|
HC RAPID HIV ANTIBODY
|
Facility
|
OP
|
$156.78
|
|
|
Service Code
|
CPT 86701
|
| Hospital Charge Code |
30200290
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.65 |
| Max. Negotiated Rate |
$156.78 |
| Rate for Payer: Aetna Commercial |
$141.10
|
| Rate for Payer: Aetna Medicare |
$8.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.11
|
| Rate for Payer: ASR ASR |
$152.08
|
| Rate for Payer: BCBS Complete |
$4.88
|
| Rate for Payer: BCBS MAPPO |
$8.89
|
| Rate for Payer: BCBS Trust/PPO |
$129.27
|
| Rate for Payer: BCN Commercial |
$129.27
|
| Rate for Payer: BCN Medicare Advantage |
$8.89
|
| Rate for Payer: Cash Price |
$125.42
|
| Rate for Payer: Cash Price |
$125.42
|
| Rate for Payer: Cofinity Commercial |
$147.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$125.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.89
|
| Rate for Payer: Healthscope Commercial |
$152.08
|
| Rate for Payer: Healthscope Whirlpool |
$156.78
|
| Rate for Payer: Humana Choice PPO Medicare |
$8.89
|
| Rate for Payer: Mclaren Commercial |
$141.10
|
| Rate for Payer: Mclaren Medicaid |
$8.89
|
| Rate for Payer: Mclaren Medicare |
$8.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.33
|
| Rate for Payer: Meridian Medicaid |
$4.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$133.26
|
| Rate for Payer: Nomi Health Commercial |
$128.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.58
|
| Rate for Payer: PACE Medicare |
$8.45
|
| Rate for Payer: PACE SWMI |
$8.89
|
| Rate for Payer: PHP Commercial |
$9.78
|
| Rate for Payer: PHP Medicaid |
$4.77
|
| Rate for Payer: PHP Medicare Advantage |
$8.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$137.37
|
| Rate for Payer: Priority Health Medicare |
$8.89
|
| Rate for Payer: Priority Health Narrow Network |
$109.90
|
| Rate for Payer: Railroad Medicare Medicare |
$8.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$137.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$8.89
|
| Rate for Payer: UHC Exchange |
$13.78
|
| Rate for Payer: UHC Medicaid |
$4.65
|
| Rate for Payer: UHCCP DNSP |
$8.89
|
| Rate for Payer: UHCCP Medicaid |
$4.65
|
| Rate for Payer: VA VA |
$8.89
|
|
|
HC RAPID HIV ANTIBODY
|
Facility
|
IP
|
$156.78
|
|
|
Service Code
|
CPT 86701
|
| Hospital Charge Code |
30200290
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$117.58 |
| Max. Negotiated Rate |
$156.78 |
| Rate for Payer: Aetna Commercial |
$141.10
|
| Rate for Payer: ASR ASR |
$152.08
|
| Rate for Payer: BCBS Trust/PPO |
$128.75
|
| Rate for Payer: BCN Commercial |
$128.75
|
| Rate for Payer: Cash Price |
$125.42
|
| Rate for Payer: Cofinity Commercial |
$147.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$125.42
|
| Rate for Payer: Healthscope Commercial |
$152.08
|
| Rate for Payer: Healthscope Whirlpool |
$156.78
|
| Rate for Payer: Mclaren Commercial |
$141.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$133.26
|
| Rate for Payer: Nomi Health Commercial |
$128.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$137.97
|
|
|
HC RAPID INFLUENZA A & B SCREEN
|
Facility
|
OP
|
$79.49
|
|
|
Service Code
|
CPT 87804
|
| Hospital Charge Code |
30600174
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.66 |
| Max. Negotiated Rate |
$143.46 |
| Rate for Payer: Aetna Commercial |
$71.54
|
| Rate for Payer: Aetna Medicare |
$16.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.69
|
| Rate for Payer: ASR ASR |
$77.11
|
| Rate for Payer: BCBS Complete |
$9.09
|
| Rate for Payer: BCBS MAPPO |
$16.55
|
| Rate for Payer: BCBS Trust/PPO |
$65.54
|
| Rate for Payer: BCN Commercial |
$65.54
|
| Rate for Payer: BCN Medicare Advantage |
$16.55
|
| Rate for Payer: Cash Price |
$63.59
|
| Rate for Payer: Cash Price |
$63.59
|
| Rate for Payer: Cofinity Commercial |
$74.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.55
|
| Rate for Payer: Healthscope Commercial |
$77.11
|
| Rate for Payer: Healthscope Whirlpool |
$79.49
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.55
|
| Rate for Payer: Mclaren Commercial |
$71.54
|
| Rate for Payer: Mclaren Medicaid |
$16.55
|
| Rate for Payer: Mclaren Medicare |
$16.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.38
|
| Rate for Payer: Meridian Medicaid |
$9.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.57
|
| Rate for Payer: Nomi Health Commercial |
$65.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.62
|
| Rate for Payer: PACE Medicare |
$15.72
|
| Rate for Payer: PACE SWMI |
$16.55
|
| Rate for Payer: PHP Commercial |
$18.20
|
| Rate for Payer: PHP Medicaid |
$8.87
|
| Rate for Payer: PHP Medicare Advantage |
$16.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$143.46
|
| Rate for Payer: Priority Health Medicare |
$16.55
|
| Rate for Payer: Priority Health Narrow Network |
$114.77
|
| Rate for Payer: Railroad Medicare Medicare |
$16.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$69.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$16.55
|
| Rate for Payer: UHC Exchange |
$25.65
|
| Rate for Payer: UHC Medicaid |
$8.66
|
| Rate for Payer: UHCCP DNSP |
$16.55
|
| Rate for Payer: UHCCP Medicaid |
$8.66
|
| Rate for Payer: VA VA |
$16.55
|
|
|
HC RAPID INFLUENZA A & B SCREEN
|
Facility
|
IP
|
$79.49
|
|
|
Service Code
|
CPT 87804
|
| Hospital Charge Code |
30600174
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$59.62 |
| Max. Negotiated Rate |
$79.49 |
| Rate for Payer: Aetna Commercial |
$71.54
|
| Rate for Payer: ASR ASR |
$77.11
|
| Rate for Payer: BCBS Trust/PPO |
$65.28
|
| Rate for Payer: BCN Commercial |
$65.28
|
| Rate for Payer: Cash Price |
$63.59
|
| Rate for Payer: Cofinity Commercial |
$74.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.59
|
| Rate for Payer: Healthscope Commercial |
$77.11
|
| Rate for Payer: Healthscope Whirlpool |
$79.49
|
| Rate for Payer: Mclaren Commercial |
$71.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.57
|
| Rate for Payer: Nomi Health Commercial |
$65.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$69.95
|
|
|
HC RAPID INFUSER
|
Facility
|
OP
|
$1,461.10
|
|
| Hospital Charge Code |
27000294
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$540.61 |
| Max. Negotiated Rate |
$1,461.10 |
| Rate for Payer: Aetna Commercial |
$1,314.99
|
| Rate for Payer: Aetna Medicare |
$540.61
|
| Rate for Payer: ASR ASR |
$1,417.27
|
| Rate for Payer: BCBS Complete |
$584.44
|
| Rate for Payer: BCBS Trust/PPO |
$1,204.68
|
| Rate for Payer: BCN Commercial |
$1,204.68
|
| Rate for Payer: Cash Price |
$1,168.88
|
| Rate for Payer: Cofinity Commercial |
$1,373.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,168.88
|
| Rate for Payer: Healthscope Commercial |
$1,417.27
|
| Rate for Payer: Healthscope Whirlpool |
$1,461.10
|
| Rate for Payer: Mclaren Commercial |
$1,314.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,168.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,241.93
|
| Rate for Payer: Nomi Health Commercial |
$1,198.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,095.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,280.22
|
| Rate for Payer: Priority Health Narrow Network |
$1,024.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,285.77
|
|
|
HC RAPID INFUSER
|
Facility
|
IP
|
$1,461.10
|
|
| Hospital Charge Code |
27000294
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,095.83 |
| Max. Negotiated Rate |
$1,461.10 |
| Rate for Payer: Aetna Commercial |
$1,314.99
|
| Rate for Payer: ASR ASR |
$1,417.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,199.86
|
| Rate for Payer: BCN Commercial |
$1,199.86
|
| Rate for Payer: Cash Price |
$1,168.88
|
| Rate for Payer: Cofinity Commercial |
$1,373.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,168.88
|
| Rate for Payer: Healthscope Commercial |
$1,417.27
|
| Rate for Payer: Healthscope Whirlpool |
$1,461.10
|
| Rate for Payer: Mclaren Commercial |
$1,314.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,241.93
|
| Rate for Payer: Nomi Health Commercial |
$1,198.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,095.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,285.77
|
|
|
HC RAPID MALARIA ASSAY
|
Facility
|
IP
|
$53.06
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30600298
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$39.80 |
| Max. Negotiated Rate |
$53.06 |
| Rate for Payer: Aetna Commercial |
$47.75
|
| Rate for Payer: ASR ASR |
$51.47
|
| Rate for Payer: BCBS Trust/PPO |
$43.57
|
| Rate for Payer: BCN Commercial |
$43.57
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$49.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Healthscope Commercial |
$51.47
|
| Rate for Payer: Healthscope Whirlpool |
$53.06
|
| Rate for Payer: Mclaren Commercial |
$47.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.69
|
|
|
HC RAPID MALARIA ASSAY
|
Facility
|
OP
|
$53.06
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30600298
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.40 |
| Max. Negotiated Rate |
$53.06 |
| Rate for Payer: Aetna Commercial |
$47.75
|
| Rate for Payer: Aetna Medicare |
$16.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.09
|
| Rate for Payer: ASR ASR |
$51.47
|
| Rate for Payer: BCBS Complete |
$8.83
|
| Rate for Payer: BCBS MAPPO |
$16.07
|
| Rate for Payer: BCBS Trust/PPO |
$43.75
|
| Rate for Payer: BCN Commercial |
$43.75
|
| Rate for Payer: BCN Medicare Advantage |
$16.07
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$49.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.07
|
| Rate for Payer: Healthscope Commercial |
$51.47
|
| Rate for Payer: Healthscope Whirlpool |
$53.06
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.07
|
| Rate for Payer: Mclaren Commercial |
$47.75
|
| Rate for Payer: Mclaren Medicaid |
$16.07
|
| Rate for Payer: Mclaren Medicare |
$16.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.87
|
| Rate for Payer: Meridian Medicaid |
$8.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PACE Medicare |
$15.27
|
| Rate for Payer: PACE SWMI |
$16.07
|
| Rate for Payer: PHP Commercial |
$17.68
|
| Rate for Payer: PHP Medicaid |
$8.61
|
| Rate for Payer: PHP Medicare Advantage |
$16.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$41.16
|
| Rate for Payer: Priority Health Medicare |
$16.07
|
| Rate for Payer: Priority Health Narrow Network |
$32.93
|
| Rate for Payer: Railroad Medicare Medicare |
$16.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$16.07
|
| Rate for Payer: UHC Exchange |
$24.91
|
| Rate for Payer: UHC Medicaid |
$8.40
|
| Rate for Payer: UHCCP DNSP |
$16.07
|
| Rate for Payer: UHCCP Medicaid |
$8.40
|
| Rate for Payer: VA VA |
$16.07
|
|
|
HC RAPID STREP SCREEN.
|
Facility
|
IP
|
$62.93
|
|
|
Service Code
|
CPT 87880
|
| Hospital Charge Code |
30600176
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$47.20 |
| Max. Negotiated Rate |
$62.93 |
| Rate for Payer: Aetna Commercial |
$56.64
|
| Rate for Payer: ASR ASR |
$61.04
|
| Rate for Payer: BCBS Trust/PPO |
$51.68
|
| Rate for Payer: BCN Commercial |
$51.68
|
| Rate for Payer: Cash Price |
$50.34
|
| Rate for Payer: Cofinity Commercial |
$59.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.34
|
| Rate for Payer: Healthscope Commercial |
$61.04
|
| Rate for Payer: Healthscope Whirlpool |
$62.93
|
| Rate for Payer: Mclaren Commercial |
$56.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.49
|
| Rate for Payer: Nomi Health Commercial |
$51.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$55.38
|
|
|
HC RAPID STREP SCREEN.
|
Facility
|
OP
|
$62.93
|
|
|
Service Code
|
CPT 87880
|
| Hospital Charge Code |
30600176
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.65 |
| Max. Negotiated Rate |
$62.93 |
| Rate for Payer: Aetna Commercial |
$56.64
|
| Rate for Payer: Aetna Medicare |
$16.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.66
|
| Rate for Payer: ASR ASR |
$61.04
|
| Rate for Payer: BCBS Complete |
$9.08
|
| Rate for Payer: BCBS MAPPO |
$16.53
|
| Rate for Payer: BCBS Trust/PPO |
$51.89
|
| Rate for Payer: BCN Commercial |
$51.89
|
| Rate for Payer: BCN Medicare Advantage |
$16.53
|
| Rate for Payer: Cash Price |
$50.34
|
| Rate for Payer: Cash Price |
$50.34
|
| Rate for Payer: Cofinity Commercial |
$59.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.53
|
| Rate for Payer: Healthscope Commercial |
$61.04
|
| Rate for Payer: Healthscope Whirlpool |
$62.93
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.53
|
| Rate for Payer: Mclaren Commercial |
$56.64
|
| Rate for Payer: Mclaren Medicaid |
$16.53
|
| Rate for Payer: Mclaren Medicare |
$16.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.36
|
| Rate for Payer: Meridian Medicaid |
$9.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.49
|
| Rate for Payer: Nomi Health Commercial |
$51.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.20
|
| Rate for Payer: PACE Medicare |
$15.70
|
| Rate for Payer: PACE SWMI |
$16.53
|
| Rate for Payer: PHP Commercial |
$18.18
|
| Rate for Payer: PHP Medicaid |
$8.86
|
| Rate for Payer: PHP Medicare Advantage |
$16.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$55.14
|
| Rate for Payer: Priority Health Medicare |
$16.53
|
| Rate for Payer: Priority Health Narrow Network |
$44.11
|
| Rate for Payer: Railroad Medicare Medicare |
$16.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$55.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$16.53
|
| Rate for Payer: UHC Exchange |
$25.62
|
| Rate for Payer: UHC Medicaid |
$8.65
|
| Rate for Payer: UHCCP DNSP |
$16.53
|
| Rate for Payer: UHCCP Medicaid |
$8.65
|
| Rate for Payer: VA VA |
$16.53
|
|
|
HC RAVAS CTO/DES
|
Facility
|
OP
|
$30,266.82
|
|
|
Service Code
|
CPT C9607
|
| Hospital Charge Code |
48100088
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$7,839.27 |
| Max. Negotiated Rate |
$30,266.82 |
| Rate for Payer: Aetna Commercial |
$27,240.14
|
| Rate for Payer: Aetna Medicare |
$18,265.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22,832.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22,832.15
|
| Rate for Payer: ASR ASR |
$29,358.82
|
| Rate for Payer: BCBS Complete |
$10,031.53
|
| Rate for Payer: BCBS MAPPO |
$18,265.72
|
| Rate for Payer: BCBS Trust/PPO |
$24,954.99
|
| Rate for Payer: BCN Commercial |
$24,954.99
|
| Rate for Payer: BCN Medicare Advantage |
$18,265.72
|
| Rate for Payer: Cash Price |
$24,213.46
|
| Rate for Payer: Cash Price |
$24,213.46
|
| Rate for Payer: Cofinity Commercial |
$28,450.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24,213.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18,265.72
|
| Rate for Payer: Healthscope Commercial |
$29,358.82
|
| Rate for Payer: Healthscope Whirlpool |
$30,266.82
|
| Rate for Payer: Humana Choice PPO Medicare |
$18,265.72
|
| Rate for Payer: Mclaren Commercial |
$27,240.14
|
| Rate for Payer: Mclaren Medicaid |
$18,265.72
|
| Rate for Payer: Mclaren Medicare |
$18,265.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19,179.01
|
| Rate for Payer: Meridian Medicaid |
$10,031.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21,005.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$20,092.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,726.80
|
| Rate for Payer: Nomi Health Commercial |
$24,818.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22,700.12
|
| Rate for Payer: PACE Medicare |
$17,352.43
|
| Rate for Payer: PACE SWMI |
$18,265.72
|
| Rate for Payer: PHP Commercial |
$20,092.29
|
| Rate for Payer: PHP Medicaid |
$9,790.43
|
| Rate for Payer: PHP Medicare Advantage |
$18,265.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,552.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$9,799.08
|
| Rate for Payer: Priority Health Medicare |
$18,265.72
|
| Rate for Payer: Priority Health Narrow Network |
$7,839.27
|
| Rate for Payer: Railroad Medicare Medicare |
$18,265.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26,634.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18,265.72
|
| Rate for Payer: UHC Exchange |
$28,311.87
|
| Rate for Payer: UHC Medicaid |
$9,552.97
|
| Rate for Payer: UHCCP DNSP |
$18,265.72
|
| Rate for Payer: UHCCP Medicaid |
$9,552.97
|
| Rate for Payer: VA VA |
$18,265.72
|
|
|
HC RAVAS CTO/DES
|
Facility
|
IP
|
$30,266.82
|
|
|
Service Code
|
CPT C9607
|
| Hospital Charge Code |
48100088
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$22,700.12 |
| Max. Negotiated Rate |
$30,266.82 |
| Rate for Payer: Aetna Commercial |
$27,240.14
|
| Rate for Payer: ASR ASR |
$29,358.82
|
| Rate for Payer: BCBS Trust/PPO |
$24,855.11
|
| Rate for Payer: BCN Commercial |
$24,855.11
|
| Rate for Payer: Cash Price |
$24,213.46
|
| Rate for Payer: Cofinity Commercial |
$28,450.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24,213.46
|
| Rate for Payer: Healthscope Commercial |
$29,358.82
|
| Rate for Payer: Healthscope Whirlpool |
$30,266.82
|
| Rate for Payer: Mclaren Commercial |
$27,240.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,726.80
|
| Rate for Payer: Nomi Health Commercial |
$24,818.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22,700.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26,634.80
|
|
|
HC RAVAS CTO/STENT
|
Facility
|
OP
|
$30,266.82
|
|
|
Service Code
|
CPT 92943
|
| Hospital Charge Code |
48100087
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$6,015.90 |
| Max. Negotiated Rate |
$30,266.82 |
| Rate for Payer: Aetna Commercial |
$27,240.14
|
| Rate for Payer: Aetna Medicare |
$11,502.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,378.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,378.35
|
| Rate for Payer: ASR ASR |
$29,358.82
|
| Rate for Payer: BCBS Complete |
$6,317.27
|
| Rate for Payer: BCBS MAPPO |
$11,502.68
|
| Rate for Payer: BCBS Trust/PPO |
$24,954.99
|
| Rate for Payer: BCN Commercial |
$24,954.99
|
| Rate for Payer: BCN Medicare Advantage |
$11,502.68
|
| Rate for Payer: Cash Price |
$24,213.46
|
| Rate for Payer: Cash Price |
$24,213.46
|
| Rate for Payer: Cofinity Commercial |
$28,450.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24,213.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,502.68
|
| Rate for Payer: Healthscope Commercial |
$29,358.82
|
| Rate for Payer: Healthscope Whirlpool |
$30,266.82
|
| Rate for Payer: Humana Choice PPO Medicare |
$11,502.68
|
| Rate for Payer: Mclaren Commercial |
$27,240.14
|
| Rate for Payer: Mclaren Medicaid |
$11,502.68
|
| Rate for Payer: Mclaren Medicare |
$11,502.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,077.81
|
| Rate for Payer: Meridian Medicaid |
$6,317.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,228.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$12,652.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,726.80
|
| Rate for Payer: Nomi Health Commercial |
$24,818.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22,700.12
|
| Rate for Payer: PACE Medicare |
$10,927.55
|
| Rate for Payer: PACE SWMI |
$11,502.68
|
| Rate for Payer: PHP Commercial |
$12,652.95
|
| Rate for Payer: PHP Medicaid |
$6,165.44
|
| Rate for Payer: PHP Medicare Advantage |
$11,502.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,015.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$7,712.91
|
| Rate for Payer: Priority Health Medicare |
$11,502.68
|
| Rate for Payer: Priority Health Narrow Network |
$6,170.33
|
| Rate for Payer: Railroad Medicare Medicare |
$11,502.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26,634.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11,502.68
|
| Rate for Payer: UHC Exchange |
$17,829.15
|
| Rate for Payer: UHC Medicaid |
$6,015.90
|
| Rate for Payer: UHCCP DNSP |
$11,502.68
|
| Rate for Payer: UHCCP Medicaid |
$6,015.90
|
| Rate for Payer: VA VA |
$11,502.68
|
|
|
HC RAVAS CTO/STENT
|
Facility
|
IP
|
$30,266.82
|
|
|
Service Code
|
CPT 92943
|
| Hospital Charge Code |
48100087
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$22,700.12 |
| Max. Negotiated Rate |
$30,266.82 |
| Rate for Payer: Aetna Commercial |
$27,240.14
|
| Rate for Payer: ASR ASR |
$29,358.82
|
| Rate for Payer: BCBS Trust/PPO |
$24,855.11
|
| Rate for Payer: BCN Commercial |
$24,855.11
|
| Rate for Payer: Cash Price |
$24,213.46
|
| Rate for Payer: Cofinity Commercial |
$28,450.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24,213.46
|
| Rate for Payer: Healthscope Commercial |
$29,358.82
|
| Rate for Payer: Healthscope Whirlpool |
$30,266.82
|
| Rate for Payer: Mclaren Commercial |
$27,240.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,726.80
|
| Rate for Payer: Nomi Health Commercial |
$24,818.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22,700.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26,634.80
|
|
|
HC RBC LEUKO REDUCED
|
Facility
|
IP
|
$740.11
|
|
|
Service Code
|
HCPCS P9016
|
| Hospital Charge Code |
39000059
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$555.08 |
| Max. Negotiated Rate |
$740.11 |
| Rate for Payer: Aetna Commercial |
$666.10
|
| Rate for Payer: ASR ASR |
$717.91
|
| Rate for Payer: BCBS Trust/PPO |
$607.78
|
| Rate for Payer: BCN Commercial |
$607.78
|
| Rate for Payer: Cash Price |
$592.09
|
| Rate for Payer: Cofinity Commercial |
$695.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$592.09
|
| Rate for Payer: Healthscope Commercial |
$717.91
|
| Rate for Payer: Healthscope Whirlpool |
$740.11
|
| Rate for Payer: Mclaren Commercial |
$666.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$629.09
|
| Rate for Payer: Nomi Health Commercial |
$606.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$555.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$651.30
|
|
|
HC RBC LEUKO REDUCED
|
Facility
|
OP
|
$740.11
|
|
|
Service Code
|
HCPCS P9016
|
| Hospital Charge Code |
39000059
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$94.32 |
| Max. Negotiated Rate |
$740.11 |
| Rate for Payer: Aetna Commercial |
$666.10
|
| Rate for Payer: Aetna Medicare |
$180.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$225.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$225.43
|
| Rate for Payer: ASR ASR |
$717.91
|
| Rate for Payer: BCBS Complete |
$99.04
|
| Rate for Payer: BCBS MAPPO |
$180.34
|
| Rate for Payer: BCBS Trust/PPO |
$610.22
|
| Rate for Payer: BCN Commercial |
$610.22
|
| Rate for Payer: BCN Medicare Advantage |
$180.34
|
| Rate for Payer: Cash Price |
$592.09
|
| Rate for Payer: Cash Price |
$592.09
|
| Rate for Payer: Cofinity Commercial |
$695.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$592.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$180.34
|
| Rate for Payer: Healthscope Commercial |
$717.91
|
| Rate for Payer: Healthscope Whirlpool |
$740.11
|
| Rate for Payer: Humana Choice PPO Medicare |
$180.34
|
| Rate for Payer: Mclaren Commercial |
$666.10
|
| Rate for Payer: Mclaren Medicaid |
$180.34
|
| Rate for Payer: Mclaren Medicare |
$180.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$189.36
|
| Rate for Payer: Meridian Medicaid |
$99.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$207.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$198.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$629.09
|
| Rate for Payer: Nomi Health Commercial |
$606.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$555.08
|
| Rate for Payer: PACE Medicare |
$171.32
|
| Rate for Payer: PACE SWMI |
$180.34
|
| Rate for Payer: PHP Commercial |
$198.37
|
| Rate for Payer: PHP Medicaid |
$96.66
|
| Rate for Payer: PHP Medicare Advantage |
$180.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$94.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$347.44
|
| Rate for Payer: Priority Health Medicare |
$180.34
|
| Rate for Payer: Priority Health Narrow Network |
$277.96
|
| Rate for Payer: Railroad Medicare Medicare |
$180.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$651.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$180.34
|
| Rate for Payer: UHC Exchange |
$279.53
|
| Rate for Payer: UHC Medicaid |
$94.32
|
| Rate for Payer: UHCCP DNSP |
$180.34
|
| Rate for Payer: UHCCP Medicaid |
$94.32
|
| Rate for Payer: VA VA |
$180.34
|
|
|
HC RBC LEUKO REDUCED IRRAD
|
Facility
|
OP
|
$1,282.23
|
|
|
Service Code
|
HCPCS P9040
|
| Hospital Charge Code |
39000072
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$135.38 |
| Max. Negotiated Rate |
$1,282.23 |
| Rate for Payer: Aetna Commercial |
$1,154.01
|
| Rate for Payer: Aetna Medicare |
$258.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$323.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$323.56
|
| Rate for Payer: ASR ASR |
$1,243.76
|
| Rate for Payer: BCBS Complete |
$142.16
|
| Rate for Payer: BCBS MAPPO |
$258.85
|
| Rate for Payer: BCBS Trust/PPO |
$1,057.20
|
| Rate for Payer: BCN Commercial |
$1,057.20
|
| Rate for Payer: BCN Medicare Advantage |
$258.85
|
| Rate for Payer: Cash Price |
$1,025.78
|
| Rate for Payer: Cash Price |
$1,025.78
|
| Rate for Payer: Cofinity Commercial |
$1,205.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,025.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$258.85
|
| Rate for Payer: Healthscope Commercial |
$1,243.76
|
| Rate for Payer: Healthscope Whirlpool |
$1,282.23
|
| Rate for Payer: Humana Choice PPO Medicare |
$258.85
|
| Rate for Payer: Mclaren Commercial |
$1,154.01
|
| Rate for Payer: Mclaren Medicaid |
$258.85
|
| Rate for Payer: Mclaren Medicare |
$258.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$271.79
|
| Rate for Payer: Meridian Medicaid |
$142.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$297.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$284.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,089.90
|
| Rate for Payer: Nomi Health Commercial |
$1,051.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$961.67
|
| Rate for Payer: PACE Medicare |
$245.91
|
| Rate for Payer: PACE SWMI |
$258.85
|
| Rate for Payer: PHP Commercial |
$284.74
|
| Rate for Payer: PHP Medicaid |
$138.74
|
| Rate for Payer: PHP Medicare Advantage |
$258.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$135.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$600.44
|
| Rate for Payer: Priority Health Medicare |
$258.85
|
| Rate for Payer: Priority Health Narrow Network |
$480.35
|
| Rate for Payer: Railroad Medicare Medicare |
$258.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,128.36
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$258.85
|
| Rate for Payer: UHC Exchange |
$401.22
|
| Rate for Payer: UHC Medicaid |
$135.38
|
| Rate for Payer: UHCCP DNSP |
$258.85
|
| Rate for Payer: UHCCP Medicaid |
$135.38
|
| Rate for Payer: VA VA |
$258.85
|
|
|
HC RBC LEUKO REDUCED IRRAD
|
Facility
|
IP
|
$1,282.23
|
|
|
Service Code
|
HCPCS P9040
|
| Hospital Charge Code |
39000072
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$961.67 |
| Max. Negotiated Rate |
$1,282.23 |
| Rate for Payer: Aetna Commercial |
$1,154.01
|
| Rate for Payer: ASR ASR |
$1,243.76
|
| Rate for Payer: BCBS Trust/PPO |
$1,052.97
|
| Rate for Payer: BCN Commercial |
$1,052.97
|
| Rate for Payer: Cash Price |
$1,025.78
|
| Rate for Payer: Cofinity Commercial |
$1,205.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,025.78
|
| Rate for Payer: Healthscope Commercial |
$1,243.76
|
| Rate for Payer: Healthscope Whirlpool |
$1,282.23
|
| Rate for Payer: Mclaren Commercial |
$1,154.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,089.90
|
| Rate for Payer: Nomi Health Commercial |
$1,051.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$961.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,128.36
|
|
|
HC RECEPTOR ASSAY OTHER ENDOCRINE
|
Facility
|
IP
|
$208.05
|
|
|
Service Code
|
CPT 84235
|
| Hospital Charge Code |
30100418
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$156.04 |
| Max. Negotiated Rate |
$208.05 |
| Rate for Payer: Aetna Commercial |
$187.25
|
| Rate for Payer: ASR ASR |
$201.81
|
| Rate for Payer: BCBS Trust/PPO |
$170.85
|
| Rate for Payer: BCN Commercial |
$170.85
|
| Rate for Payer: Cash Price |
$166.44
|
| Rate for Payer: Cofinity Commercial |
$195.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$166.44
|
| Rate for Payer: Healthscope Commercial |
$201.81
|
| Rate for Payer: Healthscope Whirlpool |
$208.05
|
| Rate for Payer: Mclaren Commercial |
$187.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$176.84
|
| Rate for Payer: Nomi Health Commercial |
$170.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$156.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$183.08
|
|
|
HC RECEPTOR ASSAY OTHER ENDOCRINE
|
Facility
|
OP
|
$208.05
|
|
|
Service Code
|
CPT 84235
|
| Hospital Charge Code |
30100418
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$37.25 |
| Max. Negotiated Rate |
$208.05 |
| Rate for Payer: Aetna Commercial |
$187.25
|
| Rate for Payer: Aetna Medicare |
$71.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$89.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$89.04
|
| Rate for Payer: ASR ASR |
$201.81
|
| Rate for Payer: BCBS Complete |
$39.12
|
| Rate for Payer: BCBS MAPPO |
$71.23
|
| Rate for Payer: BCBS Trust/PPO |
$171.54
|
| Rate for Payer: BCN Commercial |
$171.54
|
| Rate for Payer: BCN Medicare Advantage |
$71.23
|
| Rate for Payer: Cash Price |
$166.44
|
| Rate for Payer: Cash Price |
$166.44
|
| Rate for Payer: Cofinity Commercial |
$195.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$166.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.23
|
| Rate for Payer: Healthscope Commercial |
$201.81
|
| Rate for Payer: Healthscope Whirlpool |
$208.05
|
| Rate for Payer: Humana Choice PPO Medicare |
$71.23
|
| Rate for Payer: Mclaren Commercial |
$187.25
|
| Rate for Payer: Mclaren Medicaid |
$71.23
|
| Rate for Payer: Mclaren Medicare |
$71.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$74.79
|
| Rate for Payer: Meridian Medicaid |
$39.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$81.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$78.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$176.84
|
| Rate for Payer: Nomi Health Commercial |
$170.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$156.04
|
| Rate for Payer: PACE Medicare |
$67.67
|
| Rate for Payer: PACE SWMI |
$71.23
|
| Rate for Payer: PHP Commercial |
$78.35
|
| Rate for Payer: PHP Medicaid |
$38.18
|
| Rate for Payer: PHP Medicare Advantage |
$71.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$182.29
|
| Rate for Payer: Priority Health Medicare |
$71.23
|
| Rate for Payer: Priority Health Narrow Network |
$145.84
|
| Rate for Payer: Railroad Medicare Medicare |
$71.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$183.08
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$71.23
|
| Rate for Payer: UHC Exchange |
$110.41
|
| Rate for Payer: UHC Medicaid |
$37.25
|
| Rate for Payer: UHCCP DNSP |
$71.23
|
| Rate for Payer: UHCCP Medicaid |
$37.25
|
| Rate for Payer: VA VA |
$71.23
|
|
|
HC RECOVERY 1 ADD'L 15 MIN
|
Facility
|
OP
|
$160.15
|
|
| Hospital Charge Code |
71000020
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$59.26 |
| Max. Negotiated Rate |
$160.15 |
| Rate for Payer: Aetna Commercial |
$144.13
|
| Rate for Payer: Aetna Medicare |
$59.26
|
| Rate for Payer: ASR ASR |
$155.35
|
| Rate for Payer: BCBS Complete |
$64.06
|
| Rate for Payer: BCBS Trust/PPO |
$132.04
|
| Rate for Payer: BCN Commercial |
$132.04
|
| Rate for Payer: Cash Price |
$128.12
|
| Rate for Payer: Cofinity Commercial |
$150.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.12
|
| Rate for Payer: Healthscope Commercial |
$155.35
|
| Rate for Payer: Healthscope Whirlpool |
$160.15
|
| Rate for Payer: Mclaren Commercial |
$144.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$128.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.13
|
| Rate for Payer: Nomi Health Commercial |
$131.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$120.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$140.32
|
| Rate for Payer: Priority Health Narrow Network |
$112.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$140.93
|
|
|
HC RECOVERY 1 ADD'L 15 MIN
|
Facility
|
IP
|
$160.15
|
|
| Hospital Charge Code |
71000020
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$120.11 |
| Max. Negotiated Rate |
$160.15 |
| Rate for Payer: Aetna Commercial |
$144.13
|
| Rate for Payer: ASR ASR |
$155.35
|
| Rate for Payer: BCBS Trust/PPO |
$131.52
|
| Rate for Payer: BCN Commercial |
$131.52
|
| Rate for Payer: Cash Price |
$128.12
|
| Rate for Payer: Cofinity Commercial |
$150.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.12
|
| Rate for Payer: Healthscope Commercial |
$155.35
|
| Rate for Payer: Healthscope Whirlpool |
$160.15
|
| Rate for Payer: Mclaren Commercial |
$144.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.13
|
| Rate for Payer: Nomi Health Commercial |
$131.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$120.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$140.93
|
|
|
HC RECOVERY 1 BASE CHARGE
|
Facility
|
IP
|
$118.32
|
|
| Hospital Charge Code |
71000039
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$88.74 |
| Max. Negotiated Rate |
$118.32 |
| Rate for Payer: Aetna Commercial |
$106.49
|
| Rate for Payer: ASR ASR |
$114.77
|
| Rate for Payer: BCBS Trust/PPO |
$97.16
|
| Rate for Payer: BCN Commercial |
$97.16
|
| Rate for Payer: Cash Price |
$94.66
|
| Rate for Payer: Cofinity Commercial |
$111.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.66
|
| Rate for Payer: Healthscope Commercial |
$114.77
|
| Rate for Payer: Healthscope Whirlpool |
$118.32
|
| Rate for Payer: Mclaren Commercial |
$106.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.57
|
| Rate for Payer: Nomi Health Commercial |
$97.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$88.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$104.12
|
|
|
HC RECOVERY 1 BASE CHARGE
|
Facility
|
OP
|
$118.32
|
|
| Hospital Charge Code |
71000039
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$43.78 |
| Max. Negotiated Rate |
$118.32 |
| Rate for Payer: Aetna Commercial |
$106.49
|
| Rate for Payer: Aetna Medicare |
$43.78
|
| Rate for Payer: ASR ASR |
$114.77
|
| Rate for Payer: BCBS Complete |
$47.33
|
| Rate for Payer: BCBS Trust/PPO |
$97.55
|
| Rate for Payer: BCN Commercial |
$97.55
|
| Rate for Payer: Cash Price |
$94.66
|
| Rate for Payer: Cofinity Commercial |
$111.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.66
|
| Rate for Payer: Healthscope Commercial |
$114.77
|
| Rate for Payer: Healthscope Whirlpool |
$118.32
|
| Rate for Payer: Mclaren Commercial |
$106.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$94.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.57
|
| Rate for Payer: Nomi Health Commercial |
$97.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$88.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$103.67
|
| Rate for Payer: Priority Health Narrow Network |
$82.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$104.12
|
|
|
HC RECOVERY 1 EA MIN
|
Facility
|
OP
|
$15.30
|
|
| Hospital Charge Code |
71000034
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$5.66 |
| Max. Negotiated Rate |
$15.30 |
| Rate for Payer: Aetna Commercial |
$13.77
|
| Rate for Payer: Aetna Medicare |
$5.66
|
| Rate for Payer: ASR ASR |
$14.84
|
| Rate for Payer: BCBS Complete |
$6.12
|
| Rate for Payer: BCBS Trust/PPO |
$12.61
|
| Rate for Payer: BCN Commercial |
$12.61
|
| Rate for Payer: Cash Price |
$12.24
|
| Rate for Payer: Cofinity Commercial |
$14.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.24
|
| Rate for Payer: Healthscope Commercial |
$14.84
|
| Rate for Payer: Healthscope Whirlpool |
$15.30
|
| Rate for Payer: Mclaren Commercial |
$13.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.01
|
| Rate for Payer: Nomi Health Commercial |
$12.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$13.41
|
| Rate for Payer: Priority Health Narrow Network |
$10.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$13.46
|
|
