|
HC PATHOLOGY LEVEL IV DERM
|
Facility
|
IP
|
$119.41
|
|
|
Service Code
|
CPT 88305
|
| Hospital Charge Code |
31000106
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$89.56 |
| Max. Negotiated Rate |
$119.41 |
| Rate for Payer: Aetna Commercial |
$107.47
|
| Rate for Payer: ASR ASR |
$115.83
|
| Rate for Payer: BCBS Trust/PPO |
$98.06
|
| Rate for Payer: BCN Commercial |
$98.06
|
| Rate for Payer: Cash Price |
$95.53
|
| Rate for Payer: Cofinity Commercial |
$112.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.53
|
| Rate for Payer: Healthscope Commercial |
$115.83
|
| Rate for Payer: Healthscope Whirlpool |
$119.41
|
| Rate for Payer: Mclaren Commercial |
$107.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.50
|
| Rate for Payer: Nomi Health Commercial |
$97.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$89.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$105.08
|
|
|
HC PATHOLOGY LEVEL IV DERM
|
Facility
|
OP
|
$119.41
|
|
|
Service Code
|
CPT 88305
|
| Hospital Charge Code |
31000106
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$27.15 |
| Max. Negotiated Rate |
$183.99 |
| Rate for Payer: Aetna Commercial |
$107.47
|
| Rate for Payer: Aetna Medicare |
$51.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$64.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$64.90
|
| Rate for Payer: ASR ASR |
$115.83
|
| Rate for Payer: BCBS Complete |
$28.51
|
| Rate for Payer: BCBS MAPPO |
$51.92
|
| Rate for Payer: BCBS Trust/PPO |
$98.45
|
| Rate for Payer: BCCCP Commercial |
$67.27
|
| Rate for Payer: BCN Commercial |
$98.45
|
| Rate for Payer: BCN Medicare Advantage |
$51.92
|
| Rate for Payer: Cash Price |
$95.53
|
| Rate for Payer: Cash Price |
$95.53
|
| Rate for Payer: Cofinity Commercial |
$112.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.92
|
| Rate for Payer: Healthscope Commercial |
$115.83
|
| Rate for Payer: Healthscope Whirlpool |
$119.41
|
| Rate for Payer: Humana Choice PPO Medicare |
$51.92
|
| Rate for Payer: Mclaren Commercial |
$107.47
|
| Rate for Payer: Mclaren Medicaid |
$51.92
|
| Rate for Payer: Mclaren Medicare |
$51.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$54.52
|
| Rate for Payer: Meridian Medicaid |
$28.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$57.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.50
|
| Rate for Payer: Nomi Health Commercial |
$97.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$89.56
|
| Rate for Payer: PACE Medicare |
$49.32
|
| Rate for Payer: PACE SWMI |
$51.92
|
| Rate for Payer: PHP Commercial |
$57.11
|
| Rate for Payer: PHP Medicaid |
$27.83
|
| Rate for Payer: PHP Medicare Advantage |
$51.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$183.99
|
| Rate for Payer: Priority Health Medicare |
$51.92
|
| Rate for Payer: Priority Health Narrow Network |
$147.19
|
| Rate for Payer: Railroad Medicare Medicare |
$51.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$105.08
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$51.92
|
| Rate for Payer: UHC Exchange |
$80.48
|
| Rate for Payer: UHC Medicaid |
$27.15
|
| Rate for Payer: UHCCP DNSP |
$51.92
|
| Rate for Payer: UHCCP Medicaid |
$27.15
|
| Rate for Payer: VA VA |
$51.92
|
|
|
HC PATHOLOGY LEVEL V
|
Facility
|
IP
|
$594.00
|
|
|
Service Code
|
CPT 88307
|
| Hospital Charge Code |
31000049
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$445.50 |
| Max. Negotiated Rate |
$594.00 |
| Rate for Payer: Aetna Commercial |
$534.60
|
| Rate for Payer: ASR ASR |
$576.18
|
| Rate for Payer: BCBS Trust/PPO |
$487.79
|
| Rate for Payer: BCN Commercial |
$487.79
|
| Rate for Payer: Cash Price |
$475.20
|
| Rate for Payer: Cofinity Commercial |
$558.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$475.20
|
| Rate for Payer: Healthscope Commercial |
$576.18
|
| Rate for Payer: Healthscope Whirlpool |
$594.00
|
| Rate for Payer: Mclaren Commercial |
$534.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$504.90
|
| Rate for Payer: Nomi Health Commercial |
$487.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$445.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$522.72
|
|
|
HC PATHOLOGY LEVEL V
|
Facility
|
OP
|
$594.00
|
|
|
Service Code
|
CPT 88307
|
| Hospital Charge Code |
31000049
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$174.32 |
| Max. Negotiated Rate |
$594.00 |
| Rate for Payer: Aetna Commercial |
$534.60
|
| Rate for Payer: Aetna Medicare |
$357.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$446.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$446.45
|
| Rate for Payer: ASR ASR |
$576.18
|
| Rate for Payer: BCBS Complete |
$196.15
|
| Rate for Payer: BCBS MAPPO |
$357.16
|
| Rate for Payer: BCBS Trust/PPO |
$489.75
|
| Rate for Payer: BCCCP Commercial |
$267.07
|
| Rate for Payer: BCN Commercial |
$489.75
|
| Rate for Payer: BCN Medicare Advantage |
$357.16
|
| Rate for Payer: Cash Price |
$475.20
|
| Rate for Payer: Cash Price |
$475.20
|
| Rate for Payer: Cofinity Commercial |
$558.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$475.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$357.16
|
| Rate for Payer: Healthscope Commercial |
$576.18
|
| Rate for Payer: Healthscope Whirlpool |
$594.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$357.16
|
| Rate for Payer: Mclaren Commercial |
$534.60
|
| Rate for Payer: Mclaren Medicaid |
$357.16
|
| Rate for Payer: Mclaren Medicare |
$357.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$375.02
|
| Rate for Payer: Meridian Medicaid |
$196.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$410.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$392.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$504.90
|
| Rate for Payer: Nomi Health Commercial |
$487.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$445.50
|
| Rate for Payer: PACE Medicare |
$339.30
|
| Rate for Payer: PACE SWMI |
$357.16
|
| Rate for Payer: PHP Commercial |
$392.88
|
| Rate for Payer: PHP Medicaid |
$191.44
|
| Rate for Payer: PHP Medicare Advantage |
$357.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$217.90
|
| Rate for Payer: Priority Health Medicare |
$357.16
|
| Rate for Payer: Priority Health Narrow Network |
$174.32
|
| Rate for Payer: Railroad Medicare Medicare |
$357.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$522.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$357.16
|
| Rate for Payer: UHC Exchange |
$553.60
|
| Rate for Payer: UHC Medicaid |
$186.79
|
| Rate for Payer: UHCCP DNSP |
$357.16
|
| Rate for Payer: UHCCP Medicaid |
$186.79
|
| Rate for Payer: VA VA |
$357.16
|
|
|
HC PATHOLOGY LEVEL VI
|
Facility
|
OP
|
$825.64
|
|
|
Service Code
|
CPT 88309
|
| Hospital Charge Code |
31000050
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$184.98 |
| Max. Negotiated Rate |
$1,244.31 |
| Rate for Payer: Aetna Commercial |
$743.08
|
| Rate for Payer: Aetna Medicare |
$802.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,003.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,003.48
|
| Rate for Payer: ASR ASR |
$800.87
|
| Rate for Payer: BCBS Complete |
$440.89
|
| Rate for Payer: BCBS MAPPO |
$802.78
|
| Rate for Payer: BCBS Trust/PPO |
$680.74
|
| Rate for Payer: BCN Commercial |
$680.74
|
| Rate for Payer: BCN Medicare Advantage |
$802.78
|
| Rate for Payer: Cash Price |
$660.51
|
| Rate for Payer: Cash Price |
$660.51
|
| Rate for Payer: Cofinity Commercial |
$776.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$660.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$802.78
|
| Rate for Payer: Healthscope Commercial |
$800.87
|
| Rate for Payer: Healthscope Whirlpool |
$825.64
|
| Rate for Payer: Humana Choice PPO Medicare |
$802.78
|
| Rate for Payer: Mclaren Commercial |
$743.08
|
| Rate for Payer: Mclaren Medicaid |
$802.78
|
| Rate for Payer: Mclaren Medicare |
$802.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$842.92
|
| Rate for Payer: Meridian Medicaid |
$440.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$923.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$883.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$701.79
|
| Rate for Payer: Nomi Health Commercial |
$677.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$619.23
|
| Rate for Payer: PACE Medicare |
$762.64
|
| Rate for Payer: PACE SWMI |
$802.78
|
| Rate for Payer: PHP Commercial |
$883.06
|
| Rate for Payer: PHP Medicaid |
$430.29
|
| Rate for Payer: PHP Medicare Advantage |
$802.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$419.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$231.22
|
| Rate for Payer: Priority Health Medicare |
$802.78
|
| Rate for Payer: Priority Health Narrow Network |
$184.98
|
| Rate for Payer: Railroad Medicare Medicare |
$802.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$726.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$802.78
|
| Rate for Payer: UHC Exchange |
$1,244.31
|
| Rate for Payer: UHC Medicaid |
$419.85
|
| Rate for Payer: UHCCP DNSP |
$802.78
|
| Rate for Payer: UHCCP Medicaid |
$419.85
|
| Rate for Payer: VA VA |
$802.78
|
|
|
HC PATHOLOGY LEVEL VI
|
Facility
|
IP
|
$825.64
|
|
|
Service Code
|
CPT 88309
|
| Hospital Charge Code |
31000050
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$619.23 |
| Max. Negotiated Rate |
$825.64 |
| Rate for Payer: Aetna Commercial |
$743.08
|
| Rate for Payer: ASR ASR |
$800.87
|
| Rate for Payer: BCBS Trust/PPO |
$678.02
|
| Rate for Payer: BCN Commercial |
$678.02
|
| Rate for Payer: Cash Price |
$660.51
|
| Rate for Payer: Cofinity Commercial |
$776.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$660.51
|
| Rate for Payer: Healthscope Commercial |
$800.87
|
| Rate for Payer: Healthscope Whirlpool |
$825.64
|
| Rate for Payer: Mclaren Commercial |
$743.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$701.79
|
| Rate for Payer: Nomi Health Commercial |
$677.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$619.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$726.56
|
|
|
HC PATH SURGERY CYTO ADDITIONAL
|
Facility
|
OP
|
$58.36
|
|
|
Service Code
|
CPT 88334
|
| Hospital Charge Code |
30000068
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$21.59 |
| Max. Negotiated Rate |
$58.36 |
| Rate for Payer: Aetna Commercial |
$52.52
|
| Rate for Payer: Aetna Medicare |
$21.59
|
| Rate for Payer: ASR ASR |
$56.61
|
| Rate for Payer: BCBS Complete |
$23.34
|
| Rate for Payer: BCBS Trust/PPO |
$48.12
|
| Rate for Payer: BCN Commercial |
$48.12
|
| Rate for Payer: Cash Price |
$46.69
|
| Rate for Payer: Cofinity Commercial |
$54.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.69
|
| Rate for Payer: Healthscope Commercial |
$56.61
|
| Rate for Payer: Healthscope Whirlpool |
$58.36
|
| Rate for Payer: Mclaren Commercial |
$52.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.61
|
| Rate for Payer: Nomi Health Commercial |
$47.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$51.14
|
| Rate for Payer: Priority Health Narrow Network |
$40.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$51.36
|
|
|
HC PATH SURGERY CYTO ADDITIONAL
|
Facility
|
IP
|
$58.36
|
|
|
Service Code
|
CPT 88334
|
| Hospital Charge Code |
30000068
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$43.77 |
| Max. Negotiated Rate |
$58.36 |
| Rate for Payer: Aetna Commercial |
$52.52
|
| Rate for Payer: ASR ASR |
$56.61
|
| Rate for Payer: BCBS Trust/PPO |
$47.93
|
| Rate for Payer: BCN Commercial |
$47.93
|
| Rate for Payer: Cash Price |
$46.69
|
| Rate for Payer: Cofinity Commercial |
$54.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.69
|
| Rate for Payer: Healthscope Commercial |
$56.61
|
| Rate for Payer: Healthscope Whirlpool |
$58.36
|
| Rate for Payer: Mclaren Commercial |
$52.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.61
|
| Rate for Payer: Nomi Health Commercial |
$47.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$51.36
|
|
|
HC PATH SURGERY CYTO INITIAL SITE
|
Facility
|
IP
|
$92.32
|
|
|
Service Code
|
CPT 88333
|
| Hospital Charge Code |
30000067
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$69.24 |
| Max. Negotiated Rate |
$92.32 |
| Rate for Payer: Aetna Commercial |
$83.09
|
| Rate for Payer: ASR ASR |
$89.55
|
| Rate for Payer: BCBS Trust/PPO |
$75.81
|
| Rate for Payer: BCN Commercial |
$75.81
|
| Rate for Payer: Cash Price |
$73.86
|
| Rate for Payer: Cofinity Commercial |
$86.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.86
|
| Rate for Payer: Healthscope Commercial |
$89.55
|
| Rate for Payer: Healthscope Whirlpool |
$92.32
|
| Rate for Payer: Mclaren Commercial |
$83.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.47
|
| Rate for Payer: Nomi Health Commercial |
$75.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$69.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$81.24
|
|
|
HC PATH SURGERY CYTO INITIAL SITE
|
Facility
|
OP
|
$92.32
|
|
|
Service Code
|
CPT 88333
|
| Hospital Charge Code |
30000067
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$64.72 |
| Max. Negotiated Rate |
$1,244.31 |
| Rate for Payer: Aetna Commercial |
$83.09
|
| Rate for Payer: Aetna Medicare |
$802.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,003.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,003.48
|
| Rate for Payer: ASR ASR |
$89.55
|
| Rate for Payer: BCBS Complete |
$440.89
|
| Rate for Payer: BCBS MAPPO |
$802.78
|
| Rate for Payer: BCBS Trust/PPO |
$76.12
|
| Rate for Payer: BCN Commercial |
$76.12
|
| Rate for Payer: BCN Medicare Advantage |
$802.78
|
| Rate for Payer: Cash Price |
$73.86
|
| Rate for Payer: Cash Price |
$73.86
|
| Rate for Payer: Cofinity Commercial |
$86.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$802.78
|
| Rate for Payer: Healthscope Commercial |
$89.55
|
| Rate for Payer: Healthscope Whirlpool |
$92.32
|
| Rate for Payer: Humana Choice PPO Medicare |
$802.78
|
| Rate for Payer: Mclaren Commercial |
$83.09
|
| Rate for Payer: Mclaren Medicaid |
$802.78
|
| Rate for Payer: Mclaren Medicare |
$802.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$842.92
|
| Rate for Payer: Meridian Medicaid |
$440.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$923.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$883.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.47
|
| Rate for Payer: Nomi Health Commercial |
$75.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$69.24
|
| Rate for Payer: PACE Medicare |
$762.64
|
| Rate for Payer: PACE SWMI |
$802.78
|
| Rate for Payer: PHP Commercial |
$883.06
|
| Rate for Payer: PHP Medicaid |
$430.29
|
| Rate for Payer: PHP Medicare Advantage |
$802.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$419.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$80.89
|
| Rate for Payer: Priority Health Medicare |
$802.78
|
| Rate for Payer: Priority Health Narrow Network |
$64.72
|
| Rate for Payer: Railroad Medicare Medicare |
$802.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$81.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$802.78
|
| Rate for Payer: UHC Exchange |
$1,244.31
|
| Rate for Payer: UHC Medicaid |
$419.85
|
| Rate for Payer: UHCCP DNSP |
$802.78
|
| Rate for Payer: UHCCP Medicaid |
$419.85
|
| Rate for Payer: VA VA |
$802.78
|
|
|
HC PCP SCREEN URIN
|
Facility
|
OP
|
$96.42
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000136
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$32.50 |
| Max. Negotiated Rate |
$96.42 |
| Rate for Payer: Aetna Commercial |
$86.78
|
| Rate for Payer: Aetna Medicare |
$62.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.67
|
| Rate for Payer: ASR ASR |
$93.53
|
| Rate for Payer: BCBS Complete |
$34.13
|
| Rate for Payer: BCBS MAPPO |
$62.14
|
| Rate for Payer: BCBS Trust/PPO |
$79.50
|
| Rate for Payer: BCN Commercial |
$79.50
|
| Rate for Payer: BCN Medicare Advantage |
$62.14
|
| Rate for Payer: Cash Price |
$77.14
|
| Rate for Payer: Cash Price |
$77.14
|
| Rate for Payer: Cofinity Commercial |
$90.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.14
|
| Rate for Payer: Healthscope Commercial |
$93.53
|
| Rate for Payer: Healthscope Whirlpool |
$96.42
|
| Rate for Payer: Humana Choice PPO Medicare |
$62.14
|
| Rate for Payer: Mclaren Commercial |
$86.78
|
| Rate for Payer: Mclaren Medicaid |
$62.14
|
| Rate for Payer: Mclaren Medicare |
$62.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.25
|
| Rate for Payer: Meridian Medicaid |
$34.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$68.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.96
|
| Rate for Payer: Nomi Health Commercial |
$79.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$72.31
|
| Rate for Payer: PACE Medicare |
$59.03
|
| Rate for Payer: PACE SWMI |
$62.14
|
| Rate for Payer: PHP Commercial |
$68.35
|
| Rate for Payer: PHP Medicaid |
$33.31
|
| Rate for Payer: PHP Medicare Advantage |
$62.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$84.48
|
| Rate for Payer: Priority Health Medicare |
$62.14
|
| Rate for Payer: Priority Health Narrow Network |
$67.59
|
| Rate for Payer: Railroad Medicare Medicare |
$62.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$84.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$62.14
|
| Rate for Payer: UHC Exchange |
$96.32
|
| Rate for Payer: UHC Medicaid |
$32.50
|
| Rate for Payer: UHCCP DNSP |
$62.14
|
| Rate for Payer: UHCCP Medicaid |
$32.50
|
| Rate for Payer: VA VA |
$62.14
|
|
|
HC PCP SCREEN URIN
|
Facility
|
IP
|
$96.42
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000136
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$72.31 |
| Max. Negotiated Rate |
$96.42 |
| Rate for Payer: Aetna Commercial |
$86.78
|
| Rate for Payer: ASR ASR |
$93.53
|
| Rate for Payer: BCBS Trust/PPO |
$79.18
|
| Rate for Payer: BCN Commercial |
$79.18
|
| Rate for Payer: Cash Price |
$77.14
|
| Rate for Payer: Cofinity Commercial |
$90.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.14
|
| Rate for Payer: Healthscope Commercial |
$93.53
|
| Rate for Payer: Healthscope Whirlpool |
$96.42
|
| Rate for Payer: Mclaren Commercial |
$86.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.96
|
| Rate for Payer: Nomi Health Commercial |
$79.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$72.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$84.85
|
|
|
HC PCP SCREEN URN.
|
Facility
|
OP
|
$42.45
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30000120
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.59 |
| Max. Negotiated Rate |
$42.45 |
| Rate for Payer: Aetna Commercial |
$38.20
|
| Rate for Payer: Aetna Medicare |
$12.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.75
|
| Rate for Payer: ASR ASR |
$41.18
|
| Rate for Payer: BCBS Complete |
$6.92
|
| Rate for Payer: BCBS MAPPO |
$12.60
|
| Rate for Payer: BCBS Trust/PPO |
$35.00
|
| Rate for Payer: BCN Commercial |
$35.00
|
| Rate for Payer: BCN Medicare Advantage |
$12.60
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Commercial |
$39.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.60
|
| Rate for Payer: Healthscope Commercial |
$41.18
|
| Rate for Payer: Healthscope Whirlpool |
$42.45
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.60
|
| Rate for Payer: Mclaren Commercial |
$38.20
|
| Rate for Payer: Mclaren Medicaid |
$12.60
|
| Rate for Payer: Mclaren Medicare |
$12.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.23
|
| Rate for Payer: Meridian Medicaid |
$6.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Nomi Health Commercial |
$34.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: PACE Medicare |
$11.97
|
| Rate for Payer: PACE SWMI |
$12.60
|
| Rate for Payer: PHP Commercial |
$13.86
|
| Rate for Payer: PHP Medicaid |
$6.75
|
| Rate for Payer: PHP Medicare Advantage |
$12.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$37.19
|
| Rate for Payer: Priority Health Medicare |
$12.60
|
| Rate for Payer: Priority Health Narrow Network |
$29.76
|
| Rate for Payer: Railroad Medicare Medicare |
$12.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.36
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.60
|
| Rate for Payer: UHC Exchange |
$19.53
|
| Rate for Payer: UHC Medicaid |
$6.59
|
| Rate for Payer: UHCCP DNSP |
$12.60
|
| Rate for Payer: UHCCP Medicaid |
$6.59
|
| Rate for Payer: VA VA |
$12.60
|
|
|
HC PCP SCREEN URN.
|
Facility
|
IP
|
$42.45
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30000120
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$31.84 |
| Max. Negotiated Rate |
$42.45 |
| Rate for Payer: Aetna Commercial |
$38.20
|
| Rate for Payer: ASR ASR |
$41.18
|
| Rate for Payer: BCBS Trust/PPO |
$34.86
|
| Rate for Payer: BCN Commercial |
$34.86
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Commercial |
$39.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Healthscope Commercial |
$41.18
|
| Rate for Payer: Healthscope Whirlpool |
$42.45
|
| Rate for Payer: Mclaren Commercial |
$38.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Nomi Health Commercial |
$34.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.36
|
|
|
HC PCV20 VACCINE FOR INTRAMUSCULAR USE
|
Facility
|
IP
|
$402.63
|
|
|
Service Code
|
CPT 90677
|
| Hospital Charge Code |
63600208
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$301.97 |
| Max. Negotiated Rate |
$402.63 |
| Rate for Payer: Aetna Commercial |
$362.37
|
| Rate for Payer: ASR ASR |
$390.55
|
| Rate for Payer: BCBS Trust/PPO |
$330.64
|
| Rate for Payer: BCN Commercial |
$330.64
|
| Rate for Payer: Cash Price |
$322.10
|
| Rate for Payer: Cofinity Commercial |
$378.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$322.10
|
| Rate for Payer: Healthscope Commercial |
$390.55
|
| Rate for Payer: Healthscope Whirlpool |
$402.63
|
| Rate for Payer: Mclaren Commercial |
$362.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$342.24
|
| Rate for Payer: Nomi Health Commercial |
$330.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$301.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$354.31
|
|
|
HC PCV20 VACCINE FOR INTRAMUSCULAR USE
|
Facility
|
OP
|
$402.63
|
|
|
Service Code
|
CPT 90677
|
| Hospital Charge Code |
63600208
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$148.97 |
| Max. Negotiated Rate |
$402.63 |
| Rate for Payer: Aetna Commercial |
$362.37
|
| Rate for Payer: Aetna Medicare |
$148.97
|
| Rate for Payer: ASR ASR |
$390.55
|
| Rate for Payer: BCBS Complete |
$161.05
|
| Rate for Payer: BCBS Trust/PPO |
$331.97
|
| Rate for Payer: BCN Commercial |
$331.97
|
| Rate for Payer: Cash Price |
$322.10
|
| Rate for Payer: Cash Price |
$322.10
|
| Rate for Payer: Cofinity Commercial |
$378.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$322.10
|
| Rate for Payer: Healthscope Commercial |
$390.55
|
| Rate for Payer: Healthscope Whirlpool |
$402.63
|
| Rate for Payer: Mclaren Commercial |
$362.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$322.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$342.24
|
| Rate for Payer: Nomi Health Commercial |
$330.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$301.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$341.00
|
| Rate for Payer: Priority Health Narrow Network |
$272.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$354.31
|
|
|
HC PEAK FLOW METER
|
Facility
|
IP
|
$29.73
|
|
| Hospital Charge Code |
27000132
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$22.30 |
| Max. Negotiated Rate |
$29.73 |
| Rate for Payer: Aetna Commercial |
$26.76
|
| Rate for Payer: ASR ASR |
$28.84
|
| Rate for Payer: BCBS Trust/PPO |
$24.41
|
| Rate for Payer: BCN Commercial |
$24.41
|
| Rate for Payer: Cash Price |
$23.78
|
| Rate for Payer: Cofinity Commercial |
$27.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.78
|
| Rate for Payer: Healthscope Commercial |
$28.84
|
| Rate for Payer: Healthscope Whirlpool |
$29.73
|
| Rate for Payer: Mclaren Commercial |
$26.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.27
|
| Rate for Payer: Nomi Health Commercial |
$24.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.16
|
|
|
HC PEAK FLOW METER
|
Facility
|
OP
|
$29.73
|
|
| Hospital Charge Code |
27000132
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$11.00 |
| Max. Negotiated Rate |
$29.73 |
| Rate for Payer: Aetna Commercial |
$26.76
|
| Rate for Payer: Aetna Medicare |
$11.00
|
| Rate for Payer: ASR ASR |
$28.84
|
| Rate for Payer: BCBS Complete |
$11.89
|
| Rate for Payer: BCBS Trust/PPO |
$24.51
|
| Rate for Payer: BCN Commercial |
$24.51
|
| Rate for Payer: Cash Price |
$23.78
|
| Rate for Payer: Cofinity Commercial |
$27.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.78
|
| Rate for Payer: Healthscope Commercial |
$28.84
|
| Rate for Payer: Healthscope Whirlpool |
$29.73
|
| Rate for Payer: Mclaren Commercial |
$26.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.27
|
| Rate for Payer: Nomi Health Commercial |
$24.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$26.05
|
| Rate for Payer: Priority Health Narrow Network |
$20.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.16
|
|
|
HC PEANUT IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200054
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$25.90 |
| Rate for Payer: Aetna Commercial |
$23.31
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: ASR ASR |
$25.12
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$21.35
|
| Rate for Payer: BCN Commercial |
$21.35
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$24.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$25.12
|
| Rate for Payer: Healthscope Whirlpool |
$25.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$23.31
|
| Rate for Payer: Mclaren Medicaid |
$5.22
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| 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 |
$2.80
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$22.69
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$18.16
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP DNSP |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC PEANUT IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200054
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.43 |
| Max. Negotiated Rate |
$25.90 |
| Rate for Payer: Aetna Commercial |
$23.31
|
| Rate for Payer: ASR ASR |
$25.12
|
| Rate for Payer: BCBS Trust/PPO |
$21.27
|
| Rate for Payer: BCN Commercial |
$21.27
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$24.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$25.12
|
| Rate for Payer: Healthscope Whirlpool |
$25.90
|
| Rate for Payer: Mclaren Commercial |
$23.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.79
|
|
|
HC PECAN NUT IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200117
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$25.90 |
| Rate for Payer: Aetna Commercial |
$23.31
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: ASR ASR |
$25.12
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$21.35
|
| Rate for Payer: BCN Commercial |
$21.35
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$24.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$25.12
|
| Rate for Payer: Healthscope Whirlpool |
$25.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$23.31
|
| Rate for Payer: Mclaren Medicaid |
$5.22
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| 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 |
$2.80
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$22.69
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$18.16
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP DNSP |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC PECAN NUT IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200117
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.43 |
| Max. Negotiated Rate |
$25.90 |
| Rate for Payer: Aetna Commercial |
$23.31
|
| Rate for Payer: ASR ASR |
$25.12
|
| Rate for Payer: BCBS Trust/PPO |
$21.27
|
| Rate for Payer: BCN Commercial |
$21.27
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$24.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$25.12
|
| Rate for Payer: Healthscope Whirlpool |
$25.90
|
| Rate for Payer: Mclaren Commercial |
$23.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.79
|
|
|
HC PED MINOR TREATMENT RM
|
Facility
|
OP
|
$131.60
|
|
| Hospital Charge Code |
51000044
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$48.69 |
| Max. Negotiated Rate |
$131.60 |
| Rate for Payer: Aetna Commercial |
$118.44
|
| Rate for Payer: Aetna Medicare |
$48.69
|
| Rate for Payer: ASR ASR |
$127.65
|
| Rate for Payer: BCBS Complete |
$52.64
|
| Rate for Payer: BCBS Trust/PPO |
$108.50
|
| Rate for Payer: BCN Commercial |
$108.50
|
| Rate for Payer: Cash Price |
$105.28
|
| Rate for Payer: Cofinity Commercial |
$123.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.28
|
| Rate for Payer: Healthscope Commercial |
$127.65
|
| Rate for Payer: Healthscope Whirlpool |
$131.60
|
| Rate for Payer: Mclaren Commercial |
$118.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$105.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.86
|
| Rate for Payer: Nomi Health Commercial |
$107.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$98.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$115.31
|
| Rate for Payer: Priority Health Narrow Network |
$92.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$115.81
|
|
|
HC PED MINOR TREATMENT RM
|
Facility
|
IP
|
$131.60
|
|
| Hospital Charge Code |
51000044
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$98.70 |
| Max. Negotiated Rate |
$131.60 |
| Rate for Payer: Aetna Commercial |
$118.44
|
| Rate for Payer: ASR ASR |
$127.65
|
| Rate for Payer: BCBS Trust/PPO |
$108.07
|
| Rate for Payer: BCN Commercial |
$108.07
|
| Rate for Payer: Cash Price |
$105.28
|
| Rate for Payer: Cofinity Commercial |
$123.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.28
|
| Rate for Payer: Healthscope Commercial |
$127.65
|
| Rate for Payer: Healthscope Whirlpool |
$131.60
|
| Rate for Payer: Mclaren Commercial |
$118.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.86
|
| Rate for Payer: Nomi Health Commercial |
$107.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$98.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$115.81
|
|
|
HC PED OBSERVATION PER HOUR
|
Facility
|
IP
|
$168.88
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200014
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$126.66 |
| Max. Negotiated Rate |
$168.88 |
| Rate for Payer: Aetna Commercial |
$151.99
|
| Rate for Payer: ASR ASR |
$163.81
|
| Rate for Payer: BCBS Trust/PPO |
$138.68
|
| Rate for Payer: BCN Commercial |
$138.68
|
| Rate for Payer: Cash Price |
$135.10
|
| Rate for Payer: Cofinity Commercial |
$158.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$135.10
|
| Rate for Payer: Healthscope Commercial |
$163.81
|
| Rate for Payer: Healthscope Whirlpool |
$168.88
|
| Rate for Payer: Mclaren Commercial |
$151.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$143.55
|
| Rate for Payer: Nomi Health Commercial |
$138.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$126.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$148.61
|
|
