|
HC SEROTONIN RELEASE ASSAY PORCINE
|
Facility
|
IP
|
$399.84
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
30200132
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$279.89 |
| Max. Negotiated Rate |
$399.84 |
| Rate for Payer: Aetna Commercial |
$359.86
|
| Rate for Payer: ASR ASR |
$387.84
|
| Rate for Payer: BCBS Trust/PPO |
$310.00
|
| Rate for Payer: BCN Commercial |
$310.00
|
| Rate for Payer: Cash Price |
$319.87
|
| Rate for Payer: Cofinity Commercial |
$375.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$319.87
|
| Rate for Payer: Healthscope Commercial |
$399.84
|
| Rate for Payer: Healthscope Whirlpool |
$387.84
|
| Rate for Payer: Mclaren Commercial |
$359.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$339.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$279.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$351.86
|
|
|
HC SEROTONIN RELEASE ASSAY PORCINE
|
Facility
|
OP
|
$399.84
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
30200132
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.05 |
| Max. Negotiated Rate |
$399.84 |
| Rate for Payer: Aetna Commercial |
$359.86
|
| Rate for Payer: Aetna Medicare |
$18.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.96
|
| Rate for Payer: ASR ASR |
$387.84
|
| Rate for Payer: BCBS Complete |
$10.55
|
| Rate for Payer: BCBS MAPPO |
$18.37
|
| Rate for Payer: BCBS Trust/PPO |
$310.00
|
| Rate for Payer: BCN Commercial |
$310.00
|
| Rate for Payer: BCN Medicare Advantage |
$18.37
|
| Rate for Payer: Cash Price |
$319.87
|
| Rate for Payer: Cash Price |
$319.87
|
| Rate for Payer: Cofinity Commercial |
$375.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$319.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.37
|
| Rate for Payer: Healthscope Commercial |
$399.84
|
| Rate for Payer: Healthscope Whirlpool |
$387.84
|
| Rate for Payer: Humana Choice PPO Medicare |
$18.37
|
| Rate for Payer: Mclaren Commercial |
$359.86
|
| Rate for Payer: Mclaren Medicaid |
$10.05
|
| Rate for Payer: Mclaren Medicare |
$18.37
|
| Rate for Payer: Meridian Medicaid |
$10.55
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$339.86
|
| Rate for Payer: PACE Medicare |
$17.45
|
| Rate for Payer: PACE SWMI |
$18.37
|
| Rate for Payer: PHP Commercial |
$20.21
|
| Rate for Payer: PHP Medicaid |
$10.05
|
| Rate for Payer: PHP Medicare Advantage |
$18.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$279.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$234.48
|
| Rate for Payer: Priority Health Medicare |
$18.37
|
| Rate for Payer: Priority Health Narrow Network |
$187.58
|
| Rate for Payer: Railroad Medicare Medicare |
$18.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$351.86
|
| Rate for Payer: UHC Medicare Advantage |
$18.92
|
| Rate for Payer: VA VA |
$18.37
|
|
|
HC SERUM FREE LIGHT CHAIN
|
Facility
|
OP
|
$75.90
|
|
|
Service Code
|
CPT 83521
|
| Hospital Charge Code |
30100305
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.45 |
| Max. Negotiated Rate |
$75.90 |
| Rate for Payer: Aetna Commercial |
$68.31
|
| Rate for Payer: Aetna Medicare |
$17.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.59
|
| Rate for Payer: ASR ASR |
$73.62
|
| Rate for Payer: BCBS Complete |
$9.92
|
| Rate for Payer: BCBS MAPPO |
$17.27
|
| Rate for Payer: BCBS Trust/PPO |
$58.85
|
| Rate for Payer: BCN Commercial |
$58.85
|
| Rate for Payer: BCN Medicare Advantage |
$17.27
|
| Rate for Payer: Cash Price |
$60.72
|
| Rate for Payer: Cash Price |
$60.72
|
| Rate for Payer: Cofinity Commercial |
$71.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.27
|
| Rate for Payer: Healthscope Commercial |
$75.90
|
| Rate for Payer: Healthscope Whirlpool |
$73.62
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.27
|
| Rate for Payer: Mclaren Commercial |
$68.31
|
| Rate for Payer: Mclaren Medicaid |
$9.45
|
| Rate for Payer: Mclaren Medicare |
$17.27
|
| Rate for Payer: Meridian Medicaid |
$9.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$18.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$64.52
|
| Rate for Payer: PACE Medicare |
$16.41
|
| Rate for Payer: PACE SWMI |
$17.27
|
| Rate for Payer: PHP Commercial |
$19.00
|
| Rate for Payer: PHP Medicaid |
$9.45
|
| Rate for Payer: PHP Medicare Advantage |
$17.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$69.07
|
| Rate for Payer: Priority Health Medicare |
$17.27
|
| Rate for Payer: Priority Health Narrow Network |
$53.89
|
| Rate for Payer: Railroad Medicare Medicare |
$17.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$66.79
|
| Rate for Payer: UHC Medicare Advantage |
$17.79
|
| Rate for Payer: VA VA |
$17.27
|
|
|
HC SERUM FREE LIGHT CHAIN
|
Facility
|
IP
|
$75.90
|
|
|
Service Code
|
CPT 83521
|
| Hospital Charge Code |
30100305
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$53.13 |
| Max. Negotiated Rate |
$75.90 |
| Rate for Payer: Aetna Commercial |
$68.31
|
| Rate for Payer: ASR ASR |
$73.62
|
| Rate for Payer: BCBS Trust/PPO |
$58.85
|
| Rate for Payer: BCN Commercial |
$58.85
|
| Rate for Payer: Cash Price |
$60.72
|
| Rate for Payer: Cofinity Commercial |
$71.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.72
|
| Rate for Payer: Healthscope Commercial |
$75.90
|
| Rate for Payer: Healthscope Whirlpool |
$73.62
|
| Rate for Payer: Mclaren Commercial |
$68.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$64.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$66.79
|
|
|
HC SERUM FREE LIGHT CHAIN CMPT
|
Facility
|
IP
|
$75.90
|
|
|
Service Code
|
CPT 83521
|
| Hospital Charge Code |
30100306
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$53.13 |
| Max. Negotiated Rate |
$75.90 |
| Rate for Payer: Aetna Commercial |
$68.31
|
| Rate for Payer: ASR ASR |
$73.62
|
| Rate for Payer: BCBS Trust/PPO |
$58.85
|
| Rate for Payer: BCN Commercial |
$58.85
|
| Rate for Payer: Cash Price |
$60.72
|
| Rate for Payer: Cofinity Commercial |
$71.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.72
|
| Rate for Payer: Healthscope Commercial |
$75.90
|
| Rate for Payer: Healthscope Whirlpool |
$73.62
|
| Rate for Payer: Mclaren Commercial |
$68.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$64.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$66.79
|
|
|
HC SERUM FREE LIGHT CHAIN CMPT
|
Facility
|
OP
|
$75.90
|
|
|
Service Code
|
CPT 83521
|
| Hospital Charge Code |
30100306
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.45 |
| Max. Negotiated Rate |
$75.90 |
| Rate for Payer: Aetna Commercial |
$68.31
|
| Rate for Payer: Aetna Medicare |
$17.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.59
|
| Rate for Payer: ASR ASR |
$73.62
|
| Rate for Payer: BCBS Complete |
$9.92
|
| Rate for Payer: BCBS MAPPO |
$17.27
|
| Rate for Payer: BCBS Trust/PPO |
$58.85
|
| Rate for Payer: BCN Commercial |
$58.85
|
| Rate for Payer: BCN Medicare Advantage |
$17.27
|
| Rate for Payer: Cash Price |
$60.72
|
| Rate for Payer: Cash Price |
$60.72
|
| Rate for Payer: Cofinity Commercial |
$71.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.27
|
| Rate for Payer: Healthscope Commercial |
$75.90
|
| Rate for Payer: Healthscope Whirlpool |
$73.62
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.27
|
| Rate for Payer: Mclaren Commercial |
$68.31
|
| Rate for Payer: Mclaren Medicaid |
$9.45
|
| Rate for Payer: Mclaren Medicare |
$17.27
|
| Rate for Payer: Meridian Medicaid |
$9.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$18.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$64.52
|
| Rate for Payer: PACE Medicare |
$16.41
|
| Rate for Payer: PACE SWMI |
$17.27
|
| Rate for Payer: PHP Commercial |
$19.00
|
| Rate for Payer: PHP Medicaid |
$9.45
|
| Rate for Payer: PHP Medicare Advantage |
$17.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$69.07
|
| Rate for Payer: Priority Health Medicare |
$17.27
|
| Rate for Payer: Priority Health Narrow Network |
$53.89
|
| Rate for Payer: Railroad Medicare Medicare |
$17.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$66.79
|
| Rate for Payer: UHC Medicare Advantage |
$17.79
|
| Rate for Payer: VA VA |
$17.27
|
|
|
HC SESAME SEED IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200101
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$17.42 |
| Max. Negotiated Rate |
$24.89 |
| Rate for Payer: Aetna Commercial |
$22.40
|
| Rate for Payer: ASR ASR |
$24.14
|
| Rate for Payer: BCBS Trust/PPO |
$19.30
|
| Rate for Payer: BCN Commercial |
$19.30
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$23.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$24.89
|
| Rate for Payer: Healthscope Whirlpool |
$24.14
|
| Rate for Payer: Mclaren Commercial |
$22.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.90
|
|
|
HC SESAME SEED IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200101
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.86 |
| Max. Negotiated Rate |
$24.89 |
| Rate for Payer: Aetna Commercial |
$22.40
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: ASR ASR |
$24.14
|
| Rate for Payer: BCBS Complete |
$3.00
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.30
|
| Rate for Payer: BCN Commercial |
$19.30
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$23.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$24.89
|
| Rate for Payer: Healthscope Whirlpool |
$24.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$22.40
|
| Rate for Payer: Mclaren Medicaid |
$2.86
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Medicaid |
$3.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$5.74
|
| Rate for Payer: PHP Medicaid |
$2.86
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.65
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$17.67
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.90
|
| Rate for Payer: UHC Medicare Advantage |
$5.38
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC SETUP 1
|
Facility
|
OP
|
$32.88
|
|
| Hospital Charge Code |
27000145
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$13.15 |
| Max. Negotiated Rate |
$32.88 |
| Rate for Payer: Aetna Commercial |
$29.59
|
| Rate for Payer: ASR ASR |
$31.89
|
| Rate for Payer: BCBS Complete |
$13.15
|
| Rate for Payer: BCBS Trust/PPO |
$25.49
|
| Rate for Payer: BCN Commercial |
$25.49
|
| Rate for Payer: Cash Price |
$26.30
|
| Rate for Payer: Cofinity Commercial |
$30.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.30
|
| Rate for Payer: Healthscope Commercial |
$32.88
|
| Rate for Payer: Healthscope Whirlpool |
$31.89
|
| Rate for Payer: Mclaren Commercial |
$29.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$27.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$29.92
|
| Rate for Payer: Priority Health Narrow Network |
$23.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.93
|
|
|
HC SETUP 1
|
Facility
|
IP
|
$32.88
|
|
| Hospital Charge Code |
27000145
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$23.02 |
| Max. Negotiated Rate |
$32.88 |
| Rate for Payer: Aetna Commercial |
$29.59
|
| Rate for Payer: ASR ASR |
$31.89
|
| Rate for Payer: BCBS Trust/PPO |
$25.49
|
| Rate for Payer: BCN Commercial |
$25.49
|
| Rate for Payer: Cash Price |
$26.30
|
| Rate for Payer: Cofinity Commercial |
$30.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.30
|
| Rate for Payer: Healthscope Commercial |
$32.88
|
| Rate for Payer: Healthscope Whirlpool |
$31.89
|
| Rate for Payer: Mclaren Commercial |
$29.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$27.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.93
|
|
|
HC SEX HORMONE BINDING GLOBULIN
|
Facility
|
IP
|
$59.16
|
|
|
Service Code
|
CPT 84270
|
| Hospital Charge Code |
30100422
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$41.41 |
| Max. Negotiated Rate |
$59.16 |
| Rate for Payer: Aetna Commercial |
$53.24
|
| Rate for Payer: ASR ASR |
$57.39
|
| Rate for Payer: BCBS Trust/PPO |
$45.87
|
| Rate for Payer: BCN Commercial |
$45.87
|
| Rate for Payer: Cash Price |
$47.33
|
| Rate for Payer: Cofinity Commercial |
$55.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.33
|
| Rate for Payer: Healthscope Commercial |
$59.16
|
| Rate for Payer: Healthscope Whirlpool |
$57.39
|
| Rate for Payer: Mclaren Commercial |
$53.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$50.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$52.06
|
|
|
HC SEX HORMONE BINDING GLOBULIN
|
Facility
|
OP
|
$59.16
|
|
|
Service Code
|
CPT 84270
|
| Hospital Charge Code |
30100422
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.89 |
| Max. Negotiated Rate |
$73.88 |
| Rate for Payer: Aetna Commercial |
$53.24
|
| Rate for Payer: Aetna Medicare |
$21.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27.16
|
| Rate for Payer: ASR ASR |
$57.39
|
| Rate for Payer: BCBS Complete |
$12.48
|
| Rate for Payer: BCBS MAPPO |
$21.73
|
| Rate for Payer: BCBS Trust/PPO |
$45.87
|
| Rate for Payer: BCN Commercial |
$45.87
|
| Rate for Payer: BCN Medicare Advantage |
$21.73
|
| Rate for Payer: Cash Price |
$47.33
|
| Rate for Payer: Cash Price |
$47.33
|
| Rate for Payer: Cofinity Commercial |
$55.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.73
|
| Rate for Payer: Healthscope Commercial |
$59.16
|
| Rate for Payer: Healthscope Whirlpool |
$57.39
|
| Rate for Payer: Humana Choice PPO Medicare |
$21.73
|
| Rate for Payer: Mclaren Commercial |
$53.24
|
| Rate for Payer: Mclaren Medicaid |
$11.89
|
| Rate for Payer: Mclaren Medicare |
$21.73
|
| Rate for Payer: Meridian Medicaid |
$12.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$22.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$50.29
|
| Rate for Payer: PACE Medicare |
$20.64
|
| Rate for Payer: PACE SWMI |
$21.73
|
| Rate for Payer: PHP Commercial |
$23.90
|
| Rate for Payer: PHP Medicaid |
$11.89
|
| Rate for Payer: PHP Medicare Advantage |
$21.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$73.88
|
| Rate for Payer: Priority Health Medicare |
$21.73
|
| Rate for Payer: Priority Health Narrow Network |
$59.10
|
| Rate for Payer: Railroad Medicare Medicare |
$21.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$52.06
|
| Rate for Payer: UHC Medicare Advantage |
$22.38
|
| Rate for Payer: VA VA |
$21.73
|
|
|
HC SEX HORMONE GLOBULIN BMH
|
Facility
|
OP
|
$83.46
|
|
|
Service Code
|
CPT 84270
|
| Hospital Charge Code |
30100718
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.89 |
| Max. Negotiated Rate |
$83.46 |
| Rate for Payer: Aetna Commercial |
$75.11
|
| Rate for Payer: Aetna Medicare |
$21.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27.16
|
| Rate for Payer: ASR ASR |
$80.96
|
| Rate for Payer: BCBS Complete |
$12.48
|
| Rate for Payer: BCBS MAPPO |
$21.73
|
| Rate for Payer: BCBS Trust/PPO |
$64.71
|
| Rate for Payer: BCN Commercial |
$64.71
|
| Rate for Payer: BCN Medicare Advantage |
$21.73
|
| Rate for Payer: Cash Price |
$66.77
|
| Rate for Payer: Cash Price |
$66.77
|
| Rate for Payer: Cofinity Commercial |
$78.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.73
|
| Rate for Payer: Healthscope Commercial |
$83.46
|
| Rate for Payer: Healthscope Whirlpool |
$80.96
|
| Rate for Payer: Humana Choice PPO Medicare |
$21.73
|
| Rate for Payer: Mclaren Commercial |
$75.11
|
| Rate for Payer: Mclaren Medicaid |
$11.89
|
| Rate for Payer: Mclaren Medicare |
$21.73
|
| Rate for Payer: Meridian Medicaid |
$12.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$22.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$70.94
|
| Rate for Payer: PACE Medicare |
$20.64
|
| Rate for Payer: PACE SWMI |
$21.73
|
| Rate for Payer: PHP Commercial |
$23.90
|
| Rate for Payer: PHP Medicaid |
$11.89
|
| Rate for Payer: PHP Medicare Advantage |
$21.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$73.88
|
| Rate for Payer: Priority Health Medicare |
$21.73
|
| Rate for Payer: Priority Health Narrow Network |
$59.10
|
| Rate for Payer: Railroad Medicare Medicare |
$21.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$73.44
|
| Rate for Payer: UHC Medicare Advantage |
$22.38
|
| Rate for Payer: VA VA |
$21.73
|
|
|
HC SEX HORMONE GLOBULIN BMH
|
Facility
|
IP
|
$83.46
|
|
|
Service Code
|
CPT 84270
|
| Hospital Charge Code |
30100718
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$58.42 |
| Max. Negotiated Rate |
$83.46 |
| Rate for Payer: Aetna Commercial |
$75.11
|
| Rate for Payer: ASR ASR |
$80.96
|
| Rate for Payer: BCBS Trust/PPO |
$64.71
|
| Rate for Payer: BCN Commercial |
$64.71
|
| Rate for Payer: Cash Price |
$66.77
|
| Rate for Payer: Cofinity Commercial |
$78.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.77
|
| Rate for Payer: Healthscope Commercial |
$83.46
|
| Rate for Payer: Healthscope Whirlpool |
$80.96
|
| Rate for Payer: Mclaren Commercial |
$75.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$70.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$73.44
|
|
|
HC SGOT AST
|
Facility
|
IP
|
$19.08
|
|
|
Service Code
|
CPT 84450
|
| Hospital Charge Code |
30100441
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.36 |
| Max. Negotiated Rate |
$19.08 |
| Rate for Payer: Aetna Commercial |
$17.17
|
| Rate for Payer: ASR ASR |
$18.51
|
| Rate for Payer: BCBS Trust/PPO |
$14.79
|
| Rate for Payer: BCN Commercial |
$14.79
|
| Rate for Payer: Cash Price |
$15.26
|
| Rate for Payer: Cofinity Commercial |
$17.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.26
|
| Rate for Payer: Healthscope Commercial |
$19.08
|
| Rate for Payer: Healthscope Whirlpool |
$18.51
|
| Rate for Payer: Mclaren Commercial |
$17.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$16.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16.79
|
|
|
HC SGOT AST
|
Facility
|
OP
|
$19.08
|
|
|
Service Code
|
CPT 84450
|
| Hospital Charge Code |
30100441
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.83 |
| Max. Negotiated Rate |
$20.01 |
| Rate for Payer: Aetna Commercial |
$17.17
|
| Rate for Payer: Aetna Medicare |
$5.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.48
|
| Rate for Payer: ASR ASR |
$18.51
|
| Rate for Payer: BCBS Complete |
$2.98
|
| Rate for Payer: BCBS MAPPO |
$5.18
|
| Rate for Payer: BCBS Trust/PPO |
$14.79
|
| Rate for Payer: BCN Commercial |
$14.79
|
| Rate for Payer: BCN Medicare Advantage |
$5.18
|
| Rate for Payer: Cash Price |
$15.26
|
| Rate for Payer: Cash Price |
$15.26
|
| Rate for Payer: Cofinity Commercial |
$17.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.18
|
| Rate for Payer: Healthscope Commercial |
$19.08
|
| Rate for Payer: Healthscope Whirlpool |
$18.51
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.18
|
| Rate for Payer: Mclaren Commercial |
$17.17
|
| Rate for Payer: Mclaren Medicaid |
$2.83
|
| Rate for Payer: Mclaren Medicare |
$5.18
|
| Rate for Payer: Meridian Medicaid |
$2.98
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$16.22
|
| Rate for Payer: PACE Medicare |
$4.92
|
| Rate for Payer: PACE SWMI |
$5.18
|
| Rate for Payer: PHP Commercial |
$5.70
|
| Rate for Payer: PHP Medicaid |
$2.83
|
| Rate for Payer: PHP Medicare Advantage |
$5.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20.01
|
| Rate for Payer: Priority Health Medicare |
$5.18
|
| Rate for Payer: Priority Health Narrow Network |
$16.01
|
| Rate for Payer: Railroad Medicare Medicare |
$5.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16.79
|
| Rate for Payer: UHC Medicare Advantage |
$5.34
|
| Rate for Payer: VA VA |
$5.18
|
|
|
HC SGPT ALT
|
Facility
|
IP
|
$19.24
|
|
|
Service Code
|
CPT 84460
|
| Hospital Charge Code |
30100442
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.47 |
| Max. Negotiated Rate |
$19.24 |
| Rate for Payer: Aetna Commercial |
$17.32
|
| Rate for Payer: ASR ASR |
$18.66
|
| Rate for Payer: BCBS Trust/PPO |
$14.92
|
| Rate for Payer: BCN Commercial |
$14.92
|
| Rate for Payer: Cash Price |
$15.39
|
| Rate for Payer: Cofinity Commercial |
$18.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.39
|
| Rate for Payer: Healthscope Commercial |
$19.24
|
| Rate for Payer: Healthscope Whirlpool |
$18.66
|
| Rate for Payer: Mclaren Commercial |
$17.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$16.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16.93
|
|
|
HC SGPT ALT
|
Facility
|
OP
|
$19.24
|
|
|
Service Code
|
CPT 84460
|
| Hospital Charge Code |
30100442
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.90 |
| Max. Negotiated Rate |
$20.01 |
| Rate for Payer: Aetna Commercial |
$17.32
|
| Rate for Payer: Aetna Medicare |
$5.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.62
|
| Rate for Payer: ASR ASR |
$18.66
|
| Rate for Payer: BCBS Complete |
$3.04
|
| Rate for Payer: BCBS MAPPO |
$5.30
|
| Rate for Payer: BCBS Trust/PPO |
$14.92
|
| Rate for Payer: BCN Commercial |
$14.92
|
| Rate for Payer: BCN Medicare Advantage |
$5.30
|
| Rate for Payer: Cash Price |
$15.39
|
| Rate for Payer: Cash Price |
$15.39
|
| Rate for Payer: Cofinity Commercial |
$18.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.30
|
| Rate for Payer: Healthscope Commercial |
$19.24
|
| Rate for Payer: Healthscope Whirlpool |
$18.66
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.30
|
| Rate for Payer: Mclaren Commercial |
$17.32
|
| Rate for Payer: Mclaren Medicaid |
$2.90
|
| Rate for Payer: Mclaren Medicare |
$5.30
|
| Rate for Payer: Meridian Medicaid |
$3.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$16.35
|
| Rate for Payer: PACE Medicare |
$5.04
|
| Rate for Payer: PACE SWMI |
$5.30
|
| Rate for Payer: PHP Commercial |
$5.83
|
| Rate for Payer: PHP Medicaid |
$2.90
|
| Rate for Payer: PHP Medicare Advantage |
$5.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20.01
|
| Rate for Payer: Priority Health Medicare |
$5.30
|
| Rate for Payer: Priority Health Narrow Network |
$16.01
|
| Rate for Payer: Railroad Medicare Medicare |
$5.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16.93
|
| Rate for Payer: UHC Medicare Advantage |
$5.46
|
| Rate for Payer: VA VA |
$5.30
|
|
|
HC SHAVE EPIDURAL SKIN LESION 1.1-2.0 CM
|
Facility
|
IP
|
$298.86
|
|
|
Service Code
|
CPT 11312
|
| Hospital Charge Code |
76100073
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$209.20 |
| Max. Negotiated Rate |
$298.86 |
| Rate for Payer: Aetna Commercial |
$268.97
|
| Rate for Payer: ASR ASR |
$289.89
|
| Rate for Payer: BCBS Trust/PPO |
$231.71
|
| Rate for Payer: BCN Commercial |
$231.71
|
| Rate for Payer: Cash Price |
$239.09
|
| Rate for Payer: Cofinity Commercial |
$280.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$239.09
|
| Rate for Payer: Healthscope Commercial |
$298.86
|
| Rate for Payer: Healthscope Whirlpool |
$289.89
|
| Rate for Payer: Mclaren Commercial |
$268.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$254.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$209.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$263.00
|
|
|
HC SHAVE EPIDURAL SKIN LESION 1.1-2.0 CM
|
Facility
|
OP
|
$298.86
|
|
|
Service Code
|
CPT 11312
|
| Hospital Charge Code |
76100073
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$193.87 |
| Max. Negotiated Rate |
$443.04 |
| Rate for Payer: Aetna Commercial |
$268.97
|
| Rate for Payer: Aetna Medicare |
$354.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$443.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$443.04
|
| Rate for Payer: ASR ASR |
$289.89
|
| Rate for Payer: BCBS Complete |
$203.58
|
| Rate for Payer: BCBS MAPPO |
$354.43
|
| Rate for Payer: BCBS Trust/PPO |
$231.71
|
| Rate for Payer: BCN Commercial |
$231.71
|
| Rate for Payer: BCN Medicare Advantage |
$354.43
|
| Rate for Payer: Cash Price |
$239.09
|
| Rate for Payer: Cash Price |
$239.09
|
| Rate for Payer: Cofinity Commercial |
$280.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$239.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$354.43
|
| Rate for Payer: Healthscope Commercial |
$298.86
|
| Rate for Payer: Healthscope Whirlpool |
$289.89
|
| Rate for Payer: Humana Choice PPO Medicare |
$354.43
|
| Rate for Payer: Mclaren Commercial |
$268.97
|
| Rate for Payer: Mclaren Medicaid |
$193.87
|
| Rate for Payer: Mclaren Medicare |
$354.43
|
| Rate for Payer: Meridian Medicaid |
$203.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$372.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$407.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$254.03
|
| Rate for Payer: PACE Medicare |
$336.71
|
| Rate for Payer: PACE SWMI |
$354.43
|
| Rate for Payer: PHP Commercial |
$389.87
|
| Rate for Payer: PHP Medicaid |
$193.87
|
| Rate for Payer: PHP Medicare Advantage |
$354.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$193.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$209.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$271.96
|
| Rate for Payer: Priority Health Medicare |
$354.43
|
| Rate for Payer: Priority Health Narrow Network |
$212.19
|
| Rate for Payer: Railroad Medicare Medicare |
$354.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$263.00
|
| Rate for Payer: UHC Medicare Advantage |
$365.06
|
| Rate for Payer: VA VA |
$354.43
|
|
|
HC SHAVE EPIDURAL SKIN LESION > 2.0 CM
|
Facility
|
OP
|
$298.86
|
|
|
Service Code
|
CPT 11313
|
| Hospital Charge Code |
76100074
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$193.87 |
| Max. Negotiated Rate |
$443.04 |
| Rate for Payer: Aetna Commercial |
$268.97
|
| Rate for Payer: Aetna Medicare |
$354.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$443.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$443.04
|
| Rate for Payer: ASR ASR |
$289.89
|
| Rate for Payer: BCBS Complete |
$203.58
|
| Rate for Payer: BCBS MAPPO |
$354.43
|
| Rate for Payer: BCBS Trust/PPO |
$231.71
|
| Rate for Payer: BCN Commercial |
$231.71
|
| Rate for Payer: BCN Medicare Advantage |
$354.43
|
| Rate for Payer: Cash Price |
$239.09
|
| Rate for Payer: Cash Price |
$239.09
|
| Rate for Payer: Cofinity Commercial |
$280.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$239.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$354.43
|
| Rate for Payer: Healthscope Commercial |
$298.86
|
| Rate for Payer: Healthscope Whirlpool |
$289.89
|
| Rate for Payer: Humana Choice PPO Medicare |
$354.43
|
| Rate for Payer: Mclaren Commercial |
$268.97
|
| Rate for Payer: Mclaren Medicaid |
$193.87
|
| Rate for Payer: Mclaren Medicare |
$354.43
|
| Rate for Payer: Meridian Medicaid |
$203.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$372.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$407.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$254.03
|
| Rate for Payer: PACE Medicare |
$336.71
|
| Rate for Payer: PACE SWMI |
$354.43
|
| Rate for Payer: PHP Commercial |
$389.87
|
| Rate for Payer: PHP Medicaid |
$193.87
|
| Rate for Payer: PHP Medicare Advantage |
$354.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$193.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$209.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$271.96
|
| Rate for Payer: Priority Health Medicare |
$354.43
|
| Rate for Payer: Priority Health Narrow Network |
$212.19
|
| Rate for Payer: Railroad Medicare Medicare |
$354.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$263.00
|
| Rate for Payer: UHC Medicare Advantage |
$365.06
|
| Rate for Payer: VA VA |
$354.43
|
|
|
HC SHAVE EPIDURAL SKIN LESION > 2.0 CM
|
Facility
|
IP
|
$298.86
|
|
|
Service Code
|
CPT 11313
|
| Hospital Charge Code |
76100074
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$209.20 |
| Max. Negotiated Rate |
$298.86 |
| Rate for Payer: Aetna Commercial |
$268.97
|
| Rate for Payer: ASR ASR |
$289.89
|
| Rate for Payer: BCBS Trust/PPO |
$231.71
|
| Rate for Payer: BCN Commercial |
$231.71
|
| Rate for Payer: Cash Price |
$239.09
|
| Rate for Payer: Cofinity Commercial |
$280.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$239.09
|
| Rate for Payer: Healthscope Commercial |
$298.86
|
| Rate for Payer: Healthscope Whirlpool |
$289.89
|
| Rate for Payer: Mclaren Commercial |
$268.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$254.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$209.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$263.00
|
|
|
HC SHAVE LESION FACE, EARS,EYELIDS, NOSE, LIPS, MUC MEMB 0.5 CM OR LESS
|
Facility
|
OP
|
$276.07
|
|
|
Service Code
|
CPT 11310
|
| Hospital Charge Code |
76100087
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$97.34 |
| Max. Negotiated Rate |
$276.07 |
| Rate for Payer: Aetna Commercial |
$248.46
|
| Rate for Payer: Aetna Medicare |
$177.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$222.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$222.44
|
| Rate for Payer: ASR ASR |
$267.79
|
| Rate for Payer: BCBS Complete |
$102.21
|
| Rate for Payer: BCBS MAPPO |
$177.95
|
| Rate for Payer: BCBS Trust/PPO |
$214.04
|
| Rate for Payer: BCN Commercial |
$214.04
|
| Rate for Payer: BCN Medicare Advantage |
$177.95
|
| Rate for Payer: Cash Price |
$220.86
|
| Rate for Payer: Cash Price |
$220.86
|
| Rate for Payer: Cofinity Commercial |
$259.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.95
|
| Rate for Payer: Healthscope Commercial |
$276.07
|
| Rate for Payer: Healthscope Whirlpool |
$267.79
|
| Rate for Payer: Humana Choice PPO Medicare |
$177.95
|
| Rate for Payer: Mclaren Commercial |
$248.46
|
| Rate for Payer: Mclaren Medicaid |
$97.34
|
| Rate for Payer: Mclaren Medicare |
$177.95
|
| Rate for Payer: Meridian Medicaid |
$102.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$186.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$204.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$234.66
|
| Rate for Payer: PACE Medicare |
$169.05
|
| Rate for Payer: PACE SWMI |
$177.95
|
| Rate for Payer: PHP Commercial |
$195.74
|
| Rate for Payer: PHP Medicaid |
$97.34
|
| Rate for Payer: PHP Medicare Advantage |
$177.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$97.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$193.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$251.22
|
| Rate for Payer: Priority Health Medicare |
$177.95
|
| Rate for Payer: Priority Health Narrow Network |
$196.01
|
| Rate for Payer: Railroad Medicare Medicare |
$177.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$242.94
|
| Rate for Payer: UHC Medicare Advantage |
$183.29
|
| Rate for Payer: VA VA |
$177.95
|
|
|
HC SHAVE LESION FACE, EARS,EYELIDS, NOSE, LIPS, MUC MEMB 0.5 CM OR LESS
|
Facility
|
IP
|
$276.07
|
|
|
Service Code
|
CPT 11310
|
| Hospital Charge Code |
76100087
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$193.25 |
| Max. Negotiated Rate |
$276.07 |
| Rate for Payer: Aetna Commercial |
$248.46
|
| Rate for Payer: ASR ASR |
$267.79
|
| Rate for Payer: BCBS Trust/PPO |
$214.04
|
| Rate for Payer: BCN Commercial |
$214.04
|
| Rate for Payer: Cash Price |
$220.86
|
| Rate for Payer: Cofinity Commercial |
$259.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.86
|
| Rate for Payer: Healthscope Commercial |
$276.07
|
| Rate for Payer: Healthscope Whirlpool |
$267.79
|
| Rate for Payer: Mclaren Commercial |
$248.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$234.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$193.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$242.94
|
|
|
HC SHAVE LESION FACE, EARS,EYELIDS, NOSE, LIPS, MUC MEMB 0.6 CM TO 1.0 CM
|
Facility
|
IP
|
$276.07
|
|
|
Service Code
|
CPT 11311
|
| Hospital Charge Code |
76100088
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$193.25 |
| Max. Negotiated Rate |
$276.07 |
| Rate for Payer: Aetna Commercial |
$248.46
|
| Rate for Payer: ASR ASR |
$267.79
|
| Rate for Payer: BCBS Trust/PPO |
$214.04
|
| Rate for Payer: BCN Commercial |
$214.04
|
| Rate for Payer: Cash Price |
$220.86
|
| Rate for Payer: Cofinity Commercial |
$259.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.86
|
| Rate for Payer: Healthscope Commercial |
$276.07
|
| Rate for Payer: Healthscope Whirlpool |
$267.79
|
| Rate for Payer: Mclaren Commercial |
$248.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$234.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$193.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$242.94
|
|
