|
HC VITAMIN C LEVEL
|
Facility
|
OP
|
$65.00
|
|
|
Service Code
|
CPT 82180
|
| Hospital Charge Code |
30100112
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.41 |
| Max. Negotiated Rate |
$129.30 |
| Rate for Payer: Aetna Commercial |
$58.50
|
| Rate for Payer: Aetna Medicare |
$9.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.36
|
| Rate for Payer: ASR ASR |
$63.05
|
| Rate for Payer: BCBS Complete |
$5.68
|
| Rate for Payer: BCBS MAPPO |
$9.89
|
| Rate for Payer: BCBS Trust/PPO |
$50.39
|
| Rate for Payer: BCN Commercial |
$50.39
|
| Rate for Payer: BCN Medicare Advantage |
$9.89
|
| Rate for Payer: Cash Price |
$52.00
|
| Rate for Payer: Cash Price |
$52.00
|
| Rate for Payer: Cofinity Commercial |
$61.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.89
|
| Rate for Payer: Healthscope Commercial |
$65.00
|
| Rate for Payer: Healthscope Whirlpool |
$63.05
|
| Rate for Payer: Humana Choice PPO Medicare |
$9.89
|
| Rate for Payer: Mclaren Commercial |
$58.50
|
| Rate for Payer: Mclaren Medicaid |
$5.41
|
| Rate for Payer: Mclaren Medicare |
$9.89
|
| Rate for Payer: Meridian Medicaid |
$5.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$55.25
|
| Rate for Payer: PACE Medicare |
$9.40
|
| Rate for Payer: PACE SWMI |
$9.89
|
| Rate for Payer: PHP Commercial |
$10.88
|
| Rate for Payer: PHP Medicaid |
$5.41
|
| Rate for Payer: PHP Medicare Advantage |
$9.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$129.30
|
| Rate for Payer: Priority Health Medicare |
$9.89
|
| Rate for Payer: Priority Health Narrow Network |
$103.44
|
| Rate for Payer: Railroad Medicare Medicare |
$9.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$57.20
|
| Rate for Payer: UHC Medicare Advantage |
$10.19
|
| Rate for Payer: VA VA |
$9.89
|
|
|
HC VITAMIN C LEVEL
|
Facility
|
IP
|
$65.00
|
|
|
Service Code
|
CPT 82180
|
| Hospital Charge Code |
30100112
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$45.50 |
| Max. Negotiated Rate |
$65.00 |
| Rate for Payer: Aetna Commercial |
$58.50
|
| Rate for Payer: ASR ASR |
$63.05
|
| Rate for Payer: BCBS Trust/PPO |
$50.39
|
| Rate for Payer: BCN Commercial |
$50.39
|
| Rate for Payer: Cash Price |
$52.00
|
| Rate for Payer: Cofinity Commercial |
$61.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.00
|
| Rate for Payer: Healthscope Commercial |
$65.00
|
| Rate for Payer: Healthscope Whirlpool |
$63.05
|
| Rate for Payer: Mclaren Commercial |
$58.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$55.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$57.20
|
|
|
HC VITAMIN D
|
Facility
|
OP
|
$76.50
|
|
|
Service Code
|
CPT 82306
|
| Hospital Charge Code |
30100481
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.19 |
| Max. Negotiated Rate |
$85.17 |
| Rate for Payer: Aetna Commercial |
$68.85
|
| Rate for Payer: Aetna Medicare |
$29.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$37.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$37.00
|
| Rate for Payer: ASR ASR |
$74.20
|
| Rate for Payer: BCBS Complete |
$17.00
|
| Rate for Payer: BCBS MAPPO |
$29.60
|
| Rate for Payer: BCBS Trust/PPO |
$59.31
|
| Rate for Payer: BCN Commercial |
$59.31
|
| Rate for Payer: BCN Medicare Advantage |
$29.60
|
| 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 |
$29.60
|
| Rate for Payer: Healthscope Commercial |
$76.50
|
| Rate for Payer: Healthscope Whirlpool |
$74.20
|
| Rate for Payer: Humana Choice PPO Medicare |
$29.60
|
| Rate for Payer: Mclaren Commercial |
$68.85
|
| Rate for Payer: Mclaren Medicaid |
$16.19
|
| Rate for Payer: Mclaren Medicare |
$29.60
|
| Rate for Payer: Meridian Medicaid |
$17.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$31.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$65.02
|
| Rate for Payer: PACE Medicare |
$28.12
|
| Rate for Payer: PACE SWMI |
$29.60
|
| Rate for Payer: PHP Commercial |
$32.56
|
| Rate for Payer: PHP Medicaid |
$16.19
|
| Rate for Payer: PHP Medicare Advantage |
$29.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$85.17
|
| Rate for Payer: Priority Health Medicare |
$29.60
|
| Rate for Payer: Priority Health Narrow Network |
$68.14
|
| Rate for Payer: Railroad Medicare Medicare |
$29.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$67.32
|
| Rate for Payer: UHC Medicare Advantage |
$30.49
|
| Rate for Payer: VA VA |
$29.60
|
|
|
HC VITAMIN D
|
Facility
|
IP
|
$76.50
|
|
|
Service Code
|
CPT 82306
|
| Hospital Charge Code |
30100481
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$53.55 |
| Max. Negotiated Rate |
$76.50 |
| Rate for Payer: Aetna Commercial |
$68.85
|
| Rate for Payer: ASR ASR |
$74.20
|
| Rate for Payer: BCBS Trust/PPO |
$59.31
|
| 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 Multiplan/Beech St/PHCS |
$65.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$67.32
|
|
|
HC VITAMIN D 1-25 DIHYDROXY
|
Facility
|
IP
|
$91.80
|
|
|
Service Code
|
CPT 82652
|
| Hospital Charge Code |
30100190
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$64.26 |
| Max. Negotiated Rate |
$91.80 |
| Rate for Payer: Aetna Commercial |
$82.62
|
| Rate for Payer: ASR ASR |
$89.05
|
| Rate for Payer: BCBS Trust/PPO |
$71.17
|
| Rate for Payer: BCN Commercial |
$71.17
|
| Rate for Payer: Cash Price |
$73.44
|
| Rate for Payer: Cofinity Commercial |
$86.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.44
|
| Rate for Payer: Healthscope Commercial |
$91.80
|
| Rate for Payer: Healthscope Whirlpool |
$89.05
|
| Rate for Payer: Mclaren Commercial |
$82.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$78.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$80.78
|
|
|
HC VITAMIN D 1-25 DIHYDROXY
|
Facility
|
OP
|
$91.80
|
|
|
Service Code
|
CPT 82652
|
| Hospital Charge Code |
30100190
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.06 |
| Max. Negotiated Rate |
$123.15 |
| Rate for Payer: Aetna Commercial |
$82.62
|
| Rate for Payer: Aetna Medicare |
$38.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48.12
|
| Rate for Payer: ASR ASR |
$89.05
|
| Rate for Payer: BCBS Complete |
$22.11
|
| Rate for Payer: BCBS MAPPO |
$38.50
|
| Rate for Payer: BCBS Trust/PPO |
$71.17
|
| Rate for Payer: BCN Commercial |
$71.17
|
| Rate for Payer: BCN Medicare Advantage |
$38.50
|
| Rate for Payer: Cash Price |
$73.44
|
| Rate for Payer: Cash Price |
$73.44
|
| Rate for Payer: Cofinity Commercial |
$86.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.50
|
| Rate for Payer: Healthscope Commercial |
$91.80
|
| Rate for Payer: Healthscope Whirlpool |
$89.05
|
| Rate for Payer: Humana Choice PPO Medicare |
$38.50
|
| Rate for Payer: Mclaren Commercial |
$82.62
|
| Rate for Payer: Mclaren Medicaid |
$21.06
|
| Rate for Payer: Mclaren Medicare |
$38.50
|
| Rate for Payer: Meridian Medicaid |
$22.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$40.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$78.03
|
| Rate for Payer: PACE Medicare |
$36.58
|
| Rate for Payer: PACE SWMI |
$38.50
|
| Rate for Payer: PHP Commercial |
$42.35
|
| Rate for Payer: PHP Medicaid |
$21.06
|
| Rate for Payer: PHP Medicare Advantage |
$38.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$123.15
|
| Rate for Payer: Priority Health Medicare |
$38.50
|
| Rate for Payer: Priority Health Narrow Network |
$98.52
|
| Rate for Payer: Railroad Medicare Medicare |
$38.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$80.78
|
| Rate for Payer: UHC Medicare Advantage |
$39.66
|
| Rate for Payer: VA VA |
$38.50
|
|
|
HC VITAMIN D LEVEL
|
Facility
|
OP
|
$76.50
|
|
|
Service Code
|
CPT 82306
|
| Hospital Charge Code |
30100126
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.19 |
| Max. Negotiated Rate |
$85.17 |
| Rate for Payer: Aetna Commercial |
$68.85
|
| Rate for Payer: Aetna Medicare |
$29.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$37.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$37.00
|
| Rate for Payer: ASR ASR |
$74.20
|
| Rate for Payer: BCBS Complete |
$17.00
|
| Rate for Payer: BCBS MAPPO |
$29.60
|
| Rate for Payer: BCBS Trust/PPO |
$59.31
|
| Rate for Payer: BCN Commercial |
$59.31
|
| Rate for Payer: BCN Medicare Advantage |
$29.60
|
| 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 |
$29.60
|
| Rate for Payer: Healthscope Commercial |
$76.50
|
| Rate for Payer: Healthscope Whirlpool |
$74.20
|
| Rate for Payer: Humana Choice PPO Medicare |
$29.60
|
| Rate for Payer: Mclaren Commercial |
$68.85
|
| Rate for Payer: Mclaren Medicaid |
$16.19
|
| Rate for Payer: Mclaren Medicare |
$29.60
|
| Rate for Payer: Meridian Medicaid |
$17.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$31.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$65.02
|
| Rate for Payer: PACE Medicare |
$28.12
|
| Rate for Payer: PACE SWMI |
$29.60
|
| Rate for Payer: PHP Commercial |
$32.56
|
| Rate for Payer: PHP Medicaid |
$16.19
|
| Rate for Payer: PHP Medicare Advantage |
$29.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$85.17
|
| Rate for Payer: Priority Health Medicare |
$29.60
|
| Rate for Payer: Priority Health Narrow Network |
$68.14
|
| Rate for Payer: Railroad Medicare Medicare |
$29.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$67.32
|
| Rate for Payer: UHC Medicare Advantage |
$30.49
|
| Rate for Payer: VA VA |
$29.60
|
|
|
HC VITAMIN D LEVEL
|
Facility
|
IP
|
$76.50
|
|
|
Service Code
|
CPT 82306
|
| Hospital Charge Code |
30100126
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$53.55 |
| Max. Negotiated Rate |
$76.50 |
| Rate for Payer: Aetna Commercial |
$68.85
|
| Rate for Payer: ASR ASR |
$74.20
|
| Rate for Payer: BCBS Trust/PPO |
$59.31
|
| 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 Multiplan/Beech St/PHCS |
$65.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$67.32
|
|
|
HC VITAMIN E LEVEL
|
Facility
|
OP
|
$51.00
|
|
|
Service Code
|
CPT 84446
|
| Hospital Charge Code |
30100440
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.76 |
| Max. Negotiated Rate |
$67.73 |
| Rate for Payer: Aetna Commercial |
$45.90
|
| 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 |
$49.47
|
| Rate for Payer: BCBS Complete |
$8.14
|
| Rate for Payer: BCBS MAPPO |
$14.18
|
| Rate for Payer: BCBS Trust/PPO |
$39.54
|
| Rate for Payer: BCN Commercial |
$39.54
|
| Rate for Payer: BCN Medicare Advantage |
$14.18
|
| 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 |
$14.18
|
| Rate for Payer: Healthscope Commercial |
$51.00
|
| Rate for Payer: Healthscope Whirlpool |
$49.47
|
| Rate for Payer: Humana Choice PPO Medicare |
$14.18
|
| Rate for Payer: Mclaren Commercial |
$45.90
|
| 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 |
$43.35
|
| 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 |
$35.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$67.73
|
| Rate for Payer: Priority Health Medicare |
$14.18
|
| Rate for Payer: Priority Health Narrow Network |
$54.18
|
| Rate for Payer: Railroad Medicare Medicare |
$14.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.88
|
| Rate for Payer: UHC Medicare Advantage |
$14.61
|
| Rate for Payer: VA VA |
$14.18
|
|
|
HC VITAMIN E LEVEL
|
Facility
|
IP
|
$51.00
|
|
|
Service Code
|
CPT 84446
|
| Hospital Charge Code |
30100440
|
|
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 VITAMIN K LEVEL
|
Facility
|
OP
|
$120.00
|
|
|
Service Code
|
CPT 84597
|
| Hospital Charge Code |
30100459
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.50 |
| Max. Negotiated Rate |
$120.00 |
| Rate for Payer: Aetna Commercial |
$108.00
|
| Rate for Payer: Aetna Medicare |
$13.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.15
|
| Rate for Payer: ASR ASR |
$116.40
|
| Rate for Payer: BCBS Complete |
$7.88
|
| Rate for Payer: BCBS MAPPO |
$13.72
|
| Rate for Payer: BCBS Trust/PPO |
$93.04
|
| Rate for Payer: BCN Commercial |
$93.04
|
| Rate for Payer: BCN Medicare Advantage |
$13.72
|
| Rate for Payer: Cash Price |
$96.00
|
| Rate for Payer: Cash Price |
$96.00
|
| Rate for Payer: Cofinity Commercial |
$112.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.72
|
| Rate for Payer: Healthscope Commercial |
$120.00
|
| Rate for Payer: Healthscope Whirlpool |
$116.40
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.72
|
| Rate for Payer: Mclaren Commercial |
$108.00
|
| Rate for Payer: Mclaren Medicaid |
$7.50
|
| Rate for Payer: Mclaren Medicare |
$13.72
|
| Rate for Payer: Meridian Medicaid |
$7.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$102.00
|
| Rate for Payer: PACE Medicare |
$13.03
|
| Rate for Payer: PACE SWMI |
$13.72
|
| Rate for Payer: PHP Commercial |
$15.09
|
| Rate for Payer: PHP Medicaid |
$7.50
|
| Rate for Payer: PHP Medicare Advantage |
$13.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$109.20
|
| Rate for Payer: Priority Health Medicare |
$13.72
|
| Rate for Payer: Priority Health Narrow Network |
$85.20
|
| Rate for Payer: Railroad Medicare Medicare |
$13.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$105.60
|
| Rate for Payer: UHC Medicare Advantage |
$14.13
|
| Rate for Payer: VA VA |
$13.72
|
|
|
HC VITAMIN K LEVEL
|
Facility
|
IP
|
$120.00
|
|
|
Service Code
|
CPT 84597
|
| Hospital Charge Code |
30100459
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$84.00 |
| Max. Negotiated Rate |
$120.00 |
| Rate for Payer: Aetna Commercial |
$108.00
|
| Rate for Payer: ASR ASR |
$116.40
|
| Rate for Payer: BCBS Trust/PPO |
$93.04
|
| Rate for Payer: BCN Commercial |
$93.04
|
| Rate for Payer: Cash Price |
$96.00
|
| Rate for Payer: Cofinity Commercial |
$112.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.00
|
| Rate for Payer: Healthscope Commercial |
$120.00
|
| Rate for Payer: Healthscope Whirlpool |
$116.40
|
| Rate for Payer: Mclaren Commercial |
$108.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$102.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$105.60
|
|
|
HC VMA AND HVA 4 HOUR RANDOM URINE
|
Facility
|
IP
|
$88.00
|
|
|
Service Code
|
CPT 84585
|
| Hospital Charge Code |
30100455
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$61.60 |
| Max. Negotiated Rate |
$88.00 |
| Rate for Payer: Aetna Commercial |
$79.20
|
| Rate for Payer: ASR ASR |
$85.36
|
| Rate for Payer: BCBS Trust/PPO |
$68.23
|
| Rate for Payer: BCN Commercial |
$68.23
|
| Rate for Payer: Cash Price |
$70.40
|
| Rate for Payer: Cofinity Commercial |
$82.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.40
|
| Rate for Payer: Healthscope Commercial |
$88.00
|
| Rate for Payer: Healthscope Whirlpool |
$85.36
|
| Rate for Payer: Mclaren Commercial |
$79.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$74.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$77.44
|
|
|
HC VMA AND HVA 4 HOUR RANDOM URINE
|
Facility
|
OP
|
$88.00
|
|
|
Service Code
|
CPT 84585
|
| Hospital Charge Code |
30100455
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.48 |
| Max. Negotiated Rate |
$88.00 |
| Rate for Payer: Aetna Commercial |
$79.20
|
| Rate for Payer: Aetna Medicare |
$15.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.38
|
| Rate for Payer: ASR ASR |
$85.36
|
| Rate for Payer: BCBS Complete |
$8.90
|
| Rate for Payer: BCBS MAPPO |
$15.50
|
| Rate for Payer: BCBS Trust/PPO |
$68.23
|
| Rate for Payer: BCN Commercial |
$68.23
|
| Rate for Payer: BCN Medicare Advantage |
$15.50
|
| Rate for Payer: Cash Price |
$70.40
|
| Rate for Payer: Cash Price |
$70.40
|
| Rate for Payer: Cofinity Commercial |
$82.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.50
|
| Rate for Payer: Healthscope Commercial |
$88.00
|
| Rate for Payer: Healthscope Whirlpool |
$85.36
|
| Rate for Payer: Humana Choice PPO Medicare |
$15.50
|
| Rate for Payer: Mclaren Commercial |
$79.20
|
| Rate for Payer: Mclaren Medicaid |
$8.48
|
| Rate for Payer: Mclaren Medicare |
$15.50
|
| Rate for Payer: Meridian Medicaid |
$8.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$74.80
|
| Rate for Payer: PACE Medicare |
$14.72
|
| Rate for Payer: PACE SWMI |
$15.50
|
| Rate for Payer: PHP Commercial |
$17.05
|
| Rate for Payer: PHP Medicaid |
$8.48
|
| Rate for Payer: PHP Medicare Advantage |
$15.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$67.73
|
| Rate for Payer: Priority Health Medicare |
$15.50
|
| Rate for Payer: Priority Health Narrow Network |
$54.18
|
| Rate for Payer: Railroad Medicare Medicare |
$15.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$77.44
|
| Rate for Payer: UHC Medicare Advantage |
$15.96
|
| Rate for Payer: VA VA |
$15.50
|
|
|
HC VMA AND HVA 4 HR RANDOM URINE CMPT
|
Facility
|
IP
|
$49.98
|
|
|
Service Code
|
CPT 83150
|
| Hospital Charge Code |
30100217
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$34.99 |
| Max. Negotiated Rate |
$49.98 |
| Rate for Payer: Aetna Commercial |
$44.98
|
| Rate for Payer: ASR ASR |
$48.48
|
| Rate for Payer: BCBS Trust/PPO |
$38.75
|
| Rate for Payer: BCN Commercial |
$38.75
|
| Rate for Payer: Cash Price |
$39.98
|
| Rate for Payer: Cofinity Commercial |
$46.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.98
|
| Rate for Payer: Healthscope Commercial |
$49.98
|
| Rate for Payer: Healthscope Whirlpool |
$48.48
|
| Rate for Payer: Mclaren Commercial |
$44.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$43.98
|
|
|
HC VMA AND HVA 4 HR RANDOM URINE CMPT
|
Facility
|
OP
|
$49.98
|
|
|
Service Code
|
CPT 83150
|
| Hospital Charge Code |
30100217
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.26 |
| Max. Negotiated Rate |
$49.98 |
| Rate for Payer: Aetna Commercial |
$44.98
|
| Rate for Payer: Aetna Medicare |
$22.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.01
|
| Rate for Payer: ASR ASR |
$48.48
|
| Rate for Payer: BCBS Complete |
$12.87
|
| Rate for Payer: BCBS MAPPO |
$22.41
|
| Rate for Payer: BCBS Trust/PPO |
$38.75
|
| Rate for Payer: BCN Commercial |
$38.75
|
| Rate for Payer: BCN Medicare Advantage |
$22.41
|
| Rate for Payer: Cash Price |
$39.98
|
| Rate for Payer: Cash Price |
$39.98
|
| Rate for Payer: Cofinity Commercial |
$46.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.41
|
| Rate for Payer: Healthscope Commercial |
$49.98
|
| Rate for Payer: Healthscope Whirlpool |
$48.48
|
| Rate for Payer: Humana Choice PPO Medicare |
$22.41
|
| Rate for Payer: Mclaren Commercial |
$44.98
|
| Rate for Payer: Mclaren Medicaid |
$12.26
|
| Rate for Payer: Mclaren Medicare |
$22.41
|
| Rate for Payer: Meridian Medicaid |
$12.87
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$23.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.48
|
| Rate for Payer: PACE Medicare |
$21.29
|
| Rate for Payer: PACE SWMI |
$22.41
|
| Rate for Payer: PHP Commercial |
$24.65
|
| Rate for Payer: PHP Medicaid |
$12.26
|
| Rate for Payer: PHP Medicare Advantage |
$22.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45.48
|
| Rate for Payer: Priority Health Medicare |
$22.41
|
| Rate for Payer: Priority Health Narrow Network |
$35.49
|
| Rate for Payer: Railroad Medicare Medicare |
$22.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$43.98
|
| Rate for Payer: UHC Medicare Advantage |
$23.08
|
| Rate for Payer: VA VA |
$22.41
|
|
|
HC VMA RANDOM URINE
|
Facility
|
IP
|
$47.00
|
|
|
Service Code
|
CPT 84585
|
| Hospital Charge Code |
30100454
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$32.90 |
| Max. Negotiated Rate |
$47.00 |
| Rate for Payer: Aetna Commercial |
$42.30
|
| Rate for Payer: ASR ASR |
$45.59
|
| Rate for Payer: BCBS Trust/PPO |
$36.44
|
| Rate for Payer: BCN Commercial |
$36.44
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Cofinity Commercial |
$44.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.60
|
| Rate for Payer: Healthscope Commercial |
$47.00
|
| Rate for Payer: Healthscope Whirlpool |
$45.59
|
| Rate for Payer: Mclaren Commercial |
$42.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$41.36
|
|
|
HC VMA RANDOM URINE
|
Facility
|
OP
|
$47.00
|
|
|
Service Code
|
CPT 84585
|
| Hospital Charge Code |
30100454
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.48 |
| Max. Negotiated Rate |
$67.73 |
| Rate for Payer: Aetna Commercial |
$42.30
|
| Rate for Payer: Aetna Medicare |
$15.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.38
|
| Rate for Payer: ASR ASR |
$45.59
|
| Rate for Payer: BCBS Complete |
$8.90
|
| Rate for Payer: BCBS MAPPO |
$15.50
|
| Rate for Payer: BCBS Trust/PPO |
$36.44
|
| Rate for Payer: BCN Commercial |
$36.44
|
| Rate for Payer: BCN Medicare Advantage |
$15.50
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Cofinity Commercial |
$44.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.50
|
| Rate for Payer: Healthscope Commercial |
$47.00
|
| Rate for Payer: Healthscope Whirlpool |
$45.59
|
| Rate for Payer: Humana Choice PPO Medicare |
$15.50
|
| Rate for Payer: Mclaren Commercial |
$42.30
|
| Rate for Payer: Mclaren Medicaid |
$8.48
|
| Rate for Payer: Mclaren Medicare |
$15.50
|
| Rate for Payer: Meridian Medicaid |
$8.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.95
|
| Rate for Payer: PACE Medicare |
$14.72
|
| Rate for Payer: PACE SWMI |
$15.50
|
| Rate for Payer: PHP Commercial |
$17.05
|
| Rate for Payer: PHP Medicaid |
$8.48
|
| Rate for Payer: PHP Medicare Advantage |
$15.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$67.73
|
| Rate for Payer: Priority Health Medicare |
$15.50
|
| Rate for Payer: Priority Health Narrow Network |
$54.18
|
| Rate for Payer: Railroad Medicare Medicare |
$15.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$41.36
|
| Rate for Payer: UHC Medicare Advantage |
$15.96
|
| Rate for Payer: VA VA |
$15.50
|
|
|
HC VMA URINE
|
Facility
|
IP
|
$47.00
|
|
|
Service Code
|
CPT 84585
|
| Hospital Charge Code |
30100488
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$32.90 |
| Max. Negotiated Rate |
$47.00 |
| Rate for Payer: Aetna Commercial |
$42.30
|
| Rate for Payer: ASR ASR |
$45.59
|
| Rate for Payer: BCBS Trust/PPO |
$36.44
|
| Rate for Payer: BCN Commercial |
$36.44
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Cofinity Commercial |
$44.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.60
|
| Rate for Payer: Healthscope Commercial |
$47.00
|
| Rate for Payer: Healthscope Whirlpool |
$45.59
|
| Rate for Payer: Mclaren Commercial |
$42.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$41.36
|
|
|
HC VMA URINE
|
Facility
|
OP
|
$47.00
|
|
|
Service Code
|
CPT 84585
|
| Hospital Charge Code |
30100488
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.48 |
| Max. Negotiated Rate |
$67.73 |
| Rate for Payer: Aetna Commercial |
$42.30
|
| Rate for Payer: Aetna Medicare |
$15.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.38
|
| Rate for Payer: ASR ASR |
$45.59
|
| Rate for Payer: BCBS Complete |
$8.90
|
| Rate for Payer: BCBS MAPPO |
$15.50
|
| Rate for Payer: BCBS Trust/PPO |
$36.44
|
| Rate for Payer: BCN Commercial |
$36.44
|
| Rate for Payer: BCN Medicare Advantage |
$15.50
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Cofinity Commercial |
$44.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.50
|
| Rate for Payer: Healthscope Commercial |
$47.00
|
| Rate for Payer: Healthscope Whirlpool |
$45.59
|
| Rate for Payer: Humana Choice PPO Medicare |
$15.50
|
| Rate for Payer: Mclaren Commercial |
$42.30
|
| Rate for Payer: Mclaren Medicaid |
$8.48
|
| Rate for Payer: Mclaren Medicare |
$15.50
|
| Rate for Payer: Meridian Medicaid |
$8.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.95
|
| Rate for Payer: PACE Medicare |
$14.72
|
| Rate for Payer: PACE SWMI |
$15.50
|
| Rate for Payer: PHP Commercial |
$17.05
|
| Rate for Payer: PHP Medicaid |
$8.48
|
| Rate for Payer: PHP Medicare Advantage |
$15.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$67.73
|
| Rate for Payer: Priority Health Medicare |
$15.50
|
| Rate for Payer: Priority Health Narrow Network |
$54.18
|
| Rate for Payer: Railroad Medicare Medicare |
$15.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$41.36
|
| Rate for Payer: UHC Medicare Advantage |
$15.96
|
| Rate for Payer: VA VA |
$15.50
|
|
|
HC VNUS ABLATION FIRST VEIN
|
Facility
|
OP
|
$4,272.62
|
|
|
Service Code
|
CPT 36475
|
| Hospital Charge Code |
36100435
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,549.81 |
| Max. Negotiated Rate |
$4,272.62 |
| Rate for Payer: Aetna Commercial |
$3,845.36
|
| Rate for Payer: Aetna Medicare |
$2,833.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,541.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,541.61
|
| Rate for Payer: ASR ASR |
$4,144.44
|
| Rate for Payer: BCBS Complete |
$1,627.44
|
| Rate for Payer: BCBS MAPPO |
$2,833.29
|
| Rate for Payer: BCBS Trust/PPO |
$3,312.56
|
| Rate for Payer: BCN Commercial |
$3,312.56
|
| Rate for Payer: BCN Medicare Advantage |
$2,833.29
|
| Rate for Payer: Cash Price |
$3,418.10
|
| Rate for Payer: Cash Price |
$3,418.10
|
| Rate for Payer: Cofinity Commercial |
$4,016.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,418.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,833.29
|
| Rate for Payer: Healthscope Commercial |
$4,272.62
|
| Rate for Payer: Healthscope Whirlpool |
$4,144.44
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,833.29
|
| Rate for Payer: Mclaren Commercial |
$3,845.36
|
| Rate for Payer: Mclaren Medicaid |
$1,549.81
|
| Rate for Payer: Mclaren Medicare |
$2,833.29
|
| Rate for Payer: Meridian Medicaid |
$1,627.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,974.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,258.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,631.73
|
| Rate for Payer: PACE Medicare |
$2,691.63
|
| Rate for Payer: PACE SWMI |
$2,833.29
|
| Rate for Payer: PHP Commercial |
$3,116.62
|
| Rate for Payer: PHP Medicaid |
$1,549.81
|
| Rate for Payer: PHP Medicare Advantage |
$2,833.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,549.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,990.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,888.08
|
| Rate for Payer: Priority Health Medicare |
$2,833.29
|
| Rate for Payer: Priority Health Narrow Network |
$3,033.56
|
| Rate for Payer: Railroad Medicare Medicare |
$2,833.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,759.91
|
| Rate for Payer: UHC Medicare Advantage |
$2,918.29
|
| Rate for Payer: VA VA |
$2,833.29
|
|
|
HC VNUS ABLATION FIRST VEIN
|
Facility
|
IP
|
$4,272.62
|
|
|
Service Code
|
CPT 36475
|
| Hospital Charge Code |
36100435
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,990.83 |
| Max. Negotiated Rate |
$4,272.62 |
| Rate for Payer: Aetna Commercial |
$3,845.36
|
| Rate for Payer: ASR ASR |
$4,144.44
|
| Rate for Payer: BCBS Trust/PPO |
$3,312.56
|
| Rate for Payer: BCN Commercial |
$3,312.56
|
| Rate for Payer: Cash Price |
$3,418.10
|
| Rate for Payer: Cofinity Commercial |
$4,016.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,418.10
|
| Rate for Payer: Healthscope Commercial |
$4,272.62
|
| Rate for Payer: Healthscope Whirlpool |
$4,144.44
|
| Rate for Payer: Mclaren Commercial |
$3,845.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,631.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,990.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,759.91
|
|
|
HC VNUS ABLATION SUBSEQ VEINS
|
Facility
|
IP
|
$2,456.02
|
|
|
Service Code
|
CPT 36476
|
| Hospital Charge Code |
36100436
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,719.21 |
| Max. Negotiated Rate |
$2,456.02 |
| Rate for Payer: Aetna Commercial |
$2,210.42
|
| Rate for Payer: ASR ASR |
$2,382.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,904.15
|
| Rate for Payer: BCN Commercial |
$1,904.15
|
| Rate for Payer: Cash Price |
$1,964.82
|
| Rate for Payer: Cofinity Commercial |
$2,308.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,964.82
|
| Rate for Payer: Healthscope Commercial |
$2,456.02
|
| Rate for Payer: Healthscope Whirlpool |
$2,382.34
|
| Rate for Payer: Mclaren Commercial |
$2,210.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,087.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,719.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,161.30
|
|
|
HC VNUS ABLATION SUBSEQ VEINS
|
Facility
|
OP
|
$2,456.02
|
|
|
Service Code
|
CPT 36476
|
| Hospital Charge Code |
36100436
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$982.41 |
| Max. Negotiated Rate |
$2,456.02 |
| Rate for Payer: Aetna Commercial |
$2,210.42
|
| Rate for Payer: ASR ASR |
$2,382.34
|
| Rate for Payer: BCBS Complete |
$982.41
|
| Rate for Payer: BCBS Trust/PPO |
$1,904.15
|
| Rate for Payer: BCN Commercial |
$1,904.15
|
| Rate for Payer: Cash Price |
$1,964.82
|
| Rate for Payer: Cofinity Commercial |
$2,308.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,964.82
|
| Rate for Payer: Healthscope Commercial |
$2,456.02
|
| Rate for Payer: Healthscope Whirlpool |
$2,382.34
|
| Rate for Payer: Mclaren Commercial |
$2,210.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,087.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,719.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,234.98
|
| Rate for Payer: Priority Health Narrow Network |
$1,743.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,161.30
|
|
|
HC VOIDING PRESS STUDY INTRA-ABDOMINAL VOID
|
Facility
|
OP
|
$257.08
|
|
|
Service Code
|
CPT 51797
|
| Hospital Charge Code |
76100193
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$102.83 |
| Max. Negotiated Rate |
$257.08 |
| Rate for Payer: Aetna Commercial |
$231.37
|
| Rate for Payer: ASR ASR |
$249.37
|
| Rate for Payer: BCBS Complete |
$102.83
|
| Rate for Payer: BCBS Trust/PPO |
$199.31
|
| Rate for Payer: BCN Commercial |
$199.31
|
| Rate for Payer: Cash Price |
$205.66
|
| Rate for Payer: Cofinity Commercial |
$241.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$205.66
|
| Rate for Payer: Healthscope Commercial |
$257.08
|
| Rate for Payer: Healthscope Whirlpool |
$249.37
|
| Rate for Payer: Mclaren Commercial |
$231.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$218.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$179.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$233.94
|
| Rate for Payer: Priority Health Narrow Network |
$182.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$226.23
|
|
