|
HC MECHANICAL REMOVAL OBSTRC CVD
|
Facility
|
IP
|
$1,568.04
|
|
|
Service Code
|
CPT 36596
|
| Hospital Charge Code |
36100143
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,019.23 |
| Max. Negotiated Rate |
$1,568.04 |
| Rate for Payer: Aetna Commercial |
$1,411.24
|
| Rate for Payer: ASR ASR |
$1,521.00
|
| Rate for Payer: ASR Commercial |
$1,521.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,277.80
|
| Rate for Payer: BCN Commercial |
$1,215.70
|
| Rate for Payer: Cash Price |
$1,254.43
|
| Rate for Payer: Cofinity Commercial |
$1,473.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,254.43
|
| Rate for Payer: Healthscope Commercial |
$1,568.04
|
| Rate for Payer: Healthscope Whirlpool |
$1,521.00
|
| Rate for Payer: Mclaren Commercial |
$1,411.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,332.83
|
| Rate for Payer: Nomi Health Commercial |
$1,285.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,019.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,379.88
|
|
|
HC MECHANICAL REMOVAL OBSTRC CVD
|
Facility
|
OP
|
$1,568.04
|
|
|
Service Code
|
CPT 36596
|
| Hospital Charge Code |
36100143
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$815.81 |
| Max. Negotiated Rate |
$2,359.15 |
| Rate for Payer: Aetna Commercial |
$1,411.24
|
| Rate for Payer: Aetna Medicare |
$1,522.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,902.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,902.54
|
| Rate for Payer: ASR ASR |
$1,521.00
|
| Rate for Payer: ASR Commercial |
$1,521.00
|
| Rate for Payer: BCBS Complete |
$856.60
|
| Rate for Payer: BCBS MAPPO |
$1,522.03
|
| Rate for Payer: BCBS Trust/PPO |
$1,284.07
|
| Rate for Payer: BCN Commercial |
$1,215.70
|
| Rate for Payer: BCN Medicare Advantage |
$1,522.03
|
| Rate for Payer: Cash Price |
$1,254.43
|
| Rate for Payer: Cash Price |
$1,254.43
|
| Rate for Payer: Cofinity Commercial |
$1,473.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,254.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,522.03
|
| Rate for Payer: Healthscope Commercial |
$1,568.04
|
| Rate for Payer: Healthscope Whirlpool |
$1,521.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,522.03
|
| Rate for Payer: Mclaren Commercial |
$1,411.24
|
| Rate for Payer: Mclaren Medicaid |
$815.81
|
| Rate for Payer: Mclaren Medicare |
$1,522.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,598.13
|
| Rate for Payer: Meridian Medicaid |
$856.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,750.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,332.83
|
| Rate for Payer: Nomi Health Commercial |
$1,285.79
|
| Rate for Payer: PACE Medicare |
$1,445.93
|
| Rate for Payer: PACE SWMI |
$1,522.03
|
| Rate for Payer: PHP Commercial |
$1,674.23
|
| Rate for Payer: PHP Medicaid |
$815.81
|
| Rate for Payer: PHP Medicare Advantage |
$1,522.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$815.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,019.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,373.92
|
| Rate for Payer: Priority Health Medicare |
$1,522.03
|
| Rate for Payer: Priority Health Narrow Network |
$1,099.20
|
| Rate for Payer: Railroad Medicare Medicare |
$1,522.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,379.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,522.03
|
| Rate for Payer: UHC Exchange |
$2,359.15
|
| Rate for Payer: UHC Medicare Advantage |
$1,522.03
|
| Rate for Payer: UHCCP DNSP |
$1,522.03
|
| Rate for Payer: UHCCP Medicaid |
$815.81
|
| Rate for Payer: VA VA |
$1,522.03
|
|
|
HC MECHANICAL REMOVAL OF PERICATHETER OBSTRUCTION
|
Facility
|
OP
|
$2,962.57
|
|
|
Service Code
|
CPT 36595
|
| Hospital Charge Code |
36100142
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,652.95 |
| Max. Negotiated Rate |
$4,779.98 |
| Rate for Payer: Aetna Commercial |
$2,666.31
|
| Rate for Payer: Aetna Medicare |
$3,083.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,854.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,854.82
|
| Rate for Payer: ASR ASR |
$2,873.69
|
| Rate for Payer: ASR Commercial |
$2,873.69
|
| Rate for Payer: BCBS Complete |
$1,735.60
|
| Rate for Payer: BCBS MAPPO |
$3,083.86
|
| Rate for Payer: BCBS Trust/PPO |
$2,426.05
|
| Rate for Payer: BCN Commercial |
$2,296.88
|
| Rate for Payer: BCN Medicare Advantage |
$3,083.86
|
| Rate for Payer: Cash Price |
$2,370.06
|
| Rate for Payer: Cash Price |
$2,370.06
|
| Rate for Payer: Cofinity Commercial |
$2,784.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,370.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,083.86
|
| Rate for Payer: Healthscope Commercial |
$2,962.57
|
| Rate for Payer: Healthscope Whirlpool |
$2,873.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,083.86
|
| Rate for Payer: Mclaren Commercial |
$2,666.31
|
| Rate for Payer: Mclaren Medicaid |
$1,652.95
|
| Rate for Payer: Mclaren Medicare |
$3,083.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,238.05
|
| Rate for Payer: Meridian Medicaid |
$1,735.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,546.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,518.18
|
| Rate for Payer: Nomi Health Commercial |
$2,429.31
|
| Rate for Payer: PACE Medicare |
$2,929.67
|
| Rate for Payer: PACE SWMI |
$3,083.86
|
| Rate for Payer: PHP Commercial |
$3,392.25
|
| Rate for Payer: PHP Medicaid |
$1,652.95
|
| Rate for Payer: PHP Medicare Advantage |
$3,083.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,652.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,925.67
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,595.80
|
| Rate for Payer: Priority Health Medicare |
$3,083.86
|
| Rate for Payer: Priority Health Narrow Network |
$2,076.76
|
| Rate for Payer: Railroad Medicare Medicare |
$3,083.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,607.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,083.86
|
| Rate for Payer: UHC Exchange |
$4,779.98
|
| Rate for Payer: UHC Medicare Advantage |
$3,083.86
|
| Rate for Payer: UHCCP DNSP |
$3,083.86
|
| Rate for Payer: UHCCP Medicaid |
$1,652.95
|
| Rate for Payer: VA VA |
$3,083.86
|
|
|
HC MECHANICAL REMOVAL OF PERICATHETER OBSTRUCTION
|
Facility
|
IP
|
$2,962.57
|
|
|
Service Code
|
CPT 36595
|
| Hospital Charge Code |
36100142
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,925.67 |
| Max. Negotiated Rate |
$2,962.57 |
| Rate for Payer: Aetna Commercial |
$2,666.31
|
| Rate for Payer: ASR ASR |
$2,873.69
|
| Rate for Payer: ASR Commercial |
$2,873.69
|
| Rate for Payer: BCBS Trust/PPO |
$2,414.20
|
| Rate for Payer: BCN Commercial |
$2,296.88
|
| Rate for Payer: Cash Price |
$2,370.06
|
| Rate for Payer: Cofinity Commercial |
$2,784.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,370.06
|
| Rate for Payer: Healthscope Commercial |
$2,962.57
|
| Rate for Payer: Healthscope Whirlpool |
$2,873.69
|
| Rate for Payer: Mclaren Commercial |
$2,666.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,518.18
|
| Rate for Payer: Nomi Health Commercial |
$2,429.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,925.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,607.06
|
|
|
HC MECH CHEST WALL OSCILLATION
|
Facility
|
OP
|
$320.61
|
|
|
Service Code
|
CPT 94669
|
| Hospital Charge Code |
41000043
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$36.04 |
| Max. Negotiated Rate |
$320.61 |
| Rate for Payer: Aetna Commercial |
$288.55
|
| Rate for Payer: Aetna Medicare |
$199.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$249.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$249.10
|
| Rate for Payer: ASR ASR |
$310.99
|
| Rate for Payer: ASR Commercial |
$310.99
|
| Rate for Payer: BCBS Complete |
$112.15
|
| Rate for Payer: BCBS MAPPO |
$199.28
|
| Rate for Payer: BCBS Trust/PPO |
$262.55
|
| Rate for Payer: BCN Commercial |
$248.57
|
| Rate for Payer: BCN Medicare Advantage |
$199.28
|
| Rate for Payer: Cash Price |
$256.49
|
| Rate for Payer: Cash Price |
$256.49
|
| Rate for Payer: Cofinity Commercial |
$301.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$256.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$199.28
|
| Rate for Payer: Healthscope Commercial |
$320.61
|
| Rate for Payer: Healthscope Whirlpool |
$310.99
|
| Rate for Payer: Humana Choice PPO Medicare |
$199.28
|
| Rate for Payer: Mclaren Commercial |
$288.55
|
| Rate for Payer: Mclaren Medicaid |
$106.81
|
| Rate for Payer: Mclaren Medicare |
$199.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$209.24
|
| Rate for Payer: Meridian Medicaid |
$112.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$229.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$272.52
|
| Rate for Payer: Nomi Health Commercial |
$262.90
|
| Rate for Payer: PACE Medicare |
$189.32
|
| Rate for Payer: PACE SWMI |
$199.28
|
| Rate for Payer: PHP Commercial |
$219.21
|
| Rate for Payer: PHP Medicaid |
$106.81
|
| Rate for Payer: PHP Medicare Advantage |
$199.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$106.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$208.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45.05
|
| Rate for Payer: Priority Health Medicare |
$199.28
|
| Rate for Payer: Priority Health Narrow Network |
$36.04
|
| Rate for Payer: Railroad Medicare Medicare |
$199.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$282.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$199.28
|
| Rate for Payer: UHC Exchange |
$308.88
|
| Rate for Payer: UHC Medicare Advantage |
$199.28
|
| Rate for Payer: UHCCP DNSP |
$199.28
|
| Rate for Payer: UHCCP Medicaid |
$106.81
|
| Rate for Payer: VA VA |
$199.28
|
|
|
HC MECH CHEST WALL OSCILLATION
|
Facility
|
IP
|
$320.61
|
|
|
Service Code
|
CPT 94669
|
| Hospital Charge Code |
41000043
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$208.40 |
| Max. Negotiated Rate |
$320.61 |
| Rate for Payer: Aetna Commercial |
$288.55
|
| Rate for Payer: ASR ASR |
$310.99
|
| Rate for Payer: ASR Commercial |
$310.99
|
| Rate for Payer: BCBS Trust/PPO |
$261.27
|
| Rate for Payer: BCN Commercial |
$248.57
|
| Rate for Payer: Cash Price |
$256.49
|
| Rate for Payer: Cofinity Commercial |
$301.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$256.49
|
| Rate for Payer: Healthscope Commercial |
$320.61
|
| Rate for Payer: Healthscope Whirlpool |
$310.99
|
| Rate for Payer: Mclaren Commercial |
$288.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$272.52
|
| Rate for Payer: Nomi Health Commercial |
$262.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$208.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$282.14
|
|
|
HC MECH VENT INITIAL DAY
|
Facility
|
IP
|
$1,506.76
|
|
|
Service Code
|
CPT 94002
|
| Hospital Charge Code |
41000002
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$979.39 |
| Max. Negotiated Rate |
$1,506.76 |
| Rate for Payer: Aetna Commercial |
$1,356.08
|
| Rate for Payer: ASR ASR |
$1,461.56
|
| Rate for Payer: ASR Commercial |
$1,461.56
|
| Rate for Payer: BCBS Trust/PPO |
$1,227.86
|
| Rate for Payer: BCN Commercial |
$1,168.19
|
| Rate for Payer: Cash Price |
$1,205.41
|
| Rate for Payer: Cofinity Commercial |
$1,416.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,205.41
|
| Rate for Payer: Healthscope Commercial |
$1,506.76
|
| Rate for Payer: Healthscope Whirlpool |
$1,461.56
|
| Rate for Payer: Mclaren Commercial |
$1,356.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,280.75
|
| Rate for Payer: Nomi Health Commercial |
$1,235.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$979.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,325.95
|
|
|
HC MECH VENT INITIAL DAY
|
Facility
|
OP
|
$1,506.76
|
|
|
Service Code
|
CPT 94002
|
| Hospital Charge Code |
41000002
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$347.18 |
| Max. Negotiated Rate |
$4,040.68 |
| Rate for Payer: Aetna Commercial |
$1,356.08
|
| Rate for Payer: Aetna Medicare |
$647.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$809.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$809.66
|
| Rate for Payer: ASR ASR |
$1,461.56
|
| Rate for Payer: ASR Commercial |
$1,461.56
|
| Rate for Payer: BCBS Complete |
$364.54
|
| Rate for Payer: BCBS MAPPO |
$647.73
|
| Rate for Payer: BCBS Trust/PPO |
$1,233.89
|
| Rate for Payer: BCN Commercial |
$1,168.19
|
| Rate for Payer: BCN Medicare Advantage |
$647.73
|
| Rate for Payer: Cash Price |
$1,205.41
|
| Rate for Payer: Cash Price |
$1,205.41
|
| Rate for Payer: Cofinity Commercial |
$1,416.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,205.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$647.73
|
| Rate for Payer: Healthscope Commercial |
$1,506.76
|
| Rate for Payer: Healthscope Whirlpool |
$1,461.56
|
| Rate for Payer: Humana Choice PPO Medicare |
$647.73
|
| Rate for Payer: Mclaren Commercial |
$1,356.08
|
| Rate for Payer: Mclaren Medicaid |
$347.18
|
| Rate for Payer: Mclaren Medicare |
$647.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$680.12
|
| Rate for Payer: Meridian Medicaid |
$364.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$744.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,280.75
|
| Rate for Payer: Nomi Health Commercial |
$1,235.54
|
| Rate for Payer: PACE Medicare |
$615.34
|
| Rate for Payer: PACE SWMI |
$647.73
|
| Rate for Payer: PHP Commercial |
$712.50
|
| Rate for Payer: PHP Medicaid |
$347.18
|
| Rate for Payer: PHP Medicare Advantage |
$647.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$347.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$979.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,040.68
|
| Rate for Payer: Priority Health Medicare |
$647.73
|
| Rate for Payer: Priority Health Narrow Network |
$3,232.54
|
| Rate for Payer: Railroad Medicare Medicare |
$647.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,325.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$647.73
|
| Rate for Payer: UHC Exchange |
$1,003.98
|
| Rate for Payer: UHC Medicare Advantage |
$647.73
|
| Rate for Payer: UHCCP DNSP |
$647.73
|
| Rate for Payer: UHCCP Medicaid |
$347.18
|
| Rate for Payer: VA VA |
$647.73
|
|
|
HC MECH VENT SUBS DAYS
|
Facility
|
OP
|
$1,312.60
|
|
|
Service Code
|
CPT 94003
|
| Hospital Charge Code |
41000003
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$347.18 |
| Max. Negotiated Rate |
$3,535.60 |
| Rate for Payer: Aetna Commercial |
$1,181.34
|
| Rate for Payer: Aetna Medicare |
$647.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$809.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$809.66
|
| Rate for Payer: ASR ASR |
$1,273.22
|
| Rate for Payer: ASR Commercial |
$1,273.22
|
| Rate for Payer: BCBS Complete |
$364.54
|
| Rate for Payer: BCBS MAPPO |
$647.73
|
| Rate for Payer: BCBS Trust/PPO |
$1,074.89
|
| Rate for Payer: BCN Commercial |
$1,017.66
|
| Rate for Payer: BCN Medicare Advantage |
$647.73
|
| Rate for Payer: Cash Price |
$1,050.08
|
| Rate for Payer: Cash Price |
$1,050.08
|
| Rate for Payer: Cofinity Commercial |
$1,233.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,050.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$647.73
|
| Rate for Payer: Healthscope Commercial |
$1,312.60
|
| Rate for Payer: Healthscope Whirlpool |
$1,273.22
|
| Rate for Payer: Humana Choice PPO Medicare |
$647.73
|
| Rate for Payer: Mclaren Commercial |
$1,181.34
|
| Rate for Payer: Mclaren Medicaid |
$347.18
|
| Rate for Payer: Mclaren Medicare |
$647.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$680.12
|
| Rate for Payer: Meridian Medicaid |
$364.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$744.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,115.71
|
| Rate for Payer: Nomi Health Commercial |
$1,076.33
|
| Rate for Payer: PACE Medicare |
$615.34
|
| Rate for Payer: PACE SWMI |
$647.73
|
| Rate for Payer: PHP Commercial |
$712.50
|
| Rate for Payer: PHP Medicaid |
$347.18
|
| Rate for Payer: PHP Medicare Advantage |
$647.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$347.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$853.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,535.60
|
| Rate for Payer: Priority Health Medicare |
$647.73
|
| Rate for Payer: Priority Health Narrow Network |
$2,828.48
|
| Rate for Payer: Railroad Medicare Medicare |
$647.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,155.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$647.73
|
| Rate for Payer: UHC Exchange |
$1,003.98
|
| Rate for Payer: UHC Medicare Advantage |
$647.73
|
| Rate for Payer: UHCCP DNSP |
$647.73
|
| Rate for Payer: UHCCP Medicaid |
$347.18
|
| Rate for Payer: VA VA |
$647.73
|
|
|
HC MECH VENT SUBS DAYS
|
Facility
|
IP
|
$1,312.60
|
|
|
Service Code
|
CPT 94003
|
| Hospital Charge Code |
41000003
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$853.19 |
| Max. Negotiated Rate |
$1,312.60 |
| Rate for Payer: Aetna Commercial |
$1,181.34
|
| Rate for Payer: ASR ASR |
$1,273.22
|
| Rate for Payer: ASR Commercial |
$1,273.22
|
| Rate for Payer: BCBS Trust/PPO |
$1,069.64
|
| Rate for Payer: BCN Commercial |
$1,017.66
|
| Rate for Payer: Cash Price |
$1,050.08
|
| Rate for Payer: Cofinity Commercial |
$1,233.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,050.08
|
| Rate for Payer: Healthscope Commercial |
$1,312.60
|
| Rate for Payer: Healthscope Whirlpool |
$1,273.22
|
| Rate for Payer: Mclaren Commercial |
$1,181.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,115.71
|
| Rate for Payer: Nomi Health Commercial |
$1,076.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$853.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,155.09
|
|
|
HC MECONIUM AMPHETAMINE CONFIRM
|
Facility
|
IP
|
$117.30
|
|
|
Service Code
|
CPT 80324
|
| Hospital Charge Code |
30000099
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$76.24 |
| Max. Negotiated Rate |
$117.30 |
| Rate for Payer: Aetna Commercial |
$105.57
|
| Rate for Payer: ASR ASR |
$113.78
|
| Rate for Payer: ASR Commercial |
$113.78
|
| Rate for Payer: BCBS Trust/PPO |
$95.59
|
| Rate for Payer: BCN Commercial |
$90.94
|
| Rate for Payer: Cash Price |
$93.84
|
| Rate for Payer: Cofinity Commercial |
$110.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.84
|
| Rate for Payer: Healthscope Commercial |
$117.30
|
| Rate for Payer: Healthscope Whirlpool |
$113.78
|
| Rate for Payer: Mclaren Commercial |
$105.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.70
|
| Rate for Payer: Nomi Health Commercial |
$96.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$103.22
|
|
|
HC MECONIUM AMPHETAMINE CONFIRM
|
Facility
|
OP
|
$117.30
|
|
|
Service Code
|
CPT 80324
|
| Hospital Charge Code |
30000099
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$46.92 |
| Max. Negotiated Rate |
$117.30 |
| Rate for Payer: Aetna Commercial |
$105.57
|
| Rate for Payer: Aetna Medicare |
$58.65
|
| Rate for Payer: ASR ASR |
$113.78
|
| Rate for Payer: ASR Commercial |
$113.78
|
| Rate for Payer: BCBS Complete |
$46.92
|
| Rate for Payer: BCBS Trust/PPO |
$96.06
|
| Rate for Payer: BCN Commercial |
$90.94
|
| Rate for Payer: Cash Price |
$93.84
|
| Rate for Payer: Cofinity Commercial |
$110.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.84
|
| Rate for Payer: Healthscope Commercial |
$117.30
|
| Rate for Payer: Healthscope Whirlpool |
$113.78
|
| Rate for Payer: Mclaren Commercial |
$105.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.70
|
| Rate for Payer: Nomi Health Commercial |
$96.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$102.78
|
| Rate for Payer: Priority Health Narrow Network |
$82.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$103.22
|
|
|
HC MECONIUM BENZODIAZAPINE CONFIRMATION
|
Facility
|
IP
|
$117.30
|
|
|
Service Code
|
CPT 80346
|
| Hospital Charge Code |
30000102
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$76.24 |
| Max. Negotiated Rate |
$117.30 |
| Rate for Payer: Aetna Commercial |
$105.57
|
| Rate for Payer: ASR ASR |
$113.78
|
| Rate for Payer: ASR Commercial |
$113.78
|
| Rate for Payer: BCBS Trust/PPO |
$95.59
|
| Rate for Payer: BCN Commercial |
$90.94
|
| Rate for Payer: Cash Price |
$93.84
|
| Rate for Payer: Cofinity Commercial |
$110.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.84
|
| Rate for Payer: Healthscope Commercial |
$117.30
|
| Rate for Payer: Healthscope Whirlpool |
$113.78
|
| Rate for Payer: Mclaren Commercial |
$105.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.70
|
| Rate for Payer: Nomi Health Commercial |
$96.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$103.22
|
|
|
HC MECONIUM BENZODIAZAPINE CONFIRMATION
|
Facility
|
OP
|
$117.30
|
|
|
Service Code
|
CPT 80346
|
| Hospital Charge Code |
30000102
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$46.92 |
| Max. Negotiated Rate |
$117.30 |
| Rate for Payer: Aetna Commercial |
$105.57
|
| Rate for Payer: Aetna Medicare |
$58.65
|
| Rate for Payer: ASR ASR |
$113.78
|
| Rate for Payer: ASR Commercial |
$113.78
|
| Rate for Payer: BCBS Complete |
$46.92
|
| Rate for Payer: BCBS Trust/PPO |
$96.06
|
| Rate for Payer: BCN Commercial |
$90.94
|
| Rate for Payer: Cash Price |
$93.84
|
| Rate for Payer: Cofinity Commercial |
$110.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.84
|
| Rate for Payer: Healthscope Commercial |
$117.30
|
| Rate for Payer: Healthscope Whirlpool |
$113.78
|
| Rate for Payer: Mclaren Commercial |
$105.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.70
|
| Rate for Payer: Nomi Health Commercial |
$96.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$102.78
|
| Rate for Payer: Priority Health Narrow Network |
$82.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$103.22
|
|
|
HC MECONIUM BUPRENORPHINE CONFIRMATION
|
Facility
|
IP
|
$117.30
|
|
|
Service Code
|
CPT 80348
|
| Hospital Charge Code |
30000100
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$76.24 |
| Max. Negotiated Rate |
$117.30 |
| Rate for Payer: Aetna Commercial |
$105.57
|
| Rate for Payer: ASR ASR |
$113.78
|
| Rate for Payer: ASR Commercial |
$113.78
|
| Rate for Payer: BCBS Trust/PPO |
$95.59
|
| Rate for Payer: BCN Commercial |
$90.94
|
| Rate for Payer: Cash Price |
$93.84
|
| Rate for Payer: Cofinity Commercial |
$110.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.84
|
| Rate for Payer: Healthscope Commercial |
$117.30
|
| Rate for Payer: Healthscope Whirlpool |
$113.78
|
| Rate for Payer: Mclaren Commercial |
$105.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.70
|
| Rate for Payer: Nomi Health Commercial |
$96.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$103.22
|
|
|
HC MECONIUM BUPRENORPHINE CONFIRMATION
|
Facility
|
OP
|
$117.30
|
|
|
Service Code
|
CPT 80348
|
| Hospital Charge Code |
30000100
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$46.92 |
| Max. Negotiated Rate |
$117.30 |
| Rate for Payer: Aetna Commercial |
$105.57
|
| Rate for Payer: Aetna Medicare |
$58.65
|
| Rate for Payer: ASR ASR |
$113.78
|
| Rate for Payer: ASR Commercial |
$113.78
|
| Rate for Payer: BCBS Complete |
$46.92
|
| Rate for Payer: BCBS Trust/PPO |
$96.06
|
| Rate for Payer: BCN Commercial |
$90.94
|
| Rate for Payer: Cash Price |
$93.84
|
| Rate for Payer: Cofinity Commercial |
$110.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.84
|
| Rate for Payer: Healthscope Commercial |
$117.30
|
| Rate for Payer: Healthscope Whirlpool |
$113.78
|
| Rate for Payer: Mclaren Commercial |
$105.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.70
|
| Rate for Payer: Nomi Health Commercial |
$96.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$102.78
|
| Rate for Payer: Priority Health Narrow Network |
$82.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$103.22
|
|
|
HC MECONIUM DRUG SCRN EA
|
Facility
|
OP
|
$94.53
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000144
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$33.31 |
| Max. Negotiated Rate |
$96.32 |
| Rate for Payer: Aetna Commercial |
$85.08
|
| Rate for Payer: Aetna Medicare |
$62.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.68
|
| Rate for Payer: ASR ASR |
$91.69
|
| Rate for Payer: ASR Commercial |
$91.69
|
| Rate for Payer: BCBS Complete |
$34.97
|
| Rate for Payer: BCBS MAPPO |
$62.14
|
| Rate for Payer: BCBS Trust/PPO |
$77.41
|
| Rate for Payer: BCN Commercial |
$73.29
|
| Rate for Payer: BCN Medicare Advantage |
$62.14
|
| Rate for Payer: Cash Price |
$75.62
|
| Rate for Payer: Cash Price |
$75.62
|
| Rate for Payer: Cofinity Commercial |
$88.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.14
|
| Rate for Payer: Healthscope Commercial |
$94.53
|
| Rate for Payer: Healthscope Whirlpool |
$91.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$62.14
|
| Rate for Payer: Mclaren Commercial |
$85.08
|
| Rate for Payer: Mclaren Medicaid |
$33.31
|
| Rate for Payer: Mclaren Medicare |
$62.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.25
|
| Rate for Payer: Meridian Medicaid |
$34.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.35
|
| Rate for Payer: Nomi Health Commercial |
$77.51
|
| Rate for Payer: PACE Medicare |
$59.03
|
| Rate for Payer: PACE SWMI |
$62.14
|
| Rate for Payer: PHP Commercial |
$68.35
|
| Rate for Payer: PHP Medicaid |
$33.31
|
| Rate for Payer: PHP Medicare Advantage |
$62.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$82.83
|
| Rate for Payer: Priority Health Medicare |
$62.14
|
| Rate for Payer: Priority Health Narrow Network |
$66.27
|
| Rate for Payer: Railroad Medicare Medicare |
$62.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$83.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.14
|
| Rate for Payer: UHC Exchange |
$96.32
|
| Rate for Payer: UHC Medicare Advantage |
$62.14
|
| Rate for Payer: UHCCP DNSP |
$62.14
|
| Rate for Payer: UHCCP Medicaid |
$33.31
|
| Rate for Payer: VA VA |
$62.14
|
|
|
HC MECONIUM DRUG SCRN EA
|
Facility
|
IP
|
$94.53
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000144
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$61.44 |
| Max. Negotiated Rate |
$94.53 |
| Rate for Payer: Aetna Commercial |
$85.08
|
| Rate for Payer: ASR ASR |
$91.69
|
| Rate for Payer: ASR Commercial |
$91.69
|
| Rate for Payer: BCBS Trust/PPO |
$77.03
|
| Rate for Payer: BCN Commercial |
$73.29
|
| Rate for Payer: Cash Price |
$75.62
|
| Rate for Payer: Cofinity Commercial |
$88.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.62
|
| Rate for Payer: Healthscope Commercial |
$94.53
|
| Rate for Payer: Healthscope Whirlpool |
$91.69
|
| Rate for Payer: Mclaren Commercial |
$85.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.35
|
| Rate for Payer: Nomi Health Commercial |
$77.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$83.19
|
|
|
HC MECONIUM DRUG SCRN MULTI DRUGS.
|
Facility
|
IP
|
$104.04
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100653
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$67.63 |
| Max. Negotiated Rate |
$104.04 |
| Rate for Payer: Aetna Commercial |
$93.64
|
| Rate for Payer: ASR ASR |
$100.92
|
| Rate for Payer: ASR Commercial |
$100.92
|
| Rate for Payer: BCBS Trust/PPO |
$84.78
|
| Rate for Payer: BCN Commercial |
$80.66
|
| Rate for Payer: Cash Price |
$83.23
|
| Rate for Payer: Cofinity Commercial |
$97.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.23
|
| Rate for Payer: Healthscope Commercial |
$104.04
|
| Rate for Payer: Healthscope Whirlpool |
$100.92
|
| Rate for Payer: Mclaren Commercial |
$93.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.43
|
| Rate for Payer: Nomi Health Commercial |
$85.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$91.56
|
|
|
HC MECONIUM DRUG SCRN MULTI DRUGS.
|
Facility
|
OP
|
$104.04
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100653
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.31 |
| Max. Negotiated Rate |
$104.04 |
| Rate for Payer: Aetna Commercial |
$93.64
|
| Rate for Payer: Aetna Medicare |
$62.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.68
|
| Rate for Payer: ASR ASR |
$100.92
|
| Rate for Payer: ASR Commercial |
$100.92
|
| Rate for Payer: BCBS Complete |
$34.97
|
| Rate for Payer: BCBS MAPPO |
$62.14
|
| Rate for Payer: BCBS Trust/PPO |
$85.20
|
| Rate for Payer: BCN Commercial |
$80.66
|
| Rate for Payer: BCN Medicare Advantage |
$62.14
|
| Rate for Payer: Cash Price |
$83.23
|
| Rate for Payer: Cash Price |
$83.23
|
| Rate for Payer: Cofinity Commercial |
$97.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.14
|
| Rate for Payer: Healthscope Commercial |
$104.04
|
| Rate for Payer: Healthscope Whirlpool |
$100.92
|
| Rate for Payer: Humana Choice PPO Medicare |
$62.14
|
| Rate for Payer: Mclaren Commercial |
$93.64
|
| Rate for Payer: Mclaren Medicaid |
$33.31
|
| Rate for Payer: Mclaren Medicare |
$62.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.25
|
| Rate for Payer: Meridian Medicaid |
$34.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.43
|
| Rate for Payer: Nomi Health Commercial |
$85.31
|
| Rate for Payer: PACE Medicare |
$59.03
|
| Rate for Payer: PACE SWMI |
$62.14
|
| Rate for Payer: PHP Commercial |
$68.35
|
| Rate for Payer: PHP Medicaid |
$33.31
|
| Rate for Payer: PHP Medicare Advantage |
$62.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$91.16
|
| Rate for Payer: Priority Health Medicare |
$62.14
|
| Rate for Payer: Priority Health Narrow Network |
$72.93
|
| Rate for Payer: Railroad Medicare Medicare |
$62.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$91.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.14
|
| Rate for Payer: UHC Exchange |
$96.32
|
| Rate for Payer: UHC Medicare Advantage |
$62.14
|
| Rate for Payer: UHCCP DNSP |
$62.14
|
| Rate for Payer: UHCCP Medicaid |
$33.31
|
| Rate for Payer: VA VA |
$62.14
|
|
|
HC MECONIUM OPIATES CONFIRMATION
|
Facility
|
OP
|
$117.30
|
|
|
Service Code
|
CPT 80361
|
| Hospital Charge Code |
30100577
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$46.92 |
| Max. Negotiated Rate |
$117.30 |
| Rate for Payer: Aetna Commercial |
$105.57
|
| Rate for Payer: Aetna Medicare |
$58.65
|
| Rate for Payer: ASR ASR |
$113.78
|
| Rate for Payer: ASR Commercial |
$113.78
|
| Rate for Payer: BCBS Complete |
$46.92
|
| Rate for Payer: BCBS Trust/PPO |
$96.06
|
| Rate for Payer: BCN Commercial |
$90.94
|
| Rate for Payer: Cash Price |
$93.84
|
| Rate for Payer: Cofinity Commercial |
$110.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.84
|
| Rate for Payer: Healthscope Commercial |
$117.30
|
| Rate for Payer: Healthscope Whirlpool |
$113.78
|
| Rate for Payer: Mclaren Commercial |
$105.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.70
|
| Rate for Payer: Nomi Health Commercial |
$96.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$102.78
|
| Rate for Payer: Priority Health Narrow Network |
$82.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$103.22
|
|
|
HC MECONIUM OPIATES CONFIRMATION
|
Facility
|
IP
|
$117.30
|
|
|
Service Code
|
CPT 80361
|
| Hospital Charge Code |
30100577
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$76.24 |
| Max. Negotiated Rate |
$117.30 |
| Rate for Payer: Aetna Commercial |
$105.57
|
| Rate for Payer: ASR ASR |
$113.78
|
| Rate for Payer: ASR Commercial |
$113.78
|
| Rate for Payer: BCBS Trust/PPO |
$95.59
|
| Rate for Payer: BCN Commercial |
$90.94
|
| Rate for Payer: Cash Price |
$93.84
|
| Rate for Payer: Cofinity Commercial |
$110.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.84
|
| Rate for Payer: Healthscope Commercial |
$117.30
|
| Rate for Payer: Healthscope Whirlpool |
$113.78
|
| Rate for Payer: Mclaren Commercial |
$105.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.70
|
| Rate for Payer: Nomi Health Commercial |
$96.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$103.22
|
|
|
HC MECONIUM OXYCODONE CONFIRMATION
|
Facility
|
IP
|
$117.30
|
|
|
Service Code
|
CPT 80365
|
| Hospital Charge Code |
30000104
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$76.24 |
| Max. Negotiated Rate |
$117.30 |
| Rate for Payer: Aetna Commercial |
$105.57
|
| Rate for Payer: ASR ASR |
$113.78
|
| Rate for Payer: ASR Commercial |
$113.78
|
| Rate for Payer: BCBS Trust/PPO |
$95.59
|
| Rate for Payer: BCN Commercial |
$90.94
|
| Rate for Payer: Cash Price |
$93.84
|
| Rate for Payer: Cofinity Commercial |
$110.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.84
|
| Rate for Payer: Healthscope Commercial |
$117.30
|
| Rate for Payer: Healthscope Whirlpool |
$113.78
|
| Rate for Payer: Mclaren Commercial |
$105.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.70
|
| Rate for Payer: Nomi Health Commercial |
$96.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$103.22
|
|
|
HC MECONIUM OXYCODONE CONFIRMATION
|
Facility
|
OP
|
$117.30
|
|
|
Service Code
|
CPT 80365
|
| Hospital Charge Code |
30000104
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$46.92 |
| Max. Negotiated Rate |
$117.30 |
| Rate for Payer: Aetna Commercial |
$105.57
|
| Rate for Payer: Aetna Medicare |
$58.65
|
| Rate for Payer: ASR ASR |
$113.78
|
| Rate for Payer: ASR Commercial |
$113.78
|
| Rate for Payer: BCBS Complete |
$46.92
|
| Rate for Payer: BCBS Trust/PPO |
$96.06
|
| Rate for Payer: BCN Commercial |
$90.94
|
| Rate for Payer: Cash Price |
$93.84
|
| Rate for Payer: Cofinity Commercial |
$110.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.84
|
| Rate for Payer: Healthscope Commercial |
$117.30
|
| Rate for Payer: Healthscope Whirlpool |
$113.78
|
| Rate for Payer: Mclaren Commercial |
$105.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.70
|
| Rate for Payer: Nomi Health Commercial |
$96.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$102.78
|
| Rate for Payer: Priority Health Narrow Network |
$82.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$103.22
|
|
|
HC MECONIUM THC CONFIRMATION
|
Facility
|
OP
|
$117.30
|
|
|
Service Code
|
CPT 80349
|
| Hospital Charge Code |
30100567
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$46.92 |
| Max. Negotiated Rate |
$117.30 |
| Rate for Payer: Aetna Commercial |
$105.57
|
| Rate for Payer: Aetna Medicare |
$58.65
|
| Rate for Payer: ASR ASR |
$113.78
|
| Rate for Payer: ASR Commercial |
$113.78
|
| Rate for Payer: BCBS Complete |
$46.92
|
| Rate for Payer: BCBS Trust/PPO |
$96.06
|
| Rate for Payer: BCN Commercial |
$90.94
|
| Rate for Payer: Cash Price |
$93.84
|
| Rate for Payer: Cofinity Commercial |
$110.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.84
|
| Rate for Payer: Healthscope Commercial |
$117.30
|
| Rate for Payer: Healthscope Whirlpool |
$113.78
|
| Rate for Payer: Mclaren Commercial |
$105.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.70
|
| Rate for Payer: Nomi Health Commercial |
$96.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$102.78
|
| Rate for Payer: Priority Health Narrow Network |
$82.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$103.22
|
|
