|
HC RADXF UNL NM CNS 78699
|
Facility
|
OP
|
$819.59
|
|
|
Service Code
|
CPT 78699
|
| Hospital Charge Code |
34100043
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$208.33 |
| Max. Negotiated Rate |
$819.59 |
| Rate for Payer: Aetna Commercial |
$737.63
|
| Rate for Payer: Aetna Medicare |
$398.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$497.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$497.91
|
| Rate for Payer: ASR ASR |
$795.00
|
| Rate for Payer: BCBS Complete |
$218.76
|
| Rate for Payer: BCBS MAPPO |
$398.33
|
| Rate for Payer: BCBS Trust/PPO |
$675.75
|
| Rate for Payer: BCN Commercial |
$675.75
|
| Rate for Payer: BCN Medicare Advantage |
$398.33
|
| Rate for Payer: Cash Price |
$655.67
|
| Rate for Payer: Cash Price |
$655.67
|
| Rate for Payer: Cofinity Commercial |
$770.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$655.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$398.33
|
| Rate for Payer: Healthscope Commercial |
$795.00
|
| Rate for Payer: Healthscope Whirlpool |
$819.59
|
| Rate for Payer: Humana Choice PPO Medicare |
$398.33
|
| Rate for Payer: Mclaren Commercial |
$737.63
|
| Rate for Payer: Mclaren Medicaid |
$398.33
|
| Rate for Payer: Mclaren Medicare |
$398.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$418.25
|
| Rate for Payer: Meridian Medicaid |
$218.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$458.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$438.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$696.65
|
| Rate for Payer: Nomi Health Commercial |
$672.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$614.69
|
| Rate for Payer: PACE Medicare |
$378.41
|
| Rate for Payer: PACE SWMI |
$398.33
|
| Rate for Payer: PHP Commercial |
$438.16
|
| Rate for Payer: PHP Medicaid |
$213.50
|
| Rate for Payer: PHP Medicare Advantage |
$398.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$718.12
|
| Rate for Payer: Priority Health Medicare |
$398.33
|
| Rate for Payer: Priority Health Narrow Network |
$574.53
|
| Rate for Payer: Railroad Medicare Medicare |
$398.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$721.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$398.33
|
| Rate for Payer: UHC Exchange |
$617.41
|
| Rate for Payer: UHC Medicaid |
$208.33
|
| Rate for Payer: UHCCP DNSP |
$398.33
|
| Rate for Payer: UHCCP Medicaid |
$208.33
|
| Rate for Payer: VA VA |
$398.33
|
|
|
HC RADXF UNL NM ENDOCR 78099
|
Facility
|
OP
|
$819.59
|
|
|
Service Code
|
CPT 78099
|
| Hospital Charge Code |
34100008
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$208.33 |
| Max. Negotiated Rate |
$819.59 |
| Rate for Payer: Aetna Commercial |
$737.63
|
| Rate for Payer: Aetna Medicare |
$398.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$497.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$497.91
|
| Rate for Payer: ASR ASR |
$795.00
|
| Rate for Payer: BCBS Complete |
$218.76
|
| Rate for Payer: BCBS MAPPO |
$398.33
|
| Rate for Payer: BCBS Trust/PPO |
$675.75
|
| Rate for Payer: BCN Commercial |
$675.75
|
| Rate for Payer: BCN Medicare Advantage |
$398.33
|
| Rate for Payer: Cash Price |
$655.67
|
| Rate for Payer: Cash Price |
$655.67
|
| Rate for Payer: Cofinity Commercial |
$770.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$655.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$398.33
|
| Rate for Payer: Healthscope Commercial |
$795.00
|
| Rate for Payer: Healthscope Whirlpool |
$819.59
|
| Rate for Payer: Humana Choice PPO Medicare |
$398.33
|
| Rate for Payer: Mclaren Commercial |
$737.63
|
| Rate for Payer: Mclaren Medicaid |
$398.33
|
| Rate for Payer: Mclaren Medicare |
$398.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$418.25
|
| Rate for Payer: Meridian Medicaid |
$218.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$458.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$438.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$696.65
|
| Rate for Payer: Nomi Health Commercial |
$672.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$614.69
|
| Rate for Payer: PACE Medicare |
$378.41
|
| Rate for Payer: PACE SWMI |
$398.33
|
| Rate for Payer: PHP Commercial |
$438.16
|
| Rate for Payer: PHP Medicaid |
$213.50
|
| Rate for Payer: PHP Medicare Advantage |
$398.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$718.12
|
| Rate for Payer: Priority Health Medicare |
$398.33
|
| Rate for Payer: Priority Health Narrow Network |
$574.53
|
| Rate for Payer: Railroad Medicare Medicare |
$398.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$721.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$398.33
|
| Rate for Payer: UHC Exchange |
$617.41
|
| Rate for Payer: UHC Medicaid |
$208.33
|
| Rate for Payer: UHCCP DNSP |
$398.33
|
| Rate for Payer: UHCCP Medicaid |
$208.33
|
| Rate for Payer: VA VA |
$398.33
|
|
|
HC RADXF UNL NM ENDOCR 78099
|
Facility
|
IP
|
$819.59
|
|
|
Service Code
|
CPT 78099
|
| Hospital Charge Code |
34100008
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$614.69 |
| Max. Negotiated Rate |
$819.59 |
| Rate for Payer: Aetna Commercial |
$737.63
|
| Rate for Payer: ASR ASR |
$795.00
|
| Rate for Payer: BCBS Trust/PPO |
$673.05
|
| Rate for Payer: BCN Commercial |
$673.05
|
| Rate for Payer: Cash Price |
$655.67
|
| Rate for Payer: Cofinity Commercial |
$770.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$655.67
|
| Rate for Payer: Healthscope Commercial |
$795.00
|
| Rate for Payer: Healthscope Whirlpool |
$819.59
|
| Rate for Payer: Mclaren Commercial |
$737.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$696.65
|
| Rate for Payer: Nomi Health Commercial |
$672.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$614.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$721.24
|
|
|
HC RADXF UNL NM GI PROC 78299
|
Facility
|
OP
|
$819.59
|
|
|
Service Code
|
CPT 78299
|
| Hospital Charge Code |
34100022
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$208.33 |
| Max. Negotiated Rate |
$819.59 |
| Rate for Payer: Aetna Commercial |
$737.63
|
| Rate for Payer: Aetna Medicare |
$398.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$497.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$497.91
|
| Rate for Payer: ASR ASR |
$795.00
|
| Rate for Payer: BCBS Complete |
$218.76
|
| Rate for Payer: BCBS MAPPO |
$398.33
|
| Rate for Payer: BCBS Trust/PPO |
$675.75
|
| Rate for Payer: BCN Commercial |
$675.75
|
| Rate for Payer: BCN Medicare Advantage |
$398.33
|
| Rate for Payer: Cash Price |
$655.67
|
| Rate for Payer: Cash Price |
$655.67
|
| Rate for Payer: Cofinity Commercial |
$770.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$655.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$398.33
|
| Rate for Payer: Healthscope Commercial |
$795.00
|
| Rate for Payer: Healthscope Whirlpool |
$819.59
|
| Rate for Payer: Humana Choice PPO Medicare |
$398.33
|
| Rate for Payer: Mclaren Commercial |
$737.63
|
| Rate for Payer: Mclaren Medicaid |
$398.33
|
| Rate for Payer: Mclaren Medicare |
$398.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$418.25
|
| Rate for Payer: Meridian Medicaid |
$218.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$458.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$438.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$696.65
|
| Rate for Payer: Nomi Health Commercial |
$672.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$614.69
|
| Rate for Payer: PACE Medicare |
$378.41
|
| Rate for Payer: PACE SWMI |
$398.33
|
| Rate for Payer: PHP Commercial |
$438.16
|
| Rate for Payer: PHP Medicaid |
$213.50
|
| Rate for Payer: PHP Medicare Advantage |
$398.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$718.12
|
| Rate for Payer: Priority Health Medicare |
$398.33
|
| Rate for Payer: Priority Health Narrow Network |
$574.53
|
| Rate for Payer: Railroad Medicare Medicare |
$398.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$721.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$398.33
|
| Rate for Payer: UHC Exchange |
$617.41
|
| Rate for Payer: UHC Medicaid |
$208.33
|
| Rate for Payer: UHCCP DNSP |
$398.33
|
| Rate for Payer: UHCCP Medicaid |
$208.33
|
| Rate for Payer: VA VA |
$398.33
|
|
|
HC RADXF UNL NM GI PROC 78299
|
Facility
|
IP
|
$819.59
|
|
|
Service Code
|
CPT 78299
|
| Hospital Charge Code |
34100022
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$614.69 |
| Max. Negotiated Rate |
$819.59 |
| Rate for Payer: Aetna Commercial |
$737.63
|
| Rate for Payer: ASR ASR |
$795.00
|
| Rate for Payer: BCBS Trust/PPO |
$673.05
|
| Rate for Payer: BCN Commercial |
$673.05
|
| Rate for Payer: Cash Price |
$655.67
|
| Rate for Payer: Cofinity Commercial |
$770.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$655.67
|
| Rate for Payer: Healthscope Commercial |
$795.00
|
| Rate for Payer: Healthscope Whirlpool |
$819.59
|
| Rate for Payer: Mclaren Commercial |
$737.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$696.65
|
| Rate for Payer: Nomi Health Commercial |
$672.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$614.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$721.24
|
|
|
HC RADXF UNL NM GU 78799
|
Facility
|
OP
|
$819.59
|
|
|
Service Code
|
CPT 78799
|
| Hospital Charge Code |
34100051
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$208.33 |
| Max. Negotiated Rate |
$819.59 |
| Rate for Payer: Aetna Commercial |
$737.63
|
| Rate for Payer: Aetna Medicare |
$398.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$497.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$497.91
|
| Rate for Payer: ASR ASR |
$795.00
|
| Rate for Payer: BCBS Complete |
$218.76
|
| Rate for Payer: BCBS MAPPO |
$398.33
|
| Rate for Payer: BCBS Trust/PPO |
$675.75
|
| Rate for Payer: BCN Commercial |
$675.75
|
| Rate for Payer: BCN Medicare Advantage |
$398.33
|
| Rate for Payer: Cash Price |
$655.67
|
| Rate for Payer: Cash Price |
$655.67
|
| Rate for Payer: Cofinity Commercial |
$770.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$655.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$398.33
|
| Rate for Payer: Healthscope Commercial |
$795.00
|
| Rate for Payer: Healthscope Whirlpool |
$819.59
|
| Rate for Payer: Humana Choice PPO Medicare |
$398.33
|
| Rate for Payer: Mclaren Commercial |
$737.63
|
| Rate for Payer: Mclaren Medicaid |
$398.33
|
| Rate for Payer: Mclaren Medicare |
$398.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$418.25
|
| Rate for Payer: Meridian Medicaid |
$218.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$458.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$438.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$696.65
|
| Rate for Payer: Nomi Health Commercial |
$672.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$614.69
|
| Rate for Payer: PACE Medicare |
$378.41
|
| Rate for Payer: PACE SWMI |
$398.33
|
| Rate for Payer: PHP Commercial |
$438.16
|
| Rate for Payer: PHP Medicaid |
$213.50
|
| Rate for Payer: PHP Medicare Advantage |
$398.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$718.12
|
| Rate for Payer: Priority Health Medicare |
$398.33
|
| Rate for Payer: Priority Health Narrow Network |
$574.53
|
| Rate for Payer: Railroad Medicare Medicare |
$398.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$721.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$398.33
|
| Rate for Payer: UHC Exchange |
$617.41
|
| Rate for Payer: UHC Medicaid |
$208.33
|
| Rate for Payer: UHCCP DNSP |
$398.33
|
| Rate for Payer: UHCCP Medicaid |
$208.33
|
| Rate for Payer: VA VA |
$398.33
|
|
|
HC RADXF UNL NM GU 78799
|
Facility
|
IP
|
$819.59
|
|
|
Service Code
|
CPT 78799
|
| Hospital Charge Code |
34100051
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$614.69 |
| Max. Negotiated Rate |
$819.59 |
| Rate for Payer: Aetna Commercial |
$737.63
|
| Rate for Payer: ASR ASR |
$795.00
|
| Rate for Payer: BCBS Trust/PPO |
$673.05
|
| Rate for Payer: BCN Commercial |
$673.05
|
| Rate for Payer: Cash Price |
$655.67
|
| Rate for Payer: Cofinity Commercial |
$770.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$655.67
|
| Rate for Payer: Healthscope Commercial |
$795.00
|
| Rate for Payer: Healthscope Whirlpool |
$819.59
|
| Rate for Payer: Mclaren Commercial |
$737.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$696.65
|
| Rate for Payer: Nomi Health Commercial |
$672.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$614.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$721.24
|
|
|
HC RADXF UNL NM H R L 78199
|
Facility
|
OP
|
$765.35
|
|
|
Service Code
|
CPT 78199
|
| Hospital Charge Code |
34100013
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$208.33 |
| Max. Negotiated Rate |
$765.35 |
| Rate for Payer: Aetna Commercial |
$688.82
|
| Rate for Payer: Aetna Medicare |
$398.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$497.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$497.91
|
| Rate for Payer: ASR ASR |
$742.39
|
| Rate for Payer: BCBS Complete |
$218.76
|
| Rate for Payer: BCBS MAPPO |
$398.33
|
| Rate for Payer: BCBS Trust/PPO |
$631.03
|
| Rate for Payer: BCN Commercial |
$631.03
|
| Rate for Payer: BCN Medicare Advantage |
$398.33
|
| Rate for Payer: Cash Price |
$612.28
|
| Rate for Payer: Cash Price |
$612.28
|
| Rate for Payer: Cofinity Commercial |
$719.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$612.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$398.33
|
| Rate for Payer: Healthscope Commercial |
$742.39
|
| Rate for Payer: Healthscope Whirlpool |
$765.35
|
| Rate for Payer: Humana Choice PPO Medicare |
$398.33
|
| Rate for Payer: Mclaren Commercial |
$688.82
|
| Rate for Payer: Mclaren Medicaid |
$398.33
|
| Rate for Payer: Mclaren Medicare |
$398.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$418.25
|
| Rate for Payer: Meridian Medicaid |
$218.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$458.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$438.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$650.55
|
| Rate for Payer: Nomi Health Commercial |
$627.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$574.01
|
| Rate for Payer: PACE Medicare |
$378.41
|
| Rate for Payer: PACE SWMI |
$398.33
|
| Rate for Payer: PHP Commercial |
$438.16
|
| Rate for Payer: PHP Medicaid |
$213.50
|
| Rate for Payer: PHP Medicare Advantage |
$398.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$670.60
|
| Rate for Payer: Priority Health Medicare |
$398.33
|
| Rate for Payer: Priority Health Narrow Network |
$536.51
|
| Rate for Payer: Railroad Medicare Medicare |
$398.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$673.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$398.33
|
| Rate for Payer: UHC Exchange |
$617.41
|
| Rate for Payer: UHC Medicaid |
$208.33
|
| Rate for Payer: UHCCP DNSP |
$398.33
|
| Rate for Payer: UHCCP Medicaid |
$208.33
|
| Rate for Payer: VA VA |
$398.33
|
|
|
HC RADXF UNL NM H R L 78199
|
Facility
|
IP
|
$765.35
|
|
|
Service Code
|
CPT 78199
|
| Hospital Charge Code |
34100013
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$574.01 |
| Max. Negotiated Rate |
$765.35 |
| Rate for Payer: Aetna Commercial |
$688.82
|
| Rate for Payer: ASR ASR |
$742.39
|
| Rate for Payer: BCBS Trust/PPO |
$628.51
|
| Rate for Payer: BCN Commercial |
$628.51
|
| Rate for Payer: Cash Price |
$612.28
|
| Rate for Payer: Cofinity Commercial |
$719.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$612.28
|
| Rate for Payer: Healthscope Commercial |
$742.39
|
| Rate for Payer: Healthscope Whirlpool |
$765.35
|
| Rate for Payer: Mclaren Commercial |
$688.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$650.55
|
| Rate for Payer: Nomi Health Commercial |
$627.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$574.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$673.51
|
|
|
HC RADXF UNL NM MUSCSKL 78399
|
Facility
|
IP
|
$1,961.56
|
|
|
Service Code
|
CPT 78399
|
| Hospital Charge Code |
34100028
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$1,471.17 |
| Max. Negotiated Rate |
$1,961.56 |
| Rate for Payer: Aetna Commercial |
$1,765.40
|
| Rate for Payer: ASR ASR |
$1,902.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,610.83
|
| Rate for Payer: BCN Commercial |
$1,610.83
|
| Rate for Payer: Cash Price |
$1,569.25
|
| Rate for Payer: Cofinity Commercial |
$1,843.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,569.25
|
| Rate for Payer: Healthscope Commercial |
$1,902.71
|
| Rate for Payer: Healthscope Whirlpool |
$1,961.56
|
| Rate for Payer: Mclaren Commercial |
$1,765.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,667.33
|
| Rate for Payer: Nomi Health Commercial |
$1,608.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,471.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,726.17
|
|
|
HC RADXF UNL NM MUSCSKL 78399
|
Facility
|
OP
|
$1,961.56
|
|
|
Service Code
|
CPT 78399
|
| Hospital Charge Code |
34100028
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$208.33 |
| Max. Negotiated Rate |
$1,961.56 |
| Rate for Payer: Aetna Commercial |
$1,765.40
|
| Rate for Payer: Aetna Medicare |
$398.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$497.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$497.91
|
| Rate for Payer: ASR ASR |
$1,902.71
|
| Rate for Payer: BCBS Complete |
$218.76
|
| Rate for Payer: BCBS MAPPO |
$398.33
|
| Rate for Payer: BCBS Trust/PPO |
$1,617.31
|
| Rate for Payer: BCN Commercial |
$1,617.31
|
| Rate for Payer: BCN Medicare Advantage |
$398.33
|
| Rate for Payer: Cash Price |
$1,569.25
|
| Rate for Payer: Cash Price |
$1,569.25
|
| Rate for Payer: Cofinity Commercial |
$1,843.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,569.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$398.33
|
| Rate for Payer: Healthscope Commercial |
$1,902.71
|
| Rate for Payer: Healthscope Whirlpool |
$1,961.56
|
| Rate for Payer: Humana Choice PPO Medicare |
$398.33
|
| Rate for Payer: Mclaren Commercial |
$1,765.40
|
| Rate for Payer: Mclaren Medicaid |
$398.33
|
| Rate for Payer: Mclaren Medicare |
$398.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$418.25
|
| Rate for Payer: Meridian Medicaid |
$218.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$458.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$438.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,667.33
|
| Rate for Payer: Nomi Health Commercial |
$1,608.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,471.17
|
| Rate for Payer: PACE Medicare |
$378.41
|
| Rate for Payer: PACE SWMI |
$398.33
|
| Rate for Payer: PHP Commercial |
$438.16
|
| Rate for Payer: PHP Medicaid |
$213.50
|
| Rate for Payer: PHP Medicare Advantage |
$398.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,718.72
|
| Rate for Payer: Priority Health Medicare |
$398.33
|
| Rate for Payer: Priority Health Narrow Network |
$1,375.05
|
| Rate for Payer: Railroad Medicare Medicare |
$398.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,726.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$398.33
|
| Rate for Payer: UHC Exchange |
$617.41
|
| Rate for Payer: UHC Medicaid |
$208.33
|
| Rate for Payer: UHCCP DNSP |
$398.33
|
| Rate for Payer: UHCCP Medicaid |
$208.33
|
| Rate for Payer: VA VA |
$398.33
|
|
|
HC RADXF UNL NM PROC MISC 78999
|
Facility
|
OP
|
$819.59
|
|
|
Service Code
|
CPT 78999
|
| Hospital Charge Code |
34100061
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$208.33 |
| Max. Negotiated Rate |
$819.59 |
| Rate for Payer: Aetna Commercial |
$737.63
|
| Rate for Payer: Aetna Medicare |
$398.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$497.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$497.91
|
| Rate for Payer: ASR ASR |
$795.00
|
| Rate for Payer: BCBS Complete |
$218.76
|
| Rate for Payer: BCBS MAPPO |
$398.33
|
| Rate for Payer: BCBS Trust/PPO |
$675.75
|
| Rate for Payer: BCN Commercial |
$675.75
|
| Rate for Payer: BCN Medicare Advantage |
$398.33
|
| Rate for Payer: Cash Price |
$655.67
|
| Rate for Payer: Cash Price |
$655.67
|
| Rate for Payer: Cofinity Commercial |
$770.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$655.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$398.33
|
| Rate for Payer: Healthscope Commercial |
$795.00
|
| Rate for Payer: Healthscope Whirlpool |
$819.59
|
| Rate for Payer: Humana Choice PPO Medicare |
$398.33
|
| Rate for Payer: Mclaren Commercial |
$737.63
|
| Rate for Payer: Mclaren Medicaid |
$398.33
|
| Rate for Payer: Mclaren Medicare |
$398.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$418.25
|
| Rate for Payer: Meridian Medicaid |
$218.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$458.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$438.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$696.65
|
| Rate for Payer: Nomi Health Commercial |
$672.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$614.69
|
| Rate for Payer: PACE Medicare |
$378.41
|
| Rate for Payer: PACE SWMI |
$398.33
|
| Rate for Payer: PHP Commercial |
$438.16
|
| Rate for Payer: PHP Medicaid |
$213.50
|
| Rate for Payer: PHP Medicare Advantage |
$398.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$718.12
|
| Rate for Payer: Priority Health Medicare |
$398.33
|
| Rate for Payer: Priority Health Narrow Network |
$574.53
|
| Rate for Payer: Railroad Medicare Medicare |
$398.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$721.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$398.33
|
| Rate for Payer: UHC Exchange |
$617.41
|
| Rate for Payer: UHC Medicaid |
$208.33
|
| Rate for Payer: UHCCP DNSP |
$398.33
|
| Rate for Payer: UHCCP Medicaid |
$208.33
|
| Rate for Payer: VA VA |
$398.33
|
|
|
HC RADXF UNL NM PROC MISC 78999
|
Facility
|
IP
|
$819.59
|
|
|
Service Code
|
CPT 78999
|
| Hospital Charge Code |
34100061
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$614.69 |
| Max. Negotiated Rate |
$819.59 |
| Rate for Payer: Aetna Commercial |
$737.63
|
| Rate for Payer: ASR ASR |
$795.00
|
| Rate for Payer: BCBS Trust/PPO |
$673.05
|
| Rate for Payer: BCN Commercial |
$673.05
|
| Rate for Payer: Cash Price |
$655.67
|
| Rate for Payer: Cofinity Commercial |
$770.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$655.67
|
| Rate for Payer: Healthscope Commercial |
$795.00
|
| Rate for Payer: Healthscope Whirlpool |
$819.59
|
| Rate for Payer: Mclaren Commercial |
$737.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$696.65
|
| Rate for Payer: Nomi Health Commercial |
$672.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$614.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$721.24
|
|
|
HC RADXF UNL NM RADPHARM THER 799
|
Facility
|
OP
|
$819.59
|
|
|
Service Code
|
CPT 79999
|
| Hospital Charge Code |
34100066
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$121.60 |
| Max. Negotiated Rate |
$819.59 |
| Rate for Payer: Aetna Commercial |
$737.63
|
| Rate for Payer: Aetna Medicare |
$232.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$290.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$290.62
|
| Rate for Payer: ASR ASR |
$795.00
|
| Rate for Payer: BCBS Complete |
$127.69
|
| Rate for Payer: BCBS MAPPO |
$232.50
|
| Rate for Payer: BCBS Trust/PPO |
$675.75
|
| Rate for Payer: BCN Commercial |
$675.75
|
| Rate for Payer: BCN Medicare Advantage |
$232.50
|
| Rate for Payer: Cash Price |
$655.67
|
| Rate for Payer: Cash Price |
$655.67
|
| Rate for Payer: Cofinity Commercial |
$770.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$655.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$232.50
|
| Rate for Payer: Healthscope Commercial |
$795.00
|
| Rate for Payer: Healthscope Whirlpool |
$819.59
|
| Rate for Payer: Humana Choice PPO Medicare |
$232.50
|
| Rate for Payer: Mclaren Commercial |
$737.63
|
| Rate for Payer: Mclaren Medicaid |
$232.50
|
| Rate for Payer: Mclaren Medicare |
$232.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$244.12
|
| Rate for Payer: Meridian Medicaid |
$127.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$267.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$255.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$696.65
|
| Rate for Payer: Nomi Health Commercial |
$672.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$614.69
|
| Rate for Payer: PACE Medicare |
$220.88
|
| Rate for Payer: PACE SWMI |
$232.50
|
| Rate for Payer: PHP Commercial |
$255.75
|
| Rate for Payer: PHP Medicaid |
$124.62
|
| Rate for Payer: PHP Medicare Advantage |
$232.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$121.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$718.12
|
| Rate for Payer: Priority Health Medicare |
$232.50
|
| Rate for Payer: Priority Health Narrow Network |
$574.53
|
| Rate for Payer: Railroad Medicare Medicare |
$232.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$721.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$232.50
|
| Rate for Payer: UHC Exchange |
$360.38
|
| Rate for Payer: UHC Medicaid |
$121.60
|
| Rate for Payer: UHCCP DNSP |
$232.50
|
| Rate for Payer: UHCCP Medicaid |
$121.60
|
| Rate for Payer: VA VA |
$232.50
|
|
|
HC RADXF UNL NM RADPHARM THER 799
|
Facility
|
IP
|
$819.59
|
|
|
Service Code
|
CPT 79999
|
| Hospital Charge Code |
34100066
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$614.69 |
| Max. Negotiated Rate |
$819.59 |
| Rate for Payer: Aetna Commercial |
$737.63
|
| Rate for Payer: ASR ASR |
$795.00
|
| Rate for Payer: BCBS Trust/PPO |
$673.05
|
| Rate for Payer: BCN Commercial |
$673.05
|
| Rate for Payer: Cash Price |
$655.67
|
| Rate for Payer: Cofinity Commercial |
$770.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$655.67
|
| Rate for Payer: Healthscope Commercial |
$795.00
|
| Rate for Payer: Healthscope Whirlpool |
$819.59
|
| Rate for Payer: Mclaren Commercial |
$737.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$696.65
|
| Rate for Payer: Nomi Health Commercial |
$672.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$614.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$721.24
|
|
|
HC RADXF UNL NM RESP 78599
|
Facility
|
OP
|
$819.59
|
|
|
Service Code
|
CPT 78599
|
| Hospital Charge Code |
34100036
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$208.33 |
| Max. Negotiated Rate |
$819.59 |
| Rate for Payer: Aetna Commercial |
$737.63
|
| Rate for Payer: Aetna Medicare |
$398.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$497.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$497.91
|
| Rate for Payer: ASR ASR |
$795.00
|
| Rate for Payer: BCBS Complete |
$218.76
|
| Rate for Payer: BCBS MAPPO |
$398.33
|
| Rate for Payer: BCBS Trust/PPO |
$675.75
|
| Rate for Payer: BCN Commercial |
$675.75
|
| Rate for Payer: BCN Medicare Advantage |
$398.33
|
| Rate for Payer: Cash Price |
$655.67
|
| Rate for Payer: Cash Price |
$655.67
|
| Rate for Payer: Cofinity Commercial |
$770.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$655.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$398.33
|
| Rate for Payer: Healthscope Commercial |
$795.00
|
| Rate for Payer: Healthscope Whirlpool |
$819.59
|
| Rate for Payer: Humana Choice PPO Medicare |
$398.33
|
| Rate for Payer: Mclaren Commercial |
$737.63
|
| Rate for Payer: Mclaren Medicaid |
$398.33
|
| Rate for Payer: Mclaren Medicare |
$398.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$418.25
|
| Rate for Payer: Meridian Medicaid |
$218.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$458.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$438.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$696.65
|
| Rate for Payer: Nomi Health Commercial |
$672.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$614.69
|
| Rate for Payer: PACE Medicare |
$378.41
|
| Rate for Payer: PACE SWMI |
$398.33
|
| Rate for Payer: PHP Commercial |
$438.16
|
| Rate for Payer: PHP Medicaid |
$213.50
|
| Rate for Payer: PHP Medicare Advantage |
$398.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$718.12
|
| Rate for Payer: Priority Health Medicare |
$398.33
|
| Rate for Payer: Priority Health Narrow Network |
$574.53
|
| Rate for Payer: Railroad Medicare Medicare |
$398.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$721.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$398.33
|
| Rate for Payer: UHC Exchange |
$617.41
|
| Rate for Payer: UHC Medicaid |
$208.33
|
| Rate for Payer: UHCCP DNSP |
$398.33
|
| Rate for Payer: UHCCP Medicaid |
$208.33
|
| Rate for Payer: VA VA |
$398.33
|
|
|
HC RADXF UNL NM RESP 78599
|
Facility
|
IP
|
$819.59
|
|
|
Service Code
|
CPT 78599
|
| Hospital Charge Code |
34100036
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$614.69 |
| Max. Negotiated Rate |
$819.59 |
| Rate for Payer: Aetna Commercial |
$737.63
|
| Rate for Payer: ASR ASR |
$795.00
|
| Rate for Payer: BCBS Trust/PPO |
$673.05
|
| Rate for Payer: BCN Commercial |
$673.05
|
| Rate for Payer: Cash Price |
$655.67
|
| Rate for Payer: Cofinity Commercial |
$770.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$655.67
|
| Rate for Payer: Healthscope Commercial |
$795.00
|
| Rate for Payer: Healthscope Whirlpool |
$819.59
|
| Rate for Payer: Mclaren Commercial |
$737.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$696.65
|
| Rate for Payer: Nomi Health Commercial |
$672.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$614.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$721.24
|
|
|
HC RADXF UNL ULTRASOUND 76999
|
Facility
|
OP
|
$221.61
|
|
|
Service Code
|
CPT 76999
|
| Hospital Charge Code |
40200051
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$45.35 |
| Max. Negotiated Rate |
$436.41 |
| Rate for Payer: Aetna Commercial |
$199.45
|
| Rate for Payer: Aetna Medicare |
$86.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$108.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$108.39
|
| Rate for Payer: ASR ASR |
$214.96
|
| Rate for Payer: BCBS Complete |
$47.62
|
| Rate for Payer: BCBS MAPPO |
$86.71
|
| Rate for Payer: BCBS Trust/PPO |
$182.72
|
| Rate for Payer: BCN Commercial |
$182.72
|
| Rate for Payer: BCN Medicare Advantage |
$86.71
|
| Rate for Payer: Cash Price |
$177.29
|
| Rate for Payer: Cash Price |
$177.29
|
| Rate for Payer: Cofinity Commercial |
$208.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$177.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.71
|
| Rate for Payer: Healthscope Commercial |
$214.96
|
| Rate for Payer: Healthscope Whirlpool |
$221.61
|
| Rate for Payer: Humana Choice PPO Medicare |
$86.71
|
| Rate for Payer: Mclaren Commercial |
$199.45
|
| Rate for Payer: Mclaren Medicaid |
$86.71
|
| Rate for Payer: Mclaren Medicare |
$86.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.05
|
| Rate for Payer: Meridian Medicaid |
$47.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$95.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$188.37
|
| Rate for Payer: Nomi Health Commercial |
$181.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$166.21
|
| Rate for Payer: PACE Medicare |
$82.37
|
| Rate for Payer: PACE SWMI |
$86.71
|
| Rate for Payer: PHP Commercial |
$95.38
|
| Rate for Payer: PHP Medicaid |
$46.48
|
| Rate for Payer: PHP Medicare Advantage |
$86.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$436.41
|
| Rate for Payer: Priority Health Medicare |
$86.71
|
| Rate for Payer: Priority Health Narrow Network |
$349.13
|
| Rate for Payer: Railroad Medicare Medicare |
$86.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$195.02
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$86.71
|
| Rate for Payer: UHC Exchange |
$134.40
|
| Rate for Payer: UHC Medicaid |
$45.35
|
| Rate for Payer: UHCCP DNSP |
$86.71
|
| Rate for Payer: UHCCP Medicaid |
$45.35
|
| Rate for Payer: VA VA |
$86.71
|
|
|
HC RADXF UNL ULTRASOUND 76999
|
Facility
|
IP
|
$221.61
|
|
|
Service Code
|
CPT 76999
|
| Hospital Charge Code |
40200051
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$166.21 |
| Max. Negotiated Rate |
$221.61 |
| Rate for Payer: Aetna Commercial |
$199.45
|
| Rate for Payer: ASR ASR |
$214.96
|
| Rate for Payer: BCBS Trust/PPO |
$181.99
|
| Rate for Payer: BCN Commercial |
$181.99
|
| Rate for Payer: Cash Price |
$177.29
|
| Rate for Payer: Cofinity Commercial |
$208.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$177.29
|
| Rate for Payer: Healthscope Commercial |
$214.96
|
| Rate for Payer: Healthscope Whirlpool |
$221.61
|
| Rate for Payer: Mclaren Commercial |
$199.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$188.37
|
| Rate for Payer: Nomi Health Commercial |
$181.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$166.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$195.02
|
|
|
HC RAGWEED SHORT IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200056
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.43 |
| Max. Negotiated Rate |
$25.90 |
| Rate for Payer: Aetna Commercial |
$23.31
|
| Rate for Payer: ASR ASR |
$25.12
|
| Rate for Payer: BCBS Trust/PPO |
$21.27
|
| Rate for Payer: BCN Commercial |
$21.27
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$24.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$25.12
|
| Rate for Payer: Healthscope Whirlpool |
$25.90
|
| Rate for Payer: Mclaren Commercial |
$23.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.79
|
|
|
HC RAGWEED SHORT IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200056
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$25.90 |
| Rate for Payer: Aetna Commercial |
$23.31
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: ASR ASR |
$25.12
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$21.35
|
| Rate for Payer: BCN Commercial |
$21.35
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$24.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$25.12
|
| Rate for Payer: Healthscope Whirlpool |
$25.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$23.31
|
| Rate for Payer: Mclaren Medicaid |
$5.22
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$5.74
|
| Rate for Payer: PHP Medicaid |
$2.80
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$22.69
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$18.16
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP DNSP |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC RAJI CELL ASSAY
|
Facility
|
IP
|
$153.98
|
|
|
Service Code
|
CPT 86332
|
| Hospital Charge Code |
30200192
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$115.48 |
| Max. Negotiated Rate |
$153.98 |
| Rate for Payer: Aetna Commercial |
$138.58
|
| Rate for Payer: ASR ASR |
$149.36
|
| Rate for Payer: BCBS Trust/PPO |
$126.45
|
| Rate for Payer: BCN Commercial |
$126.45
|
| Rate for Payer: Cash Price |
$123.18
|
| Rate for Payer: Cofinity Commercial |
$144.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.18
|
| Rate for Payer: Healthscope Commercial |
$149.36
|
| Rate for Payer: Healthscope Whirlpool |
$153.98
|
| Rate for Payer: Mclaren Commercial |
$138.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.88
|
| Rate for Payer: Nomi Health Commercial |
$126.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$115.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$135.50
|
|
|
HC RAJI CELL ASSAY
|
Facility
|
OP
|
$153.98
|
|
|
Service Code
|
CPT 86332
|
| Hospital Charge Code |
30200192
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.75 |
| Max. Negotiated Rate |
$153.98 |
| Rate for Payer: Aetna Commercial |
$138.58
|
| Rate for Payer: Aetna Medicare |
$24.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.46
|
| Rate for Payer: ASR ASR |
$149.36
|
| Rate for Payer: BCBS Complete |
$13.38
|
| Rate for Payer: BCBS MAPPO |
$24.37
|
| Rate for Payer: BCBS Trust/PPO |
$126.96
|
| Rate for Payer: BCN Commercial |
$126.96
|
| Rate for Payer: BCN Medicare Advantage |
$24.37
|
| Rate for Payer: Cash Price |
$123.18
|
| Rate for Payer: Cash Price |
$123.18
|
| Rate for Payer: Cofinity Commercial |
$144.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.37
|
| Rate for Payer: Healthscope Commercial |
$149.36
|
| Rate for Payer: Healthscope Whirlpool |
$153.98
|
| Rate for Payer: Humana Choice PPO Medicare |
$24.37
|
| Rate for Payer: Mclaren Commercial |
$138.58
|
| Rate for Payer: Mclaren Medicaid |
$24.37
|
| Rate for Payer: Mclaren Medicare |
$24.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.59
|
| Rate for Payer: Meridian Medicaid |
$13.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$26.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.88
|
| Rate for Payer: Nomi Health Commercial |
$126.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$115.48
|
| Rate for Payer: PACE Medicare |
$23.15
|
| Rate for Payer: PACE SWMI |
$24.37
|
| Rate for Payer: PHP Commercial |
$26.81
|
| Rate for Payer: PHP Medicaid |
$13.06
|
| Rate for Payer: PHP Medicare Advantage |
$24.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$134.92
|
| Rate for Payer: Priority Health Medicare |
$24.37
|
| Rate for Payer: Priority Health Narrow Network |
$107.94
|
| Rate for Payer: Railroad Medicare Medicare |
$24.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$135.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$24.37
|
| Rate for Payer: UHC Exchange |
$37.77
|
| Rate for Payer: UHC Medicaid |
$12.75
|
| Rate for Payer: UHCCP DNSP |
$24.37
|
| Rate for Payer: UHCCP Medicaid |
$12.75
|
| Rate for Payer: VA VA |
$24.37
|
|
|
HC RAPID DESENSITIZATION PROC EA HOUR
|
Facility
|
IP
|
$551.57
|
|
|
Service Code
|
CPT 95180
|
| Hospital Charge Code |
76100075
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$413.68 |
| Max. Negotiated Rate |
$551.57 |
| Rate for Payer: Aetna Commercial |
$496.41
|
| Rate for Payer: ASR ASR |
$535.02
|
| Rate for Payer: BCBS Trust/PPO |
$452.95
|
| Rate for Payer: BCN Commercial |
$452.95
|
| Rate for Payer: Cash Price |
$441.26
|
| Rate for Payer: Cofinity Commercial |
$518.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$441.26
|
| Rate for Payer: Healthscope Commercial |
$535.02
|
| Rate for Payer: Healthscope Whirlpool |
$551.57
|
| Rate for Payer: Mclaren Commercial |
$496.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$468.83
|
| Rate for Payer: Nomi Health Commercial |
$452.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$413.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$485.38
|
|
|
HC RAPID DESENSITIZATION PROC EA HOUR
|
Facility
|
OP
|
$551.57
|
|
|
Service Code
|
CPT 95180
|
| Hospital Charge Code |
76100075
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$232.80 |
| Max. Negotiated Rate |
$689.94 |
| Rate for Payer: Aetna Commercial |
$496.41
|
| Rate for Payer: Aetna Medicare |
$445.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$556.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$556.40
|
| Rate for Payer: ASR ASR |
$535.02
|
| Rate for Payer: BCBS Complete |
$244.46
|
| Rate for Payer: BCBS MAPPO |
$445.12
|
| Rate for Payer: BCBS Trust/PPO |
$454.77
|
| Rate for Payer: BCN Commercial |
$454.77
|
| Rate for Payer: BCN Medicare Advantage |
$445.12
|
| Rate for Payer: Cash Price |
$441.26
|
| Rate for Payer: Cash Price |
$441.26
|
| Rate for Payer: Cofinity Commercial |
$518.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$441.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$445.12
|
| Rate for Payer: Healthscope Commercial |
$535.02
|
| Rate for Payer: Healthscope Whirlpool |
$551.57
|
| Rate for Payer: Humana Choice PPO Medicare |
$445.12
|
| Rate for Payer: Mclaren Commercial |
$496.41
|
| Rate for Payer: Mclaren Medicaid |
$445.12
|
| Rate for Payer: Mclaren Medicare |
$445.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$467.38
|
| Rate for Payer: Meridian Medicaid |
$244.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$511.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$489.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$468.83
|
| Rate for Payer: Nomi Health Commercial |
$452.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$413.68
|
| Rate for Payer: PACE Medicare |
$422.86
|
| Rate for Payer: PACE SWMI |
$445.12
|
| Rate for Payer: PHP Commercial |
$489.63
|
| Rate for Payer: PHP Medicaid |
$238.58
|
| Rate for Payer: PHP Medicare Advantage |
$445.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$232.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$483.29
|
| Rate for Payer: Priority Health Medicare |
$445.12
|
| Rate for Payer: Priority Health Narrow Network |
$386.65
|
| Rate for Payer: Railroad Medicare Medicare |
$445.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$485.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$445.12
|
| Rate for Payer: UHC Exchange |
$689.94
|
| Rate for Payer: UHC Medicaid |
$232.80
|
| Rate for Payer: UHCCP DNSP |
$445.12
|
| Rate for Payer: UHCCP Medicaid |
$232.80
|
| Rate for Payer: VA VA |
$445.12
|
|
