|
HC RESPIRATORY VIRAL PANEL
|
Facility
|
IP
|
$71.79
|
|
|
Service Code
|
CPT 87300
|
| Hospital Charge Code |
30600134
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$53.84 |
| Max. Negotiated Rate |
$71.79 |
| Rate for Payer: Aetna Commercial |
$64.61
|
| Rate for Payer: ASR ASR |
$69.64
|
| Rate for Payer: BCBS Trust/PPO |
$58.95
|
| Rate for Payer: BCN Commercial |
$58.95
|
| Rate for Payer: Cash Price |
$57.43
|
| Rate for Payer: Cofinity Commercial |
$67.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.43
|
| Rate for Payer: Healthscope Commercial |
$69.64
|
| Rate for Payer: Healthscope Whirlpool |
$71.79
|
| Rate for Payer: Mclaren Commercial |
$64.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.02
|
| Rate for Payer: Nomi Health Commercial |
$58.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$63.18
|
|
|
HC RESP SYNCTIAL VIRUS IG PER 50 MG
|
Facility
|
IP
|
$5,130.98
|
|
|
Service Code
|
CPT 90378
|
| Hospital Charge Code |
63600156
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3,848.24 |
| Max. Negotiated Rate |
$5,130.98 |
| Rate for Payer: Aetna Commercial |
$4,617.88
|
| Rate for Payer: ASR ASR |
$4,977.05
|
| Rate for Payer: BCBS Trust/PPO |
$4,213.56
|
| Rate for Payer: BCN Commercial |
$4,213.56
|
| Rate for Payer: Cash Price |
$4,104.78
|
| Rate for Payer: Cofinity Commercial |
$4,823.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,104.78
|
| Rate for Payer: Healthscope Commercial |
$4,977.05
|
| Rate for Payer: Healthscope Whirlpool |
$5,130.98
|
| Rate for Payer: Mclaren Commercial |
$4,617.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,361.33
|
| Rate for Payer: Nomi Health Commercial |
$4,207.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,848.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,515.26
|
|
|
HC RESP SYNCTIAL VIRUS IG PER 50 MG
|
Facility
|
OP
|
$5,130.98
|
|
|
Service Code
|
CPT 90378
|
| Hospital Charge Code |
63600156
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$228.42 |
| Max. Negotiated Rate |
$5,130.98 |
| Rate for Payer: Aetna Commercial |
$4,617.88
|
| Rate for Payer: Aetna Medicare |
$436.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$545.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$545.94
|
| Rate for Payer: ASR ASR |
$4,977.05
|
| Rate for Payer: BCBS Complete |
$239.86
|
| Rate for Payer: BCBS MAPPO |
$436.75
|
| Rate for Payer: BCBS Trust/PPO |
$4,230.49
|
| Rate for Payer: BCN Commercial |
$4,230.49
|
| Rate for Payer: BCN Medicare Advantage |
$436.75
|
| Rate for Payer: Cash Price |
$4,104.78
|
| Rate for Payer: Cash Price |
$4,104.78
|
| Rate for Payer: Cofinity Commercial |
$4,823.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,104.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$436.75
|
| Rate for Payer: Healthscope Commercial |
$4,977.05
|
| Rate for Payer: Healthscope Whirlpool |
$5,130.98
|
| Rate for Payer: Humana Choice PPO Medicare |
$436.75
|
| Rate for Payer: Mclaren Commercial |
$4,617.88
|
| Rate for Payer: Mclaren Medicaid |
$436.75
|
| Rate for Payer: Mclaren Medicare |
$436.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$458.59
|
| Rate for Payer: Meridian Medicaid |
$239.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$502.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$480.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,361.33
|
| Rate for Payer: Nomi Health Commercial |
$4,207.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,848.24
|
| Rate for Payer: PACE Medicare |
$414.91
|
| Rate for Payer: PACE SWMI |
$436.75
|
| Rate for Payer: PHP Commercial |
$480.43
|
| Rate for Payer: PHP Medicaid |
$234.10
|
| Rate for Payer: PHP Medicare Advantage |
$436.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$228.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,857.07
|
| Rate for Payer: Priority Health Medicare |
$436.75
|
| Rate for Payer: Priority Health Narrow Network |
$1,485.66
|
| Rate for Payer: Railroad Medicare Medicare |
$436.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,515.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$436.75
|
| Rate for Payer: UHC Exchange |
$676.96
|
| Rate for Payer: UHC Medicaid |
$228.42
|
| Rate for Payer: UHCCP DNSP |
$436.75
|
| Rate for Payer: UHCCP Medicaid |
$228.42
|
| Rate for Payer: VA VA |
$436.75
|
|
|
HC RESP SYNCYTIAL VIRUS W/OPTIC
|
Facility
|
IP
|
$23.46
|
|
|
Service Code
|
CPT 87807
|
| Hospital Charge Code |
30000172
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.59 |
| Max. Negotiated Rate |
$23.46 |
| Rate for Payer: Aetna Commercial |
$21.11
|
| Rate for Payer: ASR ASR |
$22.76
|
| Rate for Payer: BCBS Trust/PPO |
$19.27
|
| Rate for Payer: BCN Commercial |
$19.27
|
| Rate for Payer: Cash Price |
$18.77
|
| Rate for Payer: Cofinity Commercial |
$22.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.77
|
| Rate for Payer: Healthscope Commercial |
$22.76
|
| Rate for Payer: Healthscope Whirlpool |
$23.46
|
| Rate for Payer: Mclaren Commercial |
$21.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.94
|
| Rate for Payer: Nomi Health Commercial |
$19.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$20.64
|
|
|
HC RESP SYNCYTIAL VIRUS W/OPTIC
|
Facility
|
OP
|
$23.46
|
|
|
Service Code
|
CPT 87807
|
| Hospital Charge Code |
30000172
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.85 |
| Max. Negotiated Rate |
$23.46 |
| Rate for Payer: Aetna Commercial |
$21.11
|
| Rate for Payer: Aetna Medicare |
$13.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.38
|
| Rate for Payer: ASR ASR |
$22.76
|
| Rate for Payer: BCBS Complete |
$7.19
|
| Rate for Payer: BCBS MAPPO |
$13.10
|
| Rate for Payer: BCBS Trust/PPO |
$19.34
|
| Rate for Payer: BCN Commercial |
$19.34
|
| Rate for Payer: BCN Medicare Advantage |
$13.10
|
| Rate for Payer: Cash Price |
$18.77
|
| Rate for Payer: Cash Price |
$18.77
|
| Rate for Payer: Cofinity Commercial |
$22.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.10
|
| Rate for Payer: Healthscope Commercial |
$22.76
|
| Rate for Payer: Healthscope Whirlpool |
$23.46
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.10
|
| Rate for Payer: Mclaren Commercial |
$21.11
|
| Rate for Payer: Mclaren Medicaid |
$13.10
|
| Rate for Payer: Mclaren Medicare |
$13.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.76
|
| Rate for Payer: Meridian Medicaid |
$7.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.94
|
| Rate for Payer: Nomi Health Commercial |
$19.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.59
|
| Rate for Payer: PACE Medicare |
$12.45
|
| Rate for Payer: PACE SWMI |
$13.10
|
| Rate for Payer: PHP Commercial |
$14.41
|
| Rate for Payer: PHP Medicaid |
$7.02
|
| Rate for Payer: PHP Medicare Advantage |
$13.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$20.56
|
| Rate for Payer: Priority Health Medicare |
$13.10
|
| Rate for Payer: Priority Health Narrow Network |
$16.45
|
| Rate for Payer: Railroad Medicare Medicare |
$13.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$20.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.10
|
| Rate for Payer: UHC Exchange |
$20.30
|
| Rate for Payer: UHC Medicaid |
$6.85
|
| Rate for Payer: UHCCP DNSP |
$13.10
|
| Rate for Payer: UHCCP Medicaid |
$6.85
|
| Rate for Payer: VA VA |
$13.10
|
|
|
HC RESP VIRAL PANEL BORDETELLA
|
Facility
|
IP
|
$63.67
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600189
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$47.75 |
| Max. Negotiated Rate |
$63.67 |
| Rate for Payer: Aetna Commercial |
$57.30
|
| Rate for Payer: ASR ASR |
$61.76
|
| Rate for Payer: BCBS Trust/PPO |
$52.29
|
| Rate for Payer: BCN Commercial |
$52.29
|
| Rate for Payer: Cash Price |
$50.94
|
| Rate for Payer: Cofinity Commercial |
$59.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.94
|
| Rate for Payer: Healthscope Commercial |
$61.76
|
| Rate for Payer: Healthscope Whirlpool |
$63.67
|
| Rate for Payer: Mclaren Commercial |
$57.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.12
|
| Rate for Payer: Nomi Health Commercial |
$52.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$56.03
|
|
|
HC RESP VIRAL PANEL BORDETELLA
|
Facility
|
OP
|
$63.67
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600189
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.35 |
| Max. Negotiated Rate |
$63.67 |
| Rate for Payer: Aetna Commercial |
$57.30
|
| Rate for Payer: Aetna Medicare |
$35.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: ASR ASR |
$61.76
|
| Rate for Payer: BCBS Complete |
$19.27
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$52.50
|
| Rate for Payer: BCN Commercial |
$52.50
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$50.94
|
| Rate for Payer: Cash Price |
$50.94
|
| Rate for Payer: Cofinity Commercial |
$59.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$61.76
|
| Rate for Payer: Healthscope Whirlpool |
$63.67
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$57.30
|
| Rate for Payer: Mclaren Medicaid |
$35.09
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$19.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.12
|
| Rate for Payer: Nomi Health Commercial |
$52.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.75
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$38.60
|
| Rate for Payer: PHP Medicaid |
$18.81
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$55.79
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$44.63
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$56.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$35.09
|
| Rate for Payer: UHC Exchange |
$54.39
|
| Rate for Payer: UHC Medicaid |
$18.35
|
| Rate for Payer: UHCCP DNSP |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$18.35
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC RESP VIRAL PANEL CHLAMYDIA
|
Facility
|
OP
|
$63.67
|
|
|
Service Code
|
CPT 87486
|
| Hospital Charge Code |
30600186
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.35 |
| Max. Negotiated Rate |
$63.67 |
| Rate for Payer: Aetna Commercial |
$57.30
|
| Rate for Payer: Aetna Medicare |
$35.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: ASR ASR |
$61.76
|
| Rate for Payer: BCBS Complete |
$19.27
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$52.50
|
| Rate for Payer: BCN Commercial |
$52.50
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$50.94
|
| Rate for Payer: Cash Price |
$50.94
|
| Rate for Payer: Cofinity Commercial |
$59.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$61.76
|
| Rate for Payer: Healthscope Whirlpool |
$63.67
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$57.30
|
| Rate for Payer: Mclaren Medicaid |
$35.09
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$19.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.12
|
| Rate for Payer: Nomi Health Commercial |
$52.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.75
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$38.60
|
| Rate for Payer: PHP Medicaid |
$18.81
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$55.79
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$44.63
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$56.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$35.09
|
| Rate for Payer: UHC Exchange |
$54.39
|
| Rate for Payer: UHC Medicaid |
$18.35
|
| Rate for Payer: UHCCP DNSP |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$18.35
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC RESP VIRAL PANEL CHLAMYDIA
|
Facility
|
IP
|
$63.67
|
|
|
Service Code
|
CPT 87486
|
| Hospital Charge Code |
30600186
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$47.75 |
| Max. Negotiated Rate |
$63.67 |
| Rate for Payer: Aetna Commercial |
$57.30
|
| Rate for Payer: ASR ASR |
$61.76
|
| Rate for Payer: BCBS Trust/PPO |
$52.29
|
| Rate for Payer: BCN Commercial |
$52.29
|
| Rate for Payer: Cash Price |
$50.94
|
| Rate for Payer: Cofinity Commercial |
$59.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.94
|
| Rate for Payer: Healthscope Commercial |
$61.76
|
| Rate for Payer: Healthscope Whirlpool |
$63.67
|
| Rate for Payer: Mclaren Commercial |
$57.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.12
|
| Rate for Payer: Nomi Health Commercial |
$52.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$56.03
|
|
|
HC RESP VIRAL PANEL MYCOPLASMA
|
Facility
|
IP
|
$63.67
|
|
|
Service Code
|
CPT 87581
|
| Hospital Charge Code |
30600185
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$47.75 |
| Max. Negotiated Rate |
$63.67 |
| Rate for Payer: Aetna Commercial |
$57.30
|
| Rate for Payer: ASR ASR |
$61.76
|
| Rate for Payer: BCBS Trust/PPO |
$52.29
|
| Rate for Payer: BCN Commercial |
$52.29
|
| Rate for Payer: Cash Price |
$50.94
|
| Rate for Payer: Cofinity Commercial |
$59.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.94
|
| Rate for Payer: Healthscope Commercial |
$61.76
|
| Rate for Payer: Healthscope Whirlpool |
$63.67
|
| Rate for Payer: Mclaren Commercial |
$57.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.12
|
| Rate for Payer: Nomi Health Commercial |
$52.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$56.03
|
|
|
HC RESP VIRAL PANEL MYCOPLASMA
|
Facility
|
OP
|
$63.67
|
|
|
Service Code
|
CPT 87581
|
| Hospital Charge Code |
30600185
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.35 |
| Max. Negotiated Rate |
$63.67 |
| Rate for Payer: Aetna Commercial |
$57.30
|
| Rate for Payer: Aetna Medicare |
$35.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: ASR ASR |
$61.76
|
| Rate for Payer: BCBS Complete |
$19.27
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$52.50
|
| Rate for Payer: BCN Commercial |
$52.50
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$50.94
|
| Rate for Payer: Cash Price |
$50.94
|
| Rate for Payer: Cofinity Commercial |
$59.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$61.76
|
| Rate for Payer: Healthscope Whirlpool |
$63.67
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$57.30
|
| Rate for Payer: Mclaren Medicaid |
$35.09
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$19.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.12
|
| Rate for Payer: Nomi Health Commercial |
$52.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.75
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$38.60
|
| Rate for Payer: PHP Medicaid |
$18.81
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$55.79
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$44.63
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$56.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$35.09
|
| Rate for Payer: UHC Exchange |
$54.39
|
| Rate for Payer: UHC Medicaid |
$18.35
|
| Rate for Payer: UHCCP DNSP |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$18.35
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC RESP VIRAL PANEL RP2.1
|
Facility
|
OP
|
$636.72
|
|
|
Service Code
|
HCPCS 0202U
|
| Hospital Charge Code |
30000162
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$217.98 |
| Max. Negotiated Rate |
$646.01 |
| Rate for Payer: Aetna Commercial |
$573.05
|
| Rate for Payer: Aetna Medicare |
$416.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$520.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$520.98
|
| Rate for Payer: ASR ASR |
$617.62
|
| Rate for Payer: BCBS Complete |
$228.90
|
| Rate for Payer: BCBS MAPPO |
$416.78
|
| Rate for Payer: BCBS Trust/PPO |
$524.98
|
| Rate for Payer: BCN Commercial |
$524.98
|
| Rate for Payer: BCN Medicare Advantage |
$416.78
|
| Rate for Payer: Cash Price |
$509.38
|
| Rate for Payer: Cash Price |
$509.38
|
| Rate for Payer: Cofinity Commercial |
$598.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$509.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$416.78
|
| Rate for Payer: Healthscope Commercial |
$617.62
|
| Rate for Payer: Healthscope Whirlpool |
$636.72
|
| Rate for Payer: Humana Choice PPO Medicare |
$416.78
|
| Rate for Payer: Mclaren Commercial |
$573.05
|
| Rate for Payer: Mclaren Medicaid |
$416.78
|
| Rate for Payer: Mclaren Medicare |
$416.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$437.62
|
| Rate for Payer: Meridian Medicaid |
$228.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$479.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$458.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$541.21
|
| Rate for Payer: Nomi Health Commercial |
$522.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$477.54
|
| Rate for Payer: PACE Medicare |
$395.94
|
| Rate for Payer: PACE SWMI |
$416.78
|
| Rate for Payer: PHP Commercial |
$458.46
|
| Rate for Payer: PHP Medicaid |
$223.39
|
| Rate for Payer: PHP Medicare Advantage |
$416.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$217.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$557.89
|
| Rate for Payer: Priority Health Medicare |
$416.78
|
| Rate for Payer: Priority Health Narrow Network |
$446.34
|
| Rate for Payer: Railroad Medicare Medicare |
$416.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$560.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$416.78
|
| Rate for Payer: UHC Exchange |
$646.01
|
| Rate for Payer: UHC Medicaid |
$217.98
|
| Rate for Payer: UHCCP DNSP |
$416.78
|
| Rate for Payer: UHCCP Medicaid |
$217.98
|
| Rate for Payer: VA VA |
$416.78
|
|
|
HC RESP VIRAL PANEL RP2.1
|
Facility
|
IP
|
$636.72
|
|
|
Service Code
|
HCPCS 0202U
|
| Hospital Charge Code |
30000162
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$477.54 |
| Max. Negotiated Rate |
$636.72 |
| Rate for Payer: Aetna Commercial |
$573.05
|
| Rate for Payer: ASR ASR |
$617.62
|
| Rate for Payer: BCBS Trust/PPO |
$522.87
|
| Rate for Payer: BCN Commercial |
$522.87
|
| Rate for Payer: Cash Price |
$509.38
|
| Rate for Payer: Cofinity Commercial |
$598.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$509.38
|
| Rate for Payer: Healthscope Commercial |
$617.62
|
| Rate for Payer: Healthscope Whirlpool |
$636.72
|
| Rate for Payer: Mclaren Commercial |
$573.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$541.21
|
| Rate for Payer: Nomi Health Commercial |
$522.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$477.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$560.31
|
|
|
HC RESTORE HYDROGEL 3 OZ
|
Facility
|
IP
|
$19.23
|
|
| Hospital Charge Code |
27100015
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$14.42 |
| Max. Negotiated Rate |
$19.23 |
| Rate for Payer: Aetna Commercial |
$17.31
|
| Rate for Payer: ASR ASR |
$18.65
|
| Rate for Payer: BCBS Trust/PPO |
$15.79
|
| Rate for Payer: BCN Commercial |
$15.79
|
| Rate for Payer: Cash Price |
$15.38
|
| Rate for Payer: Cofinity Commercial |
$18.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.38
|
| Rate for Payer: Healthscope Commercial |
$18.65
|
| Rate for Payer: Healthscope Whirlpool |
$19.23
|
| Rate for Payer: Mclaren Commercial |
$17.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.35
|
| Rate for Payer: Nomi Health Commercial |
$15.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16.92
|
|
|
HC RESTORE HYDROGEL 3 OZ
|
Facility
|
OP
|
$19.23
|
|
| Hospital Charge Code |
27100015
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$7.12 |
| Max. Negotiated Rate |
$19.23 |
| Rate for Payer: Aetna Commercial |
$17.31
|
| Rate for Payer: Aetna Medicare |
$7.12
|
| Rate for Payer: ASR ASR |
$18.65
|
| Rate for Payer: BCBS Complete |
$7.69
|
| Rate for Payer: BCBS Trust/PPO |
$15.86
|
| Rate for Payer: BCN Commercial |
$15.86
|
| Rate for Payer: Cash Price |
$15.38
|
| Rate for Payer: Cofinity Commercial |
$18.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.38
|
| Rate for Payer: Healthscope Commercial |
$18.65
|
| Rate for Payer: Healthscope Whirlpool |
$19.23
|
| Rate for Payer: Mclaren Commercial |
$17.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.35
|
| Rate for Payer: Nomi Health Commercial |
$15.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$16.85
|
| Rate for Payer: Priority Health Narrow Network |
$13.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16.92
|
|
|
HC RESUPERF WND BODY <2.5 CM
|
Facility
|
OP
|
$281.22
|
|
|
Service Code
|
CPT 12001
|
| Hospital Charge Code |
76100181
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$104.55 |
| Max. Negotiated Rate |
$309.86 |
| Rate for Payer: Aetna Commercial |
$253.10
|
| Rate for Payer: Aetna Medicare |
$199.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$249.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$249.89
|
| Rate for Payer: ASR ASR |
$272.78
|
| Rate for Payer: BCBS Complete |
$109.79
|
| Rate for Payer: BCBS MAPPO |
$199.91
|
| Rate for Payer: BCBS Trust/PPO |
$231.87
|
| Rate for Payer: BCN Commercial |
$231.87
|
| Rate for Payer: BCN Medicare Advantage |
$199.91
|
| Rate for Payer: Cash Price |
$224.98
|
| Rate for Payer: Cash Price |
$224.98
|
| Rate for Payer: Cofinity Commercial |
$264.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$224.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$199.91
|
| Rate for Payer: Healthscope Commercial |
$272.78
|
| Rate for Payer: Healthscope Whirlpool |
$281.22
|
| Rate for Payer: Humana Choice PPO Medicare |
$199.91
|
| Rate for Payer: Mclaren Commercial |
$253.10
|
| Rate for Payer: Mclaren Medicaid |
$199.91
|
| Rate for Payer: Mclaren Medicare |
$199.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$209.91
|
| Rate for Payer: Meridian Medicaid |
$109.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$229.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$219.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$239.04
|
| Rate for Payer: Nomi Health Commercial |
$230.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$210.91
|
| Rate for Payer: PACE Medicare |
$189.91
|
| Rate for Payer: PACE SWMI |
$199.91
|
| Rate for Payer: PHP Commercial |
$219.90
|
| Rate for Payer: PHP Medicaid |
$107.15
|
| Rate for Payer: PHP Medicare Advantage |
$199.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$293.24
|
| Rate for Payer: Priority Health Medicare |
$199.91
|
| Rate for Payer: Priority Health Narrow Network |
$234.60
|
| Rate for Payer: Railroad Medicare Medicare |
$199.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$247.47
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$199.91
|
| Rate for Payer: UHC Exchange |
$309.86
|
| Rate for Payer: UHC Medicaid |
$104.55
|
| Rate for Payer: UHCCP DNSP |
$199.91
|
| Rate for Payer: UHCCP Medicaid |
$104.55
|
| Rate for Payer: VA VA |
$199.91
|
|
|
HC RESUPERF WND BODY <2.5 CM
|
Facility
|
IP
|
$281.22
|
|
|
Service Code
|
CPT 12001
|
| Hospital Charge Code |
76100181
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$210.91 |
| Max. Negotiated Rate |
$281.22 |
| Rate for Payer: Aetna Commercial |
$253.10
|
| Rate for Payer: ASR ASR |
$272.78
|
| Rate for Payer: BCBS Trust/PPO |
$230.94
|
| Rate for Payer: BCN Commercial |
$230.94
|
| Rate for Payer: Cash Price |
$224.98
|
| Rate for Payer: Cofinity Commercial |
$264.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$224.98
|
| Rate for Payer: Healthscope Commercial |
$272.78
|
| Rate for Payer: Healthscope Whirlpool |
$281.22
|
| Rate for Payer: Mclaren Commercial |
$253.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$239.04
|
| Rate for Payer: Nomi Health Commercial |
$230.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$210.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$247.47
|
|
|
HC RETICULOCYTE COUNT
|
Facility
|
IP
|
$42.34
|
|
|
Service Code
|
CPT 85046
|
| Hospital Charge Code |
30500010
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$31.75 |
| Max. Negotiated Rate |
$42.34 |
| Rate for Payer: Aetna Commercial |
$38.11
|
| Rate for Payer: ASR ASR |
$41.07
|
| Rate for Payer: BCBS Trust/PPO |
$34.77
|
| Rate for Payer: BCN Commercial |
$34.77
|
| Rate for Payer: Cash Price |
$33.87
|
| Rate for Payer: Cofinity Commercial |
$39.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.87
|
| Rate for Payer: Healthscope Commercial |
$41.07
|
| Rate for Payer: Healthscope Whirlpool |
$42.34
|
| Rate for Payer: Mclaren Commercial |
$38.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.99
|
| Rate for Payer: Nomi Health Commercial |
$34.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.26
|
|
|
HC RETICULOCYTE COUNT
|
Facility
|
OP
|
$42.34
|
|
|
Service Code
|
CPT 85046
|
| Hospital Charge Code |
30500010
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.91 |
| Max. Negotiated Rate |
$42.34 |
| Rate for Payer: Aetna Commercial |
$38.11
|
| Rate for Payer: Aetna Medicare |
$5.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.96
|
| Rate for Payer: ASR ASR |
$41.07
|
| Rate for Payer: BCBS Complete |
$3.06
|
| Rate for Payer: BCBS MAPPO |
$5.57
|
| Rate for Payer: BCBS Trust/PPO |
$34.91
|
| Rate for Payer: BCN Commercial |
$34.91
|
| Rate for Payer: BCN Medicare Advantage |
$5.57
|
| Rate for Payer: Cash Price |
$33.87
|
| Rate for Payer: Cash Price |
$33.87
|
| Rate for Payer: Cofinity Commercial |
$39.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.57
|
| Rate for Payer: Healthscope Commercial |
$41.07
|
| Rate for Payer: Healthscope Whirlpool |
$42.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.57
|
| Rate for Payer: Mclaren Commercial |
$38.11
|
| Rate for Payer: Mclaren Medicaid |
$5.57
|
| Rate for Payer: Mclaren Medicare |
$5.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.85
|
| Rate for Payer: Meridian Medicaid |
$3.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.99
|
| Rate for Payer: Nomi Health Commercial |
$34.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.75
|
| Rate for Payer: PACE Medicare |
$5.29
|
| Rate for Payer: PACE SWMI |
$5.57
|
| Rate for Payer: PHP Commercial |
$6.13
|
| Rate for Payer: PHP Medicaid |
$2.99
|
| Rate for Payer: PHP Medicare Advantage |
$5.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$37.10
|
| Rate for Payer: Priority Health Medicare |
$5.57
|
| Rate for Payer: Priority Health Narrow Network |
$29.68
|
| Rate for Payer: Railroad Medicare Medicare |
$5.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.57
|
| Rate for Payer: UHC Exchange |
$8.63
|
| Rate for Payer: UHC Medicaid |
$2.91
|
| Rate for Payer: UHCCP DNSP |
$5.57
|
| Rate for Payer: UHCCP Medicaid |
$2.91
|
| Rate for Payer: VA VA |
$5.57
|
|
|
HC REVAS ADD.VESSEL/DES
|
Facility
|
IP
|
$19,739.22
|
|
|
Service Code
|
CPT C9608
|
| Hospital Charge Code |
48100090
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$14,804.42 |
| Max. Negotiated Rate |
$19,739.22 |
| Rate for Payer: Aetna Commercial |
$17,765.30
|
| Rate for Payer: ASR ASR |
$19,147.04
|
| Rate for Payer: BCBS Trust/PPO |
$16,209.85
|
| Rate for Payer: BCN Commercial |
$16,209.85
|
| Rate for Payer: Cash Price |
$15,791.38
|
| Rate for Payer: Cofinity Commercial |
$18,554.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,791.38
|
| Rate for Payer: Healthscope Commercial |
$19,147.04
|
| Rate for Payer: Healthscope Whirlpool |
$19,739.22
|
| Rate for Payer: Mclaren Commercial |
$17,765.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,778.34
|
| Rate for Payer: Nomi Health Commercial |
$16,186.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14,804.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17,370.51
|
|
|
HC REVAS ADD.VESSEL/DES
|
Facility
|
OP
|
$19,739.22
|
|
|
Service Code
|
CPT C9608
|
| Hospital Charge Code |
48100090
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$7,303.51 |
| Max. Negotiated Rate |
$19,739.22 |
| Rate for Payer: Aetna Commercial |
$17,765.30
|
| Rate for Payer: Aetna Medicare |
$7,303.51
|
| Rate for Payer: ASR ASR |
$19,147.04
|
| Rate for Payer: BCBS Complete |
$7,895.69
|
| Rate for Payer: BCBS Trust/PPO |
$16,274.99
|
| Rate for Payer: BCN Commercial |
$16,274.99
|
| Rate for Payer: Cash Price |
$15,791.38
|
| Rate for Payer: Cash Price |
$15,791.38
|
| Rate for Payer: Cofinity Commercial |
$18,554.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,791.38
|
| Rate for Payer: Healthscope Commercial |
$19,147.04
|
| Rate for Payer: Healthscope Whirlpool |
$19,739.22
|
| Rate for Payer: Mclaren Commercial |
$17,765.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,791.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,778.34
|
| Rate for Payer: Nomi Health Commercial |
$16,186.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14,804.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$9,799.08
|
| Rate for Payer: Priority Health Narrow Network |
$7,839.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17,370.51
|
|
|
HC REVAS ADD.VESSEL/STENT
|
Facility
|
OP
|
$19,739.22
|
|
|
Service Code
|
CPT 92944
|
| Hospital Charge Code |
48100089
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$7,303.51 |
| Max. Negotiated Rate |
$19,739.22 |
| Rate for Payer: Aetna Commercial |
$17,765.30
|
| Rate for Payer: Aetna Medicare |
$7,303.51
|
| Rate for Payer: ASR ASR |
$19,147.04
|
| Rate for Payer: BCBS Complete |
$7,895.69
|
| Rate for Payer: BCBS Trust/PPO |
$16,274.99
|
| Rate for Payer: BCN Commercial |
$16,274.99
|
| Rate for Payer: Cash Price |
$15,791.38
|
| Rate for Payer: Cofinity Commercial |
$18,554.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,791.38
|
| Rate for Payer: Healthscope Commercial |
$19,147.04
|
| Rate for Payer: Healthscope Whirlpool |
$19,739.22
|
| Rate for Payer: Mclaren Commercial |
$17,765.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,791.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,778.34
|
| Rate for Payer: Nomi Health Commercial |
$16,186.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14,804.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$17,295.50
|
| Rate for Payer: Priority Health Narrow Network |
$13,837.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17,370.51
|
|
|
HC REVAS ADD.VESSEL/STENT
|
Facility
|
IP
|
$19,739.22
|
|
|
Service Code
|
CPT 92944
|
| Hospital Charge Code |
48100089
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$14,804.42 |
| Max. Negotiated Rate |
$19,739.22 |
| Rate for Payer: Aetna Commercial |
$17,765.30
|
| Rate for Payer: ASR ASR |
$19,147.04
|
| Rate for Payer: BCBS Trust/PPO |
$16,209.85
|
| Rate for Payer: BCN Commercial |
$16,209.85
|
| Rate for Payer: Cash Price |
$15,791.38
|
| Rate for Payer: Cofinity Commercial |
$18,554.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,791.38
|
| Rate for Payer: Healthscope Commercial |
$19,147.04
|
| Rate for Payer: Healthscope Whirlpool |
$19,739.22
|
| Rate for Payer: Mclaren Commercial |
$17,765.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,778.34
|
| Rate for Payer: Nomi Health Commercial |
$16,186.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14,804.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17,370.51
|
|
|
HC REVAS CABG ADD.BRANCH
|
Facility
|
OP
|
$19,483.94
|
|
|
Service Code
|
CPT 92938
|
| Hospital Charge Code |
48100082
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$7,209.06 |
| Max. Negotiated Rate |
$19,483.94 |
| Rate for Payer: Aetna Commercial |
$17,535.55
|
| Rate for Payer: Aetna Medicare |
$7,209.06
|
| Rate for Payer: ASR ASR |
$18,899.42
|
| Rate for Payer: BCBS Complete |
$7,793.58
|
| Rate for Payer: BCBS Trust/PPO |
$16,064.51
|
| Rate for Payer: BCN Commercial |
$16,064.51
|
| Rate for Payer: Cash Price |
$15,587.15
|
| Rate for Payer: Cofinity Commercial |
$18,314.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,587.15
|
| Rate for Payer: Healthscope Commercial |
$18,899.42
|
| Rate for Payer: Healthscope Whirlpool |
$19,483.94
|
| Rate for Payer: Mclaren Commercial |
$17,535.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,587.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,561.35
|
| Rate for Payer: Nomi Health Commercial |
$15,976.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14,612.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$17,071.83
|
| Rate for Payer: Priority Health Narrow Network |
$13,658.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17,145.87
|
|
|
HC REVAS CABG ADD.BRANCH
|
Facility
|
IP
|
$19,483.94
|
|
|
Service Code
|
CPT 92938
|
| Hospital Charge Code |
48100082
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$14,612.95 |
| Max. Negotiated Rate |
$19,483.94 |
| Rate for Payer: Aetna Commercial |
$17,535.55
|
| Rate for Payer: ASR ASR |
$18,899.42
|
| Rate for Payer: BCBS Trust/PPO |
$16,000.21
|
| Rate for Payer: BCN Commercial |
$16,000.21
|
| Rate for Payer: Cash Price |
$15,587.15
|
| Rate for Payer: Cofinity Commercial |
$18,314.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,587.15
|
| Rate for Payer: Healthscope Commercial |
$18,899.42
|
| Rate for Payer: Healthscope Whirlpool |
$19,483.94
|
| Rate for Payer: Mclaren Commercial |
$17,535.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,561.35
|
| Rate for Payer: Nomi Health Commercial |
$15,976.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14,612.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17,145.87
|
|
