|
HC NEUROBEHAVIORAL STATUS EXAM EA ADDL HR
|
Facility
|
IP
|
$137.96
|
|
|
Service Code
|
CPT 96121
|
| Hospital Charge Code |
91800006
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$103.47 |
| Max. Negotiated Rate |
$137.96 |
| Rate for Payer: Aetna Commercial |
$124.16
|
| Rate for Payer: ASR ASR |
$133.82
|
| Rate for Payer: BCBS Trust/PPO |
$113.29
|
| Rate for Payer: BCN Commercial |
$113.29
|
| Rate for Payer: Cash Price |
$110.37
|
| Rate for Payer: Cofinity Commercial |
$129.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$110.37
|
| Rate for Payer: Healthscope Commercial |
$133.82
|
| Rate for Payer: Healthscope Whirlpool |
$137.96
|
| Rate for Payer: Mclaren Commercial |
$124.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$117.27
|
| Rate for Payer: Nomi Health Commercial |
$113.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$103.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$121.40
|
|
|
HC NEUROBEHAVIORAL STATUS EXAM EA ADDL HR
|
Facility
|
OP
|
$137.96
|
|
|
Service Code
|
CPT 96121
|
| Hospital Charge Code |
91800006
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$51.05 |
| Max. Negotiated Rate |
$137.96 |
| Rate for Payer: Aetna Commercial |
$124.16
|
| Rate for Payer: Aetna Medicare |
$51.05
|
| Rate for Payer: ASR ASR |
$133.82
|
| Rate for Payer: BCBS Complete |
$55.18
|
| Rate for Payer: BCBS Trust/PPO |
$113.75
|
| Rate for Payer: BCN Commercial |
$113.75
|
| Rate for Payer: Cash Price |
$110.37
|
| Rate for Payer: Cofinity Commercial |
$129.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$110.37
|
| Rate for Payer: Healthscope Commercial |
$133.82
|
| Rate for Payer: Healthscope Whirlpool |
$137.96
|
| Rate for Payer: Mclaren Commercial |
$124.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$110.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$117.27
|
| Rate for Payer: Nomi Health Commercial |
$113.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$103.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$120.88
|
| Rate for Payer: Priority Health Narrow Network |
$96.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$121.40
|
|
|
HC NEUROBEHAVIORAL STATUS EXAM FIRST HOUR
|
Facility
|
OP
|
$280.60
|
|
|
Service Code
|
CPT 96116
|
| Hospital Charge Code |
91800001
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$112.52 |
| Max. Negotiated Rate |
$333.48 |
| Rate for Payer: Aetna Commercial |
$252.54
|
| Rate for Payer: Aetna Medicare |
$215.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$268.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$268.94
|
| Rate for Payer: ASR ASR |
$272.18
|
| Rate for Payer: BCBS Complete |
$118.16
|
| Rate for Payer: BCBS MAPPO |
$215.15
|
| Rate for Payer: BCBS Trust/PPO |
$231.35
|
| Rate for Payer: BCN Commercial |
$231.35
|
| Rate for Payer: BCN Medicare Advantage |
$215.15
|
| Rate for Payer: Cash Price |
$224.48
|
| Rate for Payer: Cash Price |
$224.48
|
| Rate for Payer: Cofinity Commercial |
$263.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$224.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$215.15
|
| Rate for Payer: Healthscope Commercial |
$272.18
|
| Rate for Payer: Healthscope Whirlpool |
$280.60
|
| Rate for Payer: Humana Choice PPO Medicare |
$215.15
|
| Rate for Payer: Mclaren Commercial |
$252.54
|
| Rate for Payer: Mclaren Medicaid |
$215.15
|
| Rate for Payer: Mclaren Medicare |
$215.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$225.91
|
| Rate for Payer: Meridian Medicaid |
$118.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$247.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$236.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$238.51
|
| Rate for Payer: Nomi Health Commercial |
$230.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$210.45
|
| Rate for Payer: PACE Medicare |
$204.39
|
| Rate for Payer: PACE SWMI |
$215.15
|
| Rate for Payer: PHP Commercial |
$236.66
|
| Rate for Payer: PHP Medicaid |
$115.32
|
| Rate for Payer: PHP Medicare Advantage |
$215.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$245.86
|
| Rate for Payer: Priority Health Medicare |
$215.15
|
| Rate for Payer: Priority Health Narrow Network |
$196.70
|
| Rate for Payer: Railroad Medicare Medicare |
$215.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$246.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$215.15
|
| Rate for Payer: UHC Exchange |
$333.48
|
| Rate for Payer: UHC Medicaid |
$112.52
|
| Rate for Payer: UHCCP DNSP |
$215.15
|
| Rate for Payer: UHCCP Medicaid |
$112.52
|
| Rate for Payer: VA VA |
$215.15
|
|
|
HC NEUROBEHAVIORAL STATUS EXAM FIRST HOUR
|
Facility
|
IP
|
$280.60
|
|
|
Service Code
|
CPT 96116
|
| Hospital Charge Code |
91800001
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$210.45 |
| Max. Negotiated Rate |
$280.60 |
| Rate for Payer: Aetna Commercial |
$252.54
|
| Rate for Payer: ASR ASR |
$272.18
|
| Rate for Payer: BCBS Trust/PPO |
$230.43
|
| Rate for Payer: BCN Commercial |
$230.43
|
| Rate for Payer: Cash Price |
$224.48
|
| Rate for Payer: Cofinity Commercial |
$263.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$224.48
|
| Rate for Payer: Healthscope Commercial |
$272.18
|
| Rate for Payer: Healthscope Whirlpool |
$280.60
|
| Rate for Payer: Mclaren Commercial |
$252.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$238.51
|
| Rate for Payer: Nomi Health Commercial |
$230.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$210.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$246.93
|
|
|
HC NEUROFORM ATLAS STENT
|
Facility
|
IP
|
$12,117.67
|
|
| Hospital Charge Code |
27800118
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,088.25 |
| Max. Negotiated Rate |
$12,117.67 |
| Rate for Payer: Aetna Commercial |
$10,905.90
|
| Rate for Payer: ASR ASR |
$11,754.14
|
| Rate for Payer: BCBS Trust/PPO |
$9,951.03
|
| Rate for Payer: BCN Commercial |
$9,951.03
|
| Rate for Payer: Cash Price |
$9,694.14
|
| Rate for Payer: Cofinity Commercial |
$11,390.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,694.14
|
| Rate for Payer: Healthscope Commercial |
$11,754.14
|
| Rate for Payer: Healthscope Whirlpool |
$12,117.67
|
| Rate for Payer: Mclaren Commercial |
$10,905.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,300.02
|
| Rate for Payer: Nomi Health Commercial |
$9,936.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,088.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,663.55
|
|
|
HC NEUROFORM ATLAS STENT
|
Facility
|
OP
|
$12,117.67
|
|
| Hospital Charge Code |
27800118
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,483.54 |
| Max. Negotiated Rate |
$12,117.67 |
| Rate for Payer: Aetna Commercial |
$10,905.90
|
| Rate for Payer: Aetna Medicare |
$4,483.54
|
| Rate for Payer: ASR ASR |
$11,754.14
|
| Rate for Payer: BCBS Complete |
$4,847.07
|
| Rate for Payer: BCBS Trust/PPO |
$9,991.02
|
| Rate for Payer: BCN Commercial |
$9,991.02
|
| Rate for Payer: Cash Price |
$9,694.14
|
| Rate for Payer: Cofinity Commercial |
$11,390.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,694.14
|
| Rate for Payer: Healthscope Commercial |
$11,754.14
|
| Rate for Payer: Healthscope Whirlpool |
$12,117.67
|
| Rate for Payer: Mclaren Commercial |
$10,905.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,694.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,300.02
|
| Rate for Payer: Nomi Health Commercial |
$9,936.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,088.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$10,617.50
|
| Rate for Payer: Priority Health Narrow Network |
$8,494.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,663.55
|
|
|
HC NEUROLYSIS CELIAC PLEXUS
|
Facility
|
IP
|
$1,968.54
|
|
|
Service Code
|
CPT 64680
|
| Hospital Charge Code |
36100479
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,476.40 |
| Max. Negotiated Rate |
$1,968.54 |
| Rate for Payer: Aetna Commercial |
$1,771.69
|
| Rate for Payer: ASR ASR |
$1,909.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,616.57
|
| Rate for Payer: BCN Commercial |
$1,616.57
|
| Rate for Payer: Cash Price |
$1,574.83
|
| Rate for Payer: Cofinity Commercial |
$1,850.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,574.83
|
| Rate for Payer: Healthscope Commercial |
$1,909.48
|
| Rate for Payer: Healthscope Whirlpool |
$1,968.54
|
| Rate for Payer: Mclaren Commercial |
$1,771.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,673.26
|
| Rate for Payer: Nomi Health Commercial |
$1,614.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,476.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,732.32
|
|
|
HC NEUROLYSIS CELIAC PLEXUS
|
Facility
|
OP
|
$1,968.54
|
|
|
Service Code
|
CPT 64680
|
| Hospital Charge Code |
36100479
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$460.91 |
| Max. Negotiated Rate |
$1,968.54 |
| Rate for Payer: Aetna Commercial |
$1,771.69
|
| Rate for Payer: Aetna Medicare |
$881.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,101.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,101.61
|
| Rate for Payer: ASR ASR |
$1,909.48
|
| Rate for Payer: BCBS Complete |
$484.00
|
| Rate for Payer: BCBS MAPPO |
$881.29
|
| Rate for Payer: BCBS Trust/PPO |
$1,623.06
|
| Rate for Payer: BCN Commercial |
$1,623.06
|
| Rate for Payer: BCN Medicare Advantage |
$881.29
|
| Rate for Payer: Cash Price |
$1,574.83
|
| Rate for Payer: Cash Price |
$1,574.83
|
| Rate for Payer: Cofinity Commercial |
$1,850.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,574.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$881.29
|
| Rate for Payer: Healthscope Commercial |
$1,909.48
|
| Rate for Payer: Healthscope Whirlpool |
$1,968.54
|
| Rate for Payer: Humana Choice PPO Medicare |
$881.29
|
| Rate for Payer: Mclaren Commercial |
$1,771.69
|
| Rate for Payer: Mclaren Medicaid |
$881.29
|
| Rate for Payer: Mclaren Medicare |
$881.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$925.35
|
| Rate for Payer: Meridian Medicaid |
$484.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,013.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$969.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,673.26
|
| Rate for Payer: Nomi Health Commercial |
$1,614.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,476.40
|
| Rate for Payer: PACE Medicare |
$837.23
|
| Rate for Payer: PACE SWMI |
$881.29
|
| Rate for Payer: PHP Commercial |
$969.42
|
| Rate for Payer: PHP Medicaid |
$472.37
|
| Rate for Payer: PHP Medicare Advantage |
$881.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$460.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,724.83
|
| Rate for Payer: Priority Health Medicare |
$881.29
|
| Rate for Payer: Priority Health Narrow Network |
$1,379.95
|
| Rate for Payer: Railroad Medicare Medicare |
$881.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,732.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$881.29
|
| Rate for Payer: UHC Exchange |
$1,366.00
|
| Rate for Payer: UHC Medicaid |
$460.91
|
| Rate for Payer: UHCCP DNSP |
$881.29
|
| Rate for Payer: UHCCP Medicaid |
$460.91
|
| Rate for Payer: VA VA |
$881.29
|
|
|
HC NEURONAL (V-G)K+ CHANNEL AB
|
Facility
|
OP
|
$70.04
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
30100607
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.62 |
| Max. Negotiated Rate |
$232.43 |
| Rate for Payer: Aetna Commercial |
$63.04
|
| Rate for Payer: Aetna Medicare |
$18.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.00
|
| Rate for Payer: ASR ASR |
$67.94
|
| Rate for Payer: BCBS Complete |
$10.11
|
| Rate for Payer: BCBS MAPPO |
$18.40
|
| Rate for Payer: BCBS Trust/PPO |
$57.75
|
| Rate for Payer: BCN Commercial |
$57.75
|
| Rate for Payer: BCN Medicare Advantage |
$18.40
|
| Rate for Payer: Cash Price |
$56.03
|
| Rate for Payer: Cash Price |
$56.03
|
| Rate for Payer: Cofinity Commercial |
$65.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.40
|
| Rate for Payer: Healthscope Commercial |
$67.94
|
| Rate for Payer: Healthscope Whirlpool |
$70.04
|
| Rate for Payer: Humana Choice PPO Medicare |
$18.40
|
| Rate for Payer: Mclaren Commercial |
$63.04
|
| Rate for Payer: Mclaren Medicaid |
$18.40
|
| Rate for Payer: Mclaren Medicare |
$18.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.32
|
| Rate for Payer: Meridian Medicaid |
$10.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.53
|
| Rate for Payer: Nomi Health Commercial |
$57.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.53
|
| Rate for Payer: PACE Medicare |
$17.48
|
| Rate for Payer: PACE SWMI |
$18.40
|
| Rate for Payer: PHP Commercial |
$20.24
|
| Rate for Payer: PHP Medicaid |
$9.86
|
| Rate for Payer: PHP Medicare Advantage |
$18.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$232.43
|
| Rate for Payer: Priority Health Medicare |
$18.40
|
| Rate for Payer: Priority Health Narrow Network |
$185.94
|
| Rate for Payer: Railroad Medicare Medicare |
$18.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$61.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18.40
|
| Rate for Payer: UHC Exchange |
$28.52
|
| Rate for Payer: UHC Medicaid |
$9.62
|
| Rate for Payer: UHCCP DNSP |
$18.40
|
| Rate for Payer: UHCCP Medicaid |
$9.62
|
| Rate for Payer: VA VA |
$18.40
|
|
|
HC NEURONAL (V-G)K+ CHANNEL AB
|
Facility
|
IP
|
$70.04
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
30100607
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$52.53 |
| Max. Negotiated Rate |
$70.04 |
| Rate for Payer: Aetna Commercial |
$63.04
|
| Rate for Payer: ASR ASR |
$67.94
|
| Rate for Payer: BCBS Trust/PPO |
$57.52
|
| Rate for Payer: BCN Commercial |
$57.52
|
| Rate for Payer: Cash Price |
$56.03
|
| Rate for Payer: Cofinity Commercial |
$65.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.03
|
| Rate for Payer: Healthscope Commercial |
$67.94
|
| Rate for Payer: Healthscope Whirlpool |
$70.04
|
| Rate for Payer: Mclaren Commercial |
$63.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.53
|
| Rate for Payer: Nomi Health Commercial |
$57.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$61.64
|
|
|
HC NEURON SPECIFIC ENOLASE
|
Facility
|
OP
|
$72.17
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100260
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.03 |
| Max. Negotiated Rate |
$345.01 |
| Rate for Payer: Aetna Commercial |
$64.95
|
| 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 |
$70.00
|
| Rate for Payer: BCBS Complete |
$9.48
|
| Rate for Payer: BCBS MAPPO |
$17.27
|
| Rate for Payer: BCBS Trust/PPO |
$59.50
|
| Rate for Payer: BCN Commercial |
$59.50
|
| Rate for Payer: BCN Medicare Advantage |
$17.27
|
| Rate for Payer: Cash Price |
$57.74
|
| Rate for Payer: Cash Price |
$57.74
|
| Rate for Payer: Cofinity Commercial |
$67.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.27
|
| Rate for Payer: Healthscope Commercial |
$70.00
|
| Rate for Payer: Healthscope Whirlpool |
$72.17
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.27
|
| Rate for Payer: Mclaren Commercial |
$64.95
|
| Rate for Payer: Mclaren Medicaid |
$17.27
|
| Rate for Payer: Mclaren Medicare |
$17.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.13
|
| Rate for Payer: Meridian Medicaid |
$9.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.34
|
| Rate for Payer: Nomi Health Commercial |
$59.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.13
|
| 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 |
$9.26
|
| Rate for Payer: PHP Medicare Advantage |
$17.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$345.01
|
| Rate for Payer: Priority Health Medicare |
$17.27
|
| Rate for Payer: Priority Health Narrow Network |
$276.01
|
| Rate for Payer: Railroad Medicare Medicare |
$17.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$63.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17.27
|
| Rate for Payer: UHC Exchange |
$26.77
|
| Rate for Payer: UHC Medicaid |
$9.03
|
| Rate for Payer: UHCCP DNSP |
$17.27
|
| Rate for Payer: UHCCP Medicaid |
$9.03
|
| Rate for Payer: VA VA |
$17.27
|
|
|
HC NEURON SPECIFIC ENOLASE
|
Facility
|
IP
|
$72.17
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100260
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$54.13 |
| Max. Negotiated Rate |
$72.17 |
| Rate for Payer: Aetna Commercial |
$64.95
|
| Rate for Payer: ASR ASR |
$70.00
|
| Rate for Payer: BCBS Trust/PPO |
$59.27
|
| Rate for Payer: BCN Commercial |
$59.27
|
| Rate for Payer: Cash Price |
$57.74
|
| Rate for Payer: Cofinity Commercial |
$67.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.74
|
| Rate for Payer: Healthscope Commercial |
$70.00
|
| Rate for Payer: Healthscope Whirlpool |
$72.17
|
| Rate for Payer: Mclaren Commercial |
$64.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.34
|
| Rate for Payer: Nomi Health Commercial |
$59.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$63.51
|
|
|
HC NEUROPSYCH TEST EVAL BY PHYS FIRST HR
|
Facility
|
OP
|
$71.10
|
|
|
Service Code
|
CPT 96132
|
| Hospital Charge Code |
91800007
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$53.33 |
| Max. Negotiated Rate |
$576.32 |
| Rate for Payer: Aetna Commercial |
$63.99
|
| Rate for Payer: Aetna Medicare |
$371.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$464.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$464.77
|
| Rate for Payer: ASR ASR |
$68.97
|
| Rate for Payer: BCBS Complete |
$204.20
|
| Rate for Payer: BCBS MAPPO |
$371.82
|
| Rate for Payer: BCBS Trust/PPO |
$58.62
|
| Rate for Payer: BCN Commercial |
$58.62
|
| Rate for Payer: BCN Medicare Advantage |
$371.82
|
| Rate for Payer: Cash Price |
$56.88
|
| Rate for Payer: Cash Price |
$56.88
|
| Rate for Payer: Cofinity Commercial |
$66.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$371.82
|
| Rate for Payer: Healthscope Commercial |
$68.97
|
| Rate for Payer: Healthscope Whirlpool |
$71.10
|
| Rate for Payer: Humana Choice PPO Medicare |
$371.82
|
| Rate for Payer: Mclaren Commercial |
$63.99
|
| Rate for Payer: Mclaren Medicaid |
$371.82
|
| Rate for Payer: Mclaren Medicare |
$371.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$390.41
|
| Rate for Payer: Meridian Medicaid |
$204.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$427.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$409.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.44
|
| Rate for Payer: Nomi Health Commercial |
$58.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.33
|
| Rate for Payer: PACE Medicare |
$353.23
|
| Rate for Payer: PACE SWMI |
$371.82
|
| Rate for Payer: PHP Commercial |
$409.00
|
| Rate for Payer: PHP Medicaid |
$199.30
|
| Rate for Payer: PHP Medicare Advantage |
$371.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$194.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$171.60
|
| Rate for Payer: Priority Health Medicare |
$371.82
|
| Rate for Payer: Priority Health Narrow Network |
$137.28
|
| Rate for Payer: Railroad Medicare Medicare |
$371.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$62.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$371.82
|
| Rate for Payer: UHC Exchange |
$576.32
|
| Rate for Payer: UHC Medicaid |
$194.46
|
| Rate for Payer: UHCCP DNSP |
$371.82
|
| Rate for Payer: UHCCP Medicaid |
$194.46
|
| Rate for Payer: VA VA |
$371.82
|
|
|
HC NEUROPSYCH TEST EVAL BY PHYS FIRST HR
|
Facility
|
IP
|
$71.10
|
|
|
Service Code
|
CPT 96132
|
| Hospital Charge Code |
91800007
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$53.33 |
| Max. Negotiated Rate |
$71.10 |
| Rate for Payer: Aetna Commercial |
$63.99
|
| Rate for Payer: ASR ASR |
$68.97
|
| Rate for Payer: BCBS Trust/PPO |
$58.39
|
| Rate for Payer: BCN Commercial |
$58.39
|
| Rate for Payer: Cash Price |
$56.88
|
| Rate for Payer: Cofinity Commercial |
$66.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.88
|
| Rate for Payer: Healthscope Commercial |
$68.97
|
| Rate for Payer: Healthscope Whirlpool |
$71.10
|
| Rate for Payer: Mclaren Commercial |
$63.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.44
|
| Rate for Payer: Nomi Health Commercial |
$58.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$62.57
|
|
|
HC NEUROPSYCH TEST EVAL EA ADDL HR
|
Facility
|
OP
|
$37.14
|
|
|
Service Code
|
CPT 96133
|
| Hospital Charge Code |
91800008
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$13.74 |
| Max. Negotiated Rate |
$37.14 |
| Rate for Payer: Aetna Commercial |
$33.43
|
| Rate for Payer: Aetna Medicare |
$13.74
|
| Rate for Payer: ASR ASR |
$36.03
|
| Rate for Payer: BCBS Complete |
$14.86
|
| Rate for Payer: BCBS Trust/PPO |
$30.62
|
| Rate for Payer: BCN Commercial |
$30.62
|
| Rate for Payer: Cash Price |
$29.71
|
| Rate for Payer: Cofinity Commercial |
$34.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.71
|
| Rate for Payer: Healthscope Commercial |
$36.03
|
| Rate for Payer: Healthscope Whirlpool |
$37.14
|
| Rate for Payer: Mclaren Commercial |
$33.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.57
|
| Rate for Payer: Nomi Health Commercial |
$30.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$32.54
|
| Rate for Payer: Priority Health Narrow Network |
$26.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$32.68
|
|
|
HC NEUROPSYCH TEST EVAL EA ADDL HR
|
Facility
|
IP
|
$37.14
|
|
|
Service Code
|
CPT 96133
|
| Hospital Charge Code |
91800008
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$27.86 |
| Max. Negotiated Rate |
$37.14 |
| Rate for Payer: Aetna Commercial |
$33.43
|
| Rate for Payer: ASR ASR |
$36.03
|
| Rate for Payer: BCBS Trust/PPO |
$30.50
|
| Rate for Payer: BCN Commercial |
$30.50
|
| Rate for Payer: Cash Price |
$29.71
|
| Rate for Payer: Cofinity Commercial |
$34.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.71
|
| Rate for Payer: Healthscope Commercial |
$36.03
|
| Rate for Payer: Healthscope Whirlpool |
$37.14
|
| Rate for Payer: Mclaren Commercial |
$33.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.57
|
| Rate for Payer: Nomi Health Commercial |
$30.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$32.68
|
|
|
HC NEUROSTIMULATOR TEST KIT LVL 15
|
Facility
|
OP
|
$1,530.00
|
|
|
Service Code
|
HCPCS C1897
|
| Hospital Charge Code |
27800137
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$566.10 |
| Max. Negotiated Rate |
$1,530.00 |
| Rate for Payer: Aetna Commercial |
$1,377.00
|
| Rate for Payer: Aetna Medicare |
$566.10
|
| Rate for Payer: ASR ASR |
$1,484.10
|
| Rate for Payer: BCBS Complete |
$612.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,261.48
|
| Rate for Payer: BCN Commercial |
$1,261.48
|
| Rate for Payer: Cash Price |
$1,224.00
|
| Rate for Payer: Cofinity Commercial |
$1,438.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,224.00
|
| Rate for Payer: Healthscope Commercial |
$1,484.10
|
| Rate for Payer: Healthscope Whirlpool |
$1,530.00
|
| Rate for Payer: Mclaren Commercial |
$1,377.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,224.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,300.50
|
| Rate for Payer: Nomi Health Commercial |
$1,254.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,147.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,340.59
|
| Rate for Payer: Priority Health Narrow Network |
$1,072.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,346.40
|
|
|
HC NEUROSTIMULATOR TEST KIT LVL 15
|
Facility
|
IP
|
$1,530.00
|
|
|
Service Code
|
HCPCS C1897
|
| Hospital Charge Code |
27800137
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,147.50 |
| Max. Negotiated Rate |
$1,530.00 |
| Rate for Payer: Aetna Commercial |
$1,377.00
|
| Rate for Payer: ASR ASR |
$1,484.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,256.44
|
| Rate for Payer: BCN Commercial |
$1,256.44
|
| Rate for Payer: Cash Price |
$1,224.00
|
| Rate for Payer: Cofinity Commercial |
$1,438.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,224.00
|
| Rate for Payer: Healthscope Commercial |
$1,484.10
|
| Rate for Payer: Healthscope Whirlpool |
$1,530.00
|
| Rate for Payer: Mclaren Commercial |
$1,377.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,300.50
|
| Rate for Payer: Nomi Health Commercial |
$1,254.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,147.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,346.40
|
|
|
HC NEUROSTIMULATOR TEST KIT LVL 25
|
Facility
|
IP
|
$2,550.00
|
|
|
Service Code
|
CPT C1897
|
| Hospital Charge Code |
27800138
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,912.50 |
| Max. Negotiated Rate |
$2,550.00 |
| Rate for Payer: Aetna Commercial |
$2,295.00
|
| Rate for Payer: ASR ASR |
$2,473.50
|
| Rate for Payer: BCBS Trust/PPO |
$2,094.06
|
| Rate for Payer: BCN Commercial |
$2,094.06
|
| Rate for Payer: Cash Price |
$2,040.00
|
| Rate for Payer: Cofinity Commercial |
$2,397.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,040.00
|
| Rate for Payer: Healthscope Commercial |
$2,473.50
|
| Rate for Payer: Healthscope Whirlpool |
$2,550.00
|
| Rate for Payer: Mclaren Commercial |
$2,295.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,167.50
|
| Rate for Payer: Nomi Health Commercial |
$2,091.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,912.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,244.00
|
|
|
HC NEUROSTIMULATOR TEST KIT LVL 25
|
Facility
|
OP
|
$2,550.00
|
|
|
Service Code
|
CPT C1897
|
| Hospital Charge Code |
27800138
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$943.50 |
| Max. Negotiated Rate |
$2,550.00 |
| Rate for Payer: Aetna Commercial |
$2,295.00
|
| Rate for Payer: Aetna Medicare |
$943.50
|
| Rate for Payer: ASR ASR |
$2,473.50
|
| Rate for Payer: BCBS Complete |
$1,020.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,102.47
|
| Rate for Payer: BCN Commercial |
$2,102.47
|
| Rate for Payer: Cash Price |
$2,040.00
|
| Rate for Payer: Cofinity Commercial |
$2,397.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,040.00
|
| Rate for Payer: Healthscope Commercial |
$2,473.50
|
| Rate for Payer: Healthscope Whirlpool |
$2,550.00
|
| Rate for Payer: Mclaren Commercial |
$2,295.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,040.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,167.50
|
| Rate for Payer: Nomi Health Commercial |
$2,091.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,912.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,234.31
|
| Rate for Payer: Priority Health Narrow Network |
$1,787.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,244.00
|
|
|
HC NEUROSYPHILIS SCR, IGG, CSF
|
Facility
|
IP
|
$35.70
|
|
|
Service Code
|
CPT 86780
|
| Hospital Charge Code |
30200517
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$26.77 |
| Max. Negotiated Rate |
$35.70 |
| Rate for Payer: Aetna Commercial |
$32.13
|
| Rate for Payer: ASR ASR |
$34.63
|
| Rate for Payer: BCBS Trust/PPO |
$29.32
|
| Rate for Payer: BCN Commercial |
$29.32
|
| Rate for Payer: Cash Price |
$28.56
|
| Rate for Payer: Cofinity Commercial |
$33.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.56
|
| Rate for Payer: Healthscope Commercial |
$34.63
|
| Rate for Payer: Healthscope Whirlpool |
$35.70
|
| Rate for Payer: Mclaren Commercial |
$32.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.34
|
| Rate for Payer: Nomi Health Commercial |
$29.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$31.42
|
|
|
HC NEUROSYPHILIS SCR, IGG, CSF
|
Facility
|
OP
|
$35.70
|
|
|
Service Code
|
CPT 86780
|
| Hospital Charge Code |
30200517
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.92 |
| Max. Negotiated Rate |
$62.96 |
| Rate for Payer: Aetna Commercial |
$32.13
|
| Rate for Payer: Aetna Medicare |
$13.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.55
|
| Rate for Payer: ASR ASR |
$34.63
|
| Rate for Payer: BCBS Complete |
$7.27
|
| Rate for Payer: BCBS MAPPO |
$13.24
|
| Rate for Payer: BCBS Trust/PPO |
$29.43
|
| Rate for Payer: BCN Commercial |
$29.43
|
| Rate for Payer: BCN Medicare Advantage |
$13.24
|
| Rate for Payer: Cash Price |
$28.56
|
| Rate for Payer: Cash Price |
$28.56
|
| Rate for Payer: Cofinity Commercial |
$33.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.24
|
| Rate for Payer: Healthscope Commercial |
$34.63
|
| Rate for Payer: Healthscope Whirlpool |
$35.70
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.24
|
| Rate for Payer: Mclaren Commercial |
$32.13
|
| Rate for Payer: Mclaren Medicaid |
$13.24
|
| Rate for Payer: Mclaren Medicare |
$13.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.90
|
| Rate for Payer: Meridian Medicaid |
$7.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.34
|
| Rate for Payer: Nomi Health Commercial |
$29.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.77
|
| Rate for Payer: PACE Medicare |
$12.58
|
| Rate for Payer: PACE SWMI |
$13.24
|
| Rate for Payer: PHP Commercial |
$14.56
|
| Rate for Payer: PHP Medicaid |
$7.10
|
| Rate for Payer: PHP Medicare Advantage |
$13.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$62.96
|
| Rate for Payer: Priority Health Medicare |
$13.24
|
| Rate for Payer: Priority Health Narrow Network |
$50.37
|
| Rate for Payer: Railroad Medicare Medicare |
$13.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$31.42
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.24
|
| Rate for Payer: UHC Exchange |
$20.52
|
| Rate for Payer: UHC Medicaid |
$6.92
|
| Rate for Payer: UHCCP DNSP |
$13.24
|
| Rate for Payer: UHCCP Medicaid |
$6.92
|
| Rate for Payer: VA VA |
$13.24
|
|
|
HC NEUTROPHIL OXIDATIVE BURST
|
Facility
|
IP
|
$161.53
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31000003
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$121.15 |
| Max. Negotiated Rate |
$161.53 |
| Rate for Payer: Aetna Commercial |
$145.38
|
| Rate for Payer: ASR ASR |
$156.68
|
| Rate for Payer: BCBS Trust/PPO |
$132.65
|
| Rate for Payer: BCN Commercial |
$132.65
|
| Rate for Payer: Cash Price |
$129.22
|
| Rate for Payer: Cofinity Commercial |
$151.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.22
|
| Rate for Payer: Healthscope Commercial |
$156.68
|
| Rate for Payer: Healthscope Whirlpool |
$161.53
|
| Rate for Payer: Mclaren Commercial |
$145.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.30
|
| Rate for Payer: Nomi Health Commercial |
$132.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$121.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$142.15
|
|
|
HC NEUTROPHIL OXIDATIVE BURST
|
Facility
|
OP
|
$161.53
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31000003
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$52.31 |
| Max. Negotiated Rate |
$553.60 |
| Rate for Payer: Aetna Commercial |
$145.38
|
| Rate for Payer: Aetna Medicare |
$357.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$446.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$446.45
|
| Rate for Payer: ASR ASR |
$156.68
|
| Rate for Payer: BCBS Complete |
$196.15
|
| Rate for Payer: BCBS MAPPO |
$357.16
|
| Rate for Payer: BCBS Trust/PPO |
$133.18
|
| Rate for Payer: BCN Commercial |
$133.18
|
| Rate for Payer: BCN Medicare Advantage |
$357.16
|
| Rate for Payer: Cash Price |
$129.22
|
| Rate for Payer: Cash Price |
$129.22
|
| Rate for Payer: Cofinity Commercial |
$151.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$357.16
|
| Rate for Payer: Healthscope Commercial |
$156.68
|
| Rate for Payer: Healthscope Whirlpool |
$161.53
|
| Rate for Payer: Humana Choice PPO Medicare |
$357.16
|
| Rate for Payer: Mclaren Commercial |
$145.38
|
| Rate for Payer: Mclaren Medicaid |
$357.16
|
| Rate for Payer: Mclaren Medicare |
$357.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$375.02
|
| Rate for Payer: Meridian Medicaid |
$196.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$410.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$392.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.30
|
| Rate for Payer: Nomi Health Commercial |
$132.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$121.15
|
| Rate for Payer: PACE Medicare |
$339.30
|
| Rate for Payer: PACE SWMI |
$357.16
|
| Rate for Payer: PHP Commercial |
$392.88
|
| Rate for Payer: PHP Medicaid |
$191.44
|
| Rate for Payer: PHP Medicare Advantage |
$357.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$65.38
|
| Rate for Payer: Priority Health Medicare |
$357.16
|
| Rate for Payer: Priority Health Narrow Network |
$52.31
|
| Rate for Payer: Railroad Medicare Medicare |
$357.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$142.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$357.16
|
| Rate for Payer: UHC Exchange |
$553.60
|
| Rate for Payer: UHC Medicaid |
$186.79
|
| Rate for Payer: UHCCP DNSP |
$357.16
|
| Rate for Payer: UHCCP Medicaid |
$186.79
|
| Rate for Payer: VA VA |
$357.16
|
|
|
HC NEUTROPHIL OXIDATIVE BURST CMP
|
Facility
|
IP
|
$57.30
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31000012
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$42.98 |
| Max. Negotiated Rate |
$57.30 |
| Rate for Payer: Aetna Commercial |
$51.57
|
| Rate for Payer: ASR ASR |
$55.58
|
| Rate for Payer: BCBS Trust/PPO |
$47.05
|
| Rate for Payer: BCN Commercial |
$47.05
|
| Rate for Payer: Cash Price |
$45.84
|
| Rate for Payer: Cofinity Commercial |
$53.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.84
|
| Rate for Payer: Healthscope Commercial |
$55.58
|
| Rate for Payer: Healthscope Whirlpool |
$57.30
|
| Rate for Payer: Mclaren Commercial |
$51.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.70
|
| Rate for Payer: Nomi Health Commercial |
$46.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$50.42
|
|
