|
HC REDUCER W/LL ASY 1/4 X 3/8
|
Facility
|
IP
|
$9.18
|
|
| Hospital Charge Code |
27000679
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$5.97 |
| Max. Negotiated Rate |
$9.18 |
| Rate for Payer: Aetna Commercial |
$8.26
|
| Rate for Payer: ASR ASR |
$8.90
|
| Rate for Payer: ASR Commercial |
$8.90
|
| Rate for Payer: BCBS Trust/PPO |
$7.48
|
| Rate for Payer: BCN Commercial |
$7.12
|
| Rate for Payer: Cash Price |
$7.34
|
| Rate for Payer: Cofinity Commercial |
$8.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.34
|
| Rate for Payer: Healthscope Commercial |
$9.18
|
| Rate for Payer: Healthscope Whirlpool |
$8.90
|
| Rate for Payer: Mclaren Commercial |
$8.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.80
|
| Rate for Payer: Nomi Health Commercial |
$7.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8.08
|
|
|
HC REDUCER W/LL ASY 1/4 X 3/8
|
Facility
|
OP
|
$9.18
|
|
| Hospital Charge Code |
27000679
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.67 |
| Max. Negotiated Rate |
$9.18 |
| Rate for Payer: Aetna Commercial |
$8.26
|
| Rate for Payer: Aetna Medicare |
$4.59
|
| Rate for Payer: ASR ASR |
$8.90
|
| Rate for Payer: ASR Commercial |
$8.90
|
| Rate for Payer: BCBS Complete |
$3.67
|
| Rate for Payer: BCBS Trust/PPO |
$7.52
|
| Rate for Payer: BCN Commercial |
$7.12
|
| Rate for Payer: Cash Price |
$7.34
|
| Rate for Payer: Cofinity Commercial |
$8.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.34
|
| Rate for Payer: Healthscope Commercial |
$9.18
|
| Rate for Payer: Healthscope Whirlpool |
$8.90
|
| Rate for Payer: Mclaren Commercial |
$8.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.80
|
| Rate for Payer: Nomi Health Commercial |
$7.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8.04
|
| Rate for Payer: Priority Health Narrow Network |
$6.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8.08
|
|
|
HC REFILL AND MAINTENANCE OF IMPLANTED PUMP
|
Facility
|
OP
|
$438.65
|
|
|
Service Code
|
HCPCS 96522
|
| Hospital Charge Code |
33500009
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$110.14 |
| Max. Negotiated Rate |
$438.65 |
| Rate for Payer: Aetna Commercial |
$394.79
|
| Rate for Payer: Aetna Medicare |
$205.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$256.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$256.85
|
| Rate for Payer: ASR ASR |
$425.49
|
| Rate for Payer: ASR Commercial |
$425.49
|
| Rate for Payer: BCBS Complete |
$115.64
|
| Rate for Payer: BCBS MAPPO |
$205.48
|
| Rate for Payer: BCBS Trust/PPO |
$359.21
|
| Rate for Payer: BCN Commercial |
$340.09
|
| Rate for Payer: BCN Medicare Advantage |
$205.48
|
| Rate for Payer: Cash Price |
$350.92
|
| Rate for Payer: Cash Price |
$350.92
|
| Rate for Payer: Cofinity Commercial |
$412.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$205.48
|
| Rate for Payer: Healthscope Commercial |
$438.65
|
| Rate for Payer: Healthscope Whirlpool |
$425.49
|
| Rate for Payer: Humana Choice PPO Medicare |
$205.48
|
| Rate for Payer: Mclaren Commercial |
$394.79
|
| Rate for Payer: Mclaren Medicaid |
$110.14
|
| Rate for Payer: Mclaren Medicare |
$205.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$215.75
|
| Rate for Payer: Meridian Medicaid |
$115.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$236.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$372.85
|
| Rate for Payer: Nomi Health Commercial |
$359.69
|
| Rate for Payer: PACE Medicare |
$195.21
|
| Rate for Payer: PACE SWMI |
$205.48
|
| Rate for Payer: PHP Commercial |
$226.03
|
| Rate for Payer: PHP Medicaid |
$110.14
|
| Rate for Payer: PHP Medicare Advantage |
$205.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$110.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$285.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$384.35
|
| Rate for Payer: Priority Health Medicare |
$205.48
|
| Rate for Payer: Priority Health Narrow Network |
$307.49
|
| Rate for Payer: Railroad Medicare Medicare |
$205.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$386.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$205.48
|
| Rate for Payer: UHC Exchange |
$318.49
|
| Rate for Payer: UHC Medicare Advantage |
$205.48
|
| Rate for Payer: UHCCP DNSP |
$205.48
|
| Rate for Payer: UHCCP Medicaid |
$110.14
|
| Rate for Payer: VA VA |
$205.48
|
|
|
HC REFILL AND MAINTENANCE OF IMPLANTED PUMP
|
Facility
|
IP
|
$438.65
|
|
|
Service Code
|
HCPCS 96522
|
| Hospital Charge Code |
33500009
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$285.12 |
| Max. Negotiated Rate |
$438.65 |
| Rate for Payer: Aetna Commercial |
$394.79
|
| Rate for Payer: ASR ASR |
$425.49
|
| Rate for Payer: ASR Commercial |
$425.49
|
| Rate for Payer: BCBS Trust/PPO |
$357.46
|
| Rate for Payer: BCN Commercial |
$340.09
|
| Rate for Payer: Cash Price |
$350.92
|
| Rate for Payer: Cofinity Commercial |
$412.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.92
|
| Rate for Payer: Healthscope Commercial |
$438.65
|
| Rate for Payer: Healthscope Whirlpool |
$425.49
|
| Rate for Payer: Mclaren Commercial |
$394.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$372.85
|
| Rate for Payer: Nomi Health Commercial |
$359.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$285.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$386.01
|
|
|
HC REFILL AND MAINTENANCE OF PORT PUMP
|
Facility
|
OP
|
$881.99
|
|
|
Service Code
|
CPT 96521
|
| Hospital Charge Code |
33500008
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$110.14 |
| Max. Negotiated Rate |
$881.99 |
| Rate for Payer: Aetna Commercial |
$793.79
|
| Rate for Payer: Aetna Medicare |
$205.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$256.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$256.85
|
| Rate for Payer: ASR ASR |
$855.53
|
| Rate for Payer: ASR Commercial |
$855.53
|
| Rate for Payer: BCBS Complete |
$115.64
|
| Rate for Payer: BCBS MAPPO |
$205.48
|
| Rate for Payer: BCBS Trust/PPO |
$722.26
|
| Rate for Payer: BCN Commercial |
$683.81
|
| Rate for Payer: BCN Medicare Advantage |
$205.48
|
| Rate for Payer: Cash Price |
$705.59
|
| Rate for Payer: Cash Price |
$705.59
|
| Rate for Payer: Cofinity Commercial |
$829.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$705.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$205.48
|
| Rate for Payer: Healthscope Commercial |
$881.99
|
| Rate for Payer: Healthscope Whirlpool |
$855.53
|
| Rate for Payer: Humana Choice PPO Medicare |
$205.48
|
| Rate for Payer: Mclaren Commercial |
$793.79
|
| Rate for Payer: Mclaren Medicaid |
$110.14
|
| Rate for Payer: Mclaren Medicare |
$205.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$215.75
|
| Rate for Payer: Meridian Medicaid |
$115.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$236.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$749.69
|
| Rate for Payer: Nomi Health Commercial |
$723.23
|
| Rate for Payer: PACE Medicare |
$195.21
|
| Rate for Payer: PACE SWMI |
$205.48
|
| Rate for Payer: PHP Commercial |
$226.03
|
| Rate for Payer: PHP Medicaid |
$110.14
|
| Rate for Payer: PHP Medicare Advantage |
$205.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$110.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$573.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$772.80
|
| Rate for Payer: Priority Health Medicare |
$205.48
|
| Rate for Payer: Priority Health Narrow Network |
$618.27
|
| Rate for Payer: Railroad Medicare Medicare |
$205.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$776.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$205.48
|
| Rate for Payer: UHC Exchange |
$318.49
|
| Rate for Payer: UHC Medicare Advantage |
$205.48
|
| Rate for Payer: UHCCP DNSP |
$205.48
|
| Rate for Payer: UHCCP Medicaid |
$110.14
|
| Rate for Payer: VA VA |
$205.48
|
|
|
HC REFILL AND MAINTENANCE OF PORT PUMP
|
Facility
|
IP
|
$881.99
|
|
|
Service Code
|
CPT 96521
|
| Hospital Charge Code |
33500008
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$573.29 |
| Max. Negotiated Rate |
$881.99 |
| Rate for Payer: Aetna Commercial |
$793.79
|
| Rate for Payer: ASR ASR |
$855.53
|
| Rate for Payer: ASR Commercial |
$855.53
|
| Rate for Payer: BCBS Trust/PPO |
$718.73
|
| Rate for Payer: BCN Commercial |
$683.81
|
| Rate for Payer: Cash Price |
$705.59
|
| Rate for Payer: Cofinity Commercial |
$829.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$705.59
|
| Rate for Payer: Healthscope Commercial |
$881.99
|
| Rate for Payer: Healthscope Whirlpool |
$855.53
|
| Rate for Payer: Mclaren Commercial |
$793.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$749.69
|
| Rate for Payer: Nomi Health Commercial |
$723.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$573.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$776.15
|
|
|
HC REFILL AND REPROGRAM INTRATHECAL INF PUMP
|
Facility
|
OP
|
$421.57
|
|
|
Service Code
|
CPT 62370
|
| Hospital Charge Code |
36100587
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$156.78 |
| Max. Negotiated Rate |
$453.38 |
| Rate for Payer: Aetna Commercial |
$379.41
|
| Rate for Payer: Aetna Medicare |
$292.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$365.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$365.62
|
| Rate for Payer: ASR ASR |
$408.92
|
| Rate for Payer: ASR Commercial |
$408.92
|
| Rate for Payer: BCBS Complete |
$164.62
|
| Rate for Payer: BCBS MAPPO |
$292.50
|
| Rate for Payer: BCBS Trust/PPO |
$345.22
|
| Rate for Payer: BCN Commercial |
$326.84
|
| Rate for Payer: BCN Medicare Advantage |
$292.50
|
| Rate for Payer: Cash Price |
$337.26
|
| Rate for Payer: Cash Price |
$337.26
|
| Rate for Payer: Cofinity Commercial |
$396.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$337.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$292.50
|
| Rate for Payer: Healthscope Commercial |
$421.57
|
| Rate for Payer: Healthscope Whirlpool |
$408.92
|
| Rate for Payer: Humana Choice PPO Medicare |
$292.50
|
| Rate for Payer: Mclaren Commercial |
$379.41
|
| Rate for Payer: Mclaren Medicaid |
$156.78
|
| Rate for Payer: Mclaren Medicare |
$292.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$307.12
|
| Rate for Payer: Meridian Medicaid |
$164.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$336.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$358.33
|
| Rate for Payer: Nomi Health Commercial |
$345.69
|
| Rate for Payer: PACE Medicare |
$277.88
|
| Rate for Payer: PACE SWMI |
$292.50
|
| Rate for Payer: PHP Commercial |
$321.75
|
| Rate for Payer: PHP Medicaid |
$156.78
|
| Rate for Payer: PHP Medicare Advantage |
$292.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$156.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$274.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$369.38
|
| Rate for Payer: Priority Health Medicare |
$292.50
|
| Rate for Payer: Priority Health Narrow Network |
$295.52
|
| Rate for Payer: Railroad Medicare Medicare |
$292.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$370.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$292.50
|
| Rate for Payer: UHC Exchange |
$453.38
|
| Rate for Payer: UHC Medicare Advantage |
$292.50
|
| Rate for Payer: UHCCP DNSP |
$292.50
|
| Rate for Payer: UHCCP Medicaid |
$156.78
|
| Rate for Payer: VA VA |
$292.50
|
|
|
HC REFILL AND REPROGRAM INTRATHECAL INF PUMP
|
Facility
|
IP
|
$421.57
|
|
|
Service Code
|
CPT 62370
|
| Hospital Charge Code |
36100587
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$274.02 |
| Max. Negotiated Rate |
$421.57 |
| Rate for Payer: Aetna Commercial |
$379.41
|
| Rate for Payer: ASR ASR |
$408.92
|
| Rate for Payer: ASR Commercial |
$408.92
|
| Rate for Payer: BCBS Trust/PPO |
$343.54
|
| Rate for Payer: BCN Commercial |
$326.84
|
| Rate for Payer: Cash Price |
$337.26
|
| Rate for Payer: Cofinity Commercial |
$396.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$337.26
|
| Rate for Payer: Healthscope Commercial |
$421.57
|
| Rate for Payer: Healthscope Whirlpool |
$408.92
|
| Rate for Payer: Mclaren Commercial |
$379.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$358.33
|
| Rate for Payer: Nomi Health Commercial |
$345.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$274.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$370.98
|
|
|
HC REFLEX BETHESDA UNITS
|
Facility
|
IP
|
$155.02
|
|
|
Service Code
|
CPT 85335
|
| Hospital Charge Code |
30500042
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$100.76 |
| Max. Negotiated Rate |
$155.02 |
| Rate for Payer: Aetna Commercial |
$139.52
|
| Rate for Payer: ASR ASR |
$150.37
|
| Rate for Payer: ASR Commercial |
$150.37
|
| Rate for Payer: BCBS Trust/PPO |
$126.33
|
| Rate for Payer: BCN Commercial |
$120.19
|
| Rate for Payer: Cash Price |
$124.02
|
| Rate for Payer: Cofinity Commercial |
$145.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.02
|
| Rate for Payer: Healthscope Commercial |
$155.02
|
| Rate for Payer: Healthscope Whirlpool |
$150.37
|
| Rate for Payer: Mclaren Commercial |
$139.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$131.77
|
| Rate for Payer: Nomi Health Commercial |
$127.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$136.42
|
|
|
HC REFLEX BETHESDA UNITS
|
Facility
|
OP
|
$155.02
|
|
|
Service Code
|
CPT 85335
|
| Hospital Charge Code |
30500042
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$155.02 |
| Rate for Payer: Aetna Commercial |
$139.52
|
| Rate for Payer: Aetna Medicare |
$12.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.09
|
| Rate for Payer: ASR ASR |
$150.37
|
| Rate for Payer: ASR Commercial |
$150.37
|
| Rate for Payer: BCBS Complete |
$7.24
|
| Rate for Payer: BCBS MAPPO |
$12.87
|
| Rate for Payer: BCBS Trust/PPO |
$126.95
|
| Rate for Payer: BCN Commercial |
$120.19
|
| Rate for Payer: BCN Medicare Advantage |
$12.87
|
| Rate for Payer: Cash Price |
$124.02
|
| Rate for Payer: Cash Price |
$124.02
|
| Rate for Payer: Cofinity Commercial |
$145.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.87
|
| Rate for Payer: Healthscope Commercial |
$155.02
|
| Rate for Payer: Healthscope Whirlpool |
$150.37
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.87
|
| Rate for Payer: Mclaren Commercial |
$139.52
|
| Rate for Payer: Mclaren Medicaid |
$6.90
|
| Rate for Payer: Mclaren Medicare |
$12.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.51
|
| Rate for Payer: Meridian Medicaid |
$7.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$131.77
|
| Rate for Payer: Nomi Health Commercial |
$127.12
|
| Rate for Payer: PACE Medicare |
$12.23
|
| Rate for Payer: PACE SWMI |
$12.87
|
| Rate for Payer: PHP Commercial |
$14.16
|
| Rate for Payer: PHP Medicaid |
$6.90
|
| Rate for Payer: PHP Medicare Advantage |
$12.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$135.83
|
| Rate for Payer: Priority Health Medicare |
$12.87
|
| Rate for Payer: Priority Health Narrow Network |
$108.67
|
| Rate for Payer: Railroad Medicare Medicare |
$12.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$136.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.87
|
| Rate for Payer: UHC Exchange |
$19.95
|
| Rate for Payer: UHC Medicare Advantage |
$12.87
|
| Rate for Payer: UHCCP DNSP |
$12.87
|
| Rate for Payer: UHCCP Medicaid |
$6.90
|
| Rate for Payer: VA VA |
$12.87
|
|
|
HC REFLEX COAG FACTOR VIII INHIBITOR
|
Facility
|
OP
|
$320.44
|
|
|
Service Code
|
CPT 85335
|
| Hospital Charge Code |
30500043
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$320.44 |
| Rate for Payer: Aetna Commercial |
$288.40
|
| Rate for Payer: Aetna Medicare |
$12.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.09
|
| Rate for Payer: ASR ASR |
$310.83
|
| Rate for Payer: ASR Commercial |
$310.83
|
| Rate for Payer: BCBS Complete |
$7.24
|
| Rate for Payer: BCBS MAPPO |
$12.87
|
| Rate for Payer: BCBS Trust/PPO |
$262.41
|
| Rate for Payer: BCN Commercial |
$248.44
|
| Rate for Payer: BCN Medicare Advantage |
$12.87
|
| Rate for Payer: Cash Price |
$256.35
|
| Rate for Payer: Cash Price |
$256.35
|
| Rate for Payer: Cofinity Commercial |
$301.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$256.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.87
|
| Rate for Payer: Healthscope Commercial |
$320.44
|
| Rate for Payer: Healthscope Whirlpool |
$310.83
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.87
|
| Rate for Payer: Mclaren Commercial |
$288.40
|
| Rate for Payer: Mclaren Medicaid |
$6.90
|
| Rate for Payer: Mclaren Medicare |
$12.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.51
|
| Rate for Payer: Meridian Medicaid |
$7.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$272.37
|
| Rate for Payer: Nomi Health Commercial |
$262.76
|
| Rate for Payer: PACE Medicare |
$12.23
|
| Rate for Payer: PACE SWMI |
$12.87
|
| Rate for Payer: PHP Commercial |
$14.16
|
| Rate for Payer: PHP Medicaid |
$6.90
|
| Rate for Payer: PHP Medicare Advantage |
$12.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$208.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$280.77
|
| Rate for Payer: Priority Health Medicare |
$12.87
|
| Rate for Payer: Priority Health Narrow Network |
$224.63
|
| Rate for Payer: Railroad Medicare Medicare |
$12.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$281.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.87
|
| Rate for Payer: UHC Exchange |
$19.95
|
| Rate for Payer: UHC Medicare Advantage |
$12.87
|
| Rate for Payer: UHCCP DNSP |
$12.87
|
| Rate for Payer: UHCCP Medicaid |
$6.90
|
| Rate for Payer: VA VA |
$12.87
|
|
|
HC REFLEX COAG FACTOR VIII INHIBITOR
|
Facility
|
IP
|
$320.44
|
|
|
Service Code
|
CPT 85335
|
| Hospital Charge Code |
30500043
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$208.29 |
| Max. Negotiated Rate |
$320.44 |
| Rate for Payer: Aetna Commercial |
$288.40
|
| Rate for Payer: ASR ASR |
$310.83
|
| Rate for Payer: ASR Commercial |
$310.83
|
| Rate for Payer: BCBS Trust/PPO |
$261.13
|
| Rate for Payer: BCN Commercial |
$248.44
|
| Rate for Payer: Cash Price |
$256.35
|
| Rate for Payer: Cofinity Commercial |
$301.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$256.35
|
| Rate for Payer: Healthscope Commercial |
$320.44
|
| Rate for Payer: Healthscope Whirlpool |
$310.83
|
| Rate for Payer: Mclaren Commercial |
$288.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$272.37
|
| Rate for Payer: Nomi Health Commercial |
$262.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$208.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$281.99
|
|
|
HC REG/SEDAT ADDL 15 MIN
|
Facility
|
IP
|
$117.78
|
|
| Hospital Charge Code |
37000011
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$76.56 |
| Max. Negotiated Rate |
$117.78 |
| Rate for Payer: Aetna Commercial |
$106.00
|
| Rate for Payer: ASR ASR |
$114.25
|
| Rate for Payer: ASR Commercial |
$114.25
|
| Rate for Payer: BCBS Trust/PPO |
$95.98
|
| Rate for Payer: BCN Commercial |
$91.31
|
| Rate for Payer: Cash Price |
$94.22
|
| Rate for Payer: Cofinity Commercial |
$110.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.22
|
| Rate for Payer: Healthscope Commercial |
$117.78
|
| Rate for Payer: Healthscope Whirlpool |
$114.25
|
| Rate for Payer: Mclaren Commercial |
$106.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.11
|
| Rate for Payer: Nomi Health Commercial |
$96.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$103.65
|
|
|
HC REG/SEDAT ADDL 15 MIN
|
Facility
|
OP
|
$117.78
|
|
| Hospital Charge Code |
37000011
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$47.11 |
| Max. Negotiated Rate |
$117.78 |
| Rate for Payer: Aetna Commercial |
$106.00
|
| Rate for Payer: Aetna Medicare |
$58.89
|
| Rate for Payer: ASR ASR |
$114.25
|
| Rate for Payer: ASR Commercial |
$114.25
|
| Rate for Payer: BCBS Complete |
$47.11
|
| Rate for Payer: BCBS Trust/PPO |
$96.45
|
| Rate for Payer: BCN Commercial |
$91.31
|
| Rate for Payer: Cash Price |
$94.22
|
| Rate for Payer: Cofinity Commercial |
$110.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.22
|
| Rate for Payer: Healthscope Commercial |
$117.78
|
| Rate for Payer: Healthscope Whirlpool |
$114.25
|
| Rate for Payer: Mclaren Commercial |
$106.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.11
|
| Rate for Payer: Nomi Health Commercial |
$96.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$103.20
|
| Rate for Payer: Priority Health Narrow Network |
$82.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$103.65
|
|
|
HC REG/SEDAT INIT 30 MIN
|
Facility
|
IP
|
$595.78
|
|
| Hospital Charge Code |
37000012
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$387.26 |
| Max. Negotiated Rate |
$595.78 |
| Rate for Payer: Aetna Commercial |
$536.20
|
| Rate for Payer: ASR ASR |
$577.91
|
| Rate for Payer: ASR Commercial |
$577.91
|
| Rate for Payer: BCBS Trust/PPO |
$485.50
|
| Rate for Payer: BCN Commercial |
$461.91
|
| Rate for Payer: Cash Price |
$476.62
|
| Rate for Payer: Cofinity Commercial |
$560.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$476.62
|
| Rate for Payer: Healthscope Commercial |
$595.78
|
| Rate for Payer: Healthscope Whirlpool |
$577.91
|
| Rate for Payer: Mclaren Commercial |
$536.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$506.41
|
| Rate for Payer: Nomi Health Commercial |
$488.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$387.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$524.29
|
|
|
HC REG/SEDAT INIT 30 MIN
|
Facility
|
OP
|
$595.78
|
|
| Hospital Charge Code |
37000012
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$238.31 |
| Max. Negotiated Rate |
$595.78 |
| Rate for Payer: Aetna Commercial |
$536.20
|
| Rate for Payer: Aetna Medicare |
$297.89
|
| Rate for Payer: ASR ASR |
$577.91
|
| Rate for Payer: ASR Commercial |
$577.91
|
| Rate for Payer: BCBS Complete |
$238.31
|
| Rate for Payer: BCBS Trust/PPO |
$487.88
|
| Rate for Payer: BCN Commercial |
$461.91
|
| Rate for Payer: Cash Price |
$476.62
|
| Rate for Payer: Cofinity Commercial |
$560.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$476.62
|
| Rate for Payer: Healthscope Commercial |
$595.78
|
| Rate for Payer: Healthscope Whirlpool |
$577.91
|
| Rate for Payer: Mclaren Commercial |
$536.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$506.41
|
| Rate for Payer: Nomi Health Commercial |
$488.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$387.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$522.02
|
| Rate for Payer: Priority Health Narrow Network |
$417.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$524.29
|
|
|
HC REM MNTR PHYSIOL PARAM 1ST DEV SUPPLY EA 30 D
|
Facility
|
OP
|
$107.10
|
|
|
Service Code
|
CPT 99454
|
| Hospital Charge Code |
51000110
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$19.49 |
| Max. Negotiated Rate |
$107.10 |
| Rate for Payer: Aetna Commercial |
$96.39
|
| Rate for Payer: Aetna Medicare |
$36.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$45.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$45.46
|
| Rate for Payer: ASR ASR |
$103.89
|
| Rate for Payer: ASR Commercial |
$103.89
|
| Rate for Payer: BCBS Complete |
$20.47
|
| Rate for Payer: BCBS MAPPO |
$36.37
|
| Rate for Payer: BCBS Trust/PPO |
$87.70
|
| Rate for Payer: BCN Commercial |
$83.03
|
| Rate for Payer: BCN Medicare Advantage |
$36.37
|
| Rate for Payer: Cash Price |
$85.68
|
| Rate for Payer: Cash Price |
$85.68
|
| Rate for Payer: Cofinity Commercial |
$100.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.37
|
| Rate for Payer: Healthscope Commercial |
$107.10
|
| Rate for Payer: Healthscope Whirlpool |
$103.89
|
| Rate for Payer: Humana Choice PPO Medicare |
$36.37
|
| Rate for Payer: Mclaren Commercial |
$96.39
|
| Rate for Payer: Mclaren Medicaid |
$19.49
|
| Rate for Payer: Mclaren Medicare |
$36.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.19
|
| Rate for Payer: Meridian Medicaid |
$20.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$41.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.03
|
| Rate for Payer: Nomi Health Commercial |
$87.82
|
| Rate for Payer: PACE Medicare |
$34.55
|
| Rate for Payer: PACE SWMI |
$36.37
|
| Rate for Payer: PHP Commercial |
$40.01
|
| Rate for Payer: PHP Medicaid |
$19.49
|
| Rate for Payer: PHP Medicare Advantage |
$36.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$93.84
|
| Rate for Payer: Priority Health Medicare |
$36.37
|
| Rate for Payer: Priority Health Narrow Network |
$75.08
|
| Rate for Payer: Railroad Medicare Medicare |
$36.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$94.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$36.37
|
| Rate for Payer: UHC Exchange |
$56.37
|
| Rate for Payer: UHC Medicare Advantage |
$36.37
|
| Rate for Payer: UHCCP DNSP |
$36.37
|
| Rate for Payer: UHCCP Medicaid |
$19.49
|
| Rate for Payer: VA VA |
$36.37
|
|
|
HC REM MNTR PHYSIOL PARAM 1ST DEV SUPPLY EA 30 D
|
Facility
|
IP
|
$107.10
|
|
|
Service Code
|
CPT 99454
|
| Hospital Charge Code |
51000110
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$69.61 |
| Max. Negotiated Rate |
$107.10 |
| Rate for Payer: Aetna Commercial |
$96.39
|
| Rate for Payer: ASR ASR |
$103.89
|
| Rate for Payer: ASR Commercial |
$103.89
|
| Rate for Payer: BCBS Trust/PPO |
$87.28
|
| Rate for Payer: BCN Commercial |
$83.03
|
| Rate for Payer: Cash Price |
$85.68
|
| Rate for Payer: Cofinity Commercial |
$100.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.68
|
| Rate for Payer: Healthscope Commercial |
$107.10
|
| Rate for Payer: Healthscope Whirlpool |
$103.89
|
| Rate for Payer: Mclaren Commercial |
$96.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.03
|
| Rate for Payer: Nomi Health Commercial |
$87.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$94.25
|
|
|
HC REM MNTR PHYSIOL PARAM 1ST SET UP PT EDUCAJ EQP
|
Facility
|
OP
|
$346.80
|
|
|
Service Code
|
CPT 99453
|
| Hospital Charge Code |
51000111
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$67.36 |
| Max. Negotiated Rate |
$346.80 |
| Rate for Payer: Aetna Commercial |
$312.12
|
| Rate for Payer: Aetna Medicare |
$125.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.10
|
| Rate for Payer: ASR ASR |
$336.40
|
| Rate for Payer: ASR Commercial |
$336.40
|
| Rate for Payer: BCBS Complete |
$70.73
|
| Rate for Payer: BCBS MAPPO |
$125.68
|
| Rate for Payer: BCBS Trust/PPO |
$283.99
|
| Rate for Payer: BCN Commercial |
$268.87
|
| Rate for Payer: BCN Medicare Advantage |
$125.68
|
| Rate for Payer: Cash Price |
$277.44
|
| Rate for Payer: Cash Price |
$277.44
|
| Rate for Payer: Cofinity Commercial |
$325.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$277.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.68
|
| Rate for Payer: Healthscope Commercial |
$346.80
|
| Rate for Payer: Healthscope Whirlpool |
$336.40
|
| Rate for Payer: Humana Choice PPO Medicare |
$125.68
|
| Rate for Payer: Mclaren Commercial |
$312.12
|
| Rate for Payer: Mclaren Medicaid |
$67.36
|
| Rate for Payer: Mclaren Medicare |
$125.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$131.96
|
| Rate for Payer: Meridian Medicaid |
$70.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$144.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$294.78
|
| Rate for Payer: Nomi Health Commercial |
$284.38
|
| Rate for Payer: PACE Medicare |
$119.40
|
| Rate for Payer: PACE SWMI |
$125.68
|
| Rate for Payer: PHP Commercial |
$138.25
|
| Rate for Payer: PHP Medicaid |
$67.36
|
| Rate for Payer: PHP Medicare Advantage |
$125.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$225.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$303.87
|
| Rate for Payer: Priority Health Medicare |
$125.68
|
| Rate for Payer: Priority Health Narrow Network |
$243.11
|
| Rate for Payer: Railroad Medicare Medicare |
$125.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$305.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.68
|
| Rate for Payer: UHC Exchange |
$194.80
|
| Rate for Payer: UHC Medicare Advantage |
$125.68
|
| Rate for Payer: UHCCP DNSP |
$125.68
|
| Rate for Payer: UHCCP Medicaid |
$67.36
|
| Rate for Payer: VA VA |
$125.68
|
|
|
HC REM MNTR PHYSIOL PARAM 1ST SET UP PT EDUCAJ EQP
|
Facility
|
IP
|
$346.80
|
|
|
Service Code
|
CPT 99453
|
| Hospital Charge Code |
51000111
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$225.42 |
| Max. Negotiated Rate |
$346.80 |
| Rate for Payer: Aetna Commercial |
$312.12
|
| Rate for Payer: ASR ASR |
$336.40
|
| Rate for Payer: ASR Commercial |
$336.40
|
| Rate for Payer: BCBS Trust/PPO |
$282.61
|
| Rate for Payer: BCN Commercial |
$268.87
|
| Rate for Payer: Cash Price |
$277.44
|
| Rate for Payer: Cofinity Commercial |
$325.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$277.44
|
| Rate for Payer: Healthscope Commercial |
$346.80
|
| Rate for Payer: Healthscope Whirlpool |
$336.40
|
| Rate for Payer: Mclaren Commercial |
$312.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$294.78
|
| Rate for Payer: Nomi Health Commercial |
$284.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$225.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$305.18
|
|
|
HC REMOTE THER MON DEVICE SUPPLY MS EA 30 DAY
|
Facility
|
IP
|
$114.75
|
|
|
Service Code
|
CPT 98977
|
| Hospital Charge Code |
42000063
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$74.59 |
| Max. Negotiated Rate |
$114.75 |
| Rate for Payer: Aetna Commercial |
$103.28
|
| Rate for Payer: ASR ASR |
$111.31
|
| Rate for Payer: ASR Commercial |
$111.31
|
| Rate for Payer: BCBS Trust/PPO |
$93.51
|
| Rate for Payer: BCN Commercial |
$88.97
|
| Rate for Payer: Cash Price |
$91.80
|
| Rate for Payer: Cofinity Commercial |
$107.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.80
|
| Rate for Payer: Healthscope Commercial |
$114.75
|
| Rate for Payer: Healthscope Whirlpool |
$111.31
|
| Rate for Payer: Mclaren Commercial |
$103.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.54
|
| Rate for Payer: Nomi Health Commercial |
$94.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$100.98
|
|
|
HC REMOTE THER MON DEVICE SUPPLY MS EA 30 DAY
|
Facility
|
OP
|
$114.75
|
|
|
Service Code
|
CPT 98977
|
| Hospital Charge Code |
42000063
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$19.49 |
| Max. Negotiated Rate |
$114.75 |
| Rate for Payer: Aetna Commercial |
$103.28
|
| Rate for Payer: Aetna Medicare |
$36.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$45.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$45.46
|
| Rate for Payer: ASR ASR |
$111.31
|
| Rate for Payer: ASR Commercial |
$111.31
|
| Rate for Payer: BCBS Complete |
$20.47
|
| Rate for Payer: BCBS MAPPO |
$36.37
|
| Rate for Payer: BCBS Trust/PPO |
$93.97
|
| Rate for Payer: BCN Commercial |
$88.97
|
| Rate for Payer: BCN Medicare Advantage |
$36.37
|
| Rate for Payer: Cash Price |
$91.80
|
| Rate for Payer: Cash Price |
$91.80
|
| Rate for Payer: Cofinity Commercial |
$107.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.37
|
| Rate for Payer: Healthscope Commercial |
$114.75
|
| Rate for Payer: Healthscope Whirlpool |
$111.31
|
| Rate for Payer: Humana Choice PPO Medicare |
$36.37
|
| Rate for Payer: Mclaren Commercial |
$103.28
|
| Rate for Payer: Mclaren Medicaid |
$19.49
|
| Rate for Payer: Mclaren Medicare |
$36.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.19
|
| Rate for Payer: Meridian Medicaid |
$20.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$41.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.54
|
| Rate for Payer: Nomi Health Commercial |
$94.09
|
| Rate for Payer: PACE Medicare |
$34.55
|
| Rate for Payer: PACE SWMI |
$36.37
|
| Rate for Payer: PHP Commercial |
$40.01
|
| Rate for Payer: PHP Medicaid |
$19.49
|
| Rate for Payer: PHP Medicare Advantage |
$36.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$100.54
|
| Rate for Payer: Priority Health Medicare |
$36.37
|
| Rate for Payer: Priority Health Narrow Network |
$80.44
|
| Rate for Payer: Railroad Medicare Medicare |
$36.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$100.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$36.37
|
| Rate for Payer: UHC Exchange |
$56.37
|
| Rate for Payer: UHC Medicare Advantage |
$36.37
|
| Rate for Payer: UHCCP DNSP |
$36.37
|
| Rate for Payer: UHCCP Medicaid |
$19.49
|
| Rate for Payer: VA VA |
$36.37
|
|
|
HC REMOTE THER MON SETUP & EDU
|
Facility
|
OP
|
$366.14
|
|
|
Service Code
|
CPT 98975
|
| Hospital Charge Code |
42000062
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$67.36 |
| Max. Negotiated Rate |
$366.14 |
| Rate for Payer: Aetna Commercial |
$329.53
|
| Rate for Payer: Aetna Medicare |
$125.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.10
|
| Rate for Payer: ASR ASR |
$355.16
|
| Rate for Payer: ASR Commercial |
$355.16
|
| Rate for Payer: BCBS Complete |
$70.73
|
| Rate for Payer: BCBS MAPPO |
$125.68
|
| Rate for Payer: BCBS Trust/PPO |
$299.83
|
| Rate for Payer: BCN Commercial |
$283.87
|
| Rate for Payer: BCN Medicare Advantage |
$125.68
|
| Rate for Payer: Cash Price |
$292.91
|
| Rate for Payer: Cash Price |
$292.91
|
| Rate for Payer: Cofinity Commercial |
$344.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$292.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.68
|
| Rate for Payer: Healthscope Commercial |
$366.14
|
| Rate for Payer: Healthscope Whirlpool |
$355.16
|
| Rate for Payer: Humana Choice PPO Medicare |
$125.68
|
| Rate for Payer: Mclaren Commercial |
$329.53
|
| Rate for Payer: Mclaren Medicaid |
$67.36
|
| Rate for Payer: Mclaren Medicare |
$125.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$131.96
|
| Rate for Payer: Meridian Medicaid |
$70.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$144.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$311.22
|
| Rate for Payer: Nomi Health Commercial |
$300.23
|
| Rate for Payer: PACE Medicare |
$119.40
|
| Rate for Payer: PACE SWMI |
$125.68
|
| Rate for Payer: PHP Commercial |
$138.25
|
| Rate for Payer: PHP Medicaid |
$67.36
|
| Rate for Payer: PHP Medicare Advantage |
$125.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$237.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$320.81
|
| Rate for Payer: Priority Health Medicare |
$125.68
|
| Rate for Payer: Priority Health Narrow Network |
$256.66
|
| Rate for Payer: Railroad Medicare Medicare |
$125.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$322.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.68
|
| Rate for Payer: UHC Exchange |
$194.80
|
| Rate for Payer: UHC Medicare Advantage |
$125.68
|
| Rate for Payer: UHCCP DNSP |
$125.68
|
| Rate for Payer: UHCCP Medicaid |
$67.36
|
| Rate for Payer: VA VA |
$125.68
|
|
|
HC REMOTE THER MON SETUP & EDU
|
Facility
|
IP
|
$366.14
|
|
|
Service Code
|
CPT 98975
|
| Hospital Charge Code |
42000062
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$237.99 |
| Max. Negotiated Rate |
$366.14 |
| Rate for Payer: Aetna Commercial |
$329.53
|
| Rate for Payer: ASR ASR |
$355.16
|
| Rate for Payer: ASR Commercial |
$355.16
|
| Rate for Payer: BCBS Trust/PPO |
$298.37
|
| Rate for Payer: BCN Commercial |
$283.87
|
| Rate for Payer: Cash Price |
$292.91
|
| Rate for Payer: Cofinity Commercial |
$344.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$292.91
|
| Rate for Payer: Healthscope Commercial |
$366.14
|
| Rate for Payer: Healthscope Whirlpool |
$355.16
|
| Rate for Payer: Mclaren Commercial |
$329.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$311.22
|
| Rate for Payer: Nomi Health Commercial |
$300.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$237.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$322.20
|
|
|
HC REMOVAL BILIARY STONE
|
Facility
|
OP
|
$662.41
|
|
|
Service Code
|
CPT 47544
|
| Hospital Charge Code |
36100516
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$264.96 |
| Max. Negotiated Rate |
$662.41 |
| Rate for Payer: Aetna Commercial |
$596.17
|
| Rate for Payer: Aetna Medicare |
$331.20
|
| Rate for Payer: ASR ASR |
$642.54
|
| Rate for Payer: ASR Commercial |
$642.54
|
| Rate for Payer: BCBS Complete |
$264.96
|
| Rate for Payer: BCBS Trust/PPO |
$542.45
|
| Rate for Payer: BCN Commercial |
$513.57
|
| Rate for Payer: Cash Price |
$529.93
|
| Rate for Payer: Cofinity Commercial |
$622.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$529.93
|
| Rate for Payer: Healthscope Commercial |
$662.41
|
| Rate for Payer: Healthscope Whirlpool |
$642.54
|
| Rate for Payer: Mclaren Commercial |
$596.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$563.05
|
| Rate for Payer: Nomi Health Commercial |
$543.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$430.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$580.40
|
| Rate for Payer: Priority Health Narrow Network |
$464.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$582.92
|
|
