|
HC ORTHOPOX (AKA MONKEY)
|
Facility
|
IP
|
$123.27
|
|
|
Service Code
|
CPT 87593
|
| Hospital Charge Code |
30600334
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$80.13 |
| Max. Negotiated Rate |
$123.27 |
| Rate for Payer: Aetna Commercial |
$110.94
|
| Rate for Payer: ASR ASR |
$119.57
|
| Rate for Payer: ASR Commercial |
$119.57
|
| Rate for Payer: BCBS Trust/PPO |
$100.45
|
| Rate for Payer: BCN Commercial |
$95.57
|
| Rate for Payer: Cash Price |
$98.62
|
| Rate for Payer: Cofinity Commercial |
$115.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$98.62
|
| Rate for Payer: Healthscope Commercial |
$123.27
|
| Rate for Payer: Healthscope Whirlpool |
$119.57
|
| Rate for Payer: Mclaren Commercial |
$110.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.78
|
| Rate for Payer: Nomi Health Commercial |
$101.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$108.48
|
|
|
HC ORTHOPOX DNA, PCR
|
Facility
|
OP
|
$76.50
|
|
|
Service Code
|
CPT 87593
|
| Hospital Charge Code |
30600332
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$27.50 |
| Max. Negotiated Rate |
$79.53 |
| Rate for Payer: Aetna Commercial |
$68.85
|
| Rate for Payer: Aetna Medicare |
$51.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$64.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$64.14
|
| Rate for Payer: ASR ASR |
$74.20
|
| Rate for Payer: ASR Commercial |
$74.20
|
| Rate for Payer: BCBS Complete |
$28.88
|
| Rate for Payer: BCBS MAPPO |
$51.31
|
| Rate for Payer: BCBS Trust/PPO |
$62.65
|
| Rate for Payer: BCN Commercial |
$59.31
|
| Rate for Payer: BCN Medicare Advantage |
$51.31
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$71.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.31
|
| Rate for Payer: Healthscope Commercial |
$76.50
|
| Rate for Payer: Healthscope Whirlpool |
$74.20
|
| Rate for Payer: Humana Choice PPO Medicare |
$51.31
|
| Rate for Payer: Mclaren Commercial |
$68.85
|
| Rate for Payer: Mclaren Medicaid |
$27.50
|
| Rate for Payer: Mclaren Medicare |
$51.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.88
|
| Rate for Payer: Meridian Medicaid |
$28.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.03
|
| Rate for Payer: Nomi Health Commercial |
$62.73
|
| Rate for Payer: PACE Medicare |
$48.74
|
| Rate for Payer: PACE SWMI |
$51.31
|
| Rate for Payer: PHP Commercial |
$56.44
|
| Rate for Payer: PHP Medicaid |
$27.50
|
| Rate for Payer: PHP Medicare Advantage |
$51.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$67.03
|
| Rate for Payer: Priority Health Medicare |
$51.31
|
| Rate for Payer: Priority Health Narrow Network |
$53.63
|
| Rate for Payer: Railroad Medicare Medicare |
$51.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$67.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$51.31
|
| Rate for Payer: UHC Exchange |
$79.53
|
| Rate for Payer: UHC Medicare Advantage |
$51.31
|
| Rate for Payer: UHCCP DNSP |
$51.31
|
| Rate for Payer: UHCCP Medicaid |
$27.50
|
| Rate for Payer: VA VA |
$51.31
|
|
|
HC ORTHOPOX DNA, PCR
|
Facility
|
IP
|
$76.50
|
|
|
Service Code
|
CPT 87593
|
| Hospital Charge Code |
30600332
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$49.73 |
| Max. Negotiated Rate |
$76.50 |
| Rate for Payer: Aetna Commercial |
$68.85
|
| Rate for Payer: ASR ASR |
$74.20
|
| Rate for Payer: ASR Commercial |
$74.20
|
| Rate for Payer: BCBS Trust/PPO |
$62.34
|
| Rate for Payer: BCN Commercial |
$59.31
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$71.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Healthscope Commercial |
$76.50
|
| Rate for Payer: Healthscope Whirlpool |
$74.20
|
| Rate for Payer: Mclaren Commercial |
$68.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.03
|
| Rate for Payer: Nomi Health Commercial |
$62.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$67.32
|
|
|
HC ORTHO/PROSTH MGMT SUBSEQ EA 15 MIN
|
Facility
|
OP
|
$129.45
|
|
|
Service Code
|
CPT 97763
|
| Hospital Charge Code |
42000056
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$51.78 |
| Max. Negotiated Rate |
$129.45 |
| Rate for Payer: Aetna Commercial |
$116.50
|
| Rate for Payer: Aetna Medicare |
$64.72
|
| Rate for Payer: ASR ASR |
$125.57
|
| Rate for Payer: ASR Commercial |
$125.57
|
| Rate for Payer: BCBS Complete |
$51.78
|
| Rate for Payer: BCBS Trust/PPO |
$106.01
|
| Rate for Payer: BCN Commercial |
$100.36
|
| Rate for Payer: Cash Price |
$103.56
|
| Rate for Payer: Cofinity Commercial |
$121.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.56
|
| Rate for Payer: Healthscope Commercial |
$129.45
|
| Rate for Payer: Healthscope Whirlpool |
$125.57
|
| Rate for Payer: Mclaren Commercial |
$116.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$110.03
|
| Rate for Payer: Nomi Health Commercial |
$106.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$113.42
|
| Rate for Payer: Priority Health Narrow Network |
$90.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$113.92
|
|
|
HC ORTHO/PROSTH MGMT SUBSEQ EA 15 MIN
|
Facility
|
IP
|
$129.45
|
|
|
Service Code
|
CPT 97763
|
| Hospital Charge Code |
42000056
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$84.14 |
| Max. Negotiated Rate |
$129.45 |
| Rate for Payer: Aetna Commercial |
$116.50
|
| Rate for Payer: ASR ASR |
$125.57
|
| Rate for Payer: ASR Commercial |
$125.57
|
| Rate for Payer: BCBS Trust/PPO |
$105.49
|
| Rate for Payer: BCN Commercial |
$100.36
|
| Rate for Payer: Cash Price |
$103.56
|
| Rate for Payer: Cofinity Commercial |
$121.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.56
|
| Rate for Payer: Healthscope Commercial |
$129.45
|
| Rate for Payer: Healthscope Whirlpool |
$125.57
|
| Rate for Payer: Mclaren Commercial |
$116.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$110.03
|
| Rate for Payer: Nomi Health Commercial |
$106.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$113.92
|
|
|
HC ORTHOTIC FIT/TRAIN INITIAL EA 15 MIN
|
Facility
|
IP
|
$125.37
|
|
|
Service Code
|
CPT 97760
|
| Hospital Charge Code |
42000039
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$81.49 |
| Max. Negotiated Rate |
$125.37 |
| Rate for Payer: Aetna Commercial |
$112.83
|
| Rate for Payer: ASR ASR |
$121.61
|
| Rate for Payer: ASR Commercial |
$121.61
|
| Rate for Payer: BCBS Trust/PPO |
$102.16
|
| Rate for Payer: BCN Commercial |
$97.20
|
| Rate for Payer: Cash Price |
$100.30
|
| Rate for Payer: Cofinity Commercial |
$117.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.30
|
| Rate for Payer: Healthscope Commercial |
$125.37
|
| Rate for Payer: Healthscope Whirlpool |
$121.61
|
| Rate for Payer: Mclaren Commercial |
$112.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106.56
|
| Rate for Payer: Nomi Health Commercial |
$102.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$110.33
|
|
|
HC ORTHOTIC FIT/TRAIN INITIAL EA 15 MIN
|
Facility
|
OP
|
$125.37
|
|
|
Service Code
|
CPT 97760
|
| Hospital Charge Code |
42000039
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$50.15 |
| Max. Negotiated Rate |
$125.37 |
| Rate for Payer: Aetna Commercial |
$112.83
|
| Rate for Payer: Aetna Medicare |
$62.69
|
| Rate for Payer: ASR ASR |
$121.61
|
| Rate for Payer: ASR Commercial |
$121.61
|
| Rate for Payer: BCBS Complete |
$50.15
|
| Rate for Payer: BCBS Trust/PPO |
$102.67
|
| Rate for Payer: BCN Commercial |
$97.20
|
| Rate for Payer: Cash Price |
$100.30
|
| Rate for Payer: Cofinity Commercial |
$117.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.30
|
| Rate for Payer: Healthscope Commercial |
$125.37
|
| Rate for Payer: Healthscope Whirlpool |
$121.61
|
| Rate for Payer: Mclaren Commercial |
$112.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106.56
|
| Rate for Payer: Nomi Health Commercial |
$102.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.49
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$109.85
|
| Rate for Payer: Priority Health Narrow Network |
$87.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$110.33
|
|
|
HC OSCILLATOR INIT DAY
|
Facility
|
IP
|
$2,410.38
|
|
|
Service Code
|
CPT 94002
|
| Hospital Charge Code |
41000039
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$1,566.75 |
| Max. Negotiated Rate |
$2,410.38 |
| Rate for Payer: Aetna Commercial |
$2,169.34
|
| Rate for Payer: ASR ASR |
$2,338.07
|
| Rate for Payer: ASR Commercial |
$2,338.07
|
| Rate for Payer: BCBS Trust/PPO |
$1,964.22
|
| Rate for Payer: BCN Commercial |
$1,868.77
|
| Rate for Payer: Cash Price |
$1,928.30
|
| Rate for Payer: Cofinity Commercial |
$2,265.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,928.30
|
| Rate for Payer: Healthscope Commercial |
$2,410.38
|
| Rate for Payer: Healthscope Whirlpool |
$2,338.07
|
| Rate for Payer: Mclaren Commercial |
$2,169.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,048.82
|
| Rate for Payer: Nomi Health Commercial |
$1,976.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,566.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,121.13
|
|
|
HC OSCILLATOR INIT DAY
|
Facility
|
OP
|
$2,410.38
|
|
|
Service Code
|
CPT 94002
|
| Hospital Charge Code |
41000039
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$345.59 |
| Max. Negotiated Rate |
$2,410.38 |
| Rate for Payer: Aetna Commercial |
$2,169.34
|
| Rate for Payer: Aetna Medicare |
$644.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$805.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$805.95
|
| Rate for Payer: ASR ASR |
$2,338.07
|
| Rate for Payer: ASR Commercial |
$2,338.07
|
| Rate for Payer: BCBS Complete |
$362.87
|
| Rate for Payer: BCBS MAPPO |
$644.76
|
| Rate for Payer: BCBS Trust/PPO |
$1,973.86
|
| Rate for Payer: BCN Commercial |
$1,868.77
|
| Rate for Payer: BCN Medicare Advantage |
$644.76
|
| Rate for Payer: Cash Price |
$1,928.30
|
| Rate for Payer: Cash Price |
$1,928.30
|
| Rate for Payer: Cofinity Commercial |
$2,265.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,928.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$644.76
|
| Rate for Payer: Healthscope Commercial |
$2,410.38
|
| Rate for Payer: Healthscope Whirlpool |
$2,338.07
|
| Rate for Payer: Humana Choice PPO Medicare |
$644.76
|
| Rate for Payer: Mclaren Commercial |
$2,169.34
|
| Rate for Payer: Mclaren Medicaid |
$345.59
|
| Rate for Payer: Mclaren Medicare |
$644.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$677.00
|
| Rate for Payer: Meridian Medicaid |
$362.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$741.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,048.82
|
| Rate for Payer: Nomi Health Commercial |
$1,976.51
|
| Rate for Payer: PACE Medicare |
$612.52
|
| Rate for Payer: PACE SWMI |
$644.76
|
| Rate for Payer: PHP Commercial |
$709.24
|
| Rate for Payer: PHP Medicaid |
$345.59
|
| Rate for Payer: PHP Medicare Advantage |
$644.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$345.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,566.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,111.97
|
| Rate for Payer: Priority Health Medicare |
$644.76
|
| Rate for Payer: Priority Health Narrow Network |
$1,689.68
|
| Rate for Payer: Railroad Medicare Medicare |
$644.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,121.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$644.76
|
| Rate for Payer: UHC Exchange |
$999.38
|
| Rate for Payer: UHC Medicare Advantage |
$644.76
|
| Rate for Payer: UHCCP DNSP |
$644.76
|
| Rate for Payer: UHCCP Medicaid |
$345.59
|
| Rate for Payer: VA VA |
$644.76
|
|
|
HC OSCILLATOR SUB DAY
|
Facility
|
OP
|
$1,348.28
|
|
|
Service Code
|
CPT 94003
|
| Hospital Charge Code |
41000040
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$345.59 |
| Max. Negotiated Rate |
$1,348.28 |
| Rate for Payer: Aetna Commercial |
$1,213.45
|
| Rate for Payer: Aetna Medicare |
$644.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$805.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$805.95
|
| Rate for Payer: ASR ASR |
$1,307.83
|
| Rate for Payer: ASR Commercial |
$1,307.83
|
| Rate for Payer: BCBS Complete |
$362.87
|
| Rate for Payer: BCBS MAPPO |
$644.76
|
| Rate for Payer: BCBS Trust/PPO |
$1,104.11
|
| Rate for Payer: BCN Commercial |
$1,045.32
|
| Rate for Payer: BCN Medicare Advantage |
$644.76
|
| Rate for Payer: Cash Price |
$1,078.62
|
| Rate for Payer: Cash Price |
$1,078.62
|
| Rate for Payer: Cofinity Commercial |
$1,267.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,078.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$644.76
|
| Rate for Payer: Healthscope Commercial |
$1,348.28
|
| Rate for Payer: Healthscope Whirlpool |
$1,307.83
|
| Rate for Payer: Humana Choice PPO Medicare |
$644.76
|
| Rate for Payer: Mclaren Commercial |
$1,213.45
|
| Rate for Payer: Mclaren Medicaid |
$345.59
|
| Rate for Payer: Mclaren Medicare |
$644.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$677.00
|
| Rate for Payer: Meridian Medicaid |
$362.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$741.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,146.04
|
| Rate for Payer: Nomi Health Commercial |
$1,105.59
|
| Rate for Payer: PACE Medicare |
$612.52
|
| Rate for Payer: PACE SWMI |
$644.76
|
| Rate for Payer: PHP Commercial |
$709.24
|
| Rate for Payer: PHP Medicaid |
$345.59
|
| Rate for Payer: PHP Medicare Advantage |
$644.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$345.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$876.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,181.36
|
| Rate for Payer: Priority Health Medicare |
$644.76
|
| Rate for Payer: Priority Health Narrow Network |
$945.14
|
| Rate for Payer: Railroad Medicare Medicare |
$644.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,186.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$644.76
|
| Rate for Payer: UHC Exchange |
$999.38
|
| Rate for Payer: UHC Medicare Advantage |
$644.76
|
| Rate for Payer: UHCCP DNSP |
$644.76
|
| Rate for Payer: UHCCP Medicaid |
$345.59
|
| Rate for Payer: VA VA |
$644.76
|
|
|
HC OSCILLATOR SUB DAY
|
Facility
|
IP
|
$1,348.28
|
|
|
Service Code
|
CPT 94003
|
| Hospital Charge Code |
41000040
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$876.38 |
| Max. Negotiated Rate |
$1,348.28 |
| Rate for Payer: Aetna Commercial |
$1,213.45
|
| Rate for Payer: ASR ASR |
$1,307.83
|
| Rate for Payer: ASR Commercial |
$1,307.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,098.71
|
| Rate for Payer: BCN Commercial |
$1,045.32
|
| Rate for Payer: Cash Price |
$1,078.62
|
| Rate for Payer: Cofinity Commercial |
$1,267.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,078.62
|
| Rate for Payer: Healthscope Commercial |
$1,348.28
|
| Rate for Payer: Healthscope Whirlpool |
$1,307.83
|
| Rate for Payer: Mclaren Commercial |
$1,213.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,146.04
|
| Rate for Payer: Nomi Health Commercial |
$1,105.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$876.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,186.49
|
|
|
HC OSMOLALITY SERUM
|
Facility
|
OP
|
$54.94
|
|
|
Service Code
|
CPT 83930
|
| Hospital Charge Code |
30100378
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.54 |
| Max. Negotiated Rate |
$54.94 |
| Rate for Payer: Aetna Commercial |
$49.45
|
| Rate for Payer: Aetna Medicare |
$6.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.26
|
| Rate for Payer: ASR ASR |
$53.29
|
| Rate for Payer: ASR Commercial |
$53.29
|
| Rate for Payer: BCBS Complete |
$3.72
|
| Rate for Payer: BCBS MAPPO |
$6.61
|
| Rate for Payer: BCBS Trust/PPO |
$44.99
|
| Rate for Payer: BCN Commercial |
$42.59
|
| Rate for Payer: BCN Medicare Advantage |
$6.61
|
| Rate for Payer: Cash Price |
$43.95
|
| Rate for Payer: Cash Price |
$43.95
|
| Rate for Payer: Cofinity Commercial |
$51.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.61
|
| Rate for Payer: Healthscope Commercial |
$54.94
|
| Rate for Payer: Healthscope Whirlpool |
$53.29
|
| Rate for Payer: Humana Choice PPO Medicare |
$6.61
|
| Rate for Payer: Mclaren Commercial |
$49.45
|
| Rate for Payer: Mclaren Medicaid |
$3.54
|
| Rate for Payer: Mclaren Medicare |
$6.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.94
|
| Rate for Payer: Meridian Medicaid |
$3.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.70
|
| Rate for Payer: Nomi Health Commercial |
$45.05
|
| Rate for Payer: PACE Medicare |
$6.28
|
| Rate for Payer: PACE SWMI |
$6.61
|
| Rate for Payer: PHP Commercial |
$7.27
|
| Rate for Payer: PHP Medicaid |
$3.54
|
| Rate for Payer: PHP Medicare Advantage |
$6.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$48.14
|
| Rate for Payer: Priority Health Medicare |
$6.61
|
| Rate for Payer: Priority Health Narrow Network |
$38.51
|
| Rate for Payer: Railroad Medicare Medicare |
$6.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$48.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.61
|
| Rate for Payer: UHC Exchange |
$10.25
|
| Rate for Payer: UHC Medicare Advantage |
$6.61
|
| Rate for Payer: UHCCP DNSP |
$6.61
|
| Rate for Payer: UHCCP Medicaid |
$3.54
|
| Rate for Payer: VA VA |
$6.61
|
|
|
HC OSMOLALITY SERUM
|
Facility
|
IP
|
$54.94
|
|
|
Service Code
|
CPT 83930
|
| Hospital Charge Code |
30100378
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$35.71 |
| Max. Negotiated Rate |
$54.94 |
| Rate for Payer: Aetna Commercial |
$49.45
|
| Rate for Payer: ASR ASR |
$53.29
|
| Rate for Payer: ASR Commercial |
$53.29
|
| Rate for Payer: BCBS Trust/PPO |
$44.77
|
| Rate for Payer: BCN Commercial |
$42.59
|
| Rate for Payer: Cash Price |
$43.95
|
| Rate for Payer: Cofinity Commercial |
$51.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.95
|
| Rate for Payer: Healthscope Commercial |
$54.94
|
| Rate for Payer: Healthscope Whirlpool |
$53.29
|
| Rate for Payer: Mclaren Commercial |
$49.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.70
|
| Rate for Payer: Nomi Health Commercial |
$45.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$48.35
|
|
|
HC OSMOLALITY URINE
|
Facility
|
OP
|
$53.86
|
|
|
Service Code
|
CPT 83935
|
| Hospital Charge Code |
30100379
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.66 |
| Max. Negotiated Rate |
$53.86 |
| Rate for Payer: Aetna Commercial |
$48.47
|
| Rate for Payer: Aetna Medicare |
$6.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.53
|
| Rate for Payer: ASR ASR |
$52.24
|
| Rate for Payer: ASR Commercial |
$52.24
|
| Rate for Payer: BCBS Complete |
$3.84
|
| Rate for Payer: BCBS MAPPO |
$6.82
|
| Rate for Payer: BCBS Trust/PPO |
$44.11
|
| Rate for Payer: BCN Commercial |
$41.76
|
| Rate for Payer: BCN Medicare Advantage |
$6.82
|
| Rate for Payer: Cash Price |
$43.09
|
| Rate for Payer: Cash Price |
$43.09
|
| Rate for Payer: Cofinity Commercial |
$50.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.82
|
| Rate for Payer: Healthscope Commercial |
$53.86
|
| Rate for Payer: Healthscope Whirlpool |
$52.24
|
| Rate for Payer: Humana Choice PPO Medicare |
$6.82
|
| Rate for Payer: Mclaren Commercial |
$48.47
|
| Rate for Payer: Mclaren Medicaid |
$3.66
|
| Rate for Payer: Mclaren Medicare |
$6.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.16
|
| Rate for Payer: Meridian Medicaid |
$3.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.78
|
| Rate for Payer: Nomi Health Commercial |
$44.17
|
| Rate for Payer: PACE Medicare |
$6.48
|
| Rate for Payer: PACE SWMI |
$6.82
|
| Rate for Payer: PHP Commercial |
$7.50
|
| Rate for Payer: PHP Medicaid |
$3.66
|
| Rate for Payer: PHP Medicare Advantage |
$6.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.01
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$47.19
|
| Rate for Payer: Priority Health Medicare |
$6.82
|
| Rate for Payer: Priority Health Narrow Network |
$37.76
|
| Rate for Payer: Railroad Medicare Medicare |
$6.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$47.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.82
|
| Rate for Payer: UHC Exchange |
$10.57
|
| Rate for Payer: UHC Medicare Advantage |
$6.82
|
| Rate for Payer: UHCCP DNSP |
$6.82
|
| Rate for Payer: UHCCP Medicaid |
$3.66
|
| Rate for Payer: VA VA |
$6.82
|
|
|
HC OSMOLALITY URINE
|
Facility
|
IP
|
$53.86
|
|
|
Service Code
|
CPT 83935
|
| Hospital Charge Code |
30100379
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$35.01 |
| Max. Negotiated Rate |
$53.86 |
| Rate for Payer: Aetna Commercial |
$48.47
|
| Rate for Payer: ASR ASR |
$52.24
|
| Rate for Payer: ASR Commercial |
$52.24
|
| Rate for Payer: BCBS Trust/PPO |
$43.89
|
| Rate for Payer: BCN Commercial |
$41.76
|
| Rate for Payer: Cash Price |
$43.09
|
| Rate for Payer: Cofinity Commercial |
$50.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.09
|
| Rate for Payer: Healthscope Commercial |
$53.86
|
| Rate for Payer: Healthscope Whirlpool |
$52.24
|
| Rate for Payer: Mclaren Commercial |
$48.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.78
|
| Rate for Payer: Nomi Health Commercial |
$44.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$47.40
|
|
|
HC OSMOTIC FRAGILITY RBC
|
Facility
|
IP
|
$131.42
|
|
|
Service Code
|
CPT 85557
|
| Hospital Charge Code |
30500052
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$85.42 |
| Max. Negotiated Rate |
$131.42 |
| Rate for Payer: Aetna Commercial |
$118.28
|
| Rate for Payer: ASR ASR |
$127.48
|
| Rate for Payer: ASR Commercial |
$127.48
|
| Rate for Payer: BCBS Trust/PPO |
$107.09
|
| Rate for Payer: BCN Commercial |
$101.89
|
| Rate for Payer: Cash Price |
$105.14
|
| Rate for Payer: Cofinity Commercial |
$123.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.14
|
| Rate for Payer: Healthscope Commercial |
$131.42
|
| Rate for Payer: Healthscope Whirlpool |
$127.48
|
| Rate for Payer: Mclaren Commercial |
$118.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.71
|
| Rate for Payer: Nomi Health Commercial |
$107.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$115.65
|
|
|
HC OSMOTIC FRAGILITY RBC
|
Facility
|
OP
|
$131.42
|
|
|
Service Code
|
CPT 85557
|
| Hospital Charge Code |
30500052
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$7.16 |
| Max. Negotiated Rate |
$131.42 |
| Rate for Payer: Aetna Commercial |
$118.28
|
| Rate for Payer: Aetna Medicare |
$13.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.70
|
| Rate for Payer: ASR ASR |
$127.48
|
| Rate for Payer: ASR Commercial |
$127.48
|
| Rate for Payer: BCBS Complete |
$7.52
|
| Rate for Payer: BCBS MAPPO |
$13.36
|
| Rate for Payer: BCBS Trust/PPO |
$107.62
|
| Rate for Payer: BCN Commercial |
$101.89
|
| Rate for Payer: BCN Medicare Advantage |
$13.36
|
| Rate for Payer: Cash Price |
$105.14
|
| Rate for Payer: Cash Price |
$105.14
|
| Rate for Payer: Cofinity Commercial |
$123.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.36
|
| Rate for Payer: Healthscope Commercial |
$131.42
|
| Rate for Payer: Healthscope Whirlpool |
$127.48
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.36
|
| Rate for Payer: Mclaren Commercial |
$118.28
|
| Rate for Payer: Mclaren Medicaid |
$7.16
|
| Rate for Payer: Mclaren Medicare |
$13.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.03
|
| Rate for Payer: Meridian Medicaid |
$7.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.71
|
| Rate for Payer: Nomi Health Commercial |
$107.76
|
| Rate for Payer: PACE Medicare |
$12.69
|
| Rate for Payer: PACE SWMI |
$13.36
|
| Rate for Payer: PHP Commercial |
$14.70
|
| Rate for Payer: PHP Medicaid |
$7.16
|
| Rate for Payer: PHP Medicare Advantage |
$13.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$115.15
|
| Rate for Payer: Priority Health Medicare |
$13.36
|
| Rate for Payer: Priority Health Narrow Network |
$92.13
|
| Rate for Payer: Railroad Medicare Medicare |
$13.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$115.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.36
|
| Rate for Payer: UHC Exchange |
$20.71
|
| Rate for Payer: UHC Medicare Advantage |
$13.36
|
| Rate for Payer: UHCCP DNSP |
$13.36
|
| Rate for Payer: UHCCP Medicaid |
$7.16
|
| Rate for Payer: VA VA |
$13.36
|
|
|
HC OSTECTOMY COMPLETE 1ST METATARSAL HEAD
|
Facility
|
OP
|
$8,364.00
|
|
|
Service Code
|
CPT 28111
|
| Hospital Charge Code |
76100365
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,696.12 |
| Max. Negotiated Rate |
$8,364.00 |
| Rate for Payer: Aetna Commercial |
$7,527.60
|
| Rate for Payer: Aetna Medicare |
$3,164.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,955.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,955.50
|
| Rate for Payer: ASR ASR |
$8,113.08
|
| Rate for Payer: ASR Commercial |
$8,113.08
|
| Rate for Payer: BCBS Complete |
$1,780.92
|
| Rate for Payer: BCBS MAPPO |
$3,164.40
|
| Rate for Payer: BCBS Trust/PPO |
$6,849.28
|
| Rate for Payer: BCN Commercial |
$6,484.61
|
| Rate for Payer: BCN Medicare Advantage |
$3,164.40
|
| Rate for Payer: Cash Price |
$6,691.20
|
| Rate for Payer: Cash Price |
$6,691.20
|
| Rate for Payer: Cofinity Commercial |
$7,862.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,691.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,164.40
|
| Rate for Payer: Healthscope Commercial |
$8,364.00
|
| Rate for Payer: Healthscope Whirlpool |
$8,113.08
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,164.40
|
| Rate for Payer: Mclaren Commercial |
$7,527.60
|
| Rate for Payer: Mclaren Medicaid |
$1,696.12
|
| Rate for Payer: Mclaren Medicare |
$3,164.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,322.62
|
| Rate for Payer: Meridian Medicaid |
$1,780.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,639.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,109.40
|
| Rate for Payer: Nomi Health Commercial |
$6,858.48
|
| Rate for Payer: PACE Medicare |
$3,006.18
|
| Rate for Payer: PACE SWMI |
$3,164.40
|
| Rate for Payer: PHP Commercial |
$3,480.84
|
| Rate for Payer: PHP Medicaid |
$1,696.12
|
| Rate for Payer: PHP Medicare Advantage |
$3,164.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,696.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,436.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,328.54
|
| Rate for Payer: Priority Health Medicare |
$3,164.40
|
| Rate for Payer: Priority Health Narrow Network |
$5,863.16
|
| Rate for Payer: Railroad Medicare Medicare |
$3,164.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,360.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,164.40
|
| Rate for Payer: UHC Exchange |
$4,904.82
|
| Rate for Payer: UHC Medicare Advantage |
$3,164.40
|
| Rate for Payer: UHCCP DNSP |
$3,164.40
|
| Rate for Payer: UHCCP Medicaid |
$1,696.12
|
| Rate for Payer: VA VA |
$3,164.40
|
|
|
HC OSTECTOMY COMPLETE 1ST METATARSAL HEAD
|
Facility
|
IP
|
$8,364.00
|
|
|
Service Code
|
CPT 28111
|
| Hospital Charge Code |
76100365
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,436.60 |
| Max. Negotiated Rate |
$8,364.00 |
| Rate for Payer: Aetna Commercial |
$7,527.60
|
| Rate for Payer: ASR ASR |
$8,113.08
|
| Rate for Payer: ASR Commercial |
$8,113.08
|
| Rate for Payer: BCBS Trust/PPO |
$6,815.82
|
| Rate for Payer: BCN Commercial |
$6,484.61
|
| Rate for Payer: Cash Price |
$6,691.20
|
| Rate for Payer: Cofinity Commercial |
$7,862.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,691.20
|
| Rate for Payer: Healthscope Commercial |
$8,364.00
|
| Rate for Payer: Healthscope Whirlpool |
$8,113.08
|
| Rate for Payer: Mclaren Commercial |
$7,527.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,109.40
|
| Rate for Payer: Nomi Health Commercial |
$6,858.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,436.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,360.32
|
|
|
HC OSTECTOMY COMPLETE 2,3 OR 4TH METATARSAL HEAD
|
Facility
|
IP
|
$8,364.00
|
|
|
Service Code
|
CPT 28112
|
| Hospital Charge Code |
76100366
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,436.60 |
| Max. Negotiated Rate |
$8,364.00 |
| Rate for Payer: Aetna Commercial |
$7,527.60
|
| Rate for Payer: ASR ASR |
$8,113.08
|
| Rate for Payer: ASR Commercial |
$8,113.08
|
| Rate for Payer: BCBS Trust/PPO |
$6,815.82
|
| Rate for Payer: BCN Commercial |
$6,484.61
|
| Rate for Payer: Cash Price |
$6,691.20
|
| Rate for Payer: Cofinity Commercial |
$7,862.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,691.20
|
| Rate for Payer: Healthscope Commercial |
$8,364.00
|
| Rate for Payer: Healthscope Whirlpool |
$8,113.08
|
| Rate for Payer: Mclaren Commercial |
$7,527.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,109.40
|
| Rate for Payer: Nomi Health Commercial |
$6,858.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,436.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,360.32
|
|
|
HC OSTECTOMY COMPLETE 2,3 OR 4TH METATARSAL HEAD
|
Facility
|
OP
|
$8,364.00
|
|
|
Service Code
|
CPT 28112
|
| Hospital Charge Code |
76100366
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,696.12 |
| Max. Negotiated Rate |
$8,364.00 |
| Rate for Payer: Aetna Commercial |
$7,527.60
|
| Rate for Payer: Aetna Medicare |
$3,164.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,955.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,955.50
|
| Rate for Payer: ASR ASR |
$8,113.08
|
| Rate for Payer: ASR Commercial |
$8,113.08
|
| Rate for Payer: BCBS Complete |
$1,780.92
|
| Rate for Payer: BCBS MAPPO |
$3,164.40
|
| Rate for Payer: BCBS Trust/PPO |
$6,849.28
|
| Rate for Payer: BCN Commercial |
$6,484.61
|
| Rate for Payer: BCN Medicare Advantage |
$3,164.40
|
| Rate for Payer: Cash Price |
$6,691.20
|
| Rate for Payer: Cash Price |
$6,691.20
|
| Rate for Payer: Cofinity Commercial |
$7,862.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,691.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,164.40
|
| Rate for Payer: Healthscope Commercial |
$8,364.00
|
| Rate for Payer: Healthscope Whirlpool |
$8,113.08
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,164.40
|
| Rate for Payer: Mclaren Commercial |
$7,527.60
|
| Rate for Payer: Mclaren Medicaid |
$1,696.12
|
| Rate for Payer: Mclaren Medicare |
$3,164.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,322.62
|
| Rate for Payer: Meridian Medicaid |
$1,780.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,639.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,109.40
|
| Rate for Payer: Nomi Health Commercial |
$6,858.48
|
| Rate for Payer: PACE Medicare |
$3,006.18
|
| Rate for Payer: PACE SWMI |
$3,164.40
|
| Rate for Payer: PHP Commercial |
$3,480.84
|
| Rate for Payer: PHP Medicaid |
$1,696.12
|
| Rate for Payer: PHP Medicare Advantage |
$3,164.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,696.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,436.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,328.54
|
| Rate for Payer: Priority Health Medicare |
$3,164.40
|
| Rate for Payer: Priority Health Narrow Network |
$5,863.16
|
| Rate for Payer: Railroad Medicare Medicare |
$3,164.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,360.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,164.40
|
| Rate for Payer: UHC Exchange |
$4,904.82
|
| Rate for Payer: UHC Medicare Advantage |
$3,164.40
|
| Rate for Payer: UHCCP DNSP |
$3,164.40
|
| Rate for Payer: UHCCP Medicaid |
$1,696.12
|
| Rate for Payer: VA VA |
$3,164.40
|
|
|
HC OSTECTOMY COMPLETE 5TH METATARSAL HEAD
|
Facility
|
OP
|
$8,364.00
|
|
|
Service Code
|
CPT 28113
|
| Hospital Charge Code |
76100367
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,696.12 |
| Max. Negotiated Rate |
$8,364.00 |
| Rate for Payer: Aetna Commercial |
$7,527.60
|
| Rate for Payer: Aetna Medicare |
$3,164.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,955.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,955.50
|
| Rate for Payer: ASR ASR |
$8,113.08
|
| Rate for Payer: ASR Commercial |
$8,113.08
|
| Rate for Payer: BCBS Complete |
$1,780.92
|
| Rate for Payer: BCBS MAPPO |
$3,164.40
|
| Rate for Payer: BCBS Trust/PPO |
$6,849.28
|
| Rate for Payer: BCN Commercial |
$6,484.61
|
| Rate for Payer: BCN Medicare Advantage |
$3,164.40
|
| Rate for Payer: Cash Price |
$6,691.20
|
| Rate for Payer: Cash Price |
$6,691.20
|
| Rate for Payer: Cofinity Commercial |
$7,862.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,691.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,164.40
|
| Rate for Payer: Healthscope Commercial |
$8,364.00
|
| Rate for Payer: Healthscope Whirlpool |
$8,113.08
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,164.40
|
| Rate for Payer: Mclaren Commercial |
$7,527.60
|
| Rate for Payer: Mclaren Medicaid |
$1,696.12
|
| Rate for Payer: Mclaren Medicare |
$3,164.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,322.62
|
| Rate for Payer: Meridian Medicaid |
$1,780.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,639.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,109.40
|
| Rate for Payer: Nomi Health Commercial |
$6,858.48
|
| Rate for Payer: PACE Medicare |
$3,006.18
|
| Rate for Payer: PACE SWMI |
$3,164.40
|
| Rate for Payer: PHP Commercial |
$3,480.84
|
| Rate for Payer: PHP Medicaid |
$1,696.12
|
| Rate for Payer: PHP Medicare Advantage |
$3,164.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,696.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,436.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,328.54
|
| Rate for Payer: Priority Health Medicare |
$3,164.40
|
| Rate for Payer: Priority Health Narrow Network |
$5,863.16
|
| Rate for Payer: Railroad Medicare Medicare |
$3,164.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,360.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,164.40
|
| Rate for Payer: UHC Exchange |
$4,904.82
|
| Rate for Payer: UHC Medicare Advantage |
$3,164.40
|
| Rate for Payer: UHCCP DNSP |
$3,164.40
|
| Rate for Payer: UHCCP Medicaid |
$1,696.12
|
| Rate for Payer: VA VA |
$3,164.40
|
|
|
HC OSTECTOMY COMPLETE 5TH METATARSAL HEAD
|
Facility
|
IP
|
$8,364.00
|
|
|
Service Code
|
CPT 28113
|
| Hospital Charge Code |
76100367
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,436.60 |
| Max. Negotiated Rate |
$8,364.00 |
| Rate for Payer: Aetna Commercial |
$7,527.60
|
| Rate for Payer: ASR ASR |
$8,113.08
|
| Rate for Payer: ASR Commercial |
$8,113.08
|
| Rate for Payer: BCBS Trust/PPO |
$6,815.82
|
| Rate for Payer: BCN Commercial |
$6,484.61
|
| Rate for Payer: Cash Price |
$6,691.20
|
| Rate for Payer: Cofinity Commercial |
$7,862.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,691.20
|
| Rate for Payer: Healthscope Commercial |
$8,364.00
|
| Rate for Payer: Healthscope Whirlpool |
$8,113.08
|
| Rate for Payer: Mclaren Commercial |
$7,527.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,109.40
|
| Rate for Payer: Nomi Health Commercial |
$6,858.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,436.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,360.32
|
|
|
HC OSTEOCALCIN
|
Facility
|
OP
|
$103.00
|
|
|
Service Code
|
CPT 83937
|
| Hospital Charge Code |
30100380
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.00 |
| Max. Negotiated Rate |
$103.00 |
| Rate for Payer: Aetna Commercial |
$92.70
|
| Rate for Payer: Aetna Medicare |
$29.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$37.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$37.31
|
| Rate for Payer: ASR ASR |
$99.91
|
| Rate for Payer: ASR Commercial |
$99.91
|
| Rate for Payer: BCBS Complete |
$16.80
|
| Rate for Payer: BCBS MAPPO |
$29.85
|
| Rate for Payer: BCBS Trust/PPO |
$84.35
|
| Rate for Payer: BCN Commercial |
$79.86
|
| Rate for Payer: BCN Medicare Advantage |
$29.85
|
| Rate for Payer: Cash Price |
$82.40
|
| Rate for Payer: Cash Price |
$82.40
|
| Rate for Payer: Cofinity Commercial |
$96.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.85
|
| Rate for Payer: Healthscope Commercial |
$103.00
|
| Rate for Payer: Healthscope Whirlpool |
$99.91
|
| Rate for Payer: Humana Choice PPO Medicare |
$29.85
|
| Rate for Payer: Mclaren Commercial |
$92.70
|
| Rate for Payer: Mclaren Medicaid |
$16.00
|
| Rate for Payer: Mclaren Medicare |
$29.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.34
|
| Rate for Payer: Meridian Medicaid |
$16.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.55
|
| Rate for Payer: Nomi Health Commercial |
$84.46
|
| Rate for Payer: PACE Medicare |
$28.36
|
| Rate for Payer: PACE SWMI |
$29.85
|
| Rate for Payer: PHP Commercial |
$32.84
|
| Rate for Payer: PHP Medicaid |
$16.00
|
| Rate for Payer: PHP Medicare Advantage |
$29.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$90.25
|
| Rate for Payer: Priority Health Medicare |
$29.85
|
| Rate for Payer: Priority Health Narrow Network |
$72.20
|
| Rate for Payer: Railroad Medicare Medicare |
$29.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$90.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.85
|
| Rate for Payer: UHC Exchange |
$46.27
|
| Rate for Payer: UHC Medicare Advantage |
$29.85
|
| Rate for Payer: UHCCP DNSP |
$29.85
|
| Rate for Payer: UHCCP Medicaid |
$16.00
|
| Rate for Payer: VA VA |
$29.85
|
|
|
HC OSTEOCALCIN
|
Facility
|
IP
|
$103.00
|
|
|
Service Code
|
CPT 83937
|
| Hospital Charge Code |
30100380
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$66.95 |
| Max. Negotiated Rate |
$103.00 |
| Rate for Payer: Aetna Commercial |
$92.70
|
| Rate for Payer: ASR ASR |
$99.91
|
| Rate for Payer: ASR Commercial |
$99.91
|
| Rate for Payer: BCBS Trust/PPO |
$83.93
|
| Rate for Payer: BCN Commercial |
$79.86
|
| Rate for Payer: Cash Price |
$82.40
|
| Rate for Payer: Cofinity Commercial |
$96.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.40
|
| Rate for Payer: Healthscope Commercial |
$103.00
|
| Rate for Payer: Healthscope Whirlpool |
$99.91
|
| Rate for Payer: Mclaren Commercial |
$92.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.55
|
| Rate for Payer: Nomi Health Commercial |
$84.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$90.64
|
|
