|
HC PULM EXER FUNCTION INDIV 15 MIN
|
Facility
|
IP
|
$87.68
|
|
|
Service Code
|
HCPCS G0238
|
| Hospital Charge Code |
41000045
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$56.99 |
| Max. Negotiated Rate |
$87.68 |
| Rate for Payer: Aetna Commercial |
$78.91
|
| Rate for Payer: ASR ASR |
$85.05
|
| Rate for Payer: ASR Commercial |
$85.05
|
| Rate for Payer: BCBS Trust/PPO |
$71.45
|
| Rate for Payer: BCN Commercial |
$67.98
|
| Rate for Payer: Cash Price |
$70.14
|
| Rate for Payer: Cofinity Commercial |
$82.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.14
|
| Rate for Payer: Healthscope Commercial |
$87.68
|
| Rate for Payer: Healthscope Whirlpool |
$85.05
|
| Rate for Payer: Mclaren Commercial |
$78.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.53
|
| Rate for Payer: Nomi Health Commercial |
$71.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$77.16
|
|
|
HC PULMONARY ARTERIOGRAM NONSELECTIVE
|
Facility
|
OP
|
$1,701.19
|
|
|
Service Code
|
CPT 75746
|
| Hospital Charge Code |
32000197
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,105.77 |
| Max. Negotiated Rate |
$4,779.98 |
| Rate for Payer: Aetna Commercial |
$1,531.07
|
| Rate for Payer: Aetna Medicare |
$3,083.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,854.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,854.82
|
| Rate for Payer: ASR ASR |
$1,650.15
|
| Rate for Payer: ASR Commercial |
$1,650.15
|
| Rate for Payer: BCBS Complete |
$1,735.60
|
| Rate for Payer: BCBS MAPPO |
$3,083.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,393.10
|
| Rate for Payer: BCN Commercial |
$1,318.93
|
| Rate for Payer: BCN Medicare Advantage |
$3,083.86
|
| Rate for Payer: Cash Price |
$1,360.95
|
| Rate for Payer: Cash Price |
$1,360.95
|
| Rate for Payer: Cofinity Commercial |
$1,599.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,360.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,083.86
|
| Rate for Payer: Healthscope Commercial |
$1,701.19
|
| Rate for Payer: Healthscope Whirlpool |
$1,650.15
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,083.86
|
| Rate for Payer: Mclaren Commercial |
$1,531.07
|
| Rate for Payer: Mclaren Medicaid |
$1,652.95
|
| Rate for Payer: Mclaren Medicare |
$3,083.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,238.05
|
| Rate for Payer: Meridian Medicaid |
$1,735.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,546.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,446.01
|
| Rate for Payer: Nomi Health Commercial |
$1,394.98
|
| Rate for Payer: PACE Medicare |
$2,929.67
|
| Rate for Payer: PACE SWMI |
$3,083.86
|
| Rate for Payer: PHP Commercial |
$3,392.25
|
| Rate for Payer: PHP Medicaid |
$1,652.95
|
| Rate for Payer: PHP Medicare Advantage |
$3,083.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,652.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,105.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,490.58
|
| Rate for Payer: Priority Health Medicare |
$3,083.86
|
| Rate for Payer: Priority Health Narrow Network |
$1,192.53
|
| Rate for Payer: Railroad Medicare Medicare |
$3,083.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,497.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,083.86
|
| Rate for Payer: UHC Exchange |
$4,779.98
|
| Rate for Payer: UHC Medicare Advantage |
$3,083.86
|
| Rate for Payer: UHCCP DNSP |
$3,083.86
|
| Rate for Payer: UHCCP Medicaid |
$1,652.95
|
| Rate for Payer: VA VA |
$3,083.86
|
|
|
HC PULMONARY ARTERIOGRAM NONSELECTIVE
|
Facility
|
IP
|
$1,701.19
|
|
|
Service Code
|
CPT 75746
|
| Hospital Charge Code |
32000197
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,105.77 |
| Max. Negotiated Rate |
$1,701.19 |
| Rate for Payer: Aetna Commercial |
$1,531.07
|
| Rate for Payer: ASR ASR |
$1,650.15
|
| Rate for Payer: ASR Commercial |
$1,650.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,386.30
|
| Rate for Payer: BCN Commercial |
$1,318.93
|
| Rate for Payer: Cash Price |
$1,360.95
|
| Rate for Payer: Cofinity Commercial |
$1,599.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,360.95
|
| Rate for Payer: Healthscope Commercial |
$1,701.19
|
| Rate for Payer: Healthscope Whirlpool |
$1,650.15
|
| Rate for Payer: Mclaren Commercial |
$1,531.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,446.01
|
| Rate for Payer: Nomi Health Commercial |
$1,394.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,105.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,497.05
|
|
|
HC PULMONARY EXERCISE GROUP
|
Facility
|
OP
|
$105.20
|
|
|
Service Code
|
HCPCS G0239
|
| Hospital Charge Code |
41000044
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$20.61 |
| Max. Negotiated Rate |
$105.20 |
| Rate for Payer: Aetna Commercial |
$94.68
|
| Rate for Payer: Aetna Medicare |
$38.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48.08
|
| Rate for Payer: ASR ASR |
$102.04
|
| Rate for Payer: ASR Commercial |
$102.04
|
| Rate for Payer: BCBS Complete |
$21.65
|
| Rate for Payer: BCBS MAPPO |
$38.46
|
| Rate for Payer: BCBS Trust/PPO |
$86.15
|
| Rate for Payer: BCN Commercial |
$81.56
|
| Rate for Payer: BCN Medicare Advantage |
$38.46
|
| Rate for Payer: Cash Price |
$84.16
|
| Rate for Payer: Cash Price |
$84.16
|
| Rate for Payer: Cofinity Commercial |
$98.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.46
|
| Rate for Payer: Healthscope Commercial |
$105.20
|
| Rate for Payer: Healthscope Whirlpool |
$102.04
|
| Rate for Payer: Humana Choice PPO Medicare |
$38.46
|
| Rate for Payer: Mclaren Commercial |
$94.68
|
| Rate for Payer: Mclaren Medicaid |
$20.61
|
| Rate for Payer: Mclaren Medicare |
$38.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.38
|
| Rate for Payer: Meridian Medicaid |
$21.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.42
|
| Rate for Payer: Nomi Health Commercial |
$86.26
|
| Rate for Payer: PACE Medicare |
$36.54
|
| Rate for Payer: PACE SWMI |
$38.46
|
| Rate for Payer: PHP Commercial |
$42.31
|
| Rate for Payer: PHP Medicaid |
$20.61
|
| Rate for Payer: PHP Medicare Advantage |
$38.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$92.18
|
| Rate for Payer: Priority Health Medicare |
$38.46
|
| Rate for Payer: Priority Health Narrow Network |
$73.75
|
| Rate for Payer: Railroad Medicare Medicare |
$38.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$92.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.46
|
| Rate for Payer: UHC Exchange |
$59.61
|
| Rate for Payer: UHC Medicare Advantage |
$38.46
|
| Rate for Payer: UHCCP DNSP |
$38.46
|
| Rate for Payer: UHCCP Medicaid |
$20.61
|
| Rate for Payer: VA VA |
$38.46
|
|
|
HC PULMONARY EXERCISE GROUP
|
Facility
|
IP
|
$105.20
|
|
|
Service Code
|
HCPCS G0239
|
| Hospital Charge Code |
41000044
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$68.38 |
| Max. Negotiated Rate |
$105.20 |
| Rate for Payer: Aetna Commercial |
$94.68
|
| Rate for Payer: ASR ASR |
$102.04
|
| Rate for Payer: ASR Commercial |
$102.04
|
| Rate for Payer: BCBS Trust/PPO |
$85.73
|
| Rate for Payer: BCN Commercial |
$81.56
|
| Rate for Payer: Cash Price |
$84.16
|
| Rate for Payer: Cofinity Commercial |
$98.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.16
|
| Rate for Payer: Healthscope Commercial |
$105.20
|
| Rate for Payer: Healthscope Whirlpool |
$102.04
|
| Rate for Payer: Mclaren Commercial |
$94.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.42
|
| Rate for Payer: Nomi Health Commercial |
$86.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$92.58
|
|
|
HC PULMONARY STRESS TESTING (EG 6 MIN WALK)
|
Facility
|
IP
|
$371.82
|
|
|
Service Code
|
CPT 94618
|
| Hospital Charge Code |
46000030
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$241.68 |
| Max. Negotiated Rate |
$371.82 |
| Rate for Payer: Aetna Commercial |
$334.64
|
| Rate for Payer: ASR ASR |
$360.67
|
| Rate for Payer: ASR Commercial |
$360.67
|
| Rate for Payer: BCBS Trust/PPO |
$303.00
|
| Rate for Payer: BCN Commercial |
$288.27
|
| Rate for Payer: Cash Price |
$297.46
|
| Rate for Payer: Cofinity Commercial |
$349.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$297.46
|
| Rate for Payer: Healthscope Commercial |
$371.82
|
| Rate for Payer: Healthscope Whirlpool |
$360.67
|
| Rate for Payer: Mclaren Commercial |
$334.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$316.05
|
| Rate for Payer: Nomi Health Commercial |
$304.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$327.20
|
|
|
HC PULMONARY STRESS TESTING (EG 6 MIN WALK)
|
Facility
|
OP
|
$371.82
|
|
|
Service Code
|
CPT 94618
|
| Hospital Charge Code |
46000030
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$67.69 |
| Max. Negotiated Rate |
$371.82 |
| Rate for Payer: Aetna Commercial |
$334.64
|
| Rate for Payer: Aetna Medicare |
$126.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.86
|
| Rate for Payer: ASR ASR |
$360.67
|
| Rate for Payer: ASR Commercial |
$360.67
|
| Rate for Payer: BCBS Complete |
$71.08
|
| Rate for Payer: BCBS MAPPO |
$126.29
|
| Rate for Payer: BCBS Trust/PPO |
$304.48
|
| Rate for Payer: BCN Commercial |
$288.27
|
| Rate for Payer: BCN Medicare Advantage |
$126.29
|
| Rate for Payer: Cash Price |
$297.46
|
| Rate for Payer: Cash Price |
$297.46
|
| Rate for Payer: Cofinity Commercial |
$349.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$297.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.29
|
| Rate for Payer: Healthscope Commercial |
$371.82
|
| Rate for Payer: Healthscope Whirlpool |
$360.67
|
| Rate for Payer: Humana Choice PPO Medicare |
$126.29
|
| Rate for Payer: Mclaren Commercial |
$334.64
|
| Rate for Payer: Mclaren Medicaid |
$67.69
|
| Rate for Payer: Mclaren Medicare |
$126.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.60
|
| Rate for Payer: Meridian Medicaid |
$71.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$145.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$316.05
|
| Rate for Payer: Nomi Health Commercial |
$304.89
|
| Rate for Payer: PACE Medicare |
$119.98
|
| Rate for Payer: PACE SWMI |
$126.29
|
| Rate for Payer: PHP Commercial |
$138.92
|
| Rate for Payer: PHP Medicaid |
$67.69
|
| Rate for Payer: PHP Medicare Advantage |
$126.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$120.25
|
| Rate for Payer: Priority Health Medicare |
$126.29
|
| Rate for Payer: Priority Health Narrow Network |
$96.20
|
| Rate for Payer: Railroad Medicare Medicare |
$126.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$327.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$126.29
|
| Rate for Payer: UHC Exchange |
$195.75
|
| Rate for Payer: UHC Medicare Advantage |
$126.29
|
| Rate for Payer: UHCCP DNSP |
$126.29
|
| Rate for Payer: UHCCP Medicaid |
$67.69
|
| Rate for Payer: VA VA |
$126.29
|
|
|
HC PULM REHAB W/ CONT OXIMTRY MNTR
|
Facility
|
IP
|
$219.58
|
|
|
Service Code
|
CPT 94626
|
| Hospital Charge Code |
94800004
|
|
Hospital Revenue Code
|
948
|
| Min. Negotiated Rate |
$142.73 |
| Max. Negotiated Rate |
$219.58 |
| Rate for Payer: Aetna Commercial |
$197.62
|
| Rate for Payer: ASR ASR |
$212.99
|
| Rate for Payer: ASR Commercial |
$212.99
|
| Rate for Payer: BCBS Trust/PPO |
$178.94
|
| Rate for Payer: BCN Commercial |
$170.24
|
| Rate for Payer: Cash Price |
$175.66
|
| Rate for Payer: Cofinity Commercial |
$206.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$175.66
|
| Rate for Payer: Healthscope Commercial |
$219.58
|
| Rate for Payer: Healthscope Whirlpool |
$212.99
|
| Rate for Payer: Mclaren Commercial |
$197.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$186.64
|
| Rate for Payer: Nomi Health Commercial |
$180.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$142.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$193.23
|
|
|
HC PULM REHAB W/ CONT OXIMTRY MNTR
|
Facility
|
OP
|
$219.58
|
|
|
Service Code
|
CPT 94626
|
| Hospital Charge Code |
94800004
|
|
Hospital Revenue Code
|
948
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$219.58 |
| Rate for Payer: Aetna Commercial |
$197.62
|
| Rate for Payer: Aetna Medicare |
$58.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$72.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$72.75
|
| Rate for Payer: ASR ASR |
$212.99
|
| Rate for Payer: ASR Commercial |
$212.99
|
| Rate for Payer: BCBS Complete |
$32.75
|
| Rate for Payer: BCBS MAPPO |
$58.20
|
| Rate for Payer: BCBS Trust/PPO |
$179.81
|
| Rate for Payer: BCN Commercial |
$170.24
|
| Rate for Payer: BCN Medicare Advantage |
$58.20
|
| Rate for Payer: Cash Price |
$175.66
|
| Rate for Payer: Cash Price |
$175.66
|
| Rate for Payer: Cofinity Commercial |
$206.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$175.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.20
|
| Rate for Payer: Healthscope Commercial |
$219.58
|
| Rate for Payer: Healthscope Whirlpool |
$212.99
|
| Rate for Payer: Humana Choice PPO Medicare |
$58.20
|
| Rate for Payer: Mclaren Commercial |
$197.62
|
| Rate for Payer: Mclaren Medicaid |
$31.20
|
| Rate for Payer: Mclaren Medicare |
$58.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.11
|
| Rate for Payer: Meridian Medicaid |
$32.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$66.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$186.64
|
| Rate for Payer: Nomi Health Commercial |
$180.06
|
| Rate for Payer: PACE Medicare |
$55.29
|
| Rate for Payer: PACE SWMI |
$58.20
|
| Rate for Payer: PHP Commercial |
$64.02
|
| Rate for Payer: PHP Medicaid |
$31.20
|
| Rate for Payer: PHP Medicare Advantage |
$58.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$142.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$192.40
|
| Rate for Payer: Priority Health Medicare |
$58.20
|
| Rate for Payer: Priority Health Narrow Network |
$153.93
|
| Rate for Payer: Railroad Medicare Medicare |
$58.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$193.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$58.20
|
| Rate for Payer: UHC Exchange |
$90.21
|
| Rate for Payer: UHC Medicare Advantage |
$58.20
|
| Rate for Payer: UHCCP DNSP |
$58.20
|
| Rate for Payer: UHCCP Medicaid |
$31.20
|
| Rate for Payer: VA VA |
$58.20
|
|
|
HC PULM REHAB W/O CONT OXIMTRY MNTR
|
Facility
|
IP
|
$186.64
|
|
|
Service Code
|
CPT 94625
|
| Hospital Charge Code |
94800003
|
|
Hospital Revenue Code
|
948
|
| Min. Negotiated Rate |
$121.32 |
| Max. Negotiated Rate |
$186.64 |
| Rate for Payer: Aetna Commercial |
$167.98
|
| Rate for Payer: ASR ASR |
$181.04
|
| Rate for Payer: ASR Commercial |
$181.04
|
| Rate for Payer: BCBS Trust/PPO |
$152.09
|
| Rate for Payer: BCN Commercial |
$144.70
|
| Rate for Payer: Cash Price |
$149.31
|
| Rate for Payer: Cofinity Commercial |
$175.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$149.31
|
| Rate for Payer: Healthscope Commercial |
$186.64
|
| Rate for Payer: Healthscope Whirlpool |
$181.04
|
| Rate for Payer: Mclaren Commercial |
$167.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$158.64
|
| Rate for Payer: Nomi Health Commercial |
$153.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$164.24
|
|
|
HC PULM REHAB W/O CONT OXIMTRY MNTR
|
Facility
|
OP
|
$186.64
|
|
|
Service Code
|
CPT 94625
|
| Hospital Charge Code |
94800003
|
|
Hospital Revenue Code
|
948
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$186.64 |
| Rate for Payer: Aetna Commercial |
$167.98
|
| Rate for Payer: Aetna Medicare |
$58.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$72.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$72.75
|
| Rate for Payer: ASR ASR |
$181.04
|
| Rate for Payer: ASR Commercial |
$181.04
|
| Rate for Payer: BCBS Complete |
$32.75
|
| Rate for Payer: BCBS MAPPO |
$58.20
|
| Rate for Payer: BCBS Trust/PPO |
$152.84
|
| Rate for Payer: BCN Commercial |
$144.70
|
| Rate for Payer: BCN Medicare Advantage |
$58.20
|
| Rate for Payer: Cash Price |
$149.31
|
| Rate for Payer: Cash Price |
$149.31
|
| Rate for Payer: Cofinity Commercial |
$175.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$149.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.20
|
| Rate for Payer: Healthscope Commercial |
$186.64
|
| Rate for Payer: Healthscope Whirlpool |
$181.04
|
| Rate for Payer: Humana Choice PPO Medicare |
$58.20
|
| Rate for Payer: Mclaren Commercial |
$167.98
|
| Rate for Payer: Mclaren Medicaid |
$31.20
|
| Rate for Payer: Mclaren Medicare |
$58.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.11
|
| Rate for Payer: Meridian Medicaid |
$32.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$66.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$158.64
|
| Rate for Payer: Nomi Health Commercial |
$153.04
|
| Rate for Payer: PACE Medicare |
$55.29
|
| Rate for Payer: PACE SWMI |
$58.20
|
| Rate for Payer: PHP Commercial |
$64.02
|
| Rate for Payer: PHP Medicaid |
$31.20
|
| Rate for Payer: PHP Medicare Advantage |
$58.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$163.53
|
| Rate for Payer: Priority Health Medicare |
$58.20
|
| Rate for Payer: Priority Health Narrow Network |
$130.83
|
| Rate for Payer: Railroad Medicare Medicare |
$58.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$164.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$58.20
|
| Rate for Payer: UHC Exchange |
$90.21
|
| Rate for Payer: UHC Medicare Advantage |
$58.20
|
| Rate for Payer: UHCCP DNSP |
$58.20
|
| Rate for Payer: UHCCP Medicaid |
$31.20
|
| Rate for Payer: VA VA |
$58.20
|
|
|
HC PULSE OXIMETRY MULTI DETER
|
Facility
|
OP
|
$128.24
|
|
|
Service Code
|
CPT 94761
|
| Hospital Charge Code |
46000012
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$14.93 |
| Max. Negotiated Rate |
$128.24 |
| Rate for Payer: Aetna Commercial |
$115.42
|
| Rate for Payer: Aetna Medicare |
$64.12
|
| Rate for Payer: ASR ASR |
$124.39
|
| Rate for Payer: ASR Commercial |
$124.39
|
| Rate for Payer: BCBS Complete |
$51.30
|
| Rate for Payer: BCBS Trust/PPO |
$105.02
|
| Rate for Payer: BCN Commercial |
$99.42
|
| Rate for Payer: Cash Price |
$102.59
|
| Rate for Payer: Cash Price |
$102.59
|
| Rate for Payer: Cofinity Commercial |
$120.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$102.59
|
| Rate for Payer: Healthscope Commercial |
$128.24
|
| Rate for Payer: Healthscope Whirlpool |
$124.39
|
| Rate for Payer: Mclaren Commercial |
$115.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$109.00
|
| Rate for Payer: Nomi Health Commercial |
$105.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.66
|
| Rate for Payer: Priority Health Narrow Network |
$14.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$112.85
|
|
|
HC PULSE OXIMETRY MULTI DETER
|
Facility
|
IP
|
$128.24
|
|
|
Service Code
|
CPT 94761
|
| Hospital Charge Code |
46000012
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$83.36 |
| Max. Negotiated Rate |
$128.24 |
| Rate for Payer: Aetna Commercial |
$115.42
|
| Rate for Payer: ASR ASR |
$124.39
|
| Rate for Payer: ASR Commercial |
$124.39
|
| Rate for Payer: BCBS Trust/PPO |
$104.50
|
| Rate for Payer: BCN Commercial |
$99.42
|
| Rate for Payer: Cash Price |
$102.59
|
| Rate for Payer: Cofinity Commercial |
$120.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$102.59
|
| Rate for Payer: Healthscope Commercial |
$128.24
|
| Rate for Payer: Healthscope Whirlpool |
$124.39
|
| Rate for Payer: Mclaren Commercial |
$115.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$109.00
|
| Rate for Payer: Nomi Health Commercial |
$105.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$112.85
|
|
|
HC PULSE OX OVERNIGHT
|
Facility
|
IP
|
$205.42
|
|
|
Service Code
|
CPT 94762
|
| Hospital Charge Code |
46000027
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$133.52 |
| Max. Negotiated Rate |
$205.42 |
| Rate for Payer: Aetna Commercial |
$184.88
|
| Rate for Payer: ASR ASR |
$199.26
|
| Rate for Payer: ASR Commercial |
$199.26
|
| Rate for Payer: BCBS Trust/PPO |
$167.40
|
| Rate for Payer: BCN Commercial |
$159.26
|
| Rate for Payer: Cash Price |
$164.34
|
| Rate for Payer: Cofinity Commercial |
$193.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$164.34
|
| Rate for Payer: Healthscope Commercial |
$205.42
|
| Rate for Payer: Healthscope Whirlpool |
$199.26
|
| Rate for Payer: Mclaren Commercial |
$184.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$174.61
|
| Rate for Payer: Nomi Health Commercial |
$168.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$180.77
|
|
|
HC PULSE OX OVERNIGHT
|
Facility
|
OP
|
$205.42
|
|
|
Service Code
|
CPT 94762
|
| Hospital Charge Code |
46000027
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$82.17 |
| Max. Negotiated Rate |
$237.62 |
| Rate for Payer: Aetna Commercial |
$184.88
|
| Rate for Payer: Aetna Medicare |
$153.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$191.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$191.62
|
| Rate for Payer: ASR ASR |
$199.26
|
| Rate for Payer: ASR Commercial |
$199.26
|
| Rate for Payer: BCBS Complete |
$86.28
|
| Rate for Payer: BCBS MAPPO |
$153.30
|
| Rate for Payer: BCBS Trust/PPO |
$168.22
|
| Rate for Payer: BCN Commercial |
$159.26
|
| Rate for Payer: BCN Medicare Advantage |
$153.30
|
| Rate for Payer: Cash Price |
$164.34
|
| Rate for Payer: Cash Price |
$164.34
|
| Rate for Payer: Cofinity Commercial |
$193.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$164.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.30
|
| Rate for Payer: Healthscope Commercial |
$205.42
|
| Rate for Payer: Healthscope Whirlpool |
$199.26
|
| Rate for Payer: Humana Choice PPO Medicare |
$153.30
|
| Rate for Payer: Mclaren Commercial |
$184.88
|
| Rate for Payer: Mclaren Medicaid |
$82.17
|
| Rate for Payer: Mclaren Medicare |
$153.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.96
|
| Rate for Payer: Meridian Medicaid |
$86.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$176.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$174.61
|
| Rate for Payer: Nomi Health Commercial |
$168.44
|
| Rate for Payer: PACE Medicare |
$145.64
|
| Rate for Payer: PACE SWMI |
$153.30
|
| Rate for Payer: PHP Commercial |
$168.63
|
| Rate for Payer: PHP Medicaid |
$82.17
|
| Rate for Payer: PHP Medicare Advantage |
$153.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$131.77
|
| Rate for Payer: Priority Health Medicare |
$153.30
|
| Rate for Payer: Priority Health Narrow Network |
$105.42
|
| Rate for Payer: Railroad Medicare Medicare |
$153.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$180.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.30
|
| Rate for Payer: UHC Exchange |
$237.62
|
| Rate for Payer: UHC Medicare Advantage |
$153.30
|
| Rate for Payer: UHCCP DNSP |
$153.30
|
| Rate for Payer: UHCCP Medicaid |
$82.17
|
| Rate for Payer: VA VA |
$153.30
|
|
|
HC PULSE OX SINGLE
|
Facility
|
OP
|
$86.43
|
|
|
Service Code
|
CPT 94760
|
| Hospital Charge Code |
46000026
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$7.90 |
| Max. Negotiated Rate |
$86.43 |
| Rate for Payer: Aetna Commercial |
$77.79
|
| Rate for Payer: Aetna Medicare |
$43.22
|
| Rate for Payer: ASR ASR |
$83.84
|
| Rate for Payer: ASR Commercial |
$83.84
|
| Rate for Payer: BCBS Complete |
$34.57
|
| Rate for Payer: BCBS Trust/PPO |
$70.78
|
| Rate for Payer: BCN Commercial |
$67.01
|
| Rate for Payer: Cash Price |
$69.14
|
| Rate for Payer: Cash Price |
$69.14
|
| Rate for Payer: Cofinity Commercial |
$81.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.14
|
| Rate for Payer: Healthscope Commercial |
$86.43
|
| Rate for Payer: Healthscope Whirlpool |
$83.84
|
| Rate for Payer: Mclaren Commercial |
$77.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.47
|
| Rate for Payer: Nomi Health Commercial |
$70.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9.88
|
| Rate for Payer: Priority Health Narrow Network |
$7.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$76.06
|
|
|
HC PULSE OX SINGLE
|
Facility
|
IP
|
$86.43
|
|
|
Service Code
|
CPT 94760
|
| Hospital Charge Code |
46000026
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$56.18 |
| Max. Negotiated Rate |
$86.43 |
| Rate for Payer: Aetna Commercial |
$77.79
|
| Rate for Payer: ASR ASR |
$83.84
|
| Rate for Payer: ASR Commercial |
$83.84
|
| Rate for Payer: BCBS Trust/PPO |
$70.43
|
| Rate for Payer: BCN Commercial |
$67.01
|
| Rate for Payer: Cash Price |
$69.14
|
| Rate for Payer: Cofinity Commercial |
$81.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.14
|
| Rate for Payer: Healthscope Commercial |
$86.43
|
| Rate for Payer: Healthscope Whirlpool |
$83.84
|
| Rate for Payer: Mclaren Commercial |
$77.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.47
|
| Rate for Payer: Nomi Health Commercial |
$70.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$76.06
|
|
|
HC PULSERIDER
|
Facility
|
OP
|
$17,069.07
|
|
|
Service Code
|
HCPCS C2625
|
| Hospital Charge Code |
27800119
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,827.63 |
| Max. Negotiated Rate |
$17,069.07 |
| Rate for Payer: Aetna Commercial |
$15,362.16
|
| Rate for Payer: Aetna Medicare |
$8,534.54
|
| Rate for Payer: ASR ASR |
$16,557.00
|
| Rate for Payer: ASR Commercial |
$16,557.00
|
| Rate for Payer: BCBS Complete |
$6,827.63
|
| Rate for Payer: BCBS Trust/PPO |
$13,977.86
|
| Rate for Payer: BCN Commercial |
$13,233.65
|
| Rate for Payer: Cash Price |
$13,655.26
|
| Rate for Payer: Cofinity Commercial |
$16,044.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,655.26
|
| Rate for Payer: Healthscope Commercial |
$17,069.07
|
| Rate for Payer: Healthscope Whirlpool |
$16,557.00
|
| Rate for Payer: Mclaren Commercial |
$15,362.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,508.71
|
| Rate for Payer: Nomi Health Commercial |
$13,996.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,094.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14,955.92
|
| Rate for Payer: Priority Health Narrow Network |
$11,965.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15,020.78
|
|
|
HC PULSERIDER
|
Facility
|
IP
|
$17,069.07
|
|
|
Service Code
|
HCPCS C2625
|
| Hospital Charge Code |
27800119
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11,094.90 |
| Max. Negotiated Rate |
$17,069.07 |
| Rate for Payer: Aetna Commercial |
$15,362.16
|
| Rate for Payer: ASR ASR |
$16,557.00
|
| Rate for Payer: ASR Commercial |
$16,557.00
|
| Rate for Payer: BCBS Trust/PPO |
$13,909.59
|
| Rate for Payer: BCN Commercial |
$13,233.65
|
| Rate for Payer: Cash Price |
$13,655.26
|
| Rate for Payer: Cofinity Commercial |
$16,044.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,655.26
|
| Rate for Payer: Healthscope Commercial |
$17,069.07
|
| Rate for Payer: Healthscope Whirlpool |
$16,557.00
|
| Rate for Payer: Mclaren Commercial |
$15,362.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,508.71
|
| Rate for Payer: Nomi Health Commercial |
$13,996.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,094.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15,020.78
|
|
|
HC PUMP CENTRFUGAL
|
Facility
|
IP
|
$457.25
|
|
| Hospital Charge Code |
27000382
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$297.21 |
| Max. Negotiated Rate |
$457.25 |
| Rate for Payer: Aetna Commercial |
$411.52
|
| Rate for Payer: ASR ASR |
$443.53
|
| Rate for Payer: ASR Commercial |
$443.53
|
| Rate for Payer: BCBS Trust/PPO |
$372.61
|
| Rate for Payer: BCN Commercial |
$354.51
|
| Rate for Payer: Cash Price |
$365.80
|
| Rate for Payer: Cofinity Commercial |
$429.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$365.80
|
| Rate for Payer: Healthscope Commercial |
$457.25
|
| Rate for Payer: Healthscope Whirlpool |
$443.53
|
| Rate for Payer: Mclaren Commercial |
$411.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$388.66
|
| Rate for Payer: Nomi Health Commercial |
$374.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$297.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$402.38
|
|
|
HC PUMP CENTRFUGAL
|
Facility
|
OP
|
$457.25
|
|
| Hospital Charge Code |
27000382
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$182.90 |
| Max. Negotiated Rate |
$457.25 |
| Rate for Payer: Aetna Commercial |
$411.52
|
| Rate for Payer: Aetna Medicare |
$228.62
|
| Rate for Payer: ASR ASR |
$443.53
|
| Rate for Payer: ASR Commercial |
$443.53
|
| Rate for Payer: BCBS Complete |
$182.90
|
| Rate for Payer: BCBS Trust/PPO |
$374.44
|
| Rate for Payer: BCN Commercial |
$354.51
|
| Rate for Payer: Cash Price |
$365.80
|
| Rate for Payer: Cofinity Commercial |
$429.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$365.80
|
| Rate for Payer: Healthscope Commercial |
$457.25
|
| Rate for Payer: Healthscope Whirlpool |
$443.53
|
| Rate for Payer: Mclaren Commercial |
$411.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$388.66
|
| Rate for Payer: Nomi Health Commercial |
$374.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$297.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$400.64
|
| Rate for Payer: Priority Health Narrow Network |
$320.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$402.38
|
|
|
HC PUNCH BIOPSY SKIN ADDL LESION
|
Facility
|
OP
|
$83.55
|
|
|
Service Code
|
CPT 11105
|
| Hospital Charge Code |
76100151
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$33.42 |
| Max. Negotiated Rate |
$83.55 |
| Rate for Payer: Aetna Commercial |
$75.20
|
| Rate for Payer: Aetna Medicare |
$41.78
|
| Rate for Payer: ASR ASR |
$81.04
|
| Rate for Payer: ASR Commercial |
$81.04
|
| Rate for Payer: BCBS Complete |
$33.42
|
| Rate for Payer: BCBS Trust/PPO |
$68.42
|
| Rate for Payer: BCN Commercial |
$64.78
|
| Rate for Payer: Cash Price |
$66.84
|
| Rate for Payer: Cofinity Commercial |
$78.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.84
|
| Rate for Payer: Healthscope Commercial |
$83.55
|
| Rate for Payer: Healthscope Whirlpool |
$81.04
|
| Rate for Payer: Mclaren Commercial |
$75.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.02
|
| Rate for Payer: Nomi Health Commercial |
$68.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$73.21
|
| Rate for Payer: Priority Health Narrow Network |
$58.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$73.52
|
|
|
HC PUNCH BIOPSY SKIN ADDL LESION
|
Facility
|
IP
|
$83.55
|
|
|
Service Code
|
CPT 11105
|
| Hospital Charge Code |
76100151
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$54.31 |
| Max. Negotiated Rate |
$83.55 |
| Rate for Payer: Aetna Commercial |
$75.20
|
| Rate for Payer: ASR ASR |
$81.04
|
| Rate for Payer: ASR Commercial |
$81.04
|
| Rate for Payer: BCBS Trust/PPO |
$68.08
|
| Rate for Payer: BCN Commercial |
$64.78
|
| Rate for Payer: Cash Price |
$66.84
|
| Rate for Payer: Cofinity Commercial |
$78.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.84
|
| Rate for Payer: Healthscope Commercial |
$83.55
|
| Rate for Payer: Healthscope Whirlpool |
$81.04
|
| Rate for Payer: Mclaren Commercial |
$75.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.02
|
| Rate for Payer: Nomi Health Commercial |
$68.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$73.52
|
|
|
HC PUNCH BIOPSY SKIN SINGLE LESION
|
Facility
|
OP
|
$319.12
|
|
|
Service Code
|
CPT 11104
|
| Hospital Charge Code |
76100150
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$161.62 |
| Max. Negotiated Rate |
$606.75 |
| Rate for Payer: Aetna Commercial |
$287.21
|
| Rate for Payer: Aetna Medicare |
$391.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$489.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$489.31
|
| Rate for Payer: ASR ASR |
$309.55
|
| Rate for Payer: ASR Commercial |
$309.55
|
| Rate for Payer: BCBS Complete |
$220.31
|
| Rate for Payer: BCBS MAPPO |
$391.45
|
| Rate for Payer: BCBS Trust/PPO |
$261.33
|
| Rate for Payer: BCN Commercial |
$247.41
|
| Rate for Payer: BCN Medicare Advantage |
$391.45
|
| Rate for Payer: Cash Price |
$255.30
|
| Rate for Payer: Cash Price |
$255.30
|
| Rate for Payer: Cofinity Commercial |
$299.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$255.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$391.45
|
| Rate for Payer: Healthscope Commercial |
$319.12
|
| Rate for Payer: Healthscope Whirlpool |
$309.55
|
| Rate for Payer: Humana Choice PPO Medicare |
$391.45
|
| Rate for Payer: Mclaren Commercial |
$287.21
|
| Rate for Payer: Mclaren Medicaid |
$209.82
|
| Rate for Payer: Mclaren Medicare |
$391.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$411.02
|
| Rate for Payer: Meridian Medicaid |
$220.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$450.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$271.25
|
| Rate for Payer: Nomi Health Commercial |
$261.68
|
| Rate for Payer: PACE Medicare |
$371.88
|
| Rate for Payer: PACE SWMI |
$391.45
|
| Rate for Payer: PHP Commercial |
$430.60
|
| Rate for Payer: PHP Medicaid |
$209.82
|
| Rate for Payer: PHP Medicare Advantage |
$391.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$209.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$207.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$202.02
|
| Rate for Payer: Priority Health Medicare |
$391.45
|
| Rate for Payer: Priority Health Narrow Network |
$161.62
|
| Rate for Payer: Railroad Medicare Medicare |
$391.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$280.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$391.45
|
| Rate for Payer: UHC Exchange |
$606.75
|
| Rate for Payer: UHC Medicare Advantage |
$391.45
|
| Rate for Payer: UHCCP DNSP |
$391.45
|
| Rate for Payer: UHCCP Medicaid |
$209.82
|
| Rate for Payer: VA VA |
$391.45
|
|
|
HC PUNCH BIOPSY SKIN SINGLE LESION
|
Facility
|
IP
|
$319.12
|
|
|
Service Code
|
CPT 11104
|
| Hospital Charge Code |
76100150
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$207.43 |
| Max. Negotiated Rate |
$319.12 |
| Rate for Payer: Aetna Commercial |
$287.21
|
| Rate for Payer: ASR ASR |
$309.55
|
| Rate for Payer: ASR Commercial |
$309.55
|
| Rate for Payer: BCBS Trust/PPO |
$260.05
|
| Rate for Payer: BCN Commercial |
$247.41
|
| Rate for Payer: Cash Price |
$255.30
|
| Rate for Payer: Cofinity Commercial |
$299.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$255.30
|
| Rate for Payer: Healthscope Commercial |
$319.12
|
| Rate for Payer: Healthscope Whirlpool |
$309.55
|
| Rate for Payer: Mclaren Commercial |
$287.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$271.25
|
| Rate for Payer: Nomi Health Commercial |
$261.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$207.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$280.83
|
|
