|
HC TORCH PROFILE IGM CMPT 2
|
Facility
|
IP
|
$67.32
|
|
|
Service Code
|
CPT 86778
|
| Hospital Charge Code |
30200324
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$47.12 |
| Max. Negotiated Rate |
$67.32 |
| Rate for Payer: Aetna Commercial |
$60.59
|
| Rate for Payer: ASR ASR |
$65.30
|
| Rate for Payer: BCBS Trust/PPO |
$52.19
|
| Rate for Payer: BCN Commercial |
$52.19
|
| Rate for Payer: Cash Price |
$53.86
|
| Rate for Payer: Cofinity Commercial |
$63.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.86
|
| Rate for Payer: Healthscope Commercial |
$67.32
|
| Rate for Payer: Healthscope Whirlpool |
$65.30
|
| Rate for Payer: Mclaren Commercial |
$60.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$57.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$59.24
|
|
|
HC TOTAL BODY TUMOR SCAN 2 OR MORE DAYS
|
Facility
|
OP
|
$2,287.36
|
|
|
Service Code
|
CPT 78804
|
| Hospital Charge Code |
34100057
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$690.41 |
| Max. Negotiated Rate |
$2,287.36 |
| Rate for Payer: Aetna Commercial |
$2,058.62
|
| Rate for Payer: Aetna Medicare |
$1,262.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,577.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,577.72
|
| Rate for Payer: ASR ASR |
$2,218.74
|
| Rate for Payer: BCBS Complete |
$725.00
|
| Rate for Payer: BCBS MAPPO |
$1,262.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,773.39
|
| Rate for Payer: BCN Commercial |
$1,773.39
|
| Rate for Payer: BCN Medicare Advantage |
$1,262.18
|
| Rate for Payer: Cash Price |
$1,829.89
|
| Rate for Payer: Cash Price |
$1,829.89
|
| Rate for Payer: Cofinity Commercial |
$2,150.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,829.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,262.18
|
| Rate for Payer: Healthscope Commercial |
$2,287.36
|
| Rate for Payer: Healthscope Whirlpool |
$2,218.74
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,262.18
|
| Rate for Payer: Mclaren Commercial |
$2,058.62
|
| Rate for Payer: Mclaren Medicaid |
$690.41
|
| Rate for Payer: Mclaren Medicare |
$1,262.18
|
| Rate for Payer: Meridian Medicaid |
$725.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,325.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,451.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,944.26
|
| Rate for Payer: PACE Medicare |
$1,199.07
|
| Rate for Payer: PACE SWMI |
$1,262.18
|
| Rate for Payer: PHP Commercial |
$1,388.40
|
| Rate for Payer: PHP Medicaid |
$690.41
|
| Rate for Payer: PHP Medicare Advantage |
$1,262.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$690.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,601.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,060.56
|
| Rate for Payer: Priority Health Medicare |
$1,262.18
|
| Rate for Payer: Priority Health Narrow Network |
$1,648.45
|
| Rate for Payer: Railroad Medicare Medicare |
$1,262.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,012.88
|
| Rate for Payer: UHC Medicare Advantage |
$1,300.05
|
| Rate for Payer: VA VA |
$1,262.18
|
|
|
HC TOTAL BODY TUMOR SCAN 2 OR MORE DAYS
|
Facility
|
IP
|
$2,287.36
|
|
|
Service Code
|
CPT 78804
|
| Hospital Charge Code |
34100057
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$1,601.15 |
| Max. Negotiated Rate |
$2,287.36 |
| Rate for Payer: Aetna Commercial |
$2,058.62
|
| Rate for Payer: ASR ASR |
$2,218.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,773.39
|
| Rate for Payer: BCN Commercial |
$1,773.39
|
| Rate for Payer: Cash Price |
$1,829.89
|
| Rate for Payer: Cofinity Commercial |
$2,150.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,829.89
|
| Rate for Payer: Healthscope Commercial |
$2,287.36
|
| Rate for Payer: Healthscope Whirlpool |
$2,218.74
|
| Rate for Payer: Mclaren Commercial |
$2,058.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,944.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,601.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,012.88
|
|
|
HC TOTAL IRON BIND CALC & TRANSFE
|
Facility
|
OP
|
$51.00
|
|
|
Service Code
|
CPT 84466
|
| Hospital Charge Code |
30100483
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.98 |
| Max. Negotiated Rate |
$64.65 |
| Rate for Payer: Aetna Commercial |
$45.90
|
| Rate for Payer: Aetna Medicare |
$12.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.95
|
| Rate for Payer: ASR ASR |
$49.47
|
| Rate for Payer: BCBS Complete |
$7.33
|
| Rate for Payer: BCBS MAPPO |
$12.76
|
| Rate for Payer: BCBS Trust/PPO |
$39.54
|
| Rate for Payer: BCN Commercial |
$39.54
|
| Rate for Payer: BCN Medicare Advantage |
$12.76
|
| 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 |
$12.76
|
| Rate for Payer: Healthscope Commercial |
$51.00
|
| Rate for Payer: Healthscope Whirlpool |
$49.47
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.76
|
| Rate for Payer: Mclaren Commercial |
$45.90
|
| Rate for Payer: Mclaren Medicaid |
$6.98
|
| Rate for Payer: Mclaren Medicare |
$12.76
|
| Rate for Payer: Meridian Medicaid |
$7.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: PACE Medicare |
$12.12
|
| Rate for Payer: PACE SWMI |
$12.76
|
| Rate for Payer: PHP Commercial |
$14.04
|
| Rate for Payer: PHP Medicaid |
$6.98
|
| Rate for Payer: PHP Medicare Advantage |
$12.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$64.65
|
| Rate for Payer: Priority Health Medicare |
$12.76
|
| Rate for Payer: Priority Health Narrow Network |
$51.72
|
| Rate for Payer: Railroad Medicare Medicare |
$12.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.88
|
| Rate for Payer: UHC Medicare Advantage |
$13.14
|
| Rate for Payer: VA VA |
$12.76
|
|
|
HC TOTAL IRON BIND CALC & TRANSFE
|
Facility
|
IP
|
$51.00
|
|
|
Service Code
|
CPT 84466
|
| Hospital Charge Code |
30100483
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$35.70 |
| Max. Negotiated Rate |
$51.00 |
| Rate for Payer: Aetna Commercial |
$45.90
|
| Rate for Payer: ASR ASR |
$49.47
|
| Rate for Payer: BCBS Trust/PPO |
$39.54
|
| 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 Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.88
|
|
|
HC TOTAL PROTEIN
|
Facility
|
OP
|
$38.10
|
|
|
Service Code
|
CPT 84155
|
| Hospital Charge Code |
30100406
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.01 |
| Max. Negotiated Rate |
$53.36 |
| Rate for Payer: Aetna Commercial |
$34.29
|
| Rate for Payer: Aetna Medicare |
$3.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.59
|
| Rate for Payer: ASR ASR |
$36.96
|
| Rate for Payer: BCBS Complete |
$2.11
|
| Rate for Payer: BCBS MAPPO |
$3.67
|
| Rate for Payer: BCBS Trust/PPO |
$29.54
|
| Rate for Payer: BCN Commercial |
$29.54
|
| Rate for Payer: BCN Medicare Advantage |
$3.67
|
| Rate for Payer: Cash Price |
$30.48
|
| Rate for Payer: Cash Price |
$30.48
|
| Rate for Payer: Cofinity Commercial |
$35.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.67
|
| Rate for Payer: Healthscope Commercial |
$38.10
|
| Rate for Payer: Healthscope Whirlpool |
$36.96
|
| Rate for Payer: Humana Choice PPO Medicare |
$3.67
|
| Rate for Payer: Mclaren Commercial |
$34.29
|
| Rate for Payer: Mclaren Medicaid |
$2.01
|
| Rate for Payer: Mclaren Medicare |
$3.67
|
| Rate for Payer: Meridian Medicaid |
$2.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$32.38
|
| Rate for Payer: PACE Medicare |
$3.49
|
| Rate for Payer: PACE SWMI |
$3.67
|
| Rate for Payer: PHP Commercial |
$4.04
|
| Rate for Payer: PHP Medicaid |
$2.01
|
| Rate for Payer: PHP Medicare Advantage |
$3.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.67
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.36
|
| Rate for Payer: Priority Health Medicare |
$3.67
|
| Rate for Payer: Priority Health Narrow Network |
$42.69
|
| Rate for Payer: Railroad Medicare Medicare |
$3.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$33.53
|
| Rate for Payer: UHC Medicare Advantage |
$3.78
|
| Rate for Payer: VA VA |
$3.67
|
|
|
HC TOTAL PROTEIN
|
Facility
|
IP
|
$38.10
|
|
|
Service Code
|
CPT 84155
|
| Hospital Charge Code |
30100406
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$26.67 |
| Max. Negotiated Rate |
$38.10 |
| Rate for Payer: Aetna Commercial |
$34.29
|
| Rate for Payer: ASR ASR |
$36.96
|
| Rate for Payer: BCBS Trust/PPO |
$29.54
|
| Rate for Payer: BCN Commercial |
$29.54
|
| Rate for Payer: Cash Price |
$30.48
|
| Rate for Payer: Cofinity Commercial |
$35.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.48
|
| Rate for Payer: Healthscope Commercial |
$38.10
|
| Rate for Payer: Healthscope Whirlpool |
$36.96
|
| Rate for Payer: Mclaren Commercial |
$34.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$32.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$33.53
|
|
|
HC TOTAL PROTEIN FLUID
|
Facility
|
IP
|
$38.10
|
|
|
Service Code
|
CPT 84157
|
| Hospital Charge Code |
30100408
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$26.67 |
| Max. Negotiated Rate |
$38.10 |
| Rate for Payer: Aetna Commercial |
$34.29
|
| Rate for Payer: ASR ASR |
$36.96
|
| Rate for Payer: BCBS Trust/PPO |
$29.54
|
| Rate for Payer: BCN Commercial |
$29.54
|
| Rate for Payer: Cash Price |
$30.48
|
| Rate for Payer: Cofinity Commercial |
$35.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.48
|
| Rate for Payer: Healthscope Commercial |
$38.10
|
| Rate for Payer: Healthscope Whirlpool |
$36.96
|
| Rate for Payer: Mclaren Commercial |
$34.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$32.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$33.53
|
|
|
HC TOTAL PROTEIN FLUID
|
Facility
|
OP
|
$38.10
|
|
|
Service Code
|
CPT 84157
|
| Hospital Charge Code |
30100408
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.19 |
| Max. Negotiated Rate |
$38.10 |
| Rate for Payer: Aetna Commercial |
$34.29
|
| Rate for Payer: Aetna Medicare |
$4.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.00
|
| Rate for Payer: ASR ASR |
$36.96
|
| Rate for Payer: BCBS Complete |
$2.30
|
| Rate for Payer: BCBS MAPPO |
$4.00
|
| Rate for Payer: BCBS Trust/PPO |
$29.54
|
| Rate for Payer: BCN Commercial |
$29.54
|
| Rate for Payer: BCN Medicare Advantage |
$4.00
|
| Rate for Payer: Cash Price |
$30.48
|
| Rate for Payer: Cash Price |
$30.48
|
| Rate for Payer: Cofinity Commercial |
$35.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.00
|
| Rate for Payer: Healthscope Commercial |
$38.10
|
| Rate for Payer: Healthscope Whirlpool |
$36.96
|
| Rate for Payer: Humana Choice PPO Medicare |
$4.00
|
| Rate for Payer: Mclaren Commercial |
$34.29
|
| Rate for Payer: Mclaren Medicaid |
$2.19
|
| Rate for Payer: Mclaren Medicare |
$4.00
|
| Rate for Payer: Meridian Medicaid |
$2.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$32.38
|
| Rate for Payer: PACE Medicare |
$3.80
|
| Rate for Payer: PACE SWMI |
$4.00
|
| Rate for Payer: PHP Commercial |
$4.40
|
| Rate for Payer: PHP Medicaid |
$2.19
|
| Rate for Payer: PHP Medicare Advantage |
$4.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.67
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.12
|
| Rate for Payer: Priority Health Medicare |
$4.00
|
| Rate for Payer: Priority Health Narrow Network |
$19.30
|
| Rate for Payer: Railroad Medicare Medicare |
$4.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$33.53
|
| Rate for Payer: UHC Medicare Advantage |
$4.12
|
| Rate for Payer: VA VA |
$4.00
|
|
|
HC TOTAL PROTEIN URINE
|
Facility
|
IP
|
$38.10
|
|
|
Service Code
|
CPT 84156
|
| Hospital Charge Code |
30100407
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$26.67 |
| Max. Negotiated Rate |
$38.10 |
| Rate for Payer: Aetna Commercial |
$34.29
|
| Rate for Payer: ASR ASR |
$36.96
|
| Rate for Payer: BCBS Trust/PPO |
$29.54
|
| Rate for Payer: BCN Commercial |
$29.54
|
| Rate for Payer: Cash Price |
$30.48
|
| Rate for Payer: Cofinity Commercial |
$35.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.48
|
| Rate for Payer: Healthscope Commercial |
$38.10
|
| Rate for Payer: Healthscope Whirlpool |
$36.96
|
| Rate for Payer: Mclaren Commercial |
$34.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$32.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$33.53
|
|
|
HC TOTAL PROTEIN URINE
|
Facility
|
OP
|
$38.10
|
|
|
Service Code
|
CPT 84156
|
| Hospital Charge Code |
30100407
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.01 |
| Max. Negotiated Rate |
$44.13 |
| Rate for Payer: Aetna Commercial |
$34.29
|
| Rate for Payer: Aetna Medicare |
$3.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.59
|
| Rate for Payer: ASR ASR |
$36.96
|
| Rate for Payer: BCBS Complete |
$2.11
|
| Rate for Payer: BCBS MAPPO |
$3.67
|
| Rate for Payer: BCBS Trust/PPO |
$29.54
|
| Rate for Payer: BCN Commercial |
$29.54
|
| Rate for Payer: BCN Medicare Advantage |
$3.67
|
| Rate for Payer: Cash Price |
$30.48
|
| Rate for Payer: Cash Price |
$30.48
|
| Rate for Payer: Cofinity Commercial |
$35.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.67
|
| Rate for Payer: Healthscope Commercial |
$38.10
|
| Rate for Payer: Healthscope Whirlpool |
$36.96
|
| Rate for Payer: Humana Choice PPO Medicare |
$3.67
|
| Rate for Payer: Mclaren Commercial |
$34.29
|
| Rate for Payer: Mclaren Medicaid |
$2.01
|
| Rate for Payer: Mclaren Medicare |
$3.67
|
| Rate for Payer: Meridian Medicaid |
$2.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$32.38
|
| Rate for Payer: PACE Medicare |
$3.49
|
| Rate for Payer: PACE SWMI |
$3.67
|
| Rate for Payer: PHP Commercial |
$4.04
|
| Rate for Payer: PHP Medicaid |
$2.01
|
| Rate for Payer: PHP Medicare Advantage |
$3.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.67
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.13
|
| Rate for Payer: Priority Health Medicare |
$3.67
|
| Rate for Payer: Priority Health Narrow Network |
$35.30
|
| Rate for Payer: Railroad Medicare Medicare |
$3.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$33.53
|
| Rate for Payer: UHC Medicare Advantage |
$3.78
|
| Rate for Payer: VA VA |
$3.67
|
|
|
HC TOTAL T3
|
Facility
|
OP
|
$46.82
|
|
|
Service Code
|
CPT 84480
|
| Hospital Charge Code |
30100447
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.76 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$42.14
|
| Rate for Payer: Aetna Medicare |
$14.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.72
|
| Rate for Payer: ASR ASR |
$45.42
|
| Rate for Payer: BCBS Complete |
$8.14
|
| Rate for Payer: BCBS MAPPO |
$14.18
|
| Rate for Payer: BCBS Trust/PPO |
$36.30
|
| Rate for Payer: BCN Commercial |
$36.30
|
| Rate for Payer: BCN Medicare Advantage |
$14.18
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Commercial |
$44.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.18
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Healthscope Whirlpool |
$45.42
|
| Rate for Payer: Humana Choice PPO Medicare |
$14.18
|
| Rate for Payer: Mclaren Commercial |
$42.14
|
| Rate for Payer: Mclaren Medicaid |
$7.76
|
| Rate for Payer: Mclaren Medicare |
$14.18
|
| Rate for Payer: Meridian Medicaid |
$8.14
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.80
|
| Rate for Payer: PACE Medicare |
$13.47
|
| Rate for Payer: PACE SWMI |
$14.18
|
| Rate for Payer: PHP Commercial |
$15.60
|
| Rate for Payer: PHP Medicaid |
$7.76
|
| Rate for Payer: PHP Medicare Advantage |
$14.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$36.95
|
| Rate for Payer: Priority Health Medicare |
$14.18
|
| Rate for Payer: Priority Health Narrow Network |
$29.56
|
| Rate for Payer: Railroad Medicare Medicare |
$14.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$41.20
|
| Rate for Payer: UHC Medicare Advantage |
$14.61
|
| Rate for Payer: VA VA |
$14.18
|
|
|
HC TOTAL T3
|
Facility
|
IP
|
$46.82
|
|
|
Service Code
|
CPT 84480
|
| Hospital Charge Code |
30100447
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$32.77 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$42.14
|
| Rate for Payer: ASR ASR |
$45.42
|
| Rate for Payer: BCBS Trust/PPO |
$36.30
|
| Rate for Payer: BCN Commercial |
$36.30
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Commercial |
$44.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Healthscope Whirlpool |
$45.42
|
| Rate for Payer: Mclaren Commercial |
$42.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$41.20
|
|
|
HC TOXICOLOGY SCREEN SALIVA
|
Facility
|
IP
|
$163.20
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100665
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$114.24 |
| Max. Negotiated Rate |
$163.20 |
| Rate for Payer: Aetna Commercial |
$146.88
|
| Rate for Payer: ASR ASR |
$158.30
|
| Rate for Payer: BCBS Trust/PPO |
$126.53
|
| Rate for Payer: BCN Commercial |
$126.53
|
| Rate for Payer: Cash Price |
$130.56
|
| Rate for Payer: Cofinity Commercial |
$153.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$130.56
|
| Rate for Payer: Healthscope Commercial |
$163.20
|
| Rate for Payer: Healthscope Whirlpool |
$158.30
|
| Rate for Payer: Mclaren Commercial |
$146.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$138.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$143.62
|
|
|
HC TOXICOLOGY SCREEN SALIVA
|
Facility
|
OP
|
$163.20
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100665
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.99 |
| Max. Negotiated Rate |
$163.20 |
| Rate for Payer: Aetna Commercial |
$146.88
|
| Rate for Payer: Aetna Medicare |
$62.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.68
|
| Rate for Payer: ASR ASR |
$158.30
|
| Rate for Payer: BCBS Complete |
$35.69
|
| Rate for Payer: BCBS MAPPO |
$62.14
|
| Rate for Payer: BCBS Trust/PPO |
$126.53
|
| Rate for Payer: BCN Commercial |
$126.53
|
| Rate for Payer: BCN Medicare Advantage |
$62.14
|
| Rate for Payer: Cash Price |
$130.56
|
| Rate for Payer: Cash Price |
$130.56
|
| Rate for Payer: Cofinity Commercial |
$153.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$130.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.14
|
| Rate for Payer: Healthscope Commercial |
$163.20
|
| Rate for Payer: Healthscope Whirlpool |
$158.30
|
| Rate for Payer: Humana Choice PPO Medicare |
$62.14
|
| Rate for Payer: Mclaren Commercial |
$146.88
|
| Rate for Payer: Mclaren Medicaid |
$33.99
|
| Rate for Payer: Mclaren Medicare |
$62.14
|
| Rate for Payer: Meridian Medicaid |
$35.69
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$65.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$138.72
|
| 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 |
$33.99
|
| Rate for Payer: PHP Medicare Advantage |
$62.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$148.51
|
| Rate for Payer: Priority Health Medicare |
$62.14
|
| Rate for Payer: Priority Health Narrow Network |
$115.87
|
| Rate for Payer: Railroad Medicare Medicare |
$62.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$143.62
|
| Rate for Payer: UHC Medicare Advantage |
$64.00
|
| Rate for Payer: VA VA |
$62.14
|
|
|
HC TOXOPLASMA AB IGG
|
Facility
|
IP
|
$113.00
|
|
|
Service Code
|
CPT 86777
|
| Hospital Charge Code |
30200321
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$79.10 |
| Max. Negotiated Rate |
$113.00 |
| Rate for Payer: Aetna Commercial |
$101.70
|
| Rate for Payer: ASR ASR |
$109.61
|
| Rate for Payer: BCBS Trust/PPO |
$87.61
|
| Rate for Payer: BCN Commercial |
$87.61
|
| Rate for Payer: Cash Price |
$90.40
|
| Rate for Payer: Cofinity Commercial |
$106.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$90.40
|
| Rate for Payer: Healthscope Commercial |
$113.00
|
| Rate for Payer: Healthscope Whirlpool |
$109.61
|
| Rate for Payer: Mclaren Commercial |
$101.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$96.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$99.44
|
|
|
HC TOXOPLASMA AB IGG
|
Facility
|
OP
|
$113.00
|
|
|
Service Code
|
CPT 86777
|
| Hospital Charge Code |
30200321
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.87 |
| Max. Negotiated Rate |
$113.00 |
| Rate for Payer: Aetna Commercial |
$101.70
|
| Rate for Payer: Aetna Medicare |
$14.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.99
|
| Rate for Payer: ASR ASR |
$109.61
|
| Rate for Payer: BCBS Complete |
$8.27
|
| Rate for Payer: BCBS MAPPO |
$14.39
|
| Rate for Payer: BCBS Trust/PPO |
$87.61
|
| Rate for Payer: BCN Commercial |
$87.61
|
| Rate for Payer: BCN Medicare Advantage |
$14.39
|
| Rate for Payer: Cash Price |
$90.40
|
| Rate for Payer: Cash Price |
$90.40
|
| Rate for Payer: Cofinity Commercial |
$106.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$90.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.39
|
| Rate for Payer: Healthscope Commercial |
$113.00
|
| Rate for Payer: Healthscope Whirlpool |
$109.61
|
| Rate for Payer: Humana Choice PPO Medicare |
$14.39
|
| Rate for Payer: Mclaren Commercial |
$101.70
|
| Rate for Payer: Mclaren Medicaid |
$7.87
|
| Rate for Payer: Mclaren Medicare |
$14.39
|
| Rate for Payer: Meridian Medicaid |
$8.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$96.05
|
| Rate for Payer: PACE Medicare |
$13.67
|
| Rate for Payer: PACE SWMI |
$14.39
|
| Rate for Payer: PHP Commercial |
$15.83
|
| Rate for Payer: PHP Medicaid |
$7.87
|
| Rate for Payer: PHP Medicare Advantage |
$14.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$40.02
|
| Rate for Payer: Priority Health Medicare |
$14.39
|
| Rate for Payer: Priority Health Narrow Network |
$32.02
|
| Rate for Payer: Railroad Medicare Medicare |
$14.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$99.44
|
| Rate for Payer: UHC Medicare Advantage |
$14.82
|
| Rate for Payer: VA VA |
$14.39
|
|
|
HC TOXOPLASMA AB IGM
|
Facility
|
OP
|
$40.80
|
|
|
Service Code
|
CPT 86778
|
| Hospital Charge Code |
30200323
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.88 |
| Max. Negotiated Rate |
$52.33 |
| Rate for Payer: Aetna Commercial |
$36.72
|
| Rate for Payer: Aetna Medicare |
$14.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.01
|
| Rate for Payer: ASR ASR |
$39.58
|
| Rate for Payer: BCBS Complete |
$8.28
|
| Rate for Payer: BCBS MAPPO |
$14.41
|
| Rate for Payer: BCBS Trust/PPO |
$31.63
|
| Rate for Payer: BCN Commercial |
$31.63
|
| Rate for Payer: BCN Medicare Advantage |
$14.41
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cofinity Commercial |
$38.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.41
|
| Rate for Payer: Healthscope Commercial |
$40.80
|
| Rate for Payer: Healthscope Whirlpool |
$39.58
|
| Rate for Payer: Humana Choice PPO Medicare |
$14.41
|
| Rate for Payer: Mclaren Commercial |
$36.72
|
| Rate for Payer: Mclaren Medicaid |
$7.88
|
| Rate for Payer: Mclaren Medicare |
$14.41
|
| Rate for Payer: Meridian Medicaid |
$8.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.68
|
| Rate for Payer: PACE Medicare |
$13.69
|
| Rate for Payer: PACE SWMI |
$14.41
|
| Rate for Payer: PHP Commercial |
$15.85
|
| Rate for Payer: PHP Medicaid |
$7.88
|
| Rate for Payer: PHP Medicare Advantage |
$14.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$52.33
|
| Rate for Payer: Priority Health Medicare |
$14.41
|
| Rate for Payer: Priority Health Narrow Network |
$41.86
|
| Rate for Payer: Railroad Medicare Medicare |
$14.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$35.90
|
| Rate for Payer: UHC Medicare Advantage |
$14.84
|
| Rate for Payer: VA VA |
$14.41
|
|
|
HC TOXOPLASMA AB IGM
|
Facility
|
IP
|
$40.80
|
|
|
Service Code
|
CPT 86778
|
| Hospital Charge Code |
30200323
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$28.56 |
| Max. Negotiated Rate |
$40.80 |
| Rate for Payer: Aetna Commercial |
$36.72
|
| Rate for Payer: ASR ASR |
$39.58
|
| Rate for Payer: BCBS Trust/PPO |
$31.63
|
| Rate for Payer: BCN Commercial |
$31.63
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cofinity Commercial |
$38.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.64
|
| Rate for Payer: Healthscope Commercial |
$40.80
|
| Rate for Payer: Healthscope Whirlpool |
$39.58
|
| Rate for Payer: Mclaren Commercial |
$36.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$35.90
|
|
|
HC TPMT AND NUDT15 GENOTYPE
|
Facility
|
OP
|
$519.09
|
|
|
Service Code
|
CPT 0034U
|
| Hospital Charge Code |
31000138
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$254.99 |
| Max. Negotiated Rate |
$582.71 |
| Rate for Payer: Aetna Commercial |
$467.18
|
| Rate for Payer: Aetna Medicare |
$466.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$582.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$582.71
|
| Rate for Payer: ASR ASR |
$503.52
|
| Rate for Payer: BCBS Complete |
$267.77
|
| Rate for Payer: BCBS MAPPO |
$466.17
|
| Rate for Payer: BCBS Trust/PPO |
$402.45
|
| Rate for Payer: BCN Commercial |
$402.45
|
| Rate for Payer: BCN Medicare Advantage |
$466.17
|
| Rate for Payer: Cash Price |
$415.27
|
| Rate for Payer: Cash Price |
$415.27
|
| Rate for Payer: Cofinity Commercial |
$487.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$415.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$466.17
|
| Rate for Payer: Healthscope Commercial |
$519.09
|
| Rate for Payer: Healthscope Whirlpool |
$503.52
|
| Rate for Payer: Humana Choice PPO Medicare |
$466.17
|
| Rate for Payer: Mclaren Commercial |
$467.18
|
| Rate for Payer: Mclaren Medicaid |
$254.99
|
| Rate for Payer: Mclaren Medicare |
$466.17
|
| Rate for Payer: Meridian Medicaid |
$267.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$489.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$536.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$441.23
|
| Rate for Payer: PACE Medicare |
$442.86
|
| Rate for Payer: PACE SWMI |
$466.17
|
| Rate for Payer: PHP Commercial |
$512.79
|
| Rate for Payer: PHP Medicaid |
$254.99
|
| Rate for Payer: PHP Medicare Advantage |
$466.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$254.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$363.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$498.80
|
| Rate for Payer: Priority Health Medicare |
$466.17
|
| Rate for Payer: Priority Health Narrow Network |
$399.04
|
| Rate for Payer: Railroad Medicare Medicare |
$466.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$456.80
|
| Rate for Payer: UHC Medicare Advantage |
$480.16
|
| Rate for Payer: VA VA |
$466.17
|
|
|
HC TPMT AND NUDT15 GENOTYPE
|
Facility
|
IP
|
$519.09
|
|
|
Service Code
|
CPT 0034U
|
| Hospital Charge Code |
31000138
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$363.36 |
| Max. Negotiated Rate |
$519.09 |
| Rate for Payer: Aetna Commercial |
$467.18
|
| Rate for Payer: ASR ASR |
$503.52
|
| Rate for Payer: BCBS Trust/PPO |
$402.45
|
| Rate for Payer: BCN Commercial |
$402.45
|
| Rate for Payer: Cash Price |
$415.27
|
| Rate for Payer: Cofinity Commercial |
$487.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$415.27
|
| Rate for Payer: Healthscope Commercial |
$519.09
|
| Rate for Payer: Healthscope Whirlpool |
$503.52
|
| Rate for Payer: Mclaren Commercial |
$467.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$441.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$363.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$456.80
|
|
|
HC TRACH BUTTON SUPPLY
|
Facility
|
IP
|
$293.45
|
|
| Hospital Charge Code |
27000159
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$205.42 |
| Max. Negotiated Rate |
$293.45 |
| Rate for Payer: Aetna Commercial |
$264.10
|
| Rate for Payer: ASR ASR |
$284.65
|
| Rate for Payer: BCBS Trust/PPO |
$227.51
|
| Rate for Payer: BCN Commercial |
$227.51
|
| Rate for Payer: Cash Price |
$234.76
|
| Rate for Payer: Cofinity Commercial |
$275.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$234.76
|
| Rate for Payer: Healthscope Commercial |
$293.45
|
| Rate for Payer: Healthscope Whirlpool |
$284.65
|
| Rate for Payer: Mclaren Commercial |
$264.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$249.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$205.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$258.24
|
|
|
HC TRACH BUTTON SUPPLY
|
Facility
|
OP
|
$293.45
|
|
| Hospital Charge Code |
27000159
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$117.38 |
| Max. Negotiated Rate |
$293.45 |
| Rate for Payer: Aetna Commercial |
$264.10
|
| Rate for Payer: ASR ASR |
$284.65
|
| Rate for Payer: BCBS Complete |
$117.38
|
| Rate for Payer: BCBS Trust/PPO |
$227.51
|
| Rate for Payer: BCN Commercial |
$227.51
|
| Rate for Payer: Cash Price |
$234.76
|
| Rate for Payer: Cofinity Commercial |
$275.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$234.76
|
| Rate for Payer: Healthscope Commercial |
$293.45
|
| Rate for Payer: Healthscope Whirlpool |
$284.65
|
| Rate for Payer: Mclaren Commercial |
$264.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$249.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$205.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$267.04
|
| Rate for Payer: Priority Health Narrow Network |
$208.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$258.24
|
|
|
HC TRACHEOBRNCHSC THRU EST TRACHS INC
|
Facility
|
OP
|
$1,300.00
|
|
|
Service Code
|
CPT 31615
|
| Hospital Charge Code |
76100389
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$267.52 |
| Max. Negotiated Rate |
$1,300.00 |
| Rate for Payer: Aetna Commercial |
$1,170.00
|
| Rate for Payer: Aetna Medicare |
$489.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$611.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$611.32
|
| Rate for Payer: ASR ASR |
$1,261.00
|
| Rate for Payer: BCBS Complete |
$280.92
|
| Rate for Payer: BCBS MAPPO |
$489.06
|
| Rate for Payer: BCBS Trust/PPO |
$1,007.89
|
| Rate for Payer: BCN Commercial |
$1,007.89
|
| Rate for Payer: BCN Medicare Advantage |
$489.06
|
| Rate for Payer: Cash Price |
$1,040.00
|
| Rate for Payer: Cash Price |
$1,040.00
|
| Rate for Payer: Cofinity Commercial |
$1,222.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,040.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$489.06
|
| Rate for Payer: Healthscope Commercial |
$1,300.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,261.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$489.06
|
| Rate for Payer: Mclaren Commercial |
$1,170.00
|
| Rate for Payer: Mclaren Medicaid |
$267.52
|
| Rate for Payer: Mclaren Medicare |
$489.06
|
| Rate for Payer: Meridian Medicaid |
$280.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$513.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$562.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,105.00
|
| Rate for Payer: PACE Medicare |
$464.61
|
| Rate for Payer: PACE SWMI |
$489.06
|
| Rate for Payer: PHP Commercial |
$537.97
|
| Rate for Payer: PHP Medicaid |
$267.52
|
| Rate for Payer: PHP Medicare Advantage |
$489.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$267.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$910.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,183.00
|
| Rate for Payer: Priority Health Medicare |
$489.06
|
| Rate for Payer: Priority Health Narrow Network |
$923.00
|
| Rate for Payer: Railroad Medicare Medicare |
$489.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,144.00
|
| Rate for Payer: UHC Medicare Advantage |
$503.73
|
| Rate for Payer: VA VA |
$489.06
|
|
|
HC TRACHEOBRNCHSC THRU EST TRACHS INC
|
Facility
|
IP
|
$1,300.00
|
|
|
Service Code
|
CPT 31615
|
| Hospital Charge Code |
76100389
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$910.00 |
| Max. Negotiated Rate |
$1,300.00 |
| Rate for Payer: Aetna Commercial |
$1,170.00
|
| Rate for Payer: ASR ASR |
$1,261.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,007.89
|
| Rate for Payer: BCN Commercial |
$1,007.89
|
| Rate for Payer: Cash Price |
$1,040.00
|
| Rate for Payer: Cofinity Commercial |
$1,222.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,040.00
|
| Rate for Payer: Healthscope Commercial |
$1,300.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,261.00
|
| Rate for Payer: Mclaren Commercial |
$1,170.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,105.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$910.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,144.00
|
|
