|
HC PACK QUEST CARDIOPLEGIA
|
Facility
|
OP
|
$688.50
|
|
| Hospital Charge Code |
27000457
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$275.40 |
| Max. Negotiated Rate |
$688.50 |
| Rate for Payer: Aetna Commercial |
$619.65
|
| Rate for Payer: Aetna Medicare |
$344.25
|
| Rate for Payer: ASR ASR |
$667.85
|
| Rate for Payer: ASR Commercial |
$667.85
|
| Rate for Payer: BCBS Complete |
$275.40
|
| Rate for Payer: BCBS Trust/PPO |
$563.81
|
| Rate for Payer: BCN Commercial |
$533.79
|
| Rate for Payer: Cash Price |
$550.80
|
| Rate for Payer: Cofinity Commercial |
$647.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$550.80
|
| Rate for Payer: Healthscope Commercial |
$688.50
|
| Rate for Payer: Healthscope Whirlpool |
$667.85
|
| Rate for Payer: Mclaren Commercial |
$619.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$585.23
|
| Rate for Payer: Nomi Health Commercial |
$564.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$447.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$603.26
|
| Rate for Payer: Priority Health Narrow Network |
$482.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$605.88
|
|
|
HC PACK QUEST CARDIOPLEGIA
|
Facility
|
IP
|
$688.50
|
|
| Hospital Charge Code |
27000457
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$447.52 |
| Max. Negotiated Rate |
$688.50 |
| Rate for Payer: Aetna Commercial |
$619.65
|
| Rate for Payer: ASR ASR |
$667.85
|
| Rate for Payer: ASR Commercial |
$667.85
|
| Rate for Payer: BCBS Trust/PPO |
$561.06
|
| Rate for Payer: BCN Commercial |
$533.79
|
| Rate for Payer: Cash Price |
$550.80
|
| Rate for Payer: Cofinity Commercial |
$647.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$550.80
|
| Rate for Payer: Healthscope Commercial |
$688.50
|
| Rate for Payer: Healthscope Whirlpool |
$667.85
|
| Rate for Payer: Mclaren Commercial |
$619.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$585.23
|
| Rate for Payer: Nomi Health Commercial |
$564.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$447.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$605.88
|
|
|
HC PACK TABLE LINE
|
Facility
|
IP
|
$205.02
|
|
| Hospital Charge Code |
27000676
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$133.26 |
| Max. Negotiated Rate |
$205.02 |
| Rate for Payer: Aetna Commercial |
$184.52
|
| Rate for Payer: ASR ASR |
$198.87
|
| Rate for Payer: ASR Commercial |
$198.87
|
| Rate for Payer: BCBS Trust/PPO |
$167.07
|
| Rate for Payer: BCN Commercial |
$158.95
|
| Rate for Payer: Cash Price |
$164.02
|
| Rate for Payer: Cofinity Commercial |
$192.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$164.02
|
| Rate for Payer: Healthscope Commercial |
$205.02
|
| Rate for Payer: Healthscope Whirlpool |
$198.87
|
| Rate for Payer: Mclaren Commercial |
$184.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$174.27
|
| Rate for Payer: Nomi Health Commercial |
$168.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$180.42
|
|
|
HC PACK TABLE LINE
|
Facility
|
OP
|
$205.02
|
|
| Hospital Charge Code |
27000676
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$82.01 |
| Max. Negotiated Rate |
$205.02 |
| Rate for Payer: Aetna Commercial |
$184.52
|
| Rate for Payer: Aetna Medicare |
$102.51
|
| Rate for Payer: ASR ASR |
$198.87
|
| Rate for Payer: ASR Commercial |
$198.87
|
| Rate for Payer: BCBS Complete |
$82.01
|
| Rate for Payer: BCBS Trust/PPO |
$167.89
|
| Rate for Payer: BCN Commercial |
$158.95
|
| Rate for Payer: Cash Price |
$164.02
|
| Rate for Payer: Cofinity Commercial |
$192.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$164.02
|
| Rate for Payer: Healthscope Commercial |
$205.02
|
| Rate for Payer: Healthscope Whirlpool |
$198.87
|
| Rate for Payer: Mclaren Commercial |
$184.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$174.27
|
| Rate for Payer: Nomi Health Commercial |
$168.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$179.64
|
| Rate for Payer: Priority Health Narrow Network |
$143.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$180.42
|
|
|
HC PACK W/O RESERV TERUMO
|
Facility
|
IP
|
$841.50
|
|
| Hospital Charge Code |
27000648
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$546.98 |
| Max. Negotiated Rate |
$841.50 |
| Rate for Payer: Aetna Commercial |
$757.35
|
| Rate for Payer: ASR ASR |
$816.25
|
| Rate for Payer: ASR Commercial |
$816.25
|
| Rate for Payer: BCBS Trust/PPO |
$685.74
|
| Rate for Payer: BCN Commercial |
$652.41
|
| Rate for Payer: Cash Price |
$673.20
|
| Rate for Payer: Cofinity Commercial |
$791.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$673.20
|
| Rate for Payer: Healthscope Commercial |
$841.50
|
| Rate for Payer: Healthscope Whirlpool |
$816.25
|
| Rate for Payer: Mclaren Commercial |
$757.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$715.27
|
| Rate for Payer: Nomi Health Commercial |
$690.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$546.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$740.52
|
|
|
HC PACK W/O RESERV TERUMO
|
Facility
|
OP
|
$841.50
|
|
| Hospital Charge Code |
27000648
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$336.60 |
| Max. Negotiated Rate |
$841.50 |
| Rate for Payer: Aetna Commercial |
$757.35
|
| Rate for Payer: Aetna Medicare |
$420.75
|
| Rate for Payer: ASR ASR |
$816.25
|
| Rate for Payer: ASR Commercial |
$816.25
|
| Rate for Payer: BCBS Complete |
$336.60
|
| Rate for Payer: BCBS Trust/PPO |
$689.10
|
| Rate for Payer: BCN Commercial |
$652.41
|
| Rate for Payer: Cash Price |
$673.20
|
| Rate for Payer: Cofinity Commercial |
$791.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$673.20
|
| Rate for Payer: Healthscope Commercial |
$841.50
|
| Rate for Payer: Healthscope Whirlpool |
$816.25
|
| Rate for Payer: Mclaren Commercial |
$757.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$715.27
|
| Rate for Payer: Nomi Health Commercial |
$690.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$546.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$737.32
|
| Rate for Payer: Priority Health Narrow Network |
$589.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$740.52
|
|
|
HC PAIN CLINIC DRUG SCREEN, U
|
Facility
|
IP
|
$164.38
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100680
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$106.85 |
| Max. Negotiated Rate |
$164.38 |
| Rate for Payer: Aetna Commercial |
$147.94
|
| Rate for Payer: ASR ASR |
$159.45
|
| Rate for Payer: ASR Commercial |
$159.45
|
| Rate for Payer: BCBS Trust/PPO |
$133.95
|
| Rate for Payer: BCN Commercial |
$127.44
|
| Rate for Payer: Cash Price |
$131.50
|
| Rate for Payer: Cofinity Commercial |
$154.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$131.50
|
| Rate for Payer: Healthscope Commercial |
$164.38
|
| Rate for Payer: Healthscope Whirlpool |
$159.45
|
| Rate for Payer: Mclaren Commercial |
$147.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$139.72
|
| Rate for Payer: Nomi Health Commercial |
$134.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$106.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$144.65
|
|
|
HC PAIN CLINIC DRUG SCREEN, U
|
Facility
|
OP
|
$164.38
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100680
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.31 |
| Max. Negotiated Rate |
$164.38 |
| Rate for Payer: Aetna Commercial |
$147.94
|
| 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 |
$159.45
|
| Rate for Payer: ASR Commercial |
$159.45
|
| Rate for Payer: BCBS Complete |
$34.97
|
| Rate for Payer: BCBS MAPPO |
$62.14
|
| Rate for Payer: BCBS Trust/PPO |
$134.61
|
| Rate for Payer: BCN Commercial |
$127.44
|
| Rate for Payer: BCN Medicare Advantage |
$62.14
|
| Rate for Payer: Cash Price |
$131.50
|
| Rate for Payer: Cash Price |
$131.50
|
| Rate for Payer: Cofinity Commercial |
$154.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$131.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.14
|
| Rate for Payer: Healthscope Commercial |
$164.38
|
| Rate for Payer: Healthscope Whirlpool |
$159.45
|
| Rate for Payer: Humana Choice PPO Medicare |
$62.14
|
| Rate for Payer: Mclaren Commercial |
$147.94
|
| Rate for Payer: Mclaren Medicaid |
$33.31
|
| 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 |
$34.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$139.72
|
| Rate for Payer: Nomi Health Commercial |
$134.79
|
| 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 |
$33.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$106.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$144.03
|
| Rate for Payer: Priority Health Medicare |
$62.14
|
| Rate for Payer: Priority Health Narrow Network |
$115.23
|
| Rate for Payer: Railroad Medicare Medicare |
$62.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$144.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.14
|
| Rate for Payer: UHC Exchange |
$96.32
|
| Rate for Payer: UHC Medicare Advantage |
$62.14
|
| Rate for Payer: UHCCP DNSP |
$62.14
|
| Rate for Payer: UHCCP Medicaid |
$33.31
|
| Rate for Payer: VA VA |
$62.14
|
|
|
HC PAIN PUMP ADJUSTMENT
|
Facility
|
IP
|
$151.79
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
76100028
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$98.66 |
| Max. Negotiated Rate |
$151.79 |
| Rate for Payer: Aetna Commercial |
$136.61
|
| Rate for Payer: ASR ASR |
$147.24
|
| Rate for Payer: ASR Commercial |
$147.24
|
| Rate for Payer: BCBS Trust/PPO |
$123.69
|
| Rate for Payer: BCN Commercial |
$117.68
|
| Rate for Payer: Cash Price |
$121.43
|
| Rate for Payer: Cofinity Commercial |
$142.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$121.43
|
| Rate for Payer: Healthscope Commercial |
$151.79
|
| Rate for Payer: Healthscope Whirlpool |
$147.24
|
| Rate for Payer: Mclaren Commercial |
$136.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$129.02
|
| Rate for Payer: Nomi Health Commercial |
$124.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$133.58
|
|
|
HC PAIN PUMP ADJUSTMENT
|
Facility
|
OP
|
$151.79
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
76100028
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$60.72 |
| Max. Negotiated Rate |
$151.79 |
| Rate for Payer: Aetna Commercial |
$136.61
|
| Rate for Payer: Aetna Medicare |
$75.89
|
| Rate for Payer: ASR ASR |
$147.24
|
| Rate for Payer: ASR Commercial |
$147.24
|
| Rate for Payer: BCBS Complete |
$60.72
|
| Rate for Payer: BCBS Trust/PPO |
$124.30
|
| Rate for Payer: BCN Commercial |
$117.68
|
| Rate for Payer: Cash Price |
$121.43
|
| Rate for Payer: Cofinity Commercial |
$142.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$121.43
|
| Rate for Payer: Healthscope Commercial |
$151.79
|
| Rate for Payer: Healthscope Whirlpool |
$147.24
|
| Rate for Payer: Mclaren Commercial |
$136.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$129.02
|
| Rate for Payer: Nomi Health Commercial |
$124.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$133.00
|
| Rate for Payer: Priority Health Narrow Network |
$106.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$133.58
|
|
|
HC PAIN PUMP SUPPLY
|
Facility
|
IP
|
$923.62
|
|
| Hospital Charge Code |
27000130
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$600.35 |
| Max. Negotiated Rate |
$923.62 |
| Rate for Payer: Aetna Commercial |
$831.26
|
| Rate for Payer: ASR ASR |
$895.91
|
| Rate for Payer: ASR Commercial |
$895.91
|
| Rate for Payer: BCBS Trust/PPO |
$752.66
|
| Rate for Payer: BCN Commercial |
$716.08
|
| Rate for Payer: Cash Price |
$738.90
|
| Rate for Payer: Cofinity Commercial |
$868.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$738.90
|
| Rate for Payer: Healthscope Commercial |
$923.62
|
| Rate for Payer: Healthscope Whirlpool |
$895.91
|
| Rate for Payer: Mclaren Commercial |
$831.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$785.08
|
| Rate for Payer: Nomi Health Commercial |
$757.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$600.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$812.79
|
|
|
HC PAIN PUMP SUPPLY
|
Facility
|
OP
|
$923.62
|
|
| Hospital Charge Code |
27000130
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$369.45 |
| Max. Negotiated Rate |
$923.62 |
| Rate for Payer: Aetna Commercial |
$831.26
|
| Rate for Payer: Aetna Medicare |
$461.81
|
| Rate for Payer: ASR ASR |
$895.91
|
| Rate for Payer: ASR Commercial |
$895.91
|
| Rate for Payer: BCBS Complete |
$369.45
|
| Rate for Payer: BCBS Trust/PPO |
$756.35
|
| Rate for Payer: BCN Commercial |
$716.08
|
| Rate for Payer: Cash Price |
$738.90
|
| Rate for Payer: Cofinity Commercial |
$868.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$738.90
|
| Rate for Payer: Healthscope Commercial |
$923.62
|
| Rate for Payer: Healthscope Whirlpool |
$895.91
|
| Rate for Payer: Mclaren Commercial |
$831.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$785.08
|
| Rate for Payer: Nomi Health Commercial |
$757.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$600.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$809.28
|
| Rate for Payer: Priority Health Narrow Network |
$647.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$812.79
|
|
|
HC PANCREATIC AMYLASE
|
Facility
|
IP
|
$67.32
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
30100100
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$43.76 |
| Max. Negotiated Rate |
$67.32 |
| Rate for Payer: Aetna Commercial |
$60.59
|
| Rate for Payer: ASR ASR |
$65.30
|
| Rate for Payer: ASR Commercial |
$65.30
|
| Rate for Payer: BCBS Trust/PPO |
$54.86
|
| 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 Commercial |
$57.22
|
| Rate for Payer: Nomi Health Commercial |
$55.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$59.24
|
|
|
HC PANCREATIC AMYLASE
|
Facility
|
OP
|
$67.32
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
30100100
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.47 |
| Max. Negotiated Rate |
$67.32 |
| Rate for Payer: Aetna Commercial |
$60.59
|
| Rate for Payer: Aetna Medicare |
$6.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.10
|
| Rate for Payer: ASR ASR |
$65.30
|
| Rate for Payer: ASR Commercial |
$65.30
|
| Rate for Payer: BCBS Complete |
$3.65
|
| Rate for Payer: BCBS MAPPO |
$6.48
|
| Rate for Payer: BCBS Trust/PPO |
$55.13
|
| Rate for Payer: BCN Commercial |
$52.19
|
| Rate for Payer: BCN Medicare Advantage |
$6.48
|
| Rate for Payer: Cash Price |
$53.86
|
| 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: Health Alliance Plan Medicare Advantage |
$6.48
|
| Rate for Payer: Healthscope Commercial |
$67.32
|
| Rate for Payer: Healthscope Whirlpool |
$65.30
|
| Rate for Payer: Humana Choice PPO Medicare |
$6.48
|
| Rate for Payer: Mclaren Commercial |
$60.59
|
| Rate for Payer: Mclaren Medicaid |
$3.47
|
| Rate for Payer: Mclaren Medicare |
$6.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.80
|
| Rate for Payer: Meridian Medicaid |
$3.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.22
|
| Rate for Payer: Nomi Health Commercial |
$55.20
|
| Rate for Payer: PACE Medicare |
$6.16
|
| Rate for Payer: PACE SWMI |
$6.48
|
| Rate for Payer: PHP Commercial |
$7.13
|
| Rate for Payer: PHP Medicaid |
$3.47
|
| Rate for Payer: PHP Medicare Advantage |
$6.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$58.99
|
| Rate for Payer: Priority Health Medicare |
$6.48
|
| Rate for Payer: Priority Health Narrow Network |
$47.19
|
| Rate for Payer: Railroad Medicare Medicare |
$6.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$59.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.48
|
| Rate for Payer: UHC Exchange |
$10.04
|
| Rate for Payer: UHC Medicare Advantage |
$6.48
|
| Rate for Payer: UHCCP DNSP |
$6.48
|
| Rate for Payer: UHCCP Medicaid |
$3.47
|
| Rate for Payer: VA VA |
$6.48
|
|
|
HC PANCREATIC ELAST IN STOOL
|
Facility
|
IP
|
$117.30
|
|
|
Service Code
|
CPT 82653
|
| Hospital Charge Code |
30100632
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$76.25 |
| Max. Negotiated Rate |
$117.30 |
| Rate for Payer: Aetna Commercial |
$105.57
|
| Rate for Payer: ASR ASR |
$113.78
|
| Rate for Payer: ASR Commercial |
$113.78
|
| Rate for Payer: BCBS Trust/PPO |
$95.59
|
| Rate for Payer: BCN Commercial |
$90.94
|
| Rate for Payer: Cash Price |
$93.84
|
| Rate for Payer: Cofinity Commercial |
$110.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.84
|
| Rate for Payer: Healthscope Commercial |
$117.30
|
| Rate for Payer: Healthscope Whirlpool |
$113.78
|
| Rate for Payer: Mclaren Commercial |
$105.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.70
|
| Rate for Payer: Nomi Health Commercial |
$96.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$103.22
|
|
|
HC PANCREATIC ELAST IN STOOL
|
Facility
|
OP
|
$117.30
|
|
|
Service Code
|
CPT 82653
|
| Hospital Charge Code |
30100632
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.31 |
| Max. Negotiated Rate |
$117.30 |
| Rate for Payer: Aetna Commercial |
$105.57
|
| Rate for Payer: Aetna Medicare |
$22.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.71
|
| Rate for Payer: ASR ASR |
$113.78
|
| Rate for Payer: ASR Commercial |
$113.78
|
| Rate for Payer: BCBS Complete |
$12.93
|
| Rate for Payer: BCBS MAPPO |
$22.97
|
| Rate for Payer: BCBS Trust/PPO |
$96.06
|
| Rate for Payer: BCN Commercial |
$90.94
|
| Rate for Payer: BCN Medicare Advantage |
$22.97
|
| Rate for Payer: Cash Price |
$93.84
|
| Rate for Payer: Cash Price |
$93.84
|
| Rate for Payer: Cofinity Commercial |
$110.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.97
|
| Rate for Payer: Healthscope Commercial |
$117.30
|
| Rate for Payer: Healthscope Whirlpool |
$113.78
|
| Rate for Payer: Humana Choice PPO Medicare |
$22.97
|
| Rate for Payer: Mclaren Commercial |
$105.57
|
| Rate for Payer: Mclaren Medicaid |
$12.31
|
| Rate for Payer: Mclaren Medicare |
$22.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.12
|
| Rate for Payer: Meridian Medicaid |
$12.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.70
|
| Rate for Payer: Nomi Health Commercial |
$96.19
|
| Rate for Payer: PACE Medicare |
$21.82
|
| Rate for Payer: PACE SWMI |
$22.97
|
| Rate for Payer: PHP Commercial |
$25.27
|
| Rate for Payer: PHP Medicaid |
$12.31
|
| Rate for Payer: PHP Medicare Advantage |
$22.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$102.78
|
| Rate for Payer: Priority Health Medicare |
$22.97
|
| Rate for Payer: Priority Health Narrow Network |
$82.23
|
| Rate for Payer: Railroad Medicare Medicare |
$22.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$103.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.97
|
| Rate for Payer: UHC Exchange |
$35.60
|
| Rate for Payer: UHC Medicare Advantage |
$22.97
|
| Rate for Payer: UHCCP DNSP |
$22.97
|
| Rate for Payer: UHCCP Medicaid |
$12.31
|
| Rate for Payer: VA VA |
$22.97
|
|
|
HC PANTOTHENIC ACID (B-5) BIOASSAY
|
Facility
|
IP
|
$110.00
|
|
|
Service Code
|
CPT 84591
|
| Hospital Charge Code |
30100762
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$71.50 |
| Max. Negotiated Rate |
$110.00 |
| Rate for Payer: Aetna Commercial |
$99.00
|
| Rate for Payer: ASR ASR |
$106.70
|
| Rate for Payer: ASR Commercial |
$106.70
|
| Rate for Payer: BCBS Trust/PPO |
$89.64
|
| Rate for Payer: BCN Commercial |
$85.28
|
| Rate for Payer: Cash Price |
$88.00
|
| Rate for Payer: Cofinity Commercial |
$103.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.00
|
| Rate for Payer: Healthscope Commercial |
$110.00
|
| Rate for Payer: Healthscope Whirlpool |
$106.70
|
| Rate for Payer: Mclaren Commercial |
$99.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.50
|
| Rate for Payer: Nomi Health Commercial |
$90.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$96.80
|
|
|
HC PANTOTHENIC ACID (B-5) BIOASSAY
|
Facility
|
OP
|
$110.00
|
|
|
Service Code
|
CPT 84591
|
| Hospital Charge Code |
30100762
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.14 |
| Max. Negotiated Rate |
$110.00 |
| Rate for Payer: Aetna Commercial |
$99.00
|
| Rate for Payer: Aetna Medicare |
$17.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.32
|
| Rate for Payer: ASR ASR |
$106.70
|
| Rate for Payer: ASR Commercial |
$106.70
|
| Rate for Payer: BCBS Complete |
$9.60
|
| Rate for Payer: BCBS MAPPO |
$17.06
|
| Rate for Payer: BCBS Trust/PPO |
$90.08
|
| Rate for Payer: BCN Commercial |
$85.28
|
| Rate for Payer: BCN Medicare Advantage |
$17.06
|
| Rate for Payer: Cash Price |
$88.00
|
| Rate for Payer: Cash Price |
$88.00
|
| Rate for Payer: Cofinity Commercial |
$103.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.06
|
| Rate for Payer: Healthscope Commercial |
$110.00
|
| Rate for Payer: Healthscope Whirlpool |
$106.70
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.06
|
| Rate for Payer: Mclaren Commercial |
$99.00
|
| Rate for Payer: Mclaren Medicaid |
$9.14
|
| Rate for Payer: Mclaren Medicare |
$17.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.91
|
| Rate for Payer: Meridian Medicaid |
$9.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.50
|
| Rate for Payer: Nomi Health Commercial |
$90.20
|
| Rate for Payer: PACE Medicare |
$16.21
|
| Rate for Payer: PACE SWMI |
$17.06
|
| Rate for Payer: PHP Commercial |
$18.77
|
| Rate for Payer: PHP Medicaid |
$9.14
|
| Rate for Payer: PHP Medicare Advantage |
$17.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$96.38
|
| Rate for Payer: Priority Health Medicare |
$17.06
|
| Rate for Payer: Priority Health Narrow Network |
$77.11
|
| Rate for Payer: Railroad Medicare Medicare |
$17.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$96.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.06
|
| Rate for Payer: UHC Exchange |
$26.44
|
| Rate for Payer: UHC Medicare Advantage |
$17.06
|
| Rate for Payer: UHCCP DNSP |
$17.06
|
| Rate for Payer: UHCCP Medicaid |
$9.14
|
| Rate for Payer: VA VA |
$17.06
|
|
|
HC PAPER WASP IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200096
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$25.39 |
| Rate for Payer: Aetna Commercial |
$22.85
|
| Rate for Payer: ASR ASR |
$24.63
|
| Rate for Payer: ASR Commercial |
$24.63
|
| Rate for Payer: BCBS Trust/PPO |
$20.69
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$23.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$25.39
|
| Rate for Payer: Healthscope Whirlpool |
$24.63
|
| Rate for Payer: Mclaren Commercial |
$22.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.34
|
|
|
HC PAPER WASP IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200096
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$25.39 |
| Rate for Payer: Aetna Commercial |
$22.85
|
| 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 |
$24.63
|
| Rate for Payer: ASR Commercial |
$24.63
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$20.79
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$23.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$25.39
|
| Rate for Payer: Healthscope Whirlpool |
$24.63
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$22.85
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| 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 |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| 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 |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.25
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$17.80
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP DNSP |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.80
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC PAP NAP
|
Facility
|
OP
|
$2,312.24
|
|
|
Service Code
|
CPT 95807
|
| Hospital Charge Code |
92000019
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$277.37 |
| Max. Negotiated Rate |
$2,312.24 |
| Rate for Payer: Aetna Commercial |
$2,081.02
|
| Rate for Payer: Aetna Medicare |
$517.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$646.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$646.85
|
| Rate for Payer: ASR ASR |
$2,242.87
|
| Rate for Payer: ASR Commercial |
$2,242.87
|
| Rate for Payer: BCBS Complete |
$291.24
|
| Rate for Payer: BCBS MAPPO |
$517.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,893.49
|
| Rate for Payer: BCN Commercial |
$1,792.68
|
| Rate for Payer: BCN Medicare Advantage |
$517.48
|
| Rate for Payer: Cash Price |
$1,849.79
|
| Rate for Payer: Cash Price |
$1,849.79
|
| Rate for Payer: Cofinity Commercial |
$2,173.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,849.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$517.48
|
| Rate for Payer: Healthscope Commercial |
$2,312.24
|
| Rate for Payer: Healthscope Whirlpool |
$2,242.87
|
| Rate for Payer: Humana Choice PPO Medicare |
$517.48
|
| Rate for Payer: Mclaren Commercial |
$2,081.02
|
| Rate for Payer: Mclaren Medicaid |
$277.37
|
| Rate for Payer: Mclaren Medicare |
$517.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$543.35
|
| Rate for Payer: Meridian Medicaid |
$291.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$595.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,965.40
|
| Rate for Payer: Nomi Health Commercial |
$1,896.04
|
| Rate for Payer: PACE Medicare |
$491.61
|
| Rate for Payer: PACE SWMI |
$517.48
|
| Rate for Payer: PHP Commercial |
$569.23
|
| Rate for Payer: PHP Medicaid |
$277.37
|
| Rate for Payer: PHP Medicare Advantage |
$517.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$277.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,502.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,025.98
|
| Rate for Payer: Priority Health Medicare |
$517.48
|
| Rate for Payer: Priority Health Narrow Network |
$1,620.88
|
| Rate for Payer: Railroad Medicare Medicare |
$517.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,034.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$517.48
|
| Rate for Payer: UHC Exchange |
$802.09
|
| Rate for Payer: UHC Medicare Advantage |
$517.48
|
| Rate for Payer: UHCCP DNSP |
$517.48
|
| Rate for Payer: UHCCP Medicaid |
$277.37
|
| Rate for Payer: VA VA |
$517.48
|
|
|
HC PAP NAP
|
Facility
|
IP
|
$2,312.24
|
|
|
Service Code
|
CPT 95807
|
| Hospital Charge Code |
92000019
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$1,502.96 |
| Max. Negotiated Rate |
$2,312.24 |
| Rate for Payer: Aetna Commercial |
$2,081.02
|
| Rate for Payer: ASR ASR |
$2,242.87
|
| Rate for Payer: ASR Commercial |
$2,242.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,884.24
|
| Rate for Payer: BCN Commercial |
$1,792.68
|
| Rate for Payer: Cash Price |
$1,849.79
|
| Rate for Payer: Cofinity Commercial |
$2,173.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,849.79
|
| Rate for Payer: Healthscope Commercial |
$2,312.24
|
| Rate for Payer: Healthscope Whirlpool |
$2,242.87
|
| Rate for Payer: Mclaren Commercial |
$2,081.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,965.40
|
| Rate for Payer: Nomi Health Commercial |
$1,896.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,502.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,034.77
|
|
|
HC PAP SMEAR, SCREENING
|
Facility
|
OP
|
$56.10
|
|
|
Service Code
|
HCPCS P3000
|
| Hospital Charge Code |
31100027
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$9.75 |
| Max. Negotiated Rate |
$56.10 |
| Rate for Payer: Aetna Commercial |
$50.49
|
| Rate for Payer: Aetna Medicare |
$18.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.74
|
| Rate for Payer: ASR ASR |
$54.42
|
| Rate for Payer: ASR Commercial |
$54.42
|
| Rate for Payer: BCBS Complete |
$10.24
|
| Rate for Payer: BCBS MAPPO |
$18.19
|
| Rate for Payer: BCBS Trust/PPO |
$45.94
|
| Rate for Payer: BCN Commercial |
$43.49
|
| Rate for Payer: BCN Medicare Advantage |
$18.19
|
| Rate for Payer: Cash Price |
$44.88
|
| Rate for Payer: Cash Price |
$44.88
|
| Rate for Payer: Cofinity Commercial |
$52.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.19
|
| Rate for Payer: Healthscope Commercial |
$56.10
|
| Rate for Payer: Healthscope Whirlpool |
$54.42
|
| Rate for Payer: Humana Choice PPO Medicare |
$18.19
|
| Rate for Payer: Mclaren Commercial |
$50.49
|
| Rate for Payer: Mclaren Medicaid |
$9.75
|
| Rate for Payer: Mclaren Medicare |
$18.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.10
|
| Rate for Payer: Meridian Medicaid |
$10.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.69
|
| Rate for Payer: Nomi Health Commercial |
$46.00
|
| Rate for Payer: PACE Medicare |
$17.28
|
| Rate for Payer: PACE SWMI |
$18.19
|
| Rate for Payer: PHP Commercial |
$20.01
|
| Rate for Payer: PHP Medicaid |
$9.75
|
| Rate for Payer: PHP Medicare Advantage |
$18.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$49.15
|
| Rate for Payer: Priority Health Medicare |
$18.19
|
| Rate for Payer: Priority Health Narrow Network |
$39.33
|
| Rate for Payer: Railroad Medicare Medicare |
$18.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$49.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.19
|
| Rate for Payer: UHC Exchange |
$28.19
|
| Rate for Payer: UHC Medicare Advantage |
$18.19
|
| Rate for Payer: UHCCP DNSP |
$18.19
|
| Rate for Payer: UHCCP Medicaid |
$9.75
|
| Rate for Payer: VA VA |
$18.19
|
|
|
HC PAP SMEAR, SCREENING
|
Facility
|
IP
|
$56.10
|
|
|
Service Code
|
HCPCS P3000
|
| Hospital Charge Code |
31100027
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$36.47 |
| Max. Negotiated Rate |
$56.10 |
| Rate for Payer: Aetna Commercial |
$50.49
|
| Rate for Payer: ASR ASR |
$54.42
|
| Rate for Payer: ASR Commercial |
$54.42
|
| Rate for Payer: BCBS Trust/PPO |
$45.72
|
| Rate for Payer: BCN Commercial |
$43.49
|
| Rate for Payer: Cash Price |
$44.88
|
| Rate for Payer: Cofinity Commercial |
$52.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.88
|
| Rate for Payer: Healthscope Commercial |
$56.10
|
| Rate for Payer: Healthscope Whirlpool |
$54.42
|
| Rate for Payer: Mclaren Commercial |
$50.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.69
|
| Rate for Payer: Nomi Health Commercial |
$46.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$49.37
|
|
|
HC PARACENTESIS
|
Facility
|
OP
|
$995.71
|
|
| Hospital Charge Code |
36000078
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$398.28 |
| Max. Negotiated Rate |
$995.71 |
| Rate for Payer: Aetna Commercial |
$896.14
|
| Rate for Payer: Aetna Medicare |
$497.86
|
| Rate for Payer: ASR ASR |
$965.84
|
| Rate for Payer: ASR Commercial |
$965.84
|
| Rate for Payer: BCBS Complete |
$398.28
|
| Rate for Payer: BCBS Trust/PPO |
$815.39
|
| Rate for Payer: BCN Commercial |
$771.97
|
| Rate for Payer: Cash Price |
$796.57
|
| Rate for Payer: Cofinity Commercial |
$935.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$796.57
|
| Rate for Payer: Healthscope Commercial |
$995.71
|
| Rate for Payer: Healthscope Whirlpool |
$965.84
|
| Rate for Payer: Mclaren Commercial |
$896.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$846.35
|
| Rate for Payer: Nomi Health Commercial |
$816.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$647.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$872.44
|
| Rate for Payer: Priority Health Narrow Network |
$697.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$876.22
|
|
