|
HC SURG SUPPLY MISC
|
Facility
|
IP
|
$84.74
|
|
|
Service Code
|
HCPCS A4649
|
| Hospital Charge Code |
62300132
|
|
Hospital Revenue Code
|
623
|
| Min. Negotiated Rate |
$59.32 |
| Max. Negotiated Rate |
$84.74 |
| Rate for Payer: Aetna Commercial |
$76.27
|
| Rate for Payer: ASR ASR |
$82.20
|
| Rate for Payer: BCBS Trust/PPO |
$65.70
|
| Rate for Payer: BCN Commercial |
$65.70
|
| Rate for Payer: Cash Price |
$67.79
|
| Rate for Payer: Cofinity Commercial |
$79.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.79
|
| Rate for Payer: Healthscope Commercial |
$84.74
|
| Rate for Payer: Healthscope Whirlpool |
$82.20
|
| Rate for Payer: Mclaren Commercial |
$76.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$72.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$74.57
|
|
|
HC SUSCEPTIBILITY DISK
|
Facility
|
IP
|
$57.50
|
|
|
Service Code
|
CPT 87184
|
| Hospital Charge Code |
30600098
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$40.25 |
| Max. Negotiated Rate |
$57.50 |
| Rate for Payer: Aetna Commercial |
$51.75
|
| Rate for Payer: ASR ASR |
$55.78
|
| Rate for Payer: BCBS Trust/PPO |
$44.58
|
| Rate for Payer: BCN Commercial |
$44.58
|
| Rate for Payer: Cash Price |
$46.00
|
| Rate for Payer: Cofinity Commercial |
$54.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.00
|
| Rate for Payer: Healthscope Commercial |
$57.50
|
| Rate for Payer: Healthscope Whirlpool |
$55.78
|
| Rate for Payer: Mclaren Commercial |
$51.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$48.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$50.60
|
|
|
HC SUSCEPTIBILITY DISK
|
Facility
|
OP
|
$57.50
|
|
|
Service Code
|
CPT 87184
|
| Hospital Charge Code |
30600098
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.09 |
| Max. Negotiated Rate |
$57.50 |
| Rate for Payer: Aetna Commercial |
$51.75
|
| Rate for Payer: Aetna Medicare |
$7.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.35
|
| Rate for Payer: ASR ASR |
$55.78
|
| Rate for Payer: BCBS Complete |
$4.30
|
| Rate for Payer: BCBS MAPPO |
$7.48
|
| Rate for Payer: BCBS Trust/PPO |
$44.58
|
| Rate for Payer: BCN Commercial |
$44.58
|
| Rate for Payer: BCN Medicare Advantage |
$7.48
|
| Rate for Payer: Cash Price |
$46.00
|
| Rate for Payer: Cash Price |
$46.00
|
| Rate for Payer: Cofinity Commercial |
$54.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.48
|
| Rate for Payer: Healthscope Commercial |
$57.50
|
| Rate for Payer: Healthscope Whirlpool |
$55.78
|
| Rate for Payer: Humana Choice PPO Medicare |
$7.48
|
| Rate for Payer: Mclaren Commercial |
$51.75
|
| Rate for Payer: Mclaren Medicaid |
$4.09
|
| Rate for Payer: Mclaren Medicare |
$7.48
|
| Rate for Payer: Meridian Medicaid |
$4.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$48.88
|
| Rate for Payer: PACE Medicare |
$7.11
|
| Rate for Payer: PACE SWMI |
$7.48
|
| Rate for Payer: PHP Commercial |
$8.23
|
| Rate for Payer: PHP Medicaid |
$4.09
|
| Rate for Payer: PHP Medicare Advantage |
$7.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19.50
|
| Rate for Payer: Priority Health Medicare |
$7.48
|
| Rate for Payer: Priority Health Narrow Network |
$15.60
|
| Rate for Payer: Railroad Medicare Medicare |
$7.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$50.60
|
| Rate for Payer: UHC Medicare Advantage |
$7.70
|
| Rate for Payer: VA VA |
$7.48
|
|
|
HC SUSCEPTIBILITY E TEST
|
Facility
|
IP
|
$32.13
|
|
|
Service Code
|
CPT 87181
|
| Hospital Charge Code |
30600097
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$22.49 |
| Max. Negotiated Rate |
$32.13 |
| Rate for Payer: Aetna Commercial |
$28.92
|
| Rate for Payer: ASR ASR |
$31.17
|
| Rate for Payer: BCBS Trust/PPO |
$24.91
|
| Rate for Payer: BCN Commercial |
$24.91
|
| Rate for Payer: Cash Price |
$25.70
|
| Rate for Payer: Cofinity Commercial |
$30.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.70
|
| Rate for Payer: Healthscope Commercial |
$32.13
|
| Rate for Payer: Healthscope Whirlpool |
$31.17
|
| Rate for Payer: Mclaren Commercial |
$28.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$27.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.27
|
|
|
HC SUSCEPTIBILITY E TEST
|
Facility
|
OP
|
$32.13
|
|
|
Service Code
|
CPT 87181
|
| Hospital Charge Code |
30600097
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$2.60 |
| Max. Negotiated Rate |
$32.13 |
| Rate for Payer: Aetna Commercial |
$28.92
|
| Rate for Payer: Aetna Medicare |
$4.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.94
|
| Rate for Payer: ASR ASR |
$31.17
|
| Rate for Payer: BCBS Complete |
$2.73
|
| Rate for Payer: BCBS MAPPO |
$4.75
|
| Rate for Payer: BCBS Trust/PPO |
$24.91
|
| Rate for Payer: BCN Commercial |
$24.91
|
| Rate for Payer: BCN Medicare Advantage |
$4.75
|
| Rate for Payer: Cash Price |
$25.70
|
| Rate for Payer: Cash Price |
$25.70
|
| Rate for Payer: Cofinity Commercial |
$30.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.75
|
| Rate for Payer: Healthscope Commercial |
$32.13
|
| Rate for Payer: Healthscope Whirlpool |
$31.17
|
| Rate for Payer: Humana Choice PPO Medicare |
$4.75
|
| Rate for Payer: Mclaren Commercial |
$28.92
|
| Rate for Payer: Mclaren Medicaid |
$2.60
|
| Rate for Payer: Mclaren Medicare |
$4.75
|
| Rate for Payer: Meridian Medicaid |
$2.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$27.31
|
| Rate for Payer: PACE Medicare |
$4.51
|
| Rate for Payer: PACE SWMI |
$4.75
|
| Rate for Payer: PHP Commercial |
$5.22
|
| Rate for Payer: PHP Medicaid |
$2.60
|
| Rate for Payer: PHP Medicare Advantage |
$4.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.49
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$29.24
|
| Rate for Payer: Priority Health Medicare |
$4.75
|
| Rate for Payer: Priority Health Narrow Network |
$22.81
|
| Rate for Payer: Railroad Medicare Medicare |
$4.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.27
|
| Rate for Payer: UHC Medicare Advantage |
$4.89
|
| Rate for Payer: VA VA |
$4.75
|
|
|
HC SUSCEPTIBILITY, MIC
|
Facility
|
IP
|
$79.00
|
|
|
Service Code
|
CPT 87186
|
| Hospital Charge Code |
30600100
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$55.30 |
| Max. Negotiated Rate |
$79.00 |
| Rate for Payer: Aetna Commercial |
$71.10
|
| Rate for Payer: ASR ASR |
$76.63
|
| Rate for Payer: BCBS Trust/PPO |
$61.25
|
| Rate for Payer: BCN Commercial |
$61.25
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cofinity Commercial |
$74.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.20
|
| Rate for Payer: Healthscope Commercial |
$79.00
|
| Rate for Payer: Healthscope Whirlpool |
$76.63
|
| Rate for Payer: Mclaren Commercial |
$71.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$67.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$69.52
|
|
|
HC SUSCEPTIBILITY, MIC
|
Facility
|
OP
|
$79.00
|
|
|
Service Code
|
CPT 87186
|
| Hospital Charge Code |
30600100
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.73 |
| Max. Negotiated Rate |
$79.00 |
| Rate for Payer: Aetna Commercial |
$71.10
|
| Rate for Payer: Aetna Medicare |
$8.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.81
|
| Rate for Payer: ASR ASR |
$76.63
|
| Rate for Payer: BCBS Complete |
$4.97
|
| Rate for Payer: BCBS MAPPO |
$8.65
|
| Rate for Payer: BCBS Trust/PPO |
$61.25
|
| Rate for Payer: BCN Commercial |
$61.25
|
| Rate for Payer: BCN Medicare Advantage |
$8.65
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cofinity Commercial |
$74.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.65
|
| Rate for Payer: Healthscope Commercial |
$79.00
|
| Rate for Payer: Healthscope Whirlpool |
$76.63
|
| Rate for Payer: Humana Choice PPO Medicare |
$8.65
|
| Rate for Payer: Mclaren Commercial |
$71.10
|
| Rate for Payer: Mclaren Medicaid |
$4.73
|
| Rate for Payer: Mclaren Medicare |
$8.65
|
| Rate for Payer: Meridian Medicaid |
$4.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$67.15
|
| Rate for Payer: PACE Medicare |
$8.22
|
| Rate for Payer: PACE SWMI |
$8.65
|
| Rate for Payer: PHP Commercial |
$9.52
|
| Rate for Payer: PHP Medicaid |
$4.73
|
| Rate for Payer: PHP Medicare Advantage |
$8.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$36.95
|
| Rate for Payer: Priority Health Medicare |
$8.65
|
| Rate for Payer: Priority Health Narrow Network |
$29.56
|
| Rate for Payer: Railroad Medicare Medicare |
$8.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$69.52
|
| Rate for Payer: UHC Medicare Advantage |
$8.91
|
| Rate for Payer: VA VA |
$8.65
|
|
|
HC SUTURE REMOVAL UNDER ANESTHESIA
|
Facility
|
IP
|
$768.07
|
|
| Hospital Charge Code |
36100544
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$537.65 |
| Max. Negotiated Rate |
$768.07 |
| Rate for Payer: Aetna Commercial |
$691.26
|
| Rate for Payer: ASR ASR |
$745.03
|
| Rate for Payer: BCBS Trust/PPO |
$595.48
|
| Rate for Payer: BCN Commercial |
$595.48
|
| Rate for Payer: Cash Price |
$614.46
|
| Rate for Payer: Cofinity Commercial |
$721.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$614.46
|
| Rate for Payer: Healthscope Commercial |
$768.07
|
| Rate for Payer: Healthscope Whirlpool |
$745.03
|
| Rate for Payer: Mclaren Commercial |
$691.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$652.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$537.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$675.90
|
|
|
HC SUTURE REMOVAL UNDER ANESTHESIA
|
Facility
|
OP
|
$768.07
|
|
| Hospital Charge Code |
36100544
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$307.23 |
| Max. Negotiated Rate |
$768.07 |
| Rate for Payer: Aetna Commercial |
$691.26
|
| Rate for Payer: ASR ASR |
$745.03
|
| Rate for Payer: BCBS Complete |
$307.23
|
| Rate for Payer: BCBS Trust/PPO |
$595.48
|
| Rate for Payer: BCN Commercial |
$595.48
|
| Rate for Payer: Cash Price |
$614.46
|
| Rate for Payer: Cofinity Commercial |
$721.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$614.46
|
| Rate for Payer: Healthscope Commercial |
$768.07
|
| Rate for Payer: Healthscope Whirlpool |
$745.03
|
| Rate for Payer: Mclaren Commercial |
$691.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$652.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$537.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$698.94
|
| Rate for Payer: Priority Health Narrow Network |
$545.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$675.90
|
|
|
HC SWALLOW EVALUATION
|
Facility
|
OP
|
$326.81
|
|
|
Service Code
|
CPT 92610
|
| Hospital Charge Code |
44400004
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$129.71 |
| Max. Negotiated Rate |
$326.81 |
| Rate for Payer: Aetna Commercial |
$294.13
|
| Rate for Payer: ASR ASR |
$317.01
|
| Rate for Payer: BCBS Complete |
$130.72
|
| Rate for Payer: BCBS Trust/PPO |
$253.38
|
| Rate for Payer: BCN Commercial |
$253.38
|
| Rate for Payer: Cash Price |
$261.45
|
| Rate for Payer: Cash Price |
$261.45
|
| Rate for Payer: Cofinity Commercial |
$307.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$261.45
|
| Rate for Payer: Healthscope Commercial |
$326.81
|
| Rate for Payer: Healthscope Whirlpool |
$317.01
|
| Rate for Payer: Mclaren Commercial |
$294.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$277.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$228.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$162.14
|
| Rate for Payer: Priority Health Narrow Network |
$129.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$287.59
|
|
|
HC SWALLOW EVALUATION
|
Facility
|
IP
|
$326.81
|
|
|
Service Code
|
CPT 92610
|
| Hospital Charge Code |
44400004
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$228.77 |
| Max. Negotiated Rate |
$326.81 |
| Rate for Payer: Aetna Commercial |
$294.13
|
| Rate for Payer: ASR ASR |
$317.01
|
| Rate for Payer: BCBS Trust/PPO |
$253.38
|
| Rate for Payer: BCN Commercial |
$253.38
|
| Rate for Payer: Cash Price |
$261.45
|
| Rate for Payer: Cofinity Commercial |
$307.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$261.45
|
| Rate for Payer: Healthscope Commercial |
$326.81
|
| Rate for Payer: Healthscope Whirlpool |
$317.01
|
| Rate for Payer: Mclaren Commercial |
$294.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$277.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$228.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$287.59
|
|
|
HC SWALLOWING THERAPY
|
Facility
|
IP
|
$214.20
|
|
|
Service Code
|
CPT 92526
|
| Hospital Charge Code |
43000020
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$149.94 |
| Max. Negotiated Rate |
$214.20 |
| Rate for Payer: Aetna Commercial |
$192.78
|
| Rate for Payer: ASR ASR |
$207.77
|
| Rate for Payer: BCBS Trust/PPO |
$166.07
|
| Rate for Payer: BCN Commercial |
$166.07
|
| Rate for Payer: Cash Price |
$171.36
|
| Rate for Payer: Cofinity Commercial |
$201.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$171.36
|
| Rate for Payer: Healthscope Commercial |
$214.20
|
| Rate for Payer: Healthscope Whirlpool |
$207.77
|
| Rate for Payer: Mclaren Commercial |
$192.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$182.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$149.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$188.50
|
|
|
HC SWALLOWING THERAPY
|
Facility
|
OP
|
$214.20
|
|
|
Service Code
|
CPT 92526
|
| Hospital Charge Code |
43000020
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$85.68 |
| Max. Negotiated Rate |
$218.58 |
| Rate for Payer: Aetna Commercial |
$192.78
|
| Rate for Payer: ASR ASR |
$207.77
|
| Rate for Payer: BCBS Complete |
$85.68
|
| Rate for Payer: BCBS Trust/PPO |
$166.07
|
| Rate for Payer: BCN Commercial |
$166.07
|
| Rate for Payer: Cash Price |
$171.36
|
| Rate for Payer: Cash Price |
$171.36
|
| Rate for Payer: Cofinity Commercial |
$201.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$171.36
|
| Rate for Payer: Healthscope Commercial |
$214.20
|
| Rate for Payer: Healthscope Whirlpool |
$207.77
|
| Rate for Payer: Mclaren Commercial |
$192.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$182.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$149.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$218.58
|
| Rate for Payer: Priority Health Narrow Network |
$174.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$188.50
|
|
|
HC SWAN GANZ CATHETER
|
Facility
|
OP
|
$230.85
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200073
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$92.34 |
| Max. Negotiated Rate |
$230.85 |
| Rate for Payer: Aetna Commercial |
$207.76
|
| Rate for Payer: ASR ASR |
$223.92
|
| Rate for Payer: BCBS Complete |
$92.34
|
| Rate for Payer: BCBS Trust/PPO |
$178.98
|
| Rate for Payer: BCN Commercial |
$178.98
|
| Rate for Payer: Cash Price |
$184.68
|
| Rate for Payer: Cofinity Commercial |
$217.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$184.68
|
| Rate for Payer: Healthscope Commercial |
$230.85
|
| Rate for Payer: Healthscope Whirlpool |
$223.92
|
| Rate for Payer: Mclaren Commercial |
$207.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$196.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$210.07
|
| Rate for Payer: Priority Health Narrow Network |
$163.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$203.15
|
|
|
HC SWAN GANZ CATHETER
|
Facility
|
IP
|
$230.85
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200073
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$161.60 |
| Max. Negotiated Rate |
$230.85 |
| Rate for Payer: Aetna Commercial |
$207.76
|
| Rate for Payer: ASR ASR |
$223.92
|
| Rate for Payer: BCBS Trust/PPO |
$178.98
|
| Rate for Payer: BCN Commercial |
$178.98
|
| Rate for Payer: Cash Price |
$184.68
|
| Rate for Payer: Cofinity Commercial |
$217.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$184.68
|
| Rate for Payer: Healthscope Commercial |
$230.85
|
| Rate for Payer: Healthscope Whirlpool |
$223.92
|
| Rate for Payer: Mclaren Commercial |
$207.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$196.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$203.15
|
|
|
HC SWAN GANZ PLACEMENT
|
Facility
|
OP
|
$1,612.62
|
|
|
Service Code
|
CPT 93503
|
| Hospital Charge Code |
48100024
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$778.69 |
| Max. Negotiated Rate |
$1,779.46 |
| Rate for Payer: Aetna Commercial |
$1,451.36
|
| Rate for Payer: Aetna Medicare |
$1,423.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,779.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,779.46
|
| Rate for Payer: ASR ASR |
$1,564.24
|
| Rate for Payer: BCBS Complete |
$817.70
|
| Rate for Payer: BCBS MAPPO |
$1,423.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,250.26
|
| Rate for Payer: BCN Commercial |
$1,250.26
|
| Rate for Payer: BCN Medicare Advantage |
$1,423.57
|
| Rate for Payer: Cash Price |
$1,290.10
|
| Rate for Payer: Cash Price |
$1,290.10
|
| Rate for Payer: Cofinity Commercial |
$1,515.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,290.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,423.57
|
| Rate for Payer: Healthscope Commercial |
$1,612.62
|
| Rate for Payer: Healthscope Whirlpool |
$1,564.24
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,423.57
|
| Rate for Payer: Mclaren Commercial |
$1,451.36
|
| Rate for Payer: Mclaren Medicaid |
$778.69
|
| Rate for Payer: Mclaren Medicare |
$1,423.57
|
| Rate for Payer: Meridian Medicaid |
$817.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,494.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,637.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,370.73
|
| Rate for Payer: PACE Medicare |
$1,352.39
|
| Rate for Payer: PACE SWMI |
$1,423.57
|
| Rate for Payer: PHP Commercial |
$1,565.93
|
| Rate for Payer: PHP Medicaid |
$778.69
|
| Rate for Payer: PHP Medicare Advantage |
$1,423.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$778.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,128.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,467.48
|
| Rate for Payer: Priority Health Medicare |
$1,423.57
|
| Rate for Payer: Priority Health Narrow Network |
$1,144.96
|
| Rate for Payer: Railroad Medicare Medicare |
$1,423.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,419.11
|
| Rate for Payer: UHC Medicare Advantage |
$1,466.28
|
| Rate for Payer: VA VA |
$1,423.57
|
|
|
HC SWAN GANZ PLACEMENT
|
Facility
|
IP
|
$1,612.62
|
|
|
Service Code
|
CPT 93503
|
| Hospital Charge Code |
48100024
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,128.83 |
| Max. Negotiated Rate |
$1,612.62 |
| Rate for Payer: Aetna Commercial |
$1,451.36
|
| Rate for Payer: ASR ASR |
$1,564.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,250.26
|
| Rate for Payer: BCN Commercial |
$1,250.26
|
| Rate for Payer: Cash Price |
$1,290.10
|
| Rate for Payer: Cofinity Commercial |
$1,515.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,290.10
|
| Rate for Payer: Healthscope Commercial |
$1,612.62
|
| Rate for Payer: Healthscope Whirlpool |
$1,564.24
|
| Rate for Payer: Mclaren Commercial |
$1,451.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,370.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,128.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,419.11
|
|
|
HC SWEAT CHLORIDE
|
Facility
|
OP
|
$77.70
|
|
|
Service Code
|
CPT 82438
|
| Hospital Charge Code |
30100154
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.74 |
| Max. Negotiated Rate |
$77.70 |
| Rate for Payer: Aetna Commercial |
$69.93
|
| Rate for Payer: Aetna Medicare |
$5.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.25
|
| Rate for Payer: ASR ASR |
$75.37
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.00
|
| Rate for Payer: BCBS Trust/PPO |
$60.24
|
| Rate for Payer: BCN Commercial |
$60.24
|
| Rate for Payer: BCN Medicare Advantage |
$5.00
|
| Rate for Payer: Cash Price |
$62.16
|
| Rate for Payer: Cash Price |
$62.16
|
| Rate for Payer: Cofinity Commercial |
$73.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.00
|
| Rate for Payer: Healthscope Commercial |
$77.70
|
| Rate for Payer: Healthscope Whirlpool |
$75.37
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.00
|
| Rate for Payer: Mclaren Commercial |
$69.93
|
| Rate for Payer: Mclaren Medicaid |
$2.74
|
| Rate for Payer: Mclaren Medicare |
$5.00
|
| Rate for Payer: Meridian Medicaid |
$2.87
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$66.04
|
| Rate for Payer: PACE Medicare |
$4.75
|
| Rate for Payer: PACE SWMI |
$5.00
|
| Rate for Payer: PHP Commercial |
$5.50
|
| Rate for Payer: PHP Medicaid |
$2.74
|
| Rate for Payer: PHP Medicare Advantage |
$5.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25.15
|
| Rate for Payer: Priority Health Medicare |
$5.00
|
| Rate for Payer: Priority Health Narrow Network |
$20.12
|
| Rate for Payer: Railroad Medicare Medicare |
$5.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$68.38
|
| Rate for Payer: UHC Medicare Advantage |
$5.15
|
| Rate for Payer: VA VA |
$5.00
|
|
|
HC SWEAT CHLORIDE
|
Facility
|
IP
|
$77.70
|
|
|
Service Code
|
CPT 82438
|
| Hospital Charge Code |
30100154
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$54.39 |
| Max. Negotiated Rate |
$77.70 |
| Rate for Payer: Aetna Commercial |
$69.93
|
| Rate for Payer: ASR ASR |
$75.37
|
| Rate for Payer: BCBS Trust/PPO |
$60.24
|
| Rate for Payer: BCN Commercial |
$60.24
|
| Rate for Payer: Cash Price |
$62.16
|
| Rate for Payer: Cofinity Commercial |
$73.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.16
|
| Rate for Payer: Healthscope Commercial |
$77.70
|
| Rate for Payer: Healthscope Whirlpool |
$75.37
|
| Rate for Payer: Mclaren Commercial |
$69.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$66.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$68.38
|
|
|
HC SWEAT COLLECTION
|
Facility
|
IP
|
$97.20
|
|
|
Service Code
|
CPT 89230
|
| Hospital Charge Code |
30000004
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$68.04 |
| Max. Negotiated Rate |
$97.20 |
| Rate for Payer: Aetna Commercial |
$87.48
|
| Rate for Payer: ASR ASR |
$94.28
|
| Rate for Payer: BCBS Trust/PPO |
$75.36
|
| Rate for Payer: BCN Commercial |
$75.36
|
| Rate for Payer: Cash Price |
$77.76
|
| Rate for Payer: Cofinity Commercial |
$91.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.76
|
| Rate for Payer: Healthscope Commercial |
$97.20
|
| Rate for Payer: Healthscope Whirlpool |
$94.28
|
| Rate for Payer: Mclaren Commercial |
$87.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$82.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$85.54
|
|
|
HC SWEAT COLLECTION
|
Facility
|
OP
|
$97.20
|
|
|
Service Code
|
CPT 89230
|
| Hospital Charge Code |
30000004
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$26.35 |
| Max. Negotiated Rate |
$97.20 |
| Rate for Payer: Aetna Commercial |
$87.48
|
| Rate for Payer: Aetna Medicare |
$48.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$60.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$60.21
|
| Rate for Payer: ASR ASR |
$94.28
|
| Rate for Payer: BCBS Complete |
$27.67
|
| Rate for Payer: BCBS MAPPO |
$48.17
|
| Rate for Payer: BCBS Trust/PPO |
$75.36
|
| Rate for Payer: BCN Commercial |
$75.36
|
| Rate for Payer: BCN Medicare Advantage |
$48.17
|
| Rate for Payer: Cash Price |
$77.76
|
| Rate for Payer: Cash Price |
$77.76
|
| Rate for Payer: Cofinity Commercial |
$91.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.17
|
| Rate for Payer: Healthscope Commercial |
$97.20
|
| Rate for Payer: Healthscope Whirlpool |
$94.28
|
| Rate for Payer: Humana Choice PPO Medicare |
$48.17
|
| Rate for Payer: Mclaren Commercial |
$87.48
|
| Rate for Payer: Mclaren Medicaid |
$26.35
|
| Rate for Payer: Mclaren Medicare |
$48.17
|
| Rate for Payer: Meridian Medicaid |
$27.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$50.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$55.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$82.62
|
| Rate for Payer: PACE Medicare |
$45.76
|
| Rate for Payer: PACE SWMI |
$48.17
|
| Rate for Payer: PHP Commercial |
$52.99
|
| Rate for Payer: PHP Medicaid |
$26.35
|
| Rate for Payer: PHP Medicare Advantage |
$48.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$88.45
|
| Rate for Payer: Priority Health Medicare |
$48.17
|
| Rate for Payer: Priority Health Narrow Network |
$69.01
|
| Rate for Payer: Railroad Medicare Medicare |
$48.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$85.54
|
| Rate for Payer: UHC Medicare Advantage |
$49.62
|
| Rate for Payer: VA VA |
$48.17
|
|
|
HC SWEET VERNAL IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200103
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.86 |
| Max. Negotiated Rate |
$24.89 |
| Rate for Payer: Aetna Commercial |
$22.40
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: ASR ASR |
$24.14
|
| Rate for Payer: BCBS Complete |
$3.00
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.30
|
| Rate for Payer: BCN Commercial |
$19.30
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$23.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$24.89
|
| Rate for Payer: Healthscope Whirlpool |
$24.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$22.40
|
| Rate for Payer: Mclaren Medicaid |
$2.86
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Medicaid |
$3.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$5.74
|
| Rate for Payer: PHP Medicaid |
$2.86
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.65
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$17.67
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.90
|
| Rate for Payer: UHC Medicare Advantage |
$5.38
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC SWEET VERNAL IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200103
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$17.42 |
| Max. Negotiated Rate |
$24.89 |
| Rate for Payer: Aetna Commercial |
$22.40
|
| Rate for Payer: ASR ASR |
$24.14
|
| Rate for Payer: BCBS Trust/PPO |
$19.30
|
| Rate for Payer: BCN Commercial |
$19.30
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$23.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$24.89
|
| Rate for Payer: Healthscope Whirlpool |
$24.14
|
| Rate for Payer: Mclaren Commercial |
$22.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.90
|
|
|
HC SYCAMORE IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200104
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$17.42 |
| Max. Negotiated Rate |
$24.89 |
| Rate for Payer: Aetna Commercial |
$22.40
|
| Rate for Payer: ASR ASR |
$24.14
|
| Rate for Payer: BCBS Trust/PPO |
$19.30
|
| Rate for Payer: BCN Commercial |
$19.30
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$23.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$24.89
|
| Rate for Payer: Healthscope Whirlpool |
$24.14
|
| Rate for Payer: Mclaren Commercial |
$22.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.90
|
|
|
HC SYCAMORE IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200104
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.86 |
| Max. Negotiated Rate |
$24.89 |
| Rate for Payer: Aetna Commercial |
$22.40
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: ASR ASR |
$24.14
|
| Rate for Payer: BCBS Complete |
$3.00
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.30
|
| Rate for Payer: BCN Commercial |
$19.30
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$23.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$24.89
|
| Rate for Payer: Healthscope Whirlpool |
$24.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$22.40
|
| Rate for Payer: Mclaren Medicaid |
$2.86
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Medicaid |
$3.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$5.74
|
| Rate for Payer: PHP Medicaid |
$2.86
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.65
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$17.67
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.90
|
| Rate for Payer: UHC Medicare Advantage |
$5.38
|
| Rate for Payer: VA VA |
$5.22
|
|
