|
HC RAPID INFLUENZA A & B SCREEN
|
Facility
|
OP
|
$77.93
|
|
|
Service Code
|
CPT 87804
|
| Hospital Charge Code |
30600174
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.87 |
| Max. Negotiated Rate |
$77.93 |
| Rate for Payer: Aetna Commercial |
$70.14
|
| 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 |
$75.59
|
| Rate for Payer: ASR Commercial |
$75.59
|
| Rate for Payer: BCBS Complete |
$9.31
|
| Rate for Payer: BCBS MAPPO |
$16.55
|
| Rate for Payer: BCBS Trust/PPO |
$63.82
|
| Rate for Payer: BCN Commercial |
$60.42
|
| Rate for Payer: BCN Medicare Advantage |
$16.55
|
| Rate for Payer: Cash Price |
$62.34
|
| Rate for Payer: Cash Price |
$62.34
|
| Rate for Payer: Cofinity Commercial |
$73.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.55
|
| Rate for Payer: Healthscope Commercial |
$77.93
|
| Rate for Payer: Healthscope Whirlpool |
$75.59
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.55
|
| Rate for Payer: Mclaren Commercial |
$70.14
|
| Rate for Payer: Mclaren Medicaid |
$8.87
|
| 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 |
$9.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.24
|
| Rate for Payer: Nomi Health Commercial |
$63.90
|
| 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 |
$8.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$68.28
|
| Rate for Payer: Priority Health Medicare |
$16.55
|
| Rate for Payer: Priority Health Narrow Network |
$54.63
|
| Rate for Payer: Railroad Medicare Medicare |
$16.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$68.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.55
|
| Rate for Payer: UHC Exchange |
$25.65
|
| Rate for Payer: UHC Medicare Advantage |
$16.55
|
| Rate for Payer: UHCCP DNSP |
$16.55
|
| Rate for Payer: UHCCP Medicaid |
$8.87
|
| Rate for Payer: VA VA |
$16.55
|
|
|
HC RAPID INFLUENZA A & B SCREEN
|
Facility
|
IP
|
$77.93
|
|
|
Service Code
|
CPT 87804
|
| Hospital Charge Code |
30600174
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$50.65 |
| Max. Negotiated Rate |
$77.93 |
| Rate for Payer: Aetna Commercial |
$70.14
|
| Rate for Payer: ASR ASR |
$75.59
|
| Rate for Payer: ASR Commercial |
$75.59
|
| Rate for Payer: BCBS Trust/PPO |
$63.51
|
| Rate for Payer: BCN Commercial |
$60.42
|
| Rate for Payer: Cash Price |
$62.34
|
| Rate for Payer: Cofinity Commercial |
$73.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.34
|
| Rate for Payer: Healthscope Commercial |
$77.93
|
| Rate for Payer: Healthscope Whirlpool |
$75.59
|
| Rate for Payer: Mclaren Commercial |
$70.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.24
|
| Rate for Payer: Nomi Health Commercial |
$63.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$68.58
|
|
|
HC RAPID INFUSER
|
Facility
|
OP
|
$1,432.45
|
|
| Hospital Charge Code |
27000294
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$572.98 |
| Max. Negotiated Rate |
$1,432.45 |
| Rate for Payer: Aetna Commercial |
$1,289.20
|
| Rate for Payer: Aetna Medicare |
$716.23
|
| Rate for Payer: ASR ASR |
$1,389.48
|
| Rate for Payer: ASR Commercial |
$1,389.48
|
| Rate for Payer: BCBS Complete |
$572.98
|
| Rate for Payer: BCBS Trust/PPO |
$1,173.03
|
| Rate for Payer: BCN Commercial |
$1,110.58
|
| Rate for Payer: Cash Price |
$1,145.96
|
| Rate for Payer: Cofinity Commercial |
$1,346.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,145.96
|
| Rate for Payer: Healthscope Commercial |
$1,432.45
|
| Rate for Payer: Healthscope Whirlpool |
$1,389.48
|
| Rate for Payer: Mclaren Commercial |
$1,289.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,217.58
|
| Rate for Payer: Nomi Health Commercial |
$1,174.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$931.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,255.11
|
| Rate for Payer: Priority Health Narrow Network |
$1,004.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,260.56
|
|
|
HC RAPID INFUSER
|
Facility
|
IP
|
$1,432.45
|
|
| Hospital Charge Code |
27000294
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$931.09 |
| Max. Negotiated Rate |
$1,432.45 |
| Rate for Payer: Aetna Commercial |
$1,289.20
|
| Rate for Payer: ASR ASR |
$1,389.48
|
| Rate for Payer: ASR Commercial |
$1,389.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,167.30
|
| Rate for Payer: BCN Commercial |
$1,110.58
|
| Rate for Payer: Cash Price |
$1,145.96
|
| Rate for Payer: Cofinity Commercial |
$1,346.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,145.96
|
| Rate for Payer: Healthscope Commercial |
$1,432.45
|
| Rate for Payer: Healthscope Whirlpool |
$1,389.48
|
| Rate for Payer: Mclaren Commercial |
$1,289.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,217.58
|
| Rate for Payer: Nomi Health Commercial |
$1,174.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$931.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,260.56
|
|
|
HC RAPID MALARIA ASSAY
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30600298
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$33.81 |
| Max. Negotiated Rate |
$52.02 |
| Rate for Payer: Aetna Commercial |
$46.82
|
| Rate for Payer: ASR ASR |
$50.46
|
| Rate for Payer: ASR Commercial |
$50.46
|
| Rate for Payer: BCBS Trust/PPO |
$42.39
|
| Rate for Payer: BCN Commercial |
$40.33
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$48.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$52.02
|
| Rate for Payer: Healthscope Whirlpool |
$50.46
|
| Rate for Payer: Mclaren Commercial |
$46.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.78
|
|
|
HC RAPID MALARIA ASSAY
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30600298
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.61 |
| Max. Negotiated Rate |
$52.02 |
| Rate for Payer: Aetna Commercial |
$46.82
|
| 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 |
$50.46
|
| Rate for Payer: ASR Commercial |
$50.46
|
| Rate for Payer: BCBS Complete |
$9.04
|
| Rate for Payer: BCBS MAPPO |
$16.07
|
| Rate for Payer: BCBS Trust/PPO |
$42.60
|
| Rate for Payer: BCN Commercial |
$40.33
|
| Rate for Payer: BCN Medicare Advantage |
$16.07
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$48.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.07
|
| Rate for Payer: Healthscope Commercial |
$52.02
|
| Rate for Payer: Healthscope Whirlpool |
$50.46
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.07
|
| Rate for Payer: Mclaren Commercial |
$46.82
|
| Rate for Payer: Mclaren Medicaid |
$8.61
|
| 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 |
$9.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| 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 |
$8.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45.58
|
| Rate for Payer: Priority Health Medicare |
$16.07
|
| Rate for Payer: Priority Health Narrow Network |
$36.47
|
| Rate for Payer: Railroad Medicare Medicare |
$16.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.07
|
| Rate for Payer: UHC Exchange |
$24.91
|
| Rate for Payer: UHC Medicare Advantage |
$16.07
|
| Rate for Payer: UHCCP DNSP |
$16.07
|
| Rate for Payer: UHCCP Medicaid |
$8.61
|
| Rate for Payer: VA VA |
$16.07
|
|
|
HC RAPID STREP SCREEN.
|
Facility
|
IP
|
$61.70
|
|
|
Service Code
|
CPT 87880
|
| Hospital Charge Code |
30600176
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$40.10 |
| Max. Negotiated Rate |
$61.70 |
| Rate for Payer: Aetna Commercial |
$55.53
|
| Rate for Payer: ASR ASR |
$59.85
|
| Rate for Payer: ASR Commercial |
$59.85
|
| Rate for Payer: BCBS Trust/PPO |
$50.28
|
| Rate for Payer: BCN Commercial |
$47.84
|
| Rate for Payer: Cash Price |
$49.36
|
| Rate for Payer: Cofinity Commercial |
$58.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.36
|
| Rate for Payer: Healthscope Commercial |
$61.70
|
| Rate for Payer: Healthscope Whirlpool |
$59.85
|
| Rate for Payer: Mclaren Commercial |
$55.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.45
|
| Rate for Payer: Nomi Health Commercial |
$50.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$54.30
|
|
|
HC RAPID STREP SCREEN.
|
Facility
|
OP
|
$61.70
|
|
|
Service Code
|
CPT 87880
|
| Hospital Charge Code |
30600176
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.86 |
| Max. Negotiated Rate |
$61.70 |
| Rate for Payer: Aetna Commercial |
$55.53
|
| 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 |
$59.85
|
| Rate for Payer: ASR Commercial |
$59.85
|
| Rate for Payer: BCBS Complete |
$9.30
|
| Rate for Payer: BCBS MAPPO |
$16.53
|
| Rate for Payer: BCBS Trust/PPO |
$50.53
|
| Rate for Payer: BCN Commercial |
$47.84
|
| Rate for Payer: BCN Medicare Advantage |
$16.53
|
| Rate for Payer: Cash Price |
$49.36
|
| Rate for Payer: Cash Price |
$49.36
|
| Rate for Payer: Cofinity Commercial |
$58.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.53
|
| Rate for Payer: Healthscope Commercial |
$61.70
|
| Rate for Payer: Healthscope Whirlpool |
$59.85
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.53
|
| Rate for Payer: Mclaren Commercial |
$55.53
|
| Rate for Payer: Mclaren Medicaid |
$8.86
|
| 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 |
$9.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.45
|
| Rate for Payer: Nomi Health Commercial |
$50.59
|
| 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 |
$8.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$54.06
|
| Rate for Payer: Priority Health Medicare |
$16.53
|
| Rate for Payer: Priority Health Narrow Network |
$43.25
|
| Rate for Payer: Railroad Medicare Medicare |
$16.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$54.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.53
|
| Rate for Payer: UHC Exchange |
$25.62
|
| Rate for Payer: UHC Medicare Advantage |
$16.53
|
| Rate for Payer: UHCCP DNSP |
$16.53
|
| Rate for Payer: UHCCP Medicaid |
$8.86
|
| Rate for Payer: VA VA |
$16.53
|
|
|
HC RAVAS CTO/DES
|
Facility
|
IP
|
$29,673.35
|
|
|
Service Code
|
CPT C9607
|
| Hospital Charge Code |
48100088
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$19,287.68 |
| Max. Negotiated Rate |
$29,673.35 |
| Rate for Payer: Aetna Commercial |
$26,706.01
|
| Rate for Payer: ASR ASR |
$28,783.15
|
| Rate for Payer: ASR Commercial |
$28,783.15
|
| Rate for Payer: BCBS Trust/PPO |
$24,180.81
|
| Rate for Payer: BCN Commercial |
$23,005.75
|
| Rate for Payer: Cash Price |
$23,738.68
|
| Rate for Payer: Cofinity Commercial |
$27,892.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,738.68
|
| Rate for Payer: Healthscope Commercial |
$29,673.35
|
| Rate for Payer: Healthscope Whirlpool |
$28,783.15
|
| Rate for Payer: Mclaren Commercial |
$26,706.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,222.35
|
| Rate for Payer: Nomi Health Commercial |
$24,332.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19,287.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26,112.55
|
|
|
HC RAVAS CTO/DES
|
Facility
|
OP
|
$29,673.35
|
|
|
Service Code
|
CPT C9607
|
| Hospital Charge Code |
48100088
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$9,386.88 |
| Max. Negotiated Rate |
$29,673.35 |
| Rate for Payer: Aetna Commercial |
$26,706.01
|
| Rate for Payer: Aetna Medicare |
$17,512.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21,891.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21,891.04
|
| Rate for Payer: ASR ASR |
$28,783.15
|
| Rate for Payer: ASR Commercial |
$28,783.15
|
| Rate for Payer: BCBS Complete |
$9,856.22
|
| Rate for Payer: BCBS MAPPO |
$17,512.83
|
| Rate for Payer: BCBS Trust/PPO |
$24,299.51
|
| Rate for Payer: BCN Commercial |
$23,005.75
|
| Rate for Payer: BCN Medicare Advantage |
$17,512.83
|
| Rate for Payer: Cash Price |
$23,738.68
|
| Rate for Payer: Cash Price |
$23,738.68
|
| Rate for Payer: Cofinity Commercial |
$27,892.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,738.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,512.83
|
| Rate for Payer: Healthscope Commercial |
$29,673.35
|
| Rate for Payer: Healthscope Whirlpool |
$28,783.15
|
| Rate for Payer: Humana Choice PPO Medicare |
$17,512.83
|
| Rate for Payer: Mclaren Commercial |
$26,706.01
|
| Rate for Payer: Mclaren Medicaid |
$9,386.88
|
| Rate for Payer: Mclaren Medicare |
$17,512.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18,388.47
|
| Rate for Payer: Meridian Medicaid |
$9,856.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20,139.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,222.35
|
| Rate for Payer: Nomi Health Commercial |
$24,332.15
|
| Rate for Payer: PACE Medicare |
$16,637.19
|
| Rate for Payer: PACE SWMI |
$17,512.83
|
| Rate for Payer: PHP Commercial |
$19,264.11
|
| Rate for Payer: PHP Medicaid |
$9,386.88
|
| Rate for Payer: PHP Medicare Advantage |
$17,512.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,386.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19,287.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25,999.79
|
| Rate for Payer: Priority Health Medicare |
$17,512.83
|
| Rate for Payer: Priority Health Narrow Network |
$20,801.02
|
| Rate for Payer: Railroad Medicare Medicare |
$17,512.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26,112.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$17,512.83
|
| Rate for Payer: UHC Exchange |
$27,144.89
|
| Rate for Payer: UHC Medicare Advantage |
$17,512.83
|
| Rate for Payer: UHCCP DNSP |
$17,512.83
|
| Rate for Payer: UHCCP Medicaid |
$9,386.88
|
| Rate for Payer: VA VA |
$17,512.83
|
|
|
HC RAVAS CTO/STENT
|
Facility
|
IP
|
$29,673.35
|
|
|
Service Code
|
CPT 92943
|
| Hospital Charge Code |
48100087
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$19,287.68 |
| Max. Negotiated Rate |
$29,673.35 |
| Rate for Payer: Aetna Commercial |
$26,706.01
|
| Rate for Payer: ASR ASR |
$28,783.15
|
| Rate for Payer: ASR Commercial |
$28,783.15
|
| Rate for Payer: BCBS Trust/PPO |
$24,180.81
|
| Rate for Payer: BCN Commercial |
$23,005.75
|
| Rate for Payer: Cash Price |
$23,738.68
|
| Rate for Payer: Cofinity Commercial |
$27,892.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,738.68
|
| Rate for Payer: Healthscope Commercial |
$29,673.35
|
| Rate for Payer: Healthscope Whirlpool |
$28,783.15
|
| Rate for Payer: Mclaren Commercial |
$26,706.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,222.35
|
| Rate for Payer: Nomi Health Commercial |
$24,332.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19,287.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26,112.55
|
|
|
HC RAVAS CTO/STENT
|
Facility
|
OP
|
$29,673.35
|
|
|
Service Code
|
CPT 92943
|
| Hospital Charge Code |
48100087
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,928.28 |
| Max. Negotiated Rate |
$29,673.35 |
| Rate for Payer: Aetna Commercial |
$26,706.01
|
| Rate for Payer: Aetna Medicare |
$11,060.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,825.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,825.29
|
| Rate for Payer: ASR ASR |
$28,783.15
|
| Rate for Payer: ASR Commercial |
$28,783.15
|
| Rate for Payer: BCBS Complete |
$6,224.70
|
| Rate for Payer: BCBS MAPPO |
$11,060.23
|
| Rate for Payer: BCBS Trust/PPO |
$24,299.51
|
| Rate for Payer: BCN Commercial |
$23,005.75
|
| Rate for Payer: BCN Medicare Advantage |
$11,060.23
|
| Rate for Payer: Cash Price |
$23,738.68
|
| Rate for Payer: Cash Price |
$23,738.68
|
| Rate for Payer: Cofinity Commercial |
$27,892.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,738.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,060.23
|
| Rate for Payer: Healthscope Commercial |
$29,673.35
|
| Rate for Payer: Healthscope Whirlpool |
$28,783.15
|
| Rate for Payer: Humana Choice PPO Medicare |
$11,060.23
|
| Rate for Payer: Mclaren Commercial |
$26,706.01
|
| Rate for Payer: Mclaren Medicaid |
$5,928.28
|
| Rate for Payer: Mclaren Medicare |
$11,060.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,613.24
|
| Rate for Payer: Meridian Medicaid |
$6,224.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,719.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,222.35
|
| Rate for Payer: Nomi Health Commercial |
$24,332.15
|
| Rate for Payer: PACE Medicare |
$10,507.22
|
| Rate for Payer: PACE SWMI |
$11,060.23
|
| Rate for Payer: PHP Commercial |
$12,166.25
|
| Rate for Payer: PHP Medicaid |
$5,928.28
|
| Rate for Payer: PHP Medicare Advantage |
$11,060.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,928.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19,287.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25,999.79
|
| Rate for Payer: Priority Health Medicare |
$11,060.23
|
| Rate for Payer: Priority Health Narrow Network |
$20,801.02
|
| Rate for Payer: Railroad Medicare Medicare |
$11,060.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26,112.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,060.23
|
| Rate for Payer: UHC Exchange |
$17,143.36
|
| Rate for Payer: UHC Medicare Advantage |
$11,060.23
|
| Rate for Payer: UHCCP DNSP |
$11,060.23
|
| Rate for Payer: UHCCP Medicaid |
$5,928.28
|
| Rate for Payer: VA VA |
$11,060.23
|
|
|
HC RBC LEUKO REDUCED
|
Facility
|
OP
|
$725.60
|
|
|
Service Code
|
HCPCS P9016
|
| Hospital Charge Code |
39000059
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$95.14 |
| Max. Negotiated Rate |
$725.60 |
| Rate for Payer: Aetna Commercial |
$653.04
|
| Rate for Payer: Aetna Medicare |
$177.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$221.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$221.88
|
| Rate for Payer: ASR ASR |
$703.83
|
| Rate for Payer: ASR Commercial |
$703.83
|
| Rate for Payer: BCBS Complete |
$99.90
|
| Rate for Payer: BCBS MAPPO |
$177.50
|
| Rate for Payer: BCBS Trust/PPO |
$594.19
|
| Rate for Payer: BCN Commercial |
$562.56
|
| Rate for Payer: BCN Medicare Advantage |
$177.50
|
| Rate for Payer: Cash Price |
$580.48
|
| Rate for Payer: Cash Price |
$580.48
|
| Rate for Payer: Cofinity Commercial |
$682.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$580.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.50
|
| Rate for Payer: Healthscope Commercial |
$725.60
|
| Rate for Payer: Healthscope Whirlpool |
$703.83
|
| Rate for Payer: Humana Choice PPO Medicare |
$177.50
|
| Rate for Payer: Mclaren Commercial |
$653.04
|
| Rate for Payer: Mclaren Medicaid |
$95.14
|
| Rate for Payer: Mclaren Medicare |
$177.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$186.38
|
| Rate for Payer: Meridian Medicaid |
$99.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$204.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$616.76
|
| Rate for Payer: Nomi Health Commercial |
$594.99
|
| Rate for Payer: PACE Medicare |
$168.62
|
| Rate for Payer: PACE SWMI |
$177.50
|
| Rate for Payer: PHP Commercial |
$195.25
|
| Rate for Payer: PHP Medicaid |
$95.14
|
| Rate for Payer: PHP Medicare Advantage |
$177.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$95.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$471.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$635.77
|
| Rate for Payer: Priority Health Medicare |
$177.50
|
| Rate for Payer: Priority Health Narrow Network |
$508.65
|
| Rate for Payer: Railroad Medicare Medicare |
$177.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$638.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$177.50
|
| Rate for Payer: UHC Exchange |
$275.12
|
| Rate for Payer: UHC Medicare Advantage |
$177.50
|
| Rate for Payer: UHCCP DNSP |
$177.50
|
| Rate for Payer: UHCCP Medicaid |
$95.14
|
| Rate for Payer: VA VA |
$177.50
|
|
|
HC RBC LEUKO REDUCED
|
Facility
|
IP
|
$725.60
|
|
|
Service Code
|
HCPCS P9016
|
| Hospital Charge Code |
39000059
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$471.64 |
| Max. Negotiated Rate |
$725.60 |
| Rate for Payer: Aetna Commercial |
$653.04
|
| Rate for Payer: ASR ASR |
$703.83
|
| Rate for Payer: ASR Commercial |
$703.83
|
| Rate for Payer: BCBS Trust/PPO |
$591.29
|
| Rate for Payer: BCN Commercial |
$562.56
|
| Rate for Payer: Cash Price |
$580.48
|
| Rate for Payer: Cofinity Commercial |
$682.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$580.48
|
| Rate for Payer: Healthscope Commercial |
$725.60
|
| Rate for Payer: Healthscope Whirlpool |
$703.83
|
| Rate for Payer: Mclaren Commercial |
$653.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$616.76
|
| Rate for Payer: Nomi Health Commercial |
$594.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$471.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$638.53
|
|
|
HC RBC LEUKO REDUCED IRRAD
|
Facility
|
IP
|
$1,257.09
|
|
|
Service Code
|
HCPCS P9040
|
| Hospital Charge Code |
39000072
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$817.11 |
| Max. Negotiated Rate |
$1,257.09 |
| Rate for Payer: Aetna Commercial |
$1,131.38
|
| Rate for Payer: ASR ASR |
$1,219.38
|
| Rate for Payer: ASR Commercial |
$1,219.38
|
| Rate for Payer: BCBS Trust/PPO |
$1,024.40
|
| Rate for Payer: BCN Commercial |
$974.62
|
| Rate for Payer: Cash Price |
$1,005.67
|
| Rate for Payer: Cofinity Commercial |
$1,181.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,005.67
|
| Rate for Payer: Healthscope Commercial |
$1,257.09
|
| Rate for Payer: Healthscope Whirlpool |
$1,219.38
|
| Rate for Payer: Mclaren Commercial |
$1,131.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,068.53
|
| Rate for Payer: Nomi Health Commercial |
$1,030.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$817.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,106.24
|
|
|
HC RBC LEUKO REDUCED IRRAD
|
Facility
|
OP
|
$1,257.09
|
|
|
Service Code
|
HCPCS P9040
|
| Hospital Charge Code |
39000072
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$133.72 |
| Max. Negotiated Rate |
$1,257.09 |
| Rate for Payer: Aetna Commercial |
$1,131.38
|
| Rate for Payer: Aetna Medicare |
$249.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$311.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$311.85
|
| Rate for Payer: ASR ASR |
$1,219.38
|
| Rate for Payer: ASR Commercial |
$1,219.38
|
| Rate for Payer: BCBS Complete |
$140.41
|
| Rate for Payer: BCBS MAPPO |
$249.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,029.43
|
| Rate for Payer: BCN Commercial |
$974.62
|
| Rate for Payer: BCN Medicare Advantage |
$249.48
|
| Rate for Payer: Cash Price |
$1,005.67
|
| Rate for Payer: Cash Price |
$1,005.67
|
| Rate for Payer: Cofinity Commercial |
$1,181.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,005.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$249.48
|
| Rate for Payer: Healthscope Commercial |
$1,257.09
|
| Rate for Payer: Healthscope Whirlpool |
$1,219.38
|
| Rate for Payer: Humana Choice PPO Medicare |
$249.48
|
| Rate for Payer: Mclaren Commercial |
$1,131.38
|
| Rate for Payer: Mclaren Medicaid |
$133.72
|
| Rate for Payer: Mclaren Medicare |
$249.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$261.95
|
| Rate for Payer: Meridian Medicaid |
$140.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$286.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,068.53
|
| Rate for Payer: Nomi Health Commercial |
$1,030.81
|
| Rate for Payer: PACE Medicare |
$237.01
|
| Rate for Payer: PACE SWMI |
$249.48
|
| Rate for Payer: PHP Commercial |
$274.43
|
| Rate for Payer: PHP Medicaid |
$133.72
|
| Rate for Payer: PHP Medicare Advantage |
$249.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$133.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$817.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,101.46
|
| Rate for Payer: Priority Health Medicare |
$249.48
|
| Rate for Payer: Priority Health Narrow Network |
$881.22
|
| Rate for Payer: Railroad Medicare Medicare |
$249.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,106.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$249.48
|
| Rate for Payer: UHC Exchange |
$386.69
|
| Rate for Payer: UHC Medicare Advantage |
$249.48
|
| Rate for Payer: UHCCP DNSP |
$249.48
|
| Rate for Payer: UHCCP Medicaid |
$133.72
|
| Rate for Payer: VA VA |
$249.48
|
|
|
HC RECEPTOR ASSAY OTHER ENDOCRINE
|
Facility
|
IP
|
$203.97
|
|
|
Service Code
|
CPT 84235
|
| Hospital Charge Code |
30100418
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$132.58 |
| Max. Negotiated Rate |
$203.97 |
| Rate for Payer: Aetna Commercial |
$183.57
|
| Rate for Payer: ASR ASR |
$197.85
|
| Rate for Payer: ASR Commercial |
$197.85
|
| Rate for Payer: BCBS Trust/PPO |
$166.22
|
| Rate for Payer: BCN Commercial |
$158.14
|
| Rate for Payer: Cash Price |
$163.18
|
| Rate for Payer: Cofinity Commercial |
$191.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.18
|
| Rate for Payer: Healthscope Commercial |
$203.97
|
| Rate for Payer: Healthscope Whirlpool |
$197.85
|
| Rate for Payer: Mclaren Commercial |
$183.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$173.37
|
| Rate for Payer: Nomi Health Commercial |
$167.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$132.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$179.49
|
|
|
HC RECEPTOR ASSAY OTHER ENDOCRINE
|
Facility
|
OP
|
$203.97
|
|
|
Service Code
|
CPT 84235
|
| Hospital Charge Code |
30100418
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$38.18 |
| Max. Negotiated Rate |
$203.97 |
| Rate for Payer: Aetna Commercial |
$183.57
|
| 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 |
$197.85
|
| Rate for Payer: ASR Commercial |
$197.85
|
| Rate for Payer: BCBS Complete |
$40.09
|
| Rate for Payer: BCBS MAPPO |
$71.23
|
| Rate for Payer: BCBS Trust/PPO |
$167.03
|
| Rate for Payer: BCN Commercial |
$158.14
|
| Rate for Payer: BCN Medicare Advantage |
$71.23
|
| Rate for Payer: Cash Price |
$163.18
|
| Rate for Payer: Cash Price |
$163.18
|
| Rate for Payer: Cofinity Commercial |
$191.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.23
|
| Rate for Payer: Healthscope Commercial |
$203.97
|
| Rate for Payer: Healthscope Whirlpool |
$197.85
|
| Rate for Payer: Humana Choice PPO Medicare |
$71.23
|
| Rate for Payer: Mclaren Commercial |
$183.57
|
| Rate for Payer: Mclaren Medicaid |
$38.18
|
| 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 |
$40.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$81.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$173.37
|
| Rate for Payer: Nomi Health Commercial |
$167.26
|
| 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 |
$38.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$132.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$178.72
|
| Rate for Payer: Priority Health Medicare |
$71.23
|
| Rate for Payer: Priority Health Narrow Network |
$142.98
|
| Rate for Payer: Railroad Medicare Medicare |
$71.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$179.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$71.23
|
| Rate for Payer: UHC Exchange |
$110.41
|
| Rate for Payer: UHC Medicare Advantage |
$71.23
|
| Rate for Payer: UHCCP DNSP |
$71.23
|
| Rate for Payer: UHCCP Medicaid |
$38.18
|
| Rate for Payer: VA VA |
$71.23
|
|
|
HC RECOVERY 1 ADD'L 15 MIN
|
Facility
|
IP
|
$157.01
|
|
| Hospital Charge Code |
71000020
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$102.06 |
| Max. Negotiated Rate |
$157.01 |
| Rate for Payer: Aetna Commercial |
$141.31
|
| Rate for Payer: ASR ASR |
$152.30
|
| Rate for Payer: ASR Commercial |
$152.30
|
| Rate for Payer: BCBS Trust/PPO |
$127.95
|
| Rate for Payer: BCN Commercial |
$121.73
|
| Rate for Payer: Cash Price |
$125.61
|
| Rate for Payer: Cofinity Commercial |
$147.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$125.61
|
| Rate for Payer: Healthscope Commercial |
$157.01
|
| Rate for Payer: Healthscope Whirlpool |
$152.30
|
| Rate for Payer: Mclaren Commercial |
$141.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$133.46
|
| Rate for Payer: Nomi Health Commercial |
$128.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$138.17
|
|
|
HC RECOVERY 1 ADD'L 15 MIN
|
Facility
|
OP
|
$157.01
|
|
| Hospital Charge Code |
71000020
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$62.80 |
| Max. Negotiated Rate |
$157.01 |
| Rate for Payer: Aetna Commercial |
$141.31
|
| Rate for Payer: Aetna Medicare |
$78.50
|
| Rate for Payer: ASR ASR |
$152.30
|
| Rate for Payer: ASR Commercial |
$152.30
|
| Rate for Payer: BCBS Complete |
$62.80
|
| Rate for Payer: BCBS Trust/PPO |
$128.58
|
| Rate for Payer: BCN Commercial |
$121.73
|
| Rate for Payer: Cash Price |
$125.61
|
| Rate for Payer: Cofinity Commercial |
$147.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$125.61
|
| Rate for Payer: Healthscope Commercial |
$157.01
|
| Rate for Payer: Healthscope Whirlpool |
$152.30
|
| Rate for Payer: Mclaren Commercial |
$141.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$133.46
|
| Rate for Payer: Nomi Health Commercial |
$128.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$137.57
|
| Rate for Payer: Priority Health Narrow Network |
$110.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$138.17
|
|
|
HC RECOVERY 1 INIT 30 MIN
|
Facility
|
OP
|
$370.68
|
|
| Hospital Charge Code |
71000021
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$148.27 |
| Max. Negotiated Rate |
$370.68 |
| Rate for Payer: Aetna Commercial |
$333.61
|
| Rate for Payer: Aetna Medicare |
$185.34
|
| Rate for Payer: ASR ASR |
$359.56
|
| Rate for Payer: ASR Commercial |
$359.56
|
| Rate for Payer: BCBS Complete |
$148.27
|
| Rate for Payer: BCBS Trust/PPO |
$303.55
|
| Rate for Payer: BCN Commercial |
$287.39
|
| Rate for Payer: Cash Price |
$296.54
|
| Rate for Payer: Cofinity Commercial |
$348.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$296.54
|
| Rate for Payer: Healthscope Commercial |
$370.68
|
| Rate for Payer: Healthscope Whirlpool |
$359.56
|
| Rate for Payer: Mclaren Commercial |
$333.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$315.08
|
| Rate for Payer: Nomi Health Commercial |
$303.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$240.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$324.79
|
| Rate for Payer: Priority Health Narrow Network |
$259.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$326.20
|
|
|
HC RECOVERY 1 INIT 30 MIN
|
Facility
|
IP
|
$370.68
|
|
| Hospital Charge Code |
71000021
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$240.94 |
| Max. Negotiated Rate |
$370.68 |
| Rate for Payer: Aetna Commercial |
$333.61
|
| Rate for Payer: ASR ASR |
$359.56
|
| Rate for Payer: ASR Commercial |
$359.56
|
| Rate for Payer: BCBS Trust/PPO |
$302.07
|
| Rate for Payer: BCN Commercial |
$287.39
|
| Rate for Payer: Cash Price |
$296.54
|
| Rate for Payer: Cofinity Commercial |
$348.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$296.54
|
| Rate for Payer: Healthscope Commercial |
$370.68
|
| Rate for Payer: Healthscope Whirlpool |
$359.56
|
| Rate for Payer: Mclaren Commercial |
$333.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$315.08
|
| Rate for Payer: Nomi Health Commercial |
$303.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$240.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$326.20
|
|
|
HC RECOVERY 2 ADD'L 15 MIN
|
Facility
|
OP
|
$183.83
|
|
| Hospital Charge Code |
71000022
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$73.53 |
| Max. Negotiated Rate |
$183.83 |
| Rate for Payer: Aetna Commercial |
$165.45
|
| Rate for Payer: Aetna Medicare |
$91.92
|
| Rate for Payer: ASR ASR |
$178.32
|
| Rate for Payer: ASR Commercial |
$178.32
|
| Rate for Payer: BCBS Complete |
$73.53
|
| Rate for Payer: BCBS Trust/PPO |
$150.54
|
| Rate for Payer: BCN Commercial |
$142.52
|
| Rate for Payer: Cash Price |
$147.06
|
| Rate for Payer: Cofinity Commercial |
$172.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$147.06
|
| Rate for Payer: Healthscope Commercial |
$183.83
|
| Rate for Payer: Healthscope Whirlpool |
$178.32
|
| Rate for Payer: Mclaren Commercial |
$165.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$156.26
|
| Rate for Payer: Nomi Health Commercial |
$150.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$119.49
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$161.07
|
| Rate for Payer: Priority Health Narrow Network |
$128.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$161.77
|
|
|
HC RECOVERY 2 ADD'L 15 MIN
|
Facility
|
IP
|
$183.83
|
|
| Hospital Charge Code |
71000022
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$119.49 |
| Max. Negotiated Rate |
$183.83 |
| Rate for Payer: Aetna Commercial |
$165.45
|
| Rate for Payer: ASR ASR |
$178.32
|
| Rate for Payer: ASR Commercial |
$178.32
|
| Rate for Payer: BCBS Trust/PPO |
$149.80
|
| Rate for Payer: BCN Commercial |
$142.52
|
| Rate for Payer: Cash Price |
$147.06
|
| Rate for Payer: Cofinity Commercial |
$172.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$147.06
|
| Rate for Payer: Healthscope Commercial |
$183.83
|
| Rate for Payer: Healthscope Whirlpool |
$178.32
|
| Rate for Payer: Mclaren Commercial |
$165.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$156.26
|
| Rate for Payer: Nomi Health Commercial |
$150.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$119.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$161.77
|
|
|
HC RECOVERY 2 INIT 30 MIN
|
Facility
|
OP
|
$331.57
|
|
| Hospital Charge Code |
71000023
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$132.63 |
| Max. Negotiated Rate |
$331.57 |
| Rate for Payer: Aetna Commercial |
$298.41
|
| Rate for Payer: Aetna Medicare |
$165.78
|
| Rate for Payer: ASR ASR |
$321.62
|
| Rate for Payer: ASR Commercial |
$321.62
|
| Rate for Payer: BCBS Complete |
$132.63
|
| Rate for Payer: BCBS Trust/PPO |
$271.52
|
| Rate for Payer: BCN Commercial |
$257.07
|
| Rate for Payer: Cash Price |
$265.26
|
| Rate for Payer: Cofinity Commercial |
$311.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$265.26
|
| Rate for Payer: Healthscope Commercial |
$331.57
|
| Rate for Payer: Healthscope Whirlpool |
$321.62
|
| Rate for Payer: Mclaren Commercial |
$298.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$281.83
|
| Rate for Payer: Nomi Health Commercial |
$271.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$215.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$290.52
|
| Rate for Payer: Priority Health Narrow Network |
$232.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$291.78
|
|
