|
HC MYOBLOC PER 100U (RIMABOTULINUMTOXINB)
|
Facility
|
IP
|
$34.70
|
|
|
Service Code
|
HCPCS J0587
|
| Hospital Charge Code |
63600172
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$22.55 |
| Max. Negotiated Rate |
$34.70 |
| Rate for Payer: Aetna Commercial |
$31.23
|
| Rate for Payer: ASR ASR |
$33.66
|
| Rate for Payer: ASR Commercial |
$33.66
|
| Rate for Payer: BCBS Trust/PPO |
$28.28
|
| Rate for Payer: BCN Commercial |
$26.90
|
| Rate for Payer: Cash Price |
$27.76
|
| Rate for Payer: Cofinity Commercial |
$32.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.76
|
| Rate for Payer: Healthscope Commercial |
$34.70
|
| Rate for Payer: Healthscope Whirlpool |
$33.66
|
| Rate for Payer: Mclaren Commercial |
$31.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.50
|
| Rate for Payer: Nomi Health Commercial |
$28.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$30.54
|
|
|
HC MYOGLOBIN SERUM
|
Facility
|
OP
|
$145.96
|
|
|
Service Code
|
CPT 83874
|
| Hospital Charge Code |
30100303
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.93 |
| Max. Negotiated Rate |
$145.96 |
| Rate for Payer: Aetna Commercial |
$131.36
|
| Rate for Payer: Aetna Medicare |
$12.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.15
|
| Rate for Payer: ASR ASR |
$141.58
|
| Rate for Payer: ASR Commercial |
$141.58
|
| Rate for Payer: BCBS Complete |
$7.27
|
| Rate for Payer: BCBS MAPPO |
$12.92
|
| Rate for Payer: BCBS Trust/PPO |
$119.53
|
| Rate for Payer: BCN Commercial |
$113.16
|
| Rate for Payer: BCN Medicare Advantage |
$12.92
|
| Rate for Payer: Cash Price |
$116.77
|
| Rate for Payer: Cash Price |
$116.77
|
| Rate for Payer: Cofinity Commercial |
$137.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.92
|
| Rate for Payer: Healthscope Commercial |
$145.96
|
| Rate for Payer: Healthscope Whirlpool |
$141.58
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.92
|
| Rate for Payer: Mclaren Commercial |
$131.36
|
| Rate for Payer: Mclaren Medicaid |
$6.93
|
| Rate for Payer: Mclaren Medicare |
$12.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.57
|
| Rate for Payer: Meridian Medicaid |
$7.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$124.07
|
| Rate for Payer: Nomi Health Commercial |
$119.69
|
| Rate for Payer: PACE Medicare |
$12.27
|
| Rate for Payer: PACE SWMI |
$12.92
|
| Rate for Payer: PHP Commercial |
$14.21
|
| Rate for Payer: PHP Medicaid |
$6.93
|
| Rate for Payer: PHP Medicare Advantage |
$12.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$127.89
|
| Rate for Payer: Priority Health Medicare |
$12.92
|
| Rate for Payer: Priority Health Narrow Network |
$102.32
|
| Rate for Payer: Railroad Medicare Medicare |
$12.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$128.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.92
|
| Rate for Payer: UHC Exchange |
$20.03
|
| Rate for Payer: UHC Medicare Advantage |
$12.92
|
| Rate for Payer: UHCCP DNSP |
$12.92
|
| Rate for Payer: UHCCP Medicaid |
$6.93
|
| Rate for Payer: VA VA |
$12.92
|
|
|
HC MYOGLOBIN SERUM
|
Facility
|
IP
|
$145.96
|
|
|
Service Code
|
CPT 83874
|
| Hospital Charge Code |
30100303
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$94.87 |
| Max. Negotiated Rate |
$145.96 |
| Rate for Payer: Aetna Commercial |
$131.36
|
| Rate for Payer: ASR ASR |
$141.58
|
| Rate for Payer: ASR Commercial |
$141.58
|
| Rate for Payer: BCBS Trust/PPO |
$118.94
|
| Rate for Payer: BCN Commercial |
$113.16
|
| Rate for Payer: Cash Price |
$116.77
|
| Rate for Payer: Cofinity Commercial |
$137.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.77
|
| Rate for Payer: Healthscope Commercial |
$145.96
|
| Rate for Payer: Healthscope Whirlpool |
$141.58
|
| Rate for Payer: Mclaren Commercial |
$131.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$124.07
|
| Rate for Payer: Nomi Health Commercial |
$119.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$128.44
|
|
|
HC MYOGLOBIN SERUM.
|
Facility
|
OP
|
$54.10
|
|
|
Service Code
|
CPT 83874
|
| Hospital Charge Code |
30100664
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.93 |
| Max. Negotiated Rate |
$54.10 |
| Rate for Payer: Aetna Commercial |
$48.69
|
| Rate for Payer: Aetna Medicare |
$12.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.15
|
| Rate for Payer: ASR ASR |
$52.48
|
| Rate for Payer: ASR Commercial |
$52.48
|
| Rate for Payer: BCBS Complete |
$7.27
|
| Rate for Payer: BCBS MAPPO |
$12.92
|
| Rate for Payer: BCBS Trust/PPO |
$44.30
|
| Rate for Payer: BCN Commercial |
$41.94
|
| Rate for Payer: BCN Medicare Advantage |
$12.92
|
| Rate for Payer: Cash Price |
$43.28
|
| Rate for Payer: Cash Price |
$43.28
|
| Rate for Payer: Cofinity Commercial |
$50.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.92
|
| Rate for Payer: Healthscope Commercial |
$54.10
|
| Rate for Payer: Healthscope Whirlpool |
$52.48
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.92
|
| Rate for Payer: Mclaren Commercial |
$48.69
|
| Rate for Payer: Mclaren Medicaid |
$6.93
|
| Rate for Payer: Mclaren Medicare |
$12.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.57
|
| Rate for Payer: Meridian Medicaid |
$7.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.98
|
| Rate for Payer: Nomi Health Commercial |
$44.36
|
| Rate for Payer: PACE Medicare |
$12.27
|
| Rate for Payer: PACE SWMI |
$12.92
|
| Rate for Payer: PHP Commercial |
$14.21
|
| Rate for Payer: PHP Medicaid |
$6.93
|
| Rate for Payer: PHP Medicare Advantage |
$12.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$47.40
|
| Rate for Payer: Priority Health Medicare |
$12.92
|
| Rate for Payer: Priority Health Narrow Network |
$37.92
|
| Rate for Payer: Railroad Medicare Medicare |
$12.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$47.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.92
|
| Rate for Payer: UHC Exchange |
$20.03
|
| Rate for Payer: UHC Medicare Advantage |
$12.92
|
| Rate for Payer: UHCCP DNSP |
$12.92
|
| Rate for Payer: UHCCP Medicaid |
$6.93
|
| Rate for Payer: VA VA |
$12.92
|
|
|
HC MYOGLOBIN SERUM.
|
Facility
|
IP
|
$54.10
|
|
|
Service Code
|
CPT 83874
|
| Hospital Charge Code |
30100664
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$35.16 |
| Max. Negotiated Rate |
$54.10 |
| Rate for Payer: Aetna Commercial |
$48.69
|
| Rate for Payer: ASR ASR |
$52.48
|
| Rate for Payer: ASR Commercial |
$52.48
|
| Rate for Payer: BCBS Trust/PPO |
$44.09
|
| Rate for Payer: BCN Commercial |
$41.94
|
| Rate for Payer: Cash Price |
$43.28
|
| Rate for Payer: Cofinity Commercial |
$50.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.28
|
| Rate for Payer: Healthscope Commercial |
$54.10
|
| Rate for Payer: Healthscope Whirlpool |
$52.48
|
| Rate for Payer: Mclaren Commercial |
$48.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.98
|
| Rate for Payer: Nomi Health Commercial |
$44.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$47.61
|
|
|
HC MYOGLOBIN URINE
|
Facility
|
IP
|
$48.90
|
|
|
Service Code
|
CPT 83874
|
| Hospital Charge Code |
30100302
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.79 |
| Max. Negotiated Rate |
$48.90 |
| Rate for Payer: Aetna Commercial |
$44.01
|
| Rate for Payer: ASR ASR |
$47.43
|
| Rate for Payer: ASR Commercial |
$47.43
|
| Rate for Payer: BCBS Trust/PPO |
$39.85
|
| Rate for Payer: BCN Commercial |
$37.91
|
| Rate for Payer: Cash Price |
$39.12
|
| Rate for Payer: Cofinity Commercial |
$45.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.12
|
| Rate for Payer: Healthscope Commercial |
$48.90
|
| Rate for Payer: Healthscope Whirlpool |
$47.43
|
| Rate for Payer: Mclaren Commercial |
$44.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.56
|
| Rate for Payer: Nomi Health Commercial |
$40.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$43.03
|
|
|
HC MYOGLOBIN URINE
|
Facility
|
OP
|
$48.90
|
|
|
Service Code
|
CPT 83874
|
| Hospital Charge Code |
30100302
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.93 |
| Max. Negotiated Rate |
$48.90 |
| Rate for Payer: Aetna Commercial |
$44.01
|
| Rate for Payer: Aetna Medicare |
$12.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.15
|
| Rate for Payer: ASR ASR |
$47.43
|
| Rate for Payer: ASR Commercial |
$47.43
|
| Rate for Payer: BCBS Complete |
$7.27
|
| Rate for Payer: BCBS MAPPO |
$12.92
|
| Rate for Payer: BCBS Trust/PPO |
$40.04
|
| Rate for Payer: BCN Commercial |
$37.91
|
| Rate for Payer: BCN Medicare Advantage |
$12.92
|
| Rate for Payer: Cash Price |
$39.12
|
| Rate for Payer: Cash Price |
$39.12
|
| Rate for Payer: Cofinity Commercial |
$45.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.92
|
| Rate for Payer: Healthscope Commercial |
$48.90
|
| Rate for Payer: Healthscope Whirlpool |
$47.43
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.92
|
| Rate for Payer: Mclaren Commercial |
$44.01
|
| Rate for Payer: Mclaren Medicaid |
$6.93
|
| Rate for Payer: Mclaren Medicare |
$12.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.57
|
| Rate for Payer: Meridian Medicaid |
$7.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.56
|
| Rate for Payer: Nomi Health Commercial |
$40.10
|
| Rate for Payer: PACE Medicare |
$12.27
|
| Rate for Payer: PACE SWMI |
$12.92
|
| Rate for Payer: PHP Commercial |
$14.21
|
| Rate for Payer: PHP Medicaid |
$6.93
|
| Rate for Payer: PHP Medicare Advantage |
$12.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$42.85
|
| Rate for Payer: Priority Health Medicare |
$12.92
|
| Rate for Payer: Priority Health Narrow Network |
$34.28
|
| Rate for Payer: Railroad Medicare Medicare |
$12.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$43.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.92
|
| Rate for Payer: UHC Exchange |
$20.03
|
| Rate for Payer: UHC Medicare Advantage |
$12.92
|
| Rate for Payer: UHCCP DNSP |
$12.92
|
| Rate for Payer: UHCCP Medicaid |
$6.93
|
| Rate for Payer: VA VA |
$12.92
|
|
|
HC MYOMARKER 3 CMPT
|
Facility
|
OP
|
$26.56
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200503
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.61 |
| Max. Negotiated Rate |
$27.79 |
| Rate for Payer: Aetna Commercial |
$23.90
|
| Rate for Payer: Aetna Medicare |
$17.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.41
|
| Rate for Payer: ASR ASR |
$25.76
|
| Rate for Payer: ASR Commercial |
$25.76
|
| Rate for Payer: BCBS Complete |
$10.09
|
| Rate for Payer: BCBS MAPPO |
$17.93
|
| Rate for Payer: BCBS Trust/PPO |
$21.75
|
| Rate for Payer: BCN Commercial |
$20.59
|
| Rate for Payer: BCN Medicare Advantage |
$17.93
|
| Rate for Payer: Cash Price |
$21.25
|
| Rate for Payer: Cash Price |
$21.25
|
| Rate for Payer: Cofinity Commercial |
$24.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.93
|
| Rate for Payer: Healthscope Commercial |
$26.56
|
| Rate for Payer: Healthscope Whirlpool |
$25.76
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.93
|
| Rate for Payer: Mclaren Commercial |
$23.90
|
| Rate for Payer: Mclaren Medicaid |
$9.61
|
| Rate for Payer: Mclaren Medicare |
$17.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.83
|
| Rate for Payer: Meridian Medicaid |
$10.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.58
|
| Rate for Payer: Nomi Health Commercial |
$21.78
|
| Rate for Payer: PACE Medicare |
$17.03
|
| Rate for Payer: PACE SWMI |
$17.93
|
| Rate for Payer: PHP Commercial |
$19.72
|
| Rate for Payer: PHP Medicaid |
$9.61
|
| Rate for Payer: PHP Medicare Advantage |
$17.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$23.27
|
| Rate for Payer: Priority Health Medicare |
$17.93
|
| Rate for Payer: Priority Health Narrow Network |
$18.62
|
| Rate for Payer: Railroad Medicare Medicare |
$17.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$23.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.93
|
| Rate for Payer: UHC Exchange |
$27.79
|
| Rate for Payer: UHC Medicare Advantage |
$17.93
|
| Rate for Payer: UHCCP DNSP |
$17.93
|
| Rate for Payer: UHCCP Medicaid |
$9.61
|
| Rate for Payer: VA VA |
$17.93
|
|
|
HC MYOMARKER 3 CMPT
|
Facility
|
IP
|
$26.56
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200503
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$17.26 |
| Max. Negotiated Rate |
$26.56 |
| Rate for Payer: Aetna Commercial |
$23.90
|
| Rate for Payer: ASR ASR |
$25.76
|
| Rate for Payer: ASR Commercial |
$25.76
|
| Rate for Payer: BCBS Trust/PPO |
$21.64
|
| Rate for Payer: BCN Commercial |
$20.59
|
| Rate for Payer: Cash Price |
$21.25
|
| Rate for Payer: Cofinity Commercial |
$24.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.25
|
| Rate for Payer: Healthscope Commercial |
$26.56
|
| Rate for Payer: Healthscope Whirlpool |
$25.76
|
| Rate for Payer: Mclaren Commercial |
$23.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.58
|
| Rate for Payer: Nomi Health Commercial |
$21.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$23.37
|
|
|
HC MYOMARKER 3 PROFILE
|
Facility
|
OP
|
$19.91
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100746
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.18 |
| Max. Negotiated Rate |
$19.91 |
| Rate for Payer: Aetna Commercial |
$17.92
|
| Rate for Payer: Aetna Medicare |
$11.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.41
|
| Rate for Payer: ASR ASR |
$19.31
|
| Rate for Payer: ASR Commercial |
$19.31
|
| Rate for Payer: BCBS Complete |
$6.49
|
| Rate for Payer: BCBS MAPPO |
$11.53
|
| Rate for Payer: BCBS Trust/PPO |
$16.30
|
| Rate for Payer: BCN Commercial |
$15.44
|
| Rate for Payer: BCN Medicare Advantage |
$11.53
|
| Rate for Payer: Cash Price |
$15.93
|
| Rate for Payer: Cash Price |
$15.93
|
| Rate for Payer: Cofinity Commercial |
$18.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.53
|
| Rate for Payer: Healthscope Commercial |
$19.91
|
| Rate for Payer: Healthscope Whirlpool |
$19.31
|
| Rate for Payer: Humana Choice PPO Medicare |
$11.53
|
| Rate for Payer: Mclaren Commercial |
$17.92
|
| Rate for Payer: Mclaren Medicaid |
$6.18
|
| Rate for Payer: Mclaren Medicare |
$11.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.11
|
| Rate for Payer: Meridian Medicaid |
$6.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.92
|
| Rate for Payer: Nomi Health Commercial |
$16.33
|
| Rate for Payer: PACE Medicare |
$10.95
|
| Rate for Payer: PACE SWMI |
$11.53
|
| Rate for Payer: PHP Commercial |
$12.68
|
| Rate for Payer: PHP Medicaid |
$6.18
|
| Rate for Payer: PHP Medicare Advantage |
$11.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.45
|
| Rate for Payer: Priority Health Medicare |
$11.53
|
| Rate for Payer: Priority Health Narrow Network |
$13.96
|
| Rate for Payer: Railroad Medicare Medicare |
$11.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.53
|
| Rate for Payer: UHC Exchange |
$17.87
|
| Rate for Payer: UHC Medicare Advantage |
$11.53
|
| Rate for Payer: UHCCP DNSP |
$11.53
|
| Rate for Payer: UHCCP Medicaid |
$6.18
|
| Rate for Payer: VA VA |
$11.53
|
|
|
HC MYOMARKER 3 PROFILE
|
Facility
|
IP
|
$19.91
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100746
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.94 |
| Max. Negotiated Rate |
$19.91 |
| Rate for Payer: Aetna Commercial |
$17.92
|
| Rate for Payer: ASR ASR |
$19.31
|
| Rate for Payer: ASR Commercial |
$19.31
|
| Rate for Payer: BCBS Trust/PPO |
$16.22
|
| Rate for Payer: BCN Commercial |
$15.44
|
| Rate for Payer: Cash Price |
$15.93
|
| Rate for Payer: Cofinity Commercial |
$18.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.93
|
| Rate for Payer: Healthscope Commercial |
$19.91
|
| Rate for Payer: Healthscope Whirlpool |
$19.31
|
| Rate for Payer: Mclaren Commercial |
$17.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.92
|
| Rate for Payer: Nomi Health Commercial |
$16.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17.52
|
|
|
HC MYRINGOPLASTY
|
Facility
|
OP
|
$9,020.00
|
|
|
Service Code
|
CPT 69620
|
| Hospital Charge Code |
76100435
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,695.31 |
| Max. Negotiated Rate |
$9,020.00 |
| Rate for Payer: Aetna Commercial |
$8,118.00
|
| Rate for Payer: Aetna Medicare |
$3,162.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,953.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,953.62
|
| Rate for Payer: ASR ASR |
$8,749.40
|
| Rate for Payer: ASR Commercial |
$8,749.40
|
| Rate for Payer: BCBS Complete |
$1,780.08
|
| Rate for Payer: BCBS MAPPO |
$3,162.90
|
| Rate for Payer: BCBS Trust/PPO |
$7,386.48
|
| Rate for Payer: BCN Commercial |
$6,993.21
|
| Rate for Payer: BCN Medicare Advantage |
$3,162.90
|
| Rate for Payer: Cash Price |
$7,216.00
|
| Rate for Payer: Cash Price |
$7,216.00
|
| Rate for Payer: Cofinity Commercial |
$8,478.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,216.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,162.90
|
| Rate for Payer: Healthscope Commercial |
$9,020.00
|
| Rate for Payer: Healthscope Whirlpool |
$8,749.40
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,162.90
|
| Rate for Payer: Mclaren Commercial |
$8,118.00
|
| Rate for Payer: Mclaren Medicaid |
$1,695.31
|
| Rate for Payer: Mclaren Medicare |
$3,162.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,321.05
|
| Rate for Payer: Meridian Medicaid |
$1,780.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,637.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,667.00
|
| Rate for Payer: Nomi Health Commercial |
$7,396.40
|
| Rate for Payer: PACE Medicare |
$3,004.76
|
| Rate for Payer: PACE SWMI |
$3,162.90
|
| Rate for Payer: PHP Commercial |
$3,479.19
|
| Rate for Payer: PHP Medicaid |
$1,695.31
|
| Rate for Payer: PHP Medicare Advantage |
$3,162.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,695.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,863.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,903.32
|
| Rate for Payer: Priority Health Medicare |
$3,162.90
|
| Rate for Payer: Priority Health Narrow Network |
$6,323.02
|
| Rate for Payer: Railroad Medicare Medicare |
$3,162.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,937.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,162.90
|
| Rate for Payer: UHC Exchange |
$4,902.49
|
| Rate for Payer: UHC Medicare Advantage |
$3,162.90
|
| Rate for Payer: UHCCP DNSP |
$3,162.90
|
| Rate for Payer: UHCCP Medicaid |
$1,695.31
|
| Rate for Payer: VA VA |
$3,162.90
|
|
|
HC MYRINGOPLASTY
|
Facility
|
IP
|
$9,020.00
|
|
|
Service Code
|
CPT 69620
|
| Hospital Charge Code |
76100435
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,863.00 |
| Max. Negotiated Rate |
$9,020.00 |
| Rate for Payer: Aetna Commercial |
$8,118.00
|
| Rate for Payer: ASR ASR |
$8,749.40
|
| Rate for Payer: ASR Commercial |
$8,749.40
|
| Rate for Payer: BCBS Trust/PPO |
$7,350.40
|
| Rate for Payer: BCN Commercial |
$6,993.21
|
| Rate for Payer: Cash Price |
$7,216.00
|
| Rate for Payer: Cofinity Commercial |
$8,478.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,216.00
|
| Rate for Payer: Healthscope Commercial |
$9,020.00
|
| Rate for Payer: Healthscope Whirlpool |
$8,749.40
|
| Rate for Payer: Mclaren Commercial |
$8,118.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,667.00
|
| Rate for Payer: Nomi Health Commercial |
$7,396.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,863.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,937.60
|
|
|
HC MYRINGOTOMY ASPIR&EUSTACHIAN TUBE NFLTJ
|
Facility
|
OP
|
$628.32
|
|
|
Service Code
|
CPT 69420
|
| Hospital Charge Code |
76100484
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$121.39 |
| Max. Negotiated Rate |
$628.32 |
| Rate for Payer: Aetna Commercial |
$565.49
|
| Rate for Payer: Aetna Medicare |
$226.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$283.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$283.10
|
| Rate for Payer: ASR ASR |
$609.47
|
| Rate for Payer: ASR Commercial |
$609.47
|
| Rate for Payer: BCBS Complete |
$127.46
|
| Rate for Payer: BCBS MAPPO |
$226.48
|
| Rate for Payer: BCBS Trust/PPO |
$514.53
|
| Rate for Payer: BCN Commercial |
$487.14
|
| Rate for Payer: BCN Medicare Advantage |
$226.48
|
| Rate for Payer: Cash Price |
$502.66
|
| Rate for Payer: Cash Price |
$502.66
|
| Rate for Payer: Cofinity Commercial |
$590.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$502.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$226.48
|
| Rate for Payer: Healthscope Commercial |
$628.32
|
| Rate for Payer: Healthscope Whirlpool |
$609.47
|
| Rate for Payer: Humana Choice PPO Medicare |
$226.48
|
| Rate for Payer: Mclaren Commercial |
$565.49
|
| Rate for Payer: Mclaren Medicaid |
$121.39
|
| Rate for Payer: Mclaren Medicare |
$226.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$237.80
|
| Rate for Payer: Meridian Medicaid |
$127.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$260.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$534.07
|
| Rate for Payer: Nomi Health Commercial |
$515.22
|
| Rate for Payer: PACE Medicare |
$215.16
|
| Rate for Payer: PACE SWMI |
$226.48
|
| Rate for Payer: PHP Commercial |
$249.13
|
| Rate for Payer: PHP Medicaid |
$121.39
|
| Rate for Payer: PHP Medicare Advantage |
$226.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$121.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$408.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$550.53
|
| Rate for Payer: Priority Health Medicare |
$226.48
|
| Rate for Payer: Priority Health Narrow Network |
$440.45
|
| Rate for Payer: Railroad Medicare Medicare |
$226.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$552.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$226.48
|
| Rate for Payer: UHC Exchange |
$351.04
|
| Rate for Payer: UHC Medicare Advantage |
$226.48
|
| Rate for Payer: UHCCP DNSP |
$226.48
|
| Rate for Payer: UHCCP Medicaid |
$121.39
|
| Rate for Payer: VA VA |
$226.48
|
|
|
HC MYRINGOTOMY ASPIR&EUSTACHIAN TUBE NFLTJ
|
Facility
|
IP
|
$628.32
|
|
|
Service Code
|
CPT 69420
|
| Hospital Charge Code |
76100484
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$408.41 |
| Max. Negotiated Rate |
$628.32 |
| Rate for Payer: Aetna Commercial |
$565.49
|
| Rate for Payer: ASR ASR |
$609.47
|
| Rate for Payer: ASR Commercial |
$609.47
|
| Rate for Payer: BCBS Trust/PPO |
$512.02
|
| Rate for Payer: BCN Commercial |
$487.14
|
| Rate for Payer: Cash Price |
$502.66
|
| Rate for Payer: Cofinity Commercial |
$590.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$502.66
|
| Rate for Payer: Healthscope Commercial |
$628.32
|
| Rate for Payer: Healthscope Whirlpool |
$609.47
|
| Rate for Payer: Mclaren Commercial |
$565.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$534.07
|
| Rate for Payer: Nomi Health Commercial |
$515.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$408.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$552.92
|
|
|
HC NAIL BED REPAIR
|
Facility
|
IP
|
$757.63
|
|
|
Service Code
|
CPT 11760
|
| Hospital Charge Code |
45000077
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$492.46 |
| Max. Negotiated Rate |
$757.63 |
| Rate for Payer: Aetna Commercial |
$681.87
|
| Rate for Payer: ASR ASR |
$734.90
|
| Rate for Payer: ASR Commercial |
$734.90
|
| Rate for Payer: BCBS Trust/PPO |
$617.39
|
| Rate for Payer: BCN Commercial |
$587.39
|
| Rate for Payer: Cash Price |
$606.10
|
| Rate for Payer: Cofinity Commercial |
$712.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$606.10
|
| Rate for Payer: Healthscope Commercial |
$757.63
|
| Rate for Payer: Healthscope Whirlpool |
$734.90
|
| Rate for Payer: Mclaren Commercial |
$681.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$643.99
|
| Rate for Payer: Nomi Health Commercial |
$621.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$492.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$666.71
|
|
|
HC NAIL BED REPAIR
|
Facility
|
OP
|
$757.63
|
|
|
Service Code
|
CPT 11760
|
| Hospital Charge Code |
45000077
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$319.99 |
| Max. Negotiated Rate |
$925.35 |
| Rate for Payer: Aetna Commercial |
$681.87
|
| Rate for Payer: Aetna Medicare |
$597.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$746.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$746.25
|
| Rate for Payer: ASR ASR |
$734.90
|
| Rate for Payer: ASR Commercial |
$734.90
|
| Rate for Payer: BCBS Complete |
$335.99
|
| Rate for Payer: BCBS MAPPO |
$597.00
|
| Rate for Payer: BCBS Trust/PPO |
$620.42
|
| Rate for Payer: BCN Commercial |
$587.39
|
| Rate for Payer: BCN Medicare Advantage |
$597.00
|
| Rate for Payer: Cash Price |
$606.10
|
| Rate for Payer: Cash Price |
$606.10
|
| Rate for Payer: Cofinity Commercial |
$712.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$606.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$597.00
|
| Rate for Payer: Healthscope Commercial |
$757.63
|
| Rate for Payer: Healthscope Whirlpool |
$734.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$597.00
|
| Rate for Payer: Mclaren Commercial |
$681.87
|
| Rate for Payer: Mclaren Medicaid |
$319.99
|
| Rate for Payer: Mclaren Medicare |
$597.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$626.85
|
| Rate for Payer: Meridian Medicaid |
$335.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$686.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$643.99
|
| Rate for Payer: Nomi Health Commercial |
$621.26
|
| Rate for Payer: PACE Medicare |
$567.15
|
| Rate for Payer: PACE SWMI |
$597.00
|
| Rate for Payer: PHP Commercial |
$656.70
|
| Rate for Payer: PHP Medicaid |
$319.99
|
| Rate for Payer: PHP Medicare Advantage |
$597.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$319.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$492.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$663.84
|
| Rate for Payer: Priority Health Medicare |
$597.00
|
| Rate for Payer: Priority Health Narrow Network |
$531.10
|
| Rate for Payer: Railroad Medicare Medicare |
$597.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$666.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$597.00
|
| Rate for Payer: UHC Exchange |
$925.35
|
| Rate for Payer: UHC Medicare Advantage |
$597.00
|
| Rate for Payer: UHCCP DNSP |
$597.00
|
| Rate for Payer: UHCCP Medicaid |
$319.99
|
| Rate for Payer: VA VA |
$597.00
|
|
|
HC NAIL PROCEDURE
|
Facility
|
OP
|
$271.81
|
|
| Hospital Charge Code |
45000047
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$108.72 |
| Max. Negotiated Rate |
$271.81 |
| Rate for Payer: Aetna Commercial |
$244.63
|
| Rate for Payer: Aetna Medicare |
$135.91
|
| Rate for Payer: ASR ASR |
$263.66
|
| Rate for Payer: ASR Commercial |
$263.66
|
| Rate for Payer: BCBS Complete |
$108.72
|
| Rate for Payer: BCBS Trust/PPO |
$222.59
|
| Rate for Payer: BCN Commercial |
$210.73
|
| Rate for Payer: Cash Price |
$217.45
|
| Rate for Payer: Cofinity Commercial |
$255.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$217.45
|
| Rate for Payer: Healthscope Commercial |
$271.81
|
| Rate for Payer: Healthscope Whirlpool |
$263.66
|
| Rate for Payer: Mclaren Commercial |
$244.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$231.04
|
| Rate for Payer: Nomi Health Commercial |
$222.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$176.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$238.16
|
| Rate for Payer: Priority Health Narrow Network |
$190.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$239.19
|
|
|
HC NAIL PROCEDURE
|
Facility
|
IP
|
$271.81
|
|
| Hospital Charge Code |
45000047
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$176.68 |
| Max. Negotiated Rate |
$271.81 |
| Rate for Payer: Aetna Commercial |
$244.63
|
| Rate for Payer: ASR ASR |
$263.66
|
| Rate for Payer: ASR Commercial |
$263.66
|
| Rate for Payer: BCBS Trust/PPO |
$221.50
|
| Rate for Payer: BCN Commercial |
$210.73
|
| Rate for Payer: Cash Price |
$217.45
|
| Rate for Payer: Cofinity Commercial |
$255.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$217.45
|
| Rate for Payer: Healthscope Commercial |
$271.81
|
| Rate for Payer: Healthscope Whirlpool |
$263.66
|
| Rate for Payer: Mclaren Commercial |
$244.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$231.04
|
| Rate for Payer: Nomi Health Commercial |
$222.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$176.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$239.19
|
|
|
HC NA PHOSPHATE PER MCI
|
Facility
|
IP
|
$328.09
|
|
|
Service Code
|
HCPCS A9563
|
| Hospital Charge Code |
34400004
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$213.26 |
| Max. Negotiated Rate |
$328.09 |
| Rate for Payer: Aetna Commercial |
$295.28
|
| Rate for Payer: ASR ASR |
$318.25
|
| Rate for Payer: ASR Commercial |
$318.25
|
| Rate for Payer: BCBS Trust/PPO |
$267.36
|
| Rate for Payer: BCN Commercial |
$254.37
|
| Rate for Payer: Cash Price |
$262.47
|
| Rate for Payer: Cofinity Commercial |
$308.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$262.47
|
| Rate for Payer: Healthscope Commercial |
$328.09
|
| Rate for Payer: Healthscope Whirlpool |
$318.25
|
| Rate for Payer: Mclaren Commercial |
$295.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$278.88
|
| Rate for Payer: Nomi Health Commercial |
$269.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$213.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$288.72
|
|
|
HC NA PHOSPHATE PER MCI
|
Facility
|
OP
|
$328.09
|
|
|
Service Code
|
HCPCS A9563
|
| Hospital Charge Code |
34400004
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$96.01 |
| Max. Negotiated Rate |
$328.09 |
| Rate for Payer: Aetna Commercial |
$295.28
|
| Rate for Payer: Aetna Medicare |
$179.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$223.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$223.90
|
| Rate for Payer: ASR ASR |
$318.25
|
| Rate for Payer: ASR Commercial |
$318.25
|
| Rate for Payer: BCBS Complete |
$100.81
|
| Rate for Payer: BCBS MAPPO |
$179.12
|
| Rate for Payer: BCBS Trust/PPO |
$268.67
|
| Rate for Payer: BCN Commercial |
$254.37
|
| Rate for Payer: BCN Medicare Advantage |
$179.12
|
| Rate for Payer: Cash Price |
$262.47
|
| Rate for Payer: Cash Price |
$262.47
|
| Rate for Payer: Cofinity Commercial |
$308.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$262.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$179.12
|
| Rate for Payer: Healthscope Commercial |
$328.09
|
| Rate for Payer: Healthscope Whirlpool |
$318.25
|
| Rate for Payer: Humana Choice PPO Medicare |
$179.12
|
| Rate for Payer: Mclaren Commercial |
$295.28
|
| Rate for Payer: Mclaren Medicaid |
$96.01
|
| Rate for Payer: Mclaren Medicare |
$179.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$188.08
|
| Rate for Payer: Meridian Medicaid |
$100.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$205.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$278.88
|
| Rate for Payer: Nomi Health Commercial |
$269.03
|
| Rate for Payer: PACE Medicare |
$170.16
|
| Rate for Payer: PACE SWMI |
$179.12
|
| Rate for Payer: PHP Commercial |
$197.03
|
| Rate for Payer: PHP Medicaid |
$96.01
|
| Rate for Payer: PHP Medicare Advantage |
$179.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$96.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$213.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$287.47
|
| Rate for Payer: Priority Health Medicare |
$179.12
|
| Rate for Payer: Priority Health Narrow Network |
$229.99
|
| Rate for Payer: Railroad Medicare Medicare |
$179.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$288.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$179.12
|
| Rate for Payer: UHC Exchange |
$277.64
|
| Rate for Payer: UHC Medicare Advantage |
$179.12
|
| Rate for Payer: UHCCP DNSP |
$179.12
|
| Rate for Payer: UHCCP Medicaid |
$96.01
|
| Rate for Payer: VA VA |
$179.12
|
|
|
HC NASAL BONES COMP MIN 3 VW
|
Facility
|
IP
|
$198.81
|
|
|
Service Code
|
CPT 70160
|
| Hospital Charge Code |
32000011
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$129.23 |
| Max. Negotiated Rate |
$198.81 |
| Rate for Payer: Aetna Commercial |
$178.93
|
| Rate for Payer: ASR ASR |
$192.85
|
| Rate for Payer: ASR Commercial |
$192.85
|
| Rate for Payer: BCBS Trust/PPO |
$162.01
|
| Rate for Payer: BCN Commercial |
$154.14
|
| Rate for Payer: Cash Price |
$159.05
|
| Rate for Payer: Cofinity Commercial |
$186.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$159.05
|
| Rate for Payer: Healthscope Commercial |
$198.81
|
| Rate for Payer: Healthscope Whirlpool |
$192.85
|
| Rate for Payer: Mclaren Commercial |
$178.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$168.99
|
| Rate for Payer: Nomi Health Commercial |
$163.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$129.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$174.95
|
|
|
HC NASAL BONES COMP MIN 3 VW
|
Facility
|
OP
|
$198.81
|
|
|
Service Code
|
CPT 70160
|
| Hospital Charge Code |
32000011
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$46.03 |
| Max. Negotiated Rate |
$198.81 |
| Rate for Payer: Aetna Commercial |
$178.93
|
| Rate for Payer: Aetna Medicare |
$85.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.34
|
| Rate for Payer: ASR ASR |
$192.85
|
| Rate for Payer: ASR Commercial |
$192.85
|
| Rate for Payer: BCBS Complete |
$48.33
|
| Rate for Payer: BCBS MAPPO |
$85.87
|
| Rate for Payer: BCBS Trust/PPO |
$162.81
|
| Rate for Payer: BCN Commercial |
$154.14
|
| Rate for Payer: BCN Medicare Advantage |
$85.87
|
| Rate for Payer: Cash Price |
$159.05
|
| Rate for Payer: Cash Price |
$159.05
|
| Rate for Payer: Cofinity Commercial |
$186.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$159.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.87
|
| Rate for Payer: Healthscope Commercial |
$198.81
|
| Rate for Payer: Healthscope Whirlpool |
$192.85
|
| Rate for Payer: Humana Choice PPO Medicare |
$85.87
|
| Rate for Payer: Mclaren Commercial |
$178.93
|
| Rate for Payer: Mclaren Medicaid |
$46.03
|
| Rate for Payer: Mclaren Medicare |
$85.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.16
|
| Rate for Payer: Meridian Medicaid |
$48.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$168.99
|
| Rate for Payer: Nomi Health Commercial |
$163.02
|
| Rate for Payer: PACE Medicare |
$81.58
|
| Rate for Payer: PACE SWMI |
$85.87
|
| Rate for Payer: PHP Commercial |
$94.46
|
| Rate for Payer: PHP Medicaid |
$46.03
|
| Rate for Payer: PHP Medicare Advantage |
$85.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$129.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$174.20
|
| Rate for Payer: Priority Health Medicare |
$85.87
|
| Rate for Payer: Priority Health Narrow Network |
$139.37
|
| Rate for Payer: Railroad Medicare Medicare |
$85.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$174.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.87
|
| Rate for Payer: UHC Exchange |
$133.10
|
| Rate for Payer: UHC Medicare Advantage |
$85.87
|
| Rate for Payer: UHCCP DNSP |
$85.87
|
| Rate for Payer: UHCCP Medicaid |
$46.03
|
| Rate for Payer: VA VA |
$85.87
|
|
|
HC NASAL ENDOSCOPY DX
|
Facility
|
IP
|
$255.90
|
|
|
Service Code
|
CPT 31231
|
| Hospital Charge Code |
76100183
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$166.34 |
| Max. Negotiated Rate |
$255.90 |
| Rate for Payer: Aetna Commercial |
$230.31
|
| Rate for Payer: ASR ASR |
$248.22
|
| Rate for Payer: ASR Commercial |
$248.22
|
| Rate for Payer: BCBS Trust/PPO |
$208.53
|
| Rate for Payer: BCN Commercial |
$198.40
|
| Rate for Payer: Cash Price |
$204.72
|
| Rate for Payer: Cofinity Commercial |
$240.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$204.72
|
| Rate for Payer: Healthscope Commercial |
$255.90
|
| Rate for Payer: Healthscope Whirlpool |
$248.22
|
| Rate for Payer: Mclaren Commercial |
$230.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$217.51
|
| Rate for Payer: Nomi Health Commercial |
$209.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$166.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$225.19
|
|
|
HC NASAL ENDOSCOPY DX
|
Facility
|
OP
|
$255.90
|
|
|
Service Code
|
CPT 31231
|
| Hospital Charge Code |
76100183
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$101.49 |
| Max. Negotiated Rate |
$293.48 |
| Rate for Payer: Aetna Commercial |
$230.31
|
| Rate for Payer: Aetna Medicare |
$189.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$236.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$236.68
|
| Rate for Payer: ASR ASR |
$248.22
|
| Rate for Payer: ASR Commercial |
$248.22
|
| Rate for Payer: BCBS Complete |
$106.56
|
| Rate for Payer: BCBS MAPPO |
$189.34
|
| Rate for Payer: BCBS Trust/PPO |
$209.56
|
| Rate for Payer: BCN Commercial |
$198.40
|
| Rate for Payer: BCN Medicare Advantage |
$189.34
|
| Rate for Payer: Cash Price |
$204.72
|
| Rate for Payer: Cash Price |
$204.72
|
| Rate for Payer: Cofinity Commercial |
$240.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$204.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$189.34
|
| Rate for Payer: Healthscope Commercial |
$255.90
|
| Rate for Payer: Healthscope Whirlpool |
$248.22
|
| Rate for Payer: Humana Choice PPO Medicare |
$189.34
|
| Rate for Payer: Mclaren Commercial |
$230.31
|
| Rate for Payer: Mclaren Medicaid |
$101.49
|
| Rate for Payer: Mclaren Medicare |
$189.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$198.81
|
| Rate for Payer: Meridian Medicaid |
$106.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$217.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$217.51
|
| Rate for Payer: Nomi Health Commercial |
$209.84
|
| Rate for Payer: PACE Medicare |
$179.87
|
| Rate for Payer: PACE SWMI |
$189.34
|
| Rate for Payer: PHP Commercial |
$208.27
|
| Rate for Payer: PHP Medicaid |
$101.49
|
| Rate for Payer: PHP Medicare Advantage |
$189.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$101.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$166.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$224.22
|
| Rate for Payer: Priority Health Medicare |
$189.34
|
| Rate for Payer: Priority Health Narrow Network |
$179.39
|
| Rate for Payer: Railroad Medicare Medicare |
$189.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$225.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$189.34
|
| Rate for Payer: UHC Exchange |
$293.48
|
| Rate for Payer: UHC Medicare Advantage |
$189.34
|
| Rate for Payer: UHCCP DNSP |
$189.34
|
| Rate for Payer: UHCCP Medicaid |
$101.49
|
| Rate for Payer: VA VA |
$189.34
|
|
