PHP Medicaid |
$26.28
|
| Rate for Payer: PHP Medicare Advantage |
$49.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$182.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$245.41
|
| Rate for Payer: Priority Health Medicare |
$49.03
|
| Rate for Payer: Priority Health Narrow Network |
$196.34
|
| Rate for Payer: Railroad Medicare Medicare |
$49.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$246.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$49.03
|
| Rate for Payer: UHC Exchange |
$76.00
|
| Rate for Payer: UHC Medicare Advantage |
$49.03
|
| Rate for Payer: UHCCP DNSP |
$49.03
|
| Rate for Payer: UHCCP Medicaid |
$26.28
|
| Rate for Payer: VA VA |
$49.03
|
|
|
HC LYMPHOMA IMMUNOPHENO 2
|
Facility
|
OP
|
$15.61
|
|
|
Service Code
|
CPT 85060
|
| Hospital Charge Code |
30500014
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$6.24 |
| Max. Negotiated Rate |
$15.61 |
| Rate for Payer: Aetna Commercial |
$14.05
|
| Rate for Payer: Aetna Medicare |
$7.80
|
| Rate for Payer: ASR ASR |
$15.14
|
| Rate for Payer: ASR Commercial |
$15.14
|
| Rate for Payer: BCBS Complete |
$6.24
|
| Rate for Payer: BCBS Trust/PPO |
$12.78
|
| Rate for Payer: BCN Commercial |
$12.10
|
| Rate for Payer: Cash Price |
$12.49
|
| Rate for Payer: Cofinity Commercial |
$14.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.49
|
| Rate for Payer: Healthscope Commercial |
$15.61
|
| Rate for Payer: Healthscope Whirlpool |
$15.14
|
| Rate for Payer: Mclaren Commercial |
$14.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.27
|
| Rate for Payer: Nomi Health Commercial |
$12.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.68
|
| Rate for Payer: Priority Health Narrow Network |
$10.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$13.74
|
|
|
HC LYMPHOMA IMMUNOPHENO 2
|
Facility
|
IP
|
$15.61
|
|
|
Service Code
|
CPT 85060
|
| Hospital Charge Code |
30500014
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$10.15 |
| Max. Negotiated Rate |
$15.61 |
| Rate for Payer: Aetna Commercial |
$14.05
|
| Rate for Payer: ASR ASR |
$15.14
|
| Rate for Payer: ASR Commercial |
$15.14
|
| Rate for Payer: BCBS Trust/PPO |
$12.72
|
| Rate for Payer: BCN Commercial |
$12.10
|
| Rate for Payer: Cash Price |
$12.49
|
| Rate for Payer: Cofinity Commercial |
$14.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.49
|
| Rate for Payer: Healthscope Commercial |
$15.61
|
| Rate for Payer: Healthscope Whirlpool |
$15.14
|
| Rate for Payer: Mclaren Commercial |
$14.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.27
|
| Rate for Payer: Nomi Health Commercial |
$12.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$13.74
|
|
|
HC LYMPH SUPPLY CUSTOM GARMEN
|
Facility
|
IP
|
$673.20
|
|
|
Service Code
|
HCPCS L8010
|
| Hospital Charge Code |
96000003
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$437.58 |
| Max. Negotiated Rate |
$673.20 |
| Rate for Payer: Aetna Commercial |
$605.88
|
| Rate for Payer: ASR ASR |
$653.00
|
| Rate for Payer: ASR Commercial |
$653.00
|
| Rate for Payer: BCBS Trust/PPO |
$548.59
|
| Rate for Payer: BCN Commercial |
$521.93
|
| Rate for Payer: Cash Price |
$538.56
|
| Rate for Payer: Cofinity Commercial |
$632.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$538.56
|
| Rate for Payer: Healthscope Commercial |
$673.20
|
| Rate for Payer: Healthscope Whirlpool |
$653.00
|
| Rate for Payer: Mclaren Commercial |
$605.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$572.22
|
| Rate for Payer: Nomi Health Commercial |
$552.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$437.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$592.42
|
|
|
HC LYMPH SUPPLY CUSTOM GARMEN
|
Facility
|
OP
|
$673.20
|
|
|
Service Code
|
HCPCS L8010
|
| Hospital Charge Code |
96000003
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$269.28 |
| Max. Negotiated Rate |
$673.20 |
| Rate for Payer: Aetna Commercial |
$605.88
|
| Rate for Payer: Aetna Medicare |
$336.60
|
| Rate for Payer: ASR ASR |
$653.00
|
| Rate for Payer: ASR Commercial |
$653.00
|
| Rate for Payer: BCBS Complete |
$269.28
|
| Rate for Payer: BCBS Trust/PPO |
$551.28
|
| Rate for Payer: BCN Commercial |
$521.93
|
| Rate for Payer: Cash Price |
$538.56
|
| Rate for Payer: Cofinity Commercial |
$632.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$538.56
|
| Rate for Payer: Healthscope Commercial |
$673.20
|
| Rate for Payer: Healthscope Whirlpool |
$653.00
|
| Rate for Payer: Mclaren Commercial |
$605.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$572.22
|
| Rate for Payer: Nomi Health Commercial |
$552.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$437.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$589.86
|
| Rate for Payer: Priority Health Narrow Network |
$471.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$592.42
|
|
|
HC LYSIS/EXCISION PENILE POSTCIRCUMCISION ADHESIONS
|
Facility
|
IP
|
$3,730.85
|
|
|
Service Code
|
CPT 54162
|
| Hospital Charge Code |
36100617
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,425.05 |
| Max. Negotiated Rate |
$3,730.85 |
| Rate for Payer: Aetna Commercial |
$3,357.76
|
| Rate for Payer: ASR ASR |
$3,618.92
|
| Rate for Payer: ASR Commercial |
$3,618.92
|
| Rate for Payer: BCBS Trust/PPO |
$3,040.27
|
| Rate for Payer: BCN Commercial |
$2,892.53
|
| Rate for Payer: Cash Price |
$2,984.68
|
| Rate for Payer: Cofinity Commercial |
$3,507.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,984.68
|
| Rate for Payer: Healthscope Commercial |
$3,730.85
|
| Rate for Payer: Healthscope Whirlpool |
$3,618.92
|
| Rate for Payer: Mclaren Commercial |
$3,357.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,171.22
|
| Rate for Payer: Nomi Health Commercial |
$3,059.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,425.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,283.15
|
|
|
HC LYSIS/EXCISION PENILE POSTCIRCUMCISION ADHESIONS
|
Facility
|
OP
|
$3,730.85
|
|
|
Service Code
|
CPT 54162
|
| Hospital Charge Code |
36100617
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,070.86 |
| Max. Negotiated Rate |
$3,730.85 |
| Rate for Payer: Aetna Commercial |
$3,357.76
|
| Rate for Payer: Aetna Medicare |
$1,997.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,497.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,497.34
|
| Rate for Payer: ASR ASR |
$3,618.92
|
| Rate for Payer: ASR Commercial |
$3,618.92
|
| Rate for Payer: BCBS Complete |
$1,124.40
|
| Rate for Payer: BCBS MAPPO |
$1,997.87
|
| Rate for Payer: BCBS Trust/PPO |
$3,055.19
|
| Rate for Payer: BCN Commercial |
$2,892.53
|
| Rate for Payer: BCN Medicare Advantage |
$1,997.87
|
| Rate for Payer: Cash Price |
$2,984.68
|
| Rate for Payer: Cash Price |
$2,984.68
|
| Rate for Payer: Cofinity Commercial |
$3,507.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,984.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,997.87
|
| Rate for Payer: Healthscope Commercial |
$3,730.85
|
| Rate for Payer: Healthscope Whirlpool |
$3,618.92
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,997.87
|
| Rate for Payer: Mclaren Commercial |
$3,357.76
|
| Rate for Payer: Mclaren Medicaid |
$1,070.86
|
| Rate for Payer: Mclaren Medicare |
$1,997.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,097.76
|
| Rate for Payer: Meridian Medicaid |
$1,124.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,297.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,171.22
|
| Rate for Payer: Nomi Health Commercial |
$3,059.30
|
| Rate for Payer: PACE Medicare |
$1,897.98
|
| Rate for Payer: PACE SWMI |
$1,997.87
|
| Rate for Payer: PHP Commercial |
$2,197.66
|
| Rate for Payer: PHP Medicaid |
$1,070.86
|
| Rate for Payer: PHP Medicare Advantage |
$1,997.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,070.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,425.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,268.97
|
| Rate for Payer: Priority Health Medicare |
$1,997.87
|
| Rate for Payer: Priority Health Narrow Network |
$2,615.33
|
| Rate for Payer: Railroad Medicare Medicare |
$1,997.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,283.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,997.87
|
| Rate for Payer: UHC Exchange |
$3,096.70
|
| Rate for Payer: UHC Medicare Advantage |
$1,997.87
|
| Rate for Payer: UHCCP DNSP |
$1,997.87
|
| Rate for Payer: UHCCP Medicaid |
$1,070.86
|
| Rate for Payer: VA VA |
$1,997.87
|
|
|
HC LYSIS INTRANASAL SYNECHIA
|
Facility
|
IP
|
$1,377.00
|
|
|
Service Code
|
CPT 30560
|
| Hospital Charge Code |
76100452
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$895.05 |
| Max. Negotiated Rate |
$1,377.00 |
| Rate for Payer: Aetna Commercial |
$1,239.30
|
| Rate for Payer: ASR ASR |
$1,335.69
|
| Rate for Payer: ASR Commercial |
$1,335.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,122.12
|
| Rate for Payer: BCN Commercial |
$1,067.59
|
| Rate for Payer: Cash Price |
$1,101.60
|
| Rate for Payer: Cofinity Commercial |
$1,294.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,101.60
|
| Rate for Payer: Healthscope Commercial |
$1,377.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,335.69
|
| Rate for Payer: Mclaren Commercial |
$1,239.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,170.45
|
| Rate for Payer: Nomi Health Commercial |
$1,129.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$895.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,211.76
|
|
|
HC LYSIS INTRANASAL SYNECHIA
|
Facility
|
OP
|
$1,377.00
|
|
|
Service Code
|
CPT 30560
|
| Hospital Charge Code |
76100452
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$266.21 |
| Max. Negotiated Rate |
$1,377.00 |
| Rate for Payer: Aetna Commercial |
$1,239.30
|
| Rate for Payer: Aetna Medicare |
$496.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$620.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$620.83
|
| Rate for Payer: ASR ASR |
$1,335.69
|
| Rate for Payer: ASR Commercial |
$1,335.69
|
| Rate for Payer: BCBS Complete |
$279.52
|
| Rate for Payer: BCBS MAPPO |
$496.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,127.63
|
| Rate for Payer: BCN Commercial |
$1,067.59
|
| Rate for Payer: BCN Medicare Advantage |
$496.66
|
| Rate for Payer: Cash Price |
$1,101.60
|
| Rate for Payer: Cash Price |
$1,101.60
|
| Rate for Payer: Cofinity Commercial |
$1,294.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,101.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$496.66
|
| Rate for Payer: Healthscope Commercial |
$1,377.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,335.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$496.66
|
| Rate for Payer: Mclaren Commercial |
$1,239.30
|
| Rate for Payer: Mclaren Medicaid |
$266.21
|
| Rate for Payer: Mclaren Medicare |
$496.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$521.49
|
| Rate for Payer: Meridian Medicaid |
$279.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$571.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,170.45
|
| Rate for Payer: Nomi Health Commercial |
$1,129.14
|
| Rate for Payer: PACE Medicare |
$471.83
|
| Rate for Payer: PACE SWMI |
$496.66
|
| Rate for Payer: PHP Commercial |
$546.33
|
| Rate for Payer: PHP Medicaid |
$266.21
|
| Rate for Payer: PHP Medicare Advantage |
$496.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$266.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$895.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,206.53
|
| Rate for Payer: Priority Health Medicare |
$496.66
|
| Rate for Payer: Priority Health Narrow Network |
$965.28
|
| Rate for Payer: Railroad Medicare Medicare |
$496.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,211.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$496.66
|
| Rate for Payer: UHC Exchange |
$769.82
|
| Rate for Payer: UHC Medicare Advantage |
$496.66
|
| Rate for Payer: UHCCP DNSP |
$496.66
|
| Rate for Payer: UHCCP Medicaid |
$266.21
|
| Rate for Payer: VA VA |
$496.66
|
|
|
HC LYSIS OF LABIAL LESION(S)
|
Facility
|
OP
|
$7,784.64
|
|
|
Service Code
|
CPT 56441
|
| Hospital Charge Code |
76100516
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,662.10 |
| Max. Negotiated Rate |
$7,784.64 |
| Rate for Payer: Aetna Commercial |
$7,006.18
|
| Rate for Payer: Aetna Medicare |
$3,100.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,876.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,876.16
|
| Rate for Payer: ASR ASR |
$7,551.10
|
| Rate for Payer: ASR Commercial |
$7,551.10
|
| Rate for Payer: BCBS Complete |
$1,745.20
|
| Rate for Payer: BCBS MAPPO |
$3,100.93
|
| Rate for Payer: BCBS Trust/PPO |
$6,374.84
|
| Rate for Payer: BCN Commercial |
$6,035.43
|
| Rate for Payer: BCN Medicare Advantage |
$3,100.93
|
| Rate for Payer: Cash Price |
$6,227.71
|
| Rate for Payer: Cash Price |
$6,227.71
|
| Rate for Payer: Cofinity Commercial |
$7,317.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,227.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,100.93
|
| Rate for Payer: Healthscope Commercial |
$7,784.64
|
| Rate for Payer: Healthscope Whirlpool |
$7,551.10
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,100.93
|
| Rate for Payer: Mclaren Commercial |
$7,006.18
|
| Rate for Payer: Mclaren Medicaid |
$1,662.10
|
| Rate for Payer: Mclaren Medicare |
$3,100.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,255.98
|
| Rate for Payer: Meridian Medicaid |
$1,745.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,566.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,616.94
|
| Rate for Payer: Nomi Health Commercial |
$6,383.40
|
| Rate for Payer: PACE Medicare |
$2,945.88
|
| Rate for Payer: PACE SWMI |
$3,100.93
|
| Rate for Payer: PHP Commercial |
$3,411.02
|
| Rate for Payer: PHP Medicaid |
$1,662.10
|
| Rate for Payer: PHP Medicare Advantage |
$3,100.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,662.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,060.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,820.90
|
| Rate for Payer: Priority Health Medicare |
$3,100.93
|
| Rate for Payer: Priority Health Narrow Network |
$5,457.03
|
| Rate for Payer: Railroad Medicare Medicare |
$3,100.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,850.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,100.93
|
| Rate for Payer: UHC Exchange |
$4,806.44
|
| Rate for Payer: UHC Medicare Advantage |
$3,100.93
|
| Rate for Payer: UHCCP DNSP |
$3,100.93
|
| Rate for Payer: UHCCP Medicaid |
$1,662.10
|
| Rate for Payer: VA VA |
$3,100.93
|
|
|
HC LYSIS OF LABIAL LESION(S)
|
Facility
|
IP
|
$7,784.64
|
|
|
Service Code
|
CPT 56441
|
| Hospital Charge Code |
76100516
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,060.02 |
| Max. Negotiated Rate |
$7,784.64 |
| Rate for Payer: Aetna Commercial |
$7,006.18
|
| Rate for Payer: ASR ASR |
$7,551.10
|
| Rate for Payer: ASR Commercial |
$7,551.10
|
| Rate for Payer: BCBS Trust/PPO |
$6,343.70
|
| Rate for Payer: BCN Commercial |
$6,035.43
|
| Rate for Payer: Cash Price |
$6,227.71
|
| Rate for Payer: Cofinity Commercial |
$7,317.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,227.71
|
| Rate for Payer: Healthscope Commercial |
$7,784.64
|
| Rate for Payer: Healthscope Whirlpool |
$7,551.10
|
| Rate for Payer: Mclaren Commercial |
$7,006.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,616.94
|
| Rate for Payer: Nomi Health Commercial |
$6,383.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,060.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,850.48
|
|
|
HC LYSOZYME (MURAMIDASE)
|
Facility
|
IP
|
$65.28
|
|
|
Service Code
|
CPT 85549
|
| Hospital Charge Code |
30500108
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$42.43 |
| Max. Negotiated Rate |
$65.28 |
| Rate for Payer: Aetna Commercial |
$58.75
|
| Rate for Payer: ASR ASR |
$63.32
|
| Rate for Payer: ASR Commercial |
$63.32
|
| Rate for Payer: BCBS Trust/PPO |
$53.20
|
| Rate for Payer: BCN Commercial |
$50.61
|
| Rate for Payer: Cash Price |
$52.22
|
| Rate for Payer: Cofinity Commercial |
$61.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.22
|
| Rate for Payer: Healthscope Commercial |
$65.28
|
| Rate for Payer: Healthscope Whirlpool |
$63.32
|
| Rate for Payer: Mclaren Commercial |
$58.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.49
|
| Rate for Payer: Nomi Health Commercial |
$53.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$57.45
|
|
|
HC LYSOZYME (MURAMIDASE)
|
Facility
|
OP
|
$65.28
|
|
|
Service Code
|
CPT 85549
|
| Hospital Charge Code |
30500108
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$10.05 |
| Max. Negotiated Rate |
$65.28 |
| Rate for Payer: Aetna Commercial |
$58.75
|
| Rate for Payer: Aetna Medicare |
$18.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.44
|
| Rate for Payer: ASR ASR |
$63.32
|
| Rate for Payer: ASR Commercial |
$63.32
|
| Rate for Payer: BCBS Complete |
$10.55
|
| Rate for Payer: BCBS MAPPO |
$18.75
|
| Rate for Payer: BCBS Trust/PPO |
$53.46
|
| Rate for Payer: BCN Commercial |
$50.61
|
| Rate for Payer: BCN Medicare Advantage |
$18.75
|
| Rate for Payer: Cash Price |
$52.22
|
| Rate for Payer: Cash Price |
$52.22
|
| Rate for Payer: Cofinity Commercial |
$61.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.75
|
| Rate for Payer: Healthscope Commercial |
$65.28
|
| Rate for Payer: Healthscope Whirlpool |
$63.32
|
| Rate for Payer: Humana Choice PPO Medicare |
$18.75
|
| Rate for Payer: Mclaren Commercial |
$58.75
|
| Rate for Payer: Mclaren Medicaid |
$10.05
|
| Rate for Payer: Mclaren Medicare |
$18.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.69
|
| Rate for Payer: Meridian Medicaid |
$10.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.49
|
| Rate for Payer: Nomi Health Commercial |
$53.53
|
| Rate for Payer: PACE Medicare |
$17.81
|
| Rate for Payer: PACE SWMI |
$18.75
|
| Rate for Payer: PHP Commercial |
$20.62
|
| Rate for Payer: PHP Medicaid |
$10.05
|
| Rate for Payer: PHP Medicare Advantage |
$18.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$57.20
|
| Rate for Payer: Priority Health Medicare |
$18.75
|
| Rate for Payer: Priority Health Narrow Network |
$45.76
|
| Rate for Payer: Railroad Medicare Medicare |
$18.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$57.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.75
|
| Rate for Payer: UHC Exchange |
$29.06
|
| Rate for Payer: UHC Medicare Advantage |
$18.75
|
| Rate for Payer: UHCCP DNSP |
$18.75
|
| Rate for Payer: UHCCP Medicaid |
$10.05
|
| Rate for Payer: VA VA |
$18.75
|
|
|
HC MAC/REGIONAL PER MINUTE
|
Facility
|
OP
|
$14.00
|
|
| Hospital Charge Code |
37000025
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$5.60 |
| Max. Negotiated Rate |
$14.00 |
| Rate for Payer: Aetna Commercial |
$12.60
|
| Rate for Payer: Aetna Medicare |
$7.00
|
| Rate for Payer: ASR ASR |
$13.58
|
| Rate for Payer: ASR Commercial |
$13.58
|
| Rate for Payer: BCBS Complete |
$5.60
|
| Rate for Payer: BCBS Trust/PPO |
$11.46
|
| 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: Priority Health HMO/PPO/Tiered Network |
$12.27
|
| Rate for Payer: Priority Health Narrow Network |
$9.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12.32
|
|
|
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 |
$44.94 |
| 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 |
$39.38
|
| Rate for Payer: Priority Health Medicare |
$4.27
|
| Rate for Payer: Priority Health Narrow Network |
$31.50
|
| 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 |
$44.06 |
| 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 |
$38.61
|
| Rate for Payer: Priority Health Medicare |
$4.31
|
| Rate for Payer: Priority Health Narrow Network |
$30.89
|
| 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
|
OP
|
$975.34
|
|
|
Service Code
|
HCPCS A9562
|
| Hospital Charge Code |
34300016
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$390.14 |
| 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: 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 |
$854.59
|
| Rate for Payer: Priority Health Narrow Network |
$683.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$858.30
|
|
|
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 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 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 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
|
|
