|
HC NCS 1-2 STUDIES INCL F&H WAVES
|
Facility
|
OP
|
$494.34
|
|
|
Service Code
|
CPT 95907
|
| Hospital Charge Code |
92200027
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$39.49 |
| Max. Negotiated Rate |
$494.34 |
| Rate for Payer: Aetna Commercial |
$444.91
|
| Rate for Payer: Aetna Medicare |
$153.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$191.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$191.62
|
| Rate for Payer: ASR ASR |
$479.51
|
| Rate for Payer: ASR Commercial |
$479.51
|
| Rate for Payer: BCBS Complete |
$86.28
|
| Rate for Payer: BCBS MAPPO |
$153.30
|
| Rate for Payer: BCBS Trust/PPO |
$404.82
|
| Rate for Payer: BCN Commercial |
$383.26
|
| Rate for Payer: BCN Medicare Advantage |
$153.30
|
| Rate for Payer: Cash Price |
$395.47
|
| Rate for Payer: Cash Price |
$395.47
|
| Rate for Payer: Cofinity Commercial |
$464.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$395.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.30
|
| Rate for Payer: Healthscope Commercial |
$494.34
|
| Rate for Payer: Healthscope Whirlpool |
$479.51
|
| Rate for Payer: Humana Choice PPO Medicare |
$153.30
|
| Rate for Payer: Mclaren Commercial |
$444.91
|
| Rate for Payer: Mclaren Medicaid |
$82.17
|
| Rate for Payer: Mclaren Medicare |
$153.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.96
|
| Rate for Payer: Meridian Medicaid |
$86.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$176.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$420.19
|
| Rate for Payer: Nomi Health Commercial |
$405.36
|
| Rate for Payer: PACE Medicare |
$145.64
|
| Rate for Payer: PACE SWMI |
$153.30
|
| Rate for Payer: PHP Commercial |
$168.63
|
| Rate for Payer: PHP Medicaid |
$82.17
|
| Rate for Payer: PHP Medicare Advantage |
$153.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$321.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$49.36
|
| Rate for Payer: Priority Health Medicare |
$153.30
|
| Rate for Payer: Priority Health Narrow Network |
$39.49
|
| Rate for Payer: Railroad Medicare Medicare |
$153.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$435.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.30
|
| Rate for Payer: UHC Exchange |
$237.62
|
| Rate for Payer: UHC Medicare Advantage |
$153.30
|
| Rate for Payer: UHCCP DNSP |
$153.30
|
| Rate for Payer: UHCCP Medicaid |
$82.17
|
| Rate for Payer: VA VA |
$153.30
|
|
|
HC NCS 13 OR MORE STUDIES INCL F&H WAVES
|
Facility
|
IP
|
$2,954.43
|
|
|
Service Code
|
CPT 95913
|
| Hospital Charge Code |
92200033
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$1,920.38 |
| Max. Negotiated Rate |
$2,954.43 |
| Rate for Payer: Aetna Commercial |
$2,658.99
|
| Rate for Payer: ASR ASR |
$2,865.80
|
| Rate for Payer: ASR Commercial |
$2,865.80
|
| Rate for Payer: BCBS Trust/PPO |
$2,407.57
|
| Rate for Payer: BCN Commercial |
$2,290.57
|
| Rate for Payer: Cash Price |
$2,363.54
|
| Rate for Payer: Cofinity Commercial |
$2,777.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,363.54
|
| Rate for Payer: Healthscope Commercial |
$2,954.43
|
| Rate for Payer: Healthscope Whirlpool |
$2,865.80
|
| Rate for Payer: Mclaren Commercial |
$2,658.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,511.27
|
| Rate for Payer: Nomi Health Commercial |
$2,422.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,920.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,599.90
|
|
|
HC NCS 13 OR MORE STUDIES INCL F&H WAVES
|
Facility
|
OP
|
$2,954.43
|
|
|
Service Code
|
CPT 95913
|
| Hospital Charge Code |
92200033
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$73.12 |
| Max. Negotiated Rate |
$2,954.43 |
| Rate for Payer: Aetna Commercial |
$2,658.99
|
| Rate for Payer: Aetna Medicare |
$519.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$649.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$649.84
|
| Rate for Payer: ASR ASR |
$2,865.80
|
| Rate for Payer: ASR Commercial |
$2,865.80
|
| Rate for Payer: BCBS Complete |
$292.58
|
| Rate for Payer: BCBS MAPPO |
$519.87
|
| Rate for Payer: BCBS Trust/PPO |
$2,419.38
|
| Rate for Payer: BCN Commercial |
$2,290.57
|
| Rate for Payer: BCN Medicare Advantage |
$519.87
|
| Rate for Payer: Cash Price |
$2,363.54
|
| Rate for Payer: Cash Price |
$2,363.54
|
| Rate for Payer: Cofinity Commercial |
$2,777.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,363.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$519.87
|
| Rate for Payer: Healthscope Commercial |
$2,954.43
|
| Rate for Payer: Healthscope Whirlpool |
$2,865.80
|
| Rate for Payer: Humana Choice PPO Medicare |
$519.87
|
| Rate for Payer: Mclaren Commercial |
$2,658.99
|
| Rate for Payer: Mclaren Medicaid |
$278.65
|
| Rate for Payer: Mclaren Medicare |
$519.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$545.86
|
| Rate for Payer: Meridian Medicaid |
$292.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$597.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,511.27
|
| Rate for Payer: Nomi Health Commercial |
$2,422.63
|
| Rate for Payer: PACE Medicare |
$493.88
|
| Rate for Payer: PACE SWMI |
$519.87
|
| Rate for Payer: PHP Commercial |
$571.86
|
| Rate for Payer: PHP Medicaid |
$278.65
|
| Rate for Payer: PHP Medicare Advantage |
$519.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$278.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,920.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$91.40
|
| Rate for Payer: Priority Health Medicare |
$519.87
|
| Rate for Payer: Priority Health Narrow Network |
$73.12
|
| Rate for Payer: Railroad Medicare Medicare |
$519.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,599.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$519.87
|
| Rate for Payer: UHC Exchange |
$805.80
|
| Rate for Payer: UHC Medicare Advantage |
$519.87
|
| Rate for Payer: UHCCP DNSP |
$519.87
|
| Rate for Payer: UHCCP Medicaid |
$278.65
|
| Rate for Payer: VA VA |
$519.87
|
|
|
HC NCS 3-4 STUDIES INCL F&H WAVES
|
Facility
|
OP
|
$913.43
|
|
|
Service Code
|
CPT 95908
|
| Hospital Charge Code |
92200028
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$39.49 |
| Max. Negotiated Rate |
$913.43 |
| Rate for Payer: Aetna Commercial |
$822.09
|
| Rate for Payer: Aetna Medicare |
$305.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$381.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$381.38
|
| Rate for Payer: ASR ASR |
$886.03
|
| Rate for Payer: ASR Commercial |
$886.03
|
| Rate for Payer: BCBS Complete |
$171.71
|
| Rate for Payer: BCBS MAPPO |
$305.10
|
| Rate for Payer: BCBS Trust/PPO |
$748.01
|
| Rate for Payer: BCN Commercial |
$708.18
|
| Rate for Payer: BCN Medicare Advantage |
$305.10
|
| Rate for Payer: Cash Price |
$730.74
|
| Rate for Payer: Cash Price |
$730.74
|
| Rate for Payer: Cofinity Commercial |
$858.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$730.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.10
|
| Rate for Payer: Healthscope Commercial |
$913.43
|
| Rate for Payer: Healthscope Whirlpool |
$886.03
|
| Rate for Payer: Humana Choice PPO Medicare |
$305.10
|
| Rate for Payer: Mclaren Commercial |
$822.09
|
| Rate for Payer: Mclaren Medicaid |
$163.53
|
| Rate for Payer: Mclaren Medicare |
$305.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$320.36
|
| Rate for Payer: Meridian Medicaid |
$171.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$350.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$776.42
|
| Rate for Payer: Nomi Health Commercial |
$749.01
|
| Rate for Payer: PACE Medicare |
$289.84
|
| Rate for Payer: PACE SWMI |
$305.10
|
| Rate for Payer: PHP Commercial |
$335.61
|
| Rate for Payer: PHP Medicaid |
$163.53
|
| Rate for Payer: PHP Medicare Advantage |
$305.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$163.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$593.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$49.36
|
| Rate for Payer: Priority Health Medicare |
$305.10
|
| Rate for Payer: Priority Health Narrow Network |
$39.49
|
| Rate for Payer: Railroad Medicare Medicare |
$305.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$803.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$305.10
|
| Rate for Payer: UHC Exchange |
$472.90
|
| Rate for Payer: UHC Medicare Advantage |
$305.10
|
| Rate for Payer: UHCCP DNSP |
$305.10
|
| Rate for Payer: UHCCP Medicaid |
$163.53
|
| Rate for Payer: VA VA |
$305.10
|
|
|
HC NCS 3-4 STUDIES INCL F&H WAVES
|
Facility
|
IP
|
$913.43
|
|
|
Service Code
|
CPT 95908
|
| Hospital Charge Code |
92200028
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$593.73 |
| Max. Negotiated Rate |
$913.43 |
| Rate for Payer: Aetna Commercial |
$822.09
|
| Rate for Payer: ASR ASR |
$886.03
|
| Rate for Payer: ASR Commercial |
$886.03
|
| Rate for Payer: BCBS Trust/PPO |
$744.35
|
| Rate for Payer: BCN Commercial |
$708.18
|
| Rate for Payer: Cash Price |
$730.74
|
| Rate for Payer: Cofinity Commercial |
$858.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$730.74
|
| Rate for Payer: Healthscope Commercial |
$913.43
|
| Rate for Payer: Healthscope Whirlpool |
$886.03
|
| Rate for Payer: Mclaren Commercial |
$822.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$776.42
|
| Rate for Payer: Nomi Health Commercial |
$749.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$593.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$803.82
|
|
|
HC NCS 5-6 STUDIES INCL F&H WAVES
|
Facility
|
IP
|
$1,128.89
|
|
|
Service Code
|
CPT 95909
|
| Hospital Charge Code |
92200029
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$733.78 |
| Max. Negotiated Rate |
$1,128.89 |
| Rate for Payer: Aetna Commercial |
$1,016.00
|
| Rate for Payer: ASR ASR |
$1,095.02
|
| Rate for Payer: ASR Commercial |
$1,095.02
|
| Rate for Payer: BCBS Trust/PPO |
$919.93
|
| Rate for Payer: BCN Commercial |
$875.23
|
| Rate for Payer: Cash Price |
$903.11
|
| Rate for Payer: Cofinity Commercial |
$1,061.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$903.11
|
| Rate for Payer: Healthscope Commercial |
$1,128.89
|
| Rate for Payer: Healthscope Whirlpool |
$1,095.02
|
| Rate for Payer: Mclaren Commercial |
$1,016.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$959.56
|
| Rate for Payer: Nomi Health Commercial |
$925.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$733.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$993.42
|
|
|
HC NCS 5-6 STUDIES INCL F&H WAVES
|
Facility
|
OP
|
$1,128.89
|
|
|
Service Code
|
CPT 95909
|
| Hospital Charge Code |
92200029
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$39.49 |
| Max. Negotiated Rate |
$1,128.89 |
| Rate for Payer: Aetna Commercial |
$1,016.00
|
| Rate for Payer: Aetna Medicare |
$305.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$381.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$381.38
|
| Rate for Payer: ASR ASR |
$1,095.02
|
| Rate for Payer: ASR Commercial |
$1,095.02
|
| Rate for Payer: BCBS Complete |
$171.71
|
| Rate for Payer: BCBS MAPPO |
$305.10
|
| Rate for Payer: BCBS Trust/PPO |
$924.45
|
| Rate for Payer: BCN Commercial |
$875.23
|
| Rate for Payer: BCN Medicare Advantage |
$305.10
|
| Rate for Payer: Cash Price |
$903.11
|
| Rate for Payer: Cash Price |
$903.11
|
| Rate for Payer: Cofinity Commercial |
$1,061.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$903.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.10
|
| Rate for Payer: Healthscope Commercial |
$1,128.89
|
| Rate for Payer: Healthscope Whirlpool |
$1,095.02
|
| Rate for Payer: Humana Choice PPO Medicare |
$305.10
|
| Rate for Payer: Mclaren Commercial |
$1,016.00
|
| Rate for Payer: Mclaren Medicaid |
$163.53
|
| Rate for Payer: Mclaren Medicare |
$305.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$320.36
|
| Rate for Payer: Meridian Medicaid |
$171.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$350.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$959.56
|
| Rate for Payer: Nomi Health Commercial |
$925.69
|
| Rate for Payer: PACE Medicare |
$289.84
|
| Rate for Payer: PACE SWMI |
$305.10
|
| Rate for Payer: PHP Commercial |
$335.61
|
| Rate for Payer: PHP Medicaid |
$163.53
|
| Rate for Payer: PHP Medicare Advantage |
$305.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$163.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$733.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$49.36
|
| Rate for Payer: Priority Health Medicare |
$305.10
|
| Rate for Payer: Priority Health Narrow Network |
$39.49
|
| Rate for Payer: Railroad Medicare Medicare |
$305.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$993.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$305.10
|
| Rate for Payer: UHC Exchange |
$472.90
|
| Rate for Payer: UHC Medicare Advantage |
$305.10
|
| Rate for Payer: UHCCP DNSP |
$305.10
|
| Rate for Payer: UHCCP Medicaid |
$163.53
|
| Rate for Payer: VA VA |
$305.10
|
|
|
HC NCS 7-8 STUDIES INCL F&H WAVES
|
Facility
|
IP
|
$1,457.88
|
|
|
Service Code
|
CPT 95910
|
| Hospital Charge Code |
92200030
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$947.62 |
| Max. Negotiated Rate |
$1,457.88 |
| Rate for Payer: Aetna Commercial |
$1,312.09
|
| Rate for Payer: ASR ASR |
$1,414.14
|
| Rate for Payer: ASR Commercial |
$1,414.14
|
| Rate for Payer: BCBS Trust/PPO |
$1,188.03
|
| Rate for Payer: BCN Commercial |
$1,130.29
|
| Rate for Payer: Cash Price |
$1,166.30
|
| Rate for Payer: Cofinity Commercial |
$1,370.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,166.30
|
| Rate for Payer: Healthscope Commercial |
$1,457.88
|
| Rate for Payer: Healthscope Whirlpool |
$1,414.14
|
| Rate for Payer: Mclaren Commercial |
$1,312.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,239.20
|
| Rate for Payer: Nomi Health Commercial |
$1,195.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$947.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,282.93
|
|
|
HC NCS 7-8 STUDIES INCL F&H WAVES
|
Facility
|
OP
|
$1,457.88
|
|
|
Service Code
|
CPT 95910
|
| Hospital Charge Code |
92200030
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$39.49 |
| Max. Negotiated Rate |
$1,457.88 |
| Rate for Payer: Aetna Commercial |
$1,312.09
|
| Rate for Payer: Aetna Medicare |
$305.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$381.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$381.38
|
| Rate for Payer: ASR ASR |
$1,414.14
|
| Rate for Payer: ASR Commercial |
$1,414.14
|
| Rate for Payer: BCBS Complete |
$171.71
|
| Rate for Payer: BCBS MAPPO |
$305.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,193.86
|
| Rate for Payer: BCN Commercial |
$1,130.29
|
| Rate for Payer: BCN Medicare Advantage |
$305.10
|
| Rate for Payer: Cash Price |
$1,166.30
|
| Rate for Payer: Cash Price |
$1,166.30
|
| Rate for Payer: Cofinity Commercial |
$1,370.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,166.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.10
|
| Rate for Payer: Healthscope Commercial |
$1,457.88
|
| Rate for Payer: Healthscope Whirlpool |
$1,414.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$305.10
|
| Rate for Payer: Mclaren Commercial |
$1,312.09
|
| Rate for Payer: Mclaren Medicaid |
$163.53
|
| Rate for Payer: Mclaren Medicare |
$305.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$320.36
|
| Rate for Payer: Meridian Medicaid |
$171.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$350.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,239.20
|
| Rate for Payer: Nomi Health Commercial |
$1,195.46
|
| Rate for Payer: PACE Medicare |
$289.84
|
| Rate for Payer: PACE SWMI |
$305.10
|
| Rate for Payer: PHP Commercial |
$335.61
|
| Rate for Payer: PHP Medicaid |
$163.53
|
| Rate for Payer: PHP Medicare Advantage |
$305.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$163.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$947.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$49.36
|
| Rate for Payer: Priority Health Medicare |
$305.10
|
| Rate for Payer: Priority Health Narrow Network |
$39.49
|
| Rate for Payer: Railroad Medicare Medicare |
$305.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,282.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$305.10
|
| Rate for Payer: UHC Exchange |
$472.90
|
| Rate for Payer: UHC Medicare Advantage |
$305.10
|
| Rate for Payer: UHCCP DNSP |
$305.10
|
| Rate for Payer: UHCCP Medicaid |
$163.53
|
| Rate for Payer: VA VA |
$305.10
|
|
|
HC NCS 9-10 STUDIES INCL F&H WAVES
|
Facility
|
OP
|
$1,806.20
|
|
|
Service Code
|
CPT 95911
|
| Hospital Charge Code |
92200031
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$73.12 |
| Max. Negotiated Rate |
$1,806.20 |
| Rate for Payer: Aetna Commercial |
$1,625.58
|
| Rate for Payer: Aetna Medicare |
$519.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$649.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$649.84
|
| Rate for Payer: ASR ASR |
$1,752.01
|
| Rate for Payer: ASR Commercial |
$1,752.01
|
| Rate for Payer: BCBS Complete |
$292.58
|
| Rate for Payer: BCBS MAPPO |
$519.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,479.10
|
| Rate for Payer: BCN Commercial |
$1,400.35
|
| Rate for Payer: BCN Medicare Advantage |
$519.87
|
| Rate for Payer: Cash Price |
$1,444.96
|
| Rate for Payer: Cash Price |
$1,444.96
|
| Rate for Payer: Cofinity Commercial |
$1,697.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,444.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$519.87
|
| Rate for Payer: Healthscope Commercial |
$1,806.20
|
| Rate for Payer: Healthscope Whirlpool |
$1,752.01
|
| Rate for Payer: Humana Choice PPO Medicare |
$519.87
|
| Rate for Payer: Mclaren Commercial |
$1,625.58
|
| Rate for Payer: Mclaren Medicaid |
$278.65
|
| Rate for Payer: Mclaren Medicare |
$519.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$545.86
|
| Rate for Payer: Meridian Medicaid |
$292.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$597.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,535.27
|
| Rate for Payer: Nomi Health Commercial |
$1,481.08
|
| Rate for Payer: PACE Medicare |
$493.88
|
| Rate for Payer: PACE SWMI |
$519.87
|
| Rate for Payer: PHP Commercial |
$571.86
|
| Rate for Payer: PHP Medicaid |
$278.65
|
| Rate for Payer: PHP Medicare Advantage |
$519.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$278.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,174.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$91.40
|
| Rate for Payer: Priority Health Medicare |
$519.87
|
| Rate for Payer: Priority Health Narrow Network |
$73.12
|
| Rate for Payer: Railroad Medicare Medicare |
$519.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,589.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$519.87
|
| Rate for Payer: UHC Exchange |
$805.80
|
| Rate for Payer: UHC Medicare Advantage |
$519.87
|
| Rate for Payer: UHCCP DNSP |
$519.87
|
| Rate for Payer: UHCCP Medicaid |
$278.65
|
| Rate for Payer: VA VA |
$519.87
|
|
|
HC NCS 9-10 STUDIES INCL F&H WAVES
|
Facility
|
IP
|
$1,806.20
|
|
|
Service Code
|
CPT 95911
|
| Hospital Charge Code |
92200031
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$1,174.03 |
| Max. Negotiated Rate |
$1,806.20 |
| Rate for Payer: Aetna Commercial |
$1,625.58
|
| Rate for Payer: ASR ASR |
$1,752.01
|
| Rate for Payer: ASR Commercial |
$1,752.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,471.87
|
| Rate for Payer: BCN Commercial |
$1,400.35
|
| Rate for Payer: Cash Price |
$1,444.96
|
| Rate for Payer: Cofinity Commercial |
$1,697.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,444.96
|
| Rate for Payer: Healthscope Commercial |
$1,806.20
|
| Rate for Payer: Healthscope Whirlpool |
$1,752.01
|
| Rate for Payer: Mclaren Commercial |
$1,625.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,535.27
|
| Rate for Payer: Nomi Health Commercial |
$1,481.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,174.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,589.46
|
|
|
HC NEEDLE 14 GAUGE LONG
|
Facility
|
IP
|
$110.16
|
|
| Hospital Charge Code |
27000674
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$71.60 |
| Max. Negotiated Rate |
$110.16 |
| Rate for Payer: Aetna Commercial |
$99.14
|
| Rate for Payer: ASR ASR |
$106.86
|
| Rate for Payer: ASR Commercial |
$106.86
|
| Rate for Payer: BCBS Trust/PPO |
$89.77
|
| Rate for Payer: BCN Commercial |
$85.41
|
| Rate for Payer: Cash Price |
$88.13
|
| Rate for Payer: Cofinity Commercial |
$103.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.13
|
| Rate for Payer: Healthscope Commercial |
$110.16
|
| Rate for Payer: Healthscope Whirlpool |
$106.86
|
| Rate for Payer: Mclaren Commercial |
$99.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.64
|
| Rate for Payer: Nomi Health Commercial |
$90.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$96.94
|
|
|
HC NEEDLE 14 GAUGE LONG
|
Facility
|
OP
|
$110.16
|
|
| Hospital Charge Code |
27000674
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$44.06 |
| Max. Negotiated Rate |
$110.16 |
| Rate for Payer: Aetna Commercial |
$99.14
|
| Rate for Payer: Aetna Medicare |
$55.08
|
| Rate for Payer: ASR ASR |
$106.86
|
| Rate for Payer: ASR Commercial |
$106.86
|
| Rate for Payer: BCBS Complete |
$44.06
|
| Rate for Payer: BCBS Trust/PPO |
$90.21
|
| Rate for Payer: BCN Commercial |
$85.41
|
| Rate for Payer: Cash Price |
$88.13
|
| Rate for Payer: Cofinity Commercial |
$103.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.13
|
| Rate for Payer: Healthscope Commercial |
$110.16
|
| Rate for Payer: Healthscope Whirlpool |
$106.86
|
| Rate for Payer: Mclaren Commercial |
$99.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.64
|
| Rate for Payer: Nomi Health Commercial |
$90.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$96.52
|
| Rate for Payer: Priority Health Narrow Network |
$77.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$96.94
|
|
|
HC NEEDLE 1 EXTREMITY NON PARASPINAL
|
Facility
|
OP
|
$252.61
|
|
|
Service Code
|
CPT 95870
|
| Hospital Charge Code |
92200009
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$67.69 |
| Max. Negotiated Rate |
$252.61 |
| Rate for Payer: Aetna Commercial |
$227.35
|
| Rate for Payer: Aetna Medicare |
$126.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.86
|
| Rate for Payer: ASR ASR |
$245.03
|
| Rate for Payer: ASR Commercial |
$245.03
|
| Rate for Payer: BCBS Complete |
$71.08
|
| Rate for Payer: BCBS MAPPO |
$126.29
|
| Rate for Payer: BCBS Trust/PPO |
$206.86
|
| Rate for Payer: BCN Commercial |
$195.85
|
| Rate for Payer: BCN Medicare Advantage |
$126.29
|
| Rate for Payer: Cash Price |
$202.09
|
| Rate for Payer: Cash Price |
$202.09
|
| Rate for Payer: Cofinity Commercial |
$237.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$202.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.29
|
| Rate for Payer: Healthscope Commercial |
$252.61
|
| Rate for Payer: Healthscope Whirlpool |
$245.03
|
| Rate for Payer: Humana Choice PPO Medicare |
$126.29
|
| Rate for Payer: Mclaren Commercial |
$227.35
|
| Rate for Payer: Mclaren Medicaid |
$67.69
|
| Rate for Payer: Mclaren Medicare |
$126.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.60
|
| Rate for Payer: Meridian Medicaid |
$71.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$145.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$214.72
|
| Rate for Payer: Nomi Health Commercial |
$207.14
|
| Rate for Payer: PACE Medicare |
$119.98
|
| Rate for Payer: PACE SWMI |
$126.29
|
| Rate for Payer: PHP Commercial |
$138.92
|
| Rate for Payer: PHP Medicaid |
$67.69
|
| Rate for Payer: PHP Medicare Advantage |
$126.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$164.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$221.34
|
| Rate for Payer: Priority Health Medicare |
$126.29
|
| Rate for Payer: Priority Health Narrow Network |
$177.08
|
| Rate for Payer: Railroad Medicare Medicare |
$126.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$222.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$126.29
|
| Rate for Payer: UHC Exchange |
$195.75
|
| Rate for Payer: UHC Medicare Advantage |
$126.29
|
| Rate for Payer: UHCCP DNSP |
$126.29
|
| Rate for Payer: UHCCP Medicaid |
$67.69
|
| Rate for Payer: VA VA |
$126.29
|
|
|
HC NEEDLE 1 EXTREMITY NON PARASPINAL
|
Facility
|
IP
|
$252.61
|
|
|
Service Code
|
CPT 95870
|
| Hospital Charge Code |
92200009
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$164.20 |
| Max. Negotiated Rate |
$252.61 |
| Rate for Payer: Aetna Commercial |
$227.35
|
| Rate for Payer: ASR ASR |
$245.03
|
| Rate for Payer: ASR Commercial |
$245.03
|
| Rate for Payer: BCBS Trust/PPO |
$205.85
|
| Rate for Payer: BCN Commercial |
$195.85
|
| Rate for Payer: Cash Price |
$202.09
|
| Rate for Payer: Cofinity Commercial |
$237.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$202.09
|
| Rate for Payer: Healthscope Commercial |
$252.61
|
| Rate for Payer: Healthscope Whirlpool |
$245.03
|
| Rate for Payer: Mclaren Commercial |
$227.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$214.72
|
| Rate for Payer: Nomi Health Commercial |
$207.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$164.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$222.30
|
|
|
HC NEEDLE BRACHYTHERAPY EACH
|
Facility
|
OP
|
$73.90
|
|
|
Service Code
|
HCPCS C1715
|
| Hospital Charge Code |
27200247
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$29.56 |
| Max. Negotiated Rate |
$73.90 |
| Rate for Payer: Aetna Commercial |
$66.51
|
| Rate for Payer: Aetna Medicare |
$36.95
|
| Rate for Payer: ASR ASR |
$71.68
|
| Rate for Payer: ASR Commercial |
$71.68
|
| Rate for Payer: BCBS Complete |
$29.56
|
| Rate for Payer: BCBS Trust/PPO |
$60.52
|
| Rate for Payer: BCN Commercial |
$57.29
|
| Rate for Payer: Cash Price |
$59.12
|
| Rate for Payer: Cofinity Commercial |
$69.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.12
|
| Rate for Payer: Healthscope Commercial |
$73.90
|
| Rate for Payer: Healthscope Whirlpool |
$71.68
|
| Rate for Payer: Mclaren Commercial |
$66.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.82
|
| Rate for Payer: Nomi Health Commercial |
$60.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$64.75
|
| Rate for Payer: Priority Health Narrow Network |
$51.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$65.03
|
|
|
HC NEEDLE BRACHYTHERAPY EACH
|
Facility
|
IP
|
$73.90
|
|
|
Service Code
|
HCPCS C1715
|
| Hospital Charge Code |
27200247
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$48.04 |
| Max. Negotiated Rate |
$73.90 |
| Rate for Payer: Aetna Commercial |
$66.51
|
| Rate for Payer: ASR ASR |
$71.68
|
| Rate for Payer: ASR Commercial |
$71.68
|
| Rate for Payer: BCBS Trust/PPO |
$60.22
|
| Rate for Payer: BCN Commercial |
$57.29
|
| Rate for Payer: Cash Price |
$59.12
|
| Rate for Payer: Cofinity Commercial |
$69.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.12
|
| Rate for Payer: Healthscope Commercial |
$73.90
|
| Rate for Payer: Healthscope Whirlpool |
$71.68
|
| Rate for Payer: Mclaren Commercial |
$66.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.82
|
| Rate for Payer: Nomi Health Commercial |
$60.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$65.03
|
|
|
HC NEEDLE INSERT W/O INJECT 1 OR 2 MUSCLES
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 20560
|
| Hospital Charge Code |
76100364
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$33.81 |
| Max. Negotiated Rate |
$52.02 |
| Rate for Payer: Aetna Commercial |
$46.82
|
| Rate for Payer: ASR ASR |
$50.46
|
| Rate for Payer: ASR Commercial |
$50.46
|
| Rate for Payer: BCBS Trust/PPO |
$42.39
|
| Rate for Payer: BCN Commercial |
$40.33
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$48.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$52.02
|
| Rate for Payer: Healthscope Whirlpool |
$50.46
|
| Rate for Payer: Mclaren Commercial |
$46.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.78
|
|
|
HC NEEDLE INSERT W/O INJECT 1 OR 2 MUSCLES
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 20560
|
| Hospital Charge Code |
76100364
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$12.86 |
| Max. Negotiated Rate |
$52.02 |
| Rate for Payer: Aetna Commercial |
$46.82
|
| Rate for Payer: Aetna Medicare |
$23.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.99
|
| Rate for Payer: ASR ASR |
$50.46
|
| Rate for Payer: ASR Commercial |
$50.46
|
| Rate for Payer: BCBS Complete |
$13.50
|
| Rate for Payer: BCBS MAPPO |
$23.99
|
| Rate for Payer: BCBS Trust/PPO |
$42.60
|
| Rate for Payer: BCN Commercial |
$40.33
|
| Rate for Payer: BCN Medicare Advantage |
$23.99
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$48.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.99
|
| Rate for Payer: Healthscope Commercial |
$52.02
|
| Rate for Payer: Healthscope Whirlpool |
$50.46
|
| Rate for Payer: Humana Choice PPO Medicare |
$23.99
|
| Rate for Payer: Mclaren Commercial |
$46.82
|
| Rate for Payer: Mclaren Medicaid |
$12.86
|
| Rate for Payer: Mclaren Medicare |
$23.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.19
|
| Rate for Payer: Meridian Medicaid |
$13.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: PACE Medicare |
$22.79
|
| Rate for Payer: PACE SWMI |
$23.99
|
| Rate for Payer: PHP Commercial |
$26.39
|
| Rate for Payer: PHP Medicaid |
$12.86
|
| Rate for Payer: PHP Medicare Advantage |
$23.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$48.32
|
| Rate for Payer: Priority Health Medicare |
$23.99
|
| Rate for Payer: Priority Health Narrow Network |
$38.66
|
| Rate for Payer: Railroad Medicare Medicare |
$23.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.99
|
| Rate for Payer: UHC Exchange |
$37.18
|
| Rate for Payer: UHC Medicare Advantage |
$23.99
|
| Rate for Payer: UHCCP DNSP |
$23.99
|
| Rate for Payer: UHCCP Medicaid |
$12.86
|
| Rate for Payer: VA VA |
$23.99
|
|
|
HC NEEDLE INSERT W/O INJECTION, 1 OR 2 MUSCLES
|
Facility
|
OP
|
$30.60
|
|
|
Service Code
|
CPT 20560
|
| Hospital Charge Code |
42000060
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$12.86 |
| Max. Negotiated Rate |
$48.32 |
| Rate for Payer: Aetna Commercial |
$27.54
|
| Rate for Payer: Aetna Medicare |
$23.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.99
|
| Rate for Payer: ASR ASR |
$29.68
|
| Rate for Payer: ASR Commercial |
$29.68
|
| Rate for Payer: BCBS Complete |
$13.50
|
| Rate for Payer: BCBS MAPPO |
$23.99
|
| Rate for Payer: BCBS Trust/PPO |
$25.06
|
| Rate for Payer: BCN Commercial |
$23.72
|
| Rate for Payer: BCN Medicare Advantage |
$23.99
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$28.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.99
|
| Rate for Payer: Healthscope Commercial |
$30.60
|
| Rate for Payer: Healthscope Whirlpool |
$29.68
|
| Rate for Payer: Humana Choice PPO Medicare |
$23.99
|
| Rate for Payer: Mclaren Commercial |
$27.54
|
| Rate for Payer: Mclaren Medicaid |
$12.86
|
| Rate for Payer: Mclaren Medicare |
$23.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.19
|
| Rate for Payer: Meridian Medicaid |
$13.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.01
|
| Rate for Payer: Nomi Health Commercial |
$25.09
|
| Rate for Payer: PACE Medicare |
$22.79
|
| Rate for Payer: PACE SWMI |
$23.99
|
| Rate for Payer: PHP Commercial |
$26.39
|
| Rate for Payer: PHP Medicaid |
$12.86
|
| Rate for Payer: PHP Medicare Advantage |
$23.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$48.32
|
| Rate for Payer: Priority Health Medicare |
$23.99
|
| Rate for Payer: Priority Health Narrow Network |
$38.66
|
| Rate for Payer: Railroad Medicare Medicare |
$23.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.99
|
| Rate for Payer: UHC Exchange |
$37.18
|
| Rate for Payer: UHC Medicare Advantage |
$23.99
|
| Rate for Payer: UHCCP DNSP |
$23.99
|
| Rate for Payer: UHCCP Medicaid |
$12.86
|
| Rate for Payer: VA VA |
$23.99
|
|
|
HC NEEDLE INSERT W/O INJECTION, 1 OR 2 MUSCLES
|
Facility
|
IP
|
$30.60
|
|
|
Service Code
|
CPT 20560
|
| Hospital Charge Code |
42000060
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$19.89 |
| Max. Negotiated Rate |
$30.60 |
| Rate for Payer: Aetna Commercial |
$27.54
|
| Rate for Payer: ASR ASR |
$29.68
|
| Rate for Payer: ASR Commercial |
$29.68
|
| Rate for Payer: BCBS Trust/PPO |
$24.94
|
| Rate for Payer: BCN Commercial |
$23.72
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$28.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.48
|
| Rate for Payer: Healthscope Commercial |
$30.60
|
| Rate for Payer: Healthscope Whirlpool |
$29.68
|
| Rate for Payer: Mclaren Commercial |
$27.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.01
|
| Rate for Payer: Nomi Health Commercial |
$25.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.93
|
|
|
HC NEEDLE INSERT W/O INJECTION, 3 OR MORE MUSCLES
|
Facility
|
OP
|
$51.00
|
|
|
Service Code
|
CPT 20561
|
| Hospital Charge Code |
42000061
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$12.86 |
| Max. Negotiated Rate |
$70.65 |
| Rate for Payer: Aetna Commercial |
$45.90
|
| Rate for Payer: Aetna Medicare |
$23.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.99
|
| Rate for Payer: ASR ASR |
$49.47
|
| Rate for Payer: ASR Commercial |
$49.47
|
| Rate for Payer: BCBS Complete |
$13.50
|
| Rate for Payer: BCBS MAPPO |
$23.99
|
| Rate for Payer: BCBS Trust/PPO |
$41.76
|
| Rate for Payer: BCN Commercial |
$39.54
|
| Rate for Payer: BCN Medicare Advantage |
$23.99
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$47.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.99
|
| Rate for Payer: Healthscope Commercial |
$51.00
|
| Rate for Payer: Healthscope Whirlpool |
$49.47
|
| Rate for Payer: Humana Choice PPO Medicare |
$23.99
|
| Rate for Payer: Mclaren Commercial |
$45.90
|
| Rate for Payer: Mclaren Medicaid |
$12.86
|
| Rate for Payer: Mclaren Medicare |
$23.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.19
|
| Rate for Payer: Meridian Medicaid |
$13.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.35
|
| Rate for Payer: Nomi Health Commercial |
$41.82
|
| Rate for Payer: PACE Medicare |
$22.79
|
| Rate for Payer: PACE SWMI |
$23.99
|
| Rate for Payer: PHP Commercial |
$26.39
|
| Rate for Payer: PHP Medicaid |
$12.86
|
| Rate for Payer: PHP Medicare Advantage |
$23.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$70.65
|
| Rate for Payer: Priority Health Medicare |
$23.99
|
| Rate for Payer: Priority Health Narrow Network |
$56.52
|
| Rate for Payer: Railroad Medicare Medicare |
$23.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.99
|
| Rate for Payer: UHC Exchange |
$37.18
|
| Rate for Payer: UHC Medicare Advantage |
$23.99
|
| Rate for Payer: UHCCP DNSP |
$23.99
|
| Rate for Payer: UHCCP Medicaid |
$12.86
|
| Rate for Payer: VA VA |
$23.99
|
|
|
HC NEEDLE INSERT W/O INJECTION, 3 OR MORE MUSCLES
|
Facility
|
IP
|
$51.00
|
|
|
Service Code
|
CPT 20561
|
| Hospital Charge Code |
42000061
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$33.15 |
| Max. Negotiated Rate |
$51.00 |
| Rate for Payer: Aetna Commercial |
$45.90
|
| Rate for Payer: ASR ASR |
$49.47
|
| Rate for Payer: ASR Commercial |
$49.47
|
| Rate for Payer: BCBS Trust/PPO |
$41.56
|
| Rate for Payer: BCN Commercial |
$39.54
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$47.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Healthscope Commercial |
$51.00
|
| Rate for Payer: Healthscope Whirlpool |
$49.47
|
| Rate for Payer: Mclaren Commercial |
$45.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.35
|
| Rate for Payer: Nomi Health Commercial |
$41.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.88
|
|
|
HC NEEDLE LOC WIRE
|
Facility
|
IP
|
$53.06
|
|
|
Service Code
|
HCPCS C1819
|
| Hospital Charge Code |
27200323
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$34.49 |
| Max. Negotiated Rate |
$53.06 |
| Rate for Payer: Aetna Commercial |
$47.75
|
| Rate for Payer: ASR ASR |
$51.47
|
| Rate for Payer: ASR Commercial |
$51.47
|
| Rate for Payer: BCBS Trust/PPO |
$43.24
|
| Rate for Payer: BCN Commercial |
$41.14
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$49.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Healthscope Commercial |
$53.06
|
| Rate for Payer: Healthscope Whirlpool |
$51.47
|
| Rate for Payer: Mclaren Commercial |
$47.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.69
|
|
|
HC NEEDLE LOC WIRE
|
Facility
|
OP
|
$53.06
|
|
|
Service Code
|
HCPCS C1819
|
| Hospital Charge Code |
27200323
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$21.22 |
| Max. Negotiated Rate |
$53.06 |
| Rate for Payer: Aetna Commercial |
$47.75
|
| Rate for Payer: Aetna Medicare |
$26.53
|
| Rate for Payer: ASR ASR |
$51.47
|
| Rate for Payer: ASR Commercial |
$51.47
|
| Rate for Payer: BCBS Complete |
$21.22
|
| Rate for Payer: BCBS Trust/PPO |
$43.45
|
| Rate for Payer: BCN Commercial |
$41.14
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$49.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Healthscope Commercial |
$53.06
|
| Rate for Payer: Healthscope Whirlpool |
$51.47
|
| Rate for Payer: Mclaren Commercial |
$47.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.49
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$46.49
|
| Rate for Payer: Priority Health Narrow Network |
$37.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.69
|
|
