|
HC SMART NEEDLE
|
Facility
|
IP
|
$510.33
|
|
| Hospital Charge Code |
62200011
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$382.75 |
| Max. Negotiated Rate |
$510.33 |
| Rate for Payer: Aetna Commercial |
$459.30
|
| Rate for Payer: ASR ASR |
$495.02
|
| Rate for Payer: BCBS Trust/PPO |
$419.08
|
| Rate for Payer: BCN Commercial |
$419.08
|
| Rate for Payer: Cash Price |
$408.26
|
| Rate for Payer: Cofinity Commercial |
$479.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$408.26
|
| Rate for Payer: Healthscope Commercial |
$495.02
|
| Rate for Payer: Healthscope Whirlpool |
$510.33
|
| Rate for Payer: Mclaren Commercial |
$459.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$433.78
|
| Rate for Payer: Nomi Health Commercial |
$418.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$382.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$449.09
|
|
|
HC SMITH SM ANTIBODY
|
Facility
|
IP
|
$35.87
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200165
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$26.90 |
| Max. Negotiated Rate |
$35.87 |
| Rate for Payer: Aetna Commercial |
$32.28
|
| Rate for Payer: ASR ASR |
$34.79
|
| Rate for Payer: BCBS Trust/PPO |
$29.46
|
| Rate for Payer: BCN Commercial |
$29.46
|
| Rate for Payer: Cash Price |
$28.70
|
| Rate for Payer: Cofinity Commercial |
$33.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.70
|
| Rate for Payer: Healthscope Commercial |
$34.79
|
| Rate for Payer: Healthscope Whirlpool |
$35.87
|
| Rate for Payer: Mclaren Commercial |
$32.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.49
|
| Rate for Payer: Nomi Health Commercial |
$29.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$31.57
|
|
|
HC SMITH SM ANTIBODY
|
Facility
|
OP
|
$35.87
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200165
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.38 |
| Max. Negotiated Rate |
$169.49 |
| Rate for Payer: Aetna Commercial |
$32.28
|
| Rate for Payer: Aetna Medicare |
$17.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.41
|
| Rate for Payer: ASR ASR |
$34.79
|
| Rate for Payer: BCBS Complete |
$9.85
|
| Rate for Payer: BCBS MAPPO |
$17.93
|
| Rate for Payer: BCBS Trust/PPO |
$29.57
|
| Rate for Payer: BCN Commercial |
$29.57
|
| Rate for Payer: BCN Medicare Advantage |
$17.93
|
| Rate for Payer: Cash Price |
$28.70
|
| Rate for Payer: Cash Price |
$28.70
|
| Rate for Payer: Cofinity Commercial |
$33.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.93
|
| Rate for Payer: Healthscope Commercial |
$34.79
|
| Rate for Payer: Healthscope Whirlpool |
$35.87
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.93
|
| Rate for Payer: Mclaren Commercial |
$32.28
|
| Rate for Payer: Mclaren Medicaid |
$17.93
|
| Rate for Payer: Mclaren Medicare |
$17.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.83
|
| Rate for Payer: Meridian Medicaid |
$9.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.49
|
| Rate for Payer: Nomi Health Commercial |
$29.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.90
|
| Rate for Payer: PACE Medicare |
$17.03
|
| Rate for Payer: PACE SWMI |
$17.93
|
| Rate for Payer: PHP Commercial |
$19.72
|
| Rate for Payer: PHP Medicaid |
$9.61
|
| Rate for Payer: PHP Medicare Advantage |
$17.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$169.49
|
| Rate for Payer: Priority Health Medicare |
$17.93
|
| Rate for Payer: Priority Health Narrow Network |
$135.59
|
| Rate for Payer: Railroad Medicare Medicare |
$17.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$31.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17.93
|
| Rate for Payer: UHC Exchange |
$27.79
|
| Rate for Payer: UHC Medicaid |
$9.38
|
| Rate for Payer: UHCCP DNSP |
$17.93
|
| Rate for Payer: UHCCP Medicaid |
$9.38
|
| Rate for Payer: VA VA |
$17.93
|
|
|
HC SMOKE CESSATION > 10 MIN
|
Facility
|
IP
|
$125.22
|
|
|
Service Code
|
CPT 99407
|
| Hospital Charge Code |
94200033
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$93.92 |
| Max. Negotiated Rate |
$125.22 |
| Rate for Payer: Aetna Commercial |
$112.70
|
| Rate for Payer: ASR ASR |
$121.46
|
| Rate for Payer: BCBS Trust/PPO |
$102.83
|
| Rate for Payer: BCN Commercial |
$102.83
|
| Rate for Payer: Cash Price |
$100.18
|
| Rate for Payer: Cofinity Commercial |
$117.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.18
|
| Rate for Payer: Healthscope Commercial |
$121.46
|
| Rate for Payer: Healthscope Whirlpool |
$125.22
|
| Rate for Payer: Mclaren Commercial |
$112.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106.44
|
| Rate for Payer: Nomi Health Commercial |
$102.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$93.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$110.19
|
|
|
HC SMOKE CESSATION > 10 MIN
|
Facility
|
OP
|
$125.22
|
|
|
Service Code
|
CPT 99407
|
| Hospital Charge Code |
94200033
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$19.52 |
| Max. Negotiated Rate |
$125.22 |
| Rate for Payer: Aetna Commercial |
$112.70
|
| Rate for Payer: Aetna Medicare |
$37.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$46.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$46.66
|
| Rate for Payer: ASR ASR |
$121.46
|
| Rate for Payer: BCBS Complete |
$20.50
|
| Rate for Payer: BCBS MAPPO |
$37.33
|
| Rate for Payer: BCBS Trust/PPO |
$103.24
|
| Rate for Payer: BCN Commercial |
$103.24
|
| Rate for Payer: BCN Medicare Advantage |
$37.33
|
| Rate for Payer: Cash Price |
$100.18
|
| Rate for Payer: Cash Price |
$100.18
|
| Rate for Payer: Cofinity Commercial |
$117.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.33
|
| Rate for Payer: Healthscope Commercial |
$121.46
|
| Rate for Payer: Healthscope Whirlpool |
$125.22
|
| Rate for Payer: Humana Choice PPO Medicare |
$37.33
|
| Rate for Payer: Mclaren Commercial |
$112.70
|
| Rate for Payer: Mclaren Medicaid |
$37.33
|
| Rate for Payer: Mclaren Medicare |
$37.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.20
|
| Rate for Payer: Meridian Medicaid |
$20.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$41.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106.44
|
| Rate for Payer: Nomi Health Commercial |
$102.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$93.92
|
| Rate for Payer: PACE Medicare |
$35.46
|
| Rate for Payer: PACE SWMI |
$37.33
|
| Rate for Payer: PHP Commercial |
$41.06
|
| Rate for Payer: PHP Medicaid |
$20.01
|
| Rate for Payer: PHP Medicare Advantage |
$37.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$72.63
|
| Rate for Payer: Priority Health Medicare |
$37.33
|
| Rate for Payer: Priority Health Narrow Network |
$58.10
|
| Rate for Payer: Railroad Medicare Medicare |
$37.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$110.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$37.33
|
| Rate for Payer: UHC Exchange |
$57.86
|
| Rate for Payer: UHC Medicaid |
$19.52
|
| Rate for Payer: UHCCP DNSP |
$37.33
|
| Rate for Payer: UHCCP Medicaid |
$19.52
|
| Rate for Payer: VA VA |
$37.33
|
|
|
HC SMOKING CESSATION 3-10 MIN
|
Facility
|
OP
|
$125.22
|
|
|
Service Code
|
CPT 99406
|
| Hospital Charge Code |
94200034
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$19.52 |
| Max. Negotiated Rate |
$125.22 |
| Rate for Payer: Aetna Commercial |
$112.70
|
| Rate for Payer: Aetna Medicare |
$37.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$46.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$46.66
|
| Rate for Payer: ASR ASR |
$121.46
|
| Rate for Payer: BCBS Complete |
$20.50
|
| Rate for Payer: BCBS MAPPO |
$37.33
|
| Rate for Payer: BCBS Trust/PPO |
$103.24
|
| Rate for Payer: BCN Commercial |
$103.24
|
| Rate for Payer: BCN Medicare Advantage |
$37.33
|
| Rate for Payer: Cash Price |
$100.18
|
| Rate for Payer: Cash Price |
$100.18
|
| Rate for Payer: Cofinity Commercial |
$117.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.33
|
| Rate for Payer: Healthscope Commercial |
$121.46
|
| Rate for Payer: Healthscope Whirlpool |
$125.22
|
| Rate for Payer: Humana Choice PPO Medicare |
$37.33
|
| Rate for Payer: Mclaren Commercial |
$112.70
|
| Rate for Payer: Mclaren Medicaid |
$37.33
|
| Rate for Payer: Mclaren Medicare |
$37.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.20
|
| Rate for Payer: Meridian Medicaid |
$20.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$41.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106.44
|
| Rate for Payer: Nomi Health Commercial |
$102.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$93.92
|
| Rate for Payer: PACE Medicare |
$35.46
|
| Rate for Payer: PACE SWMI |
$37.33
|
| Rate for Payer: PHP Commercial |
$41.06
|
| Rate for Payer: PHP Medicaid |
$20.01
|
| Rate for Payer: PHP Medicare Advantage |
$37.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$62.96
|
| Rate for Payer: Priority Health Medicare |
$37.33
|
| Rate for Payer: Priority Health Narrow Network |
$50.37
|
| Rate for Payer: Railroad Medicare Medicare |
$37.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$110.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$37.33
|
| Rate for Payer: UHC Exchange |
$57.86
|
| Rate for Payer: UHC Medicaid |
$19.52
|
| Rate for Payer: UHCCP DNSP |
$37.33
|
| Rate for Payer: UHCCP Medicaid |
$19.52
|
| Rate for Payer: VA VA |
$37.33
|
|
|
HC SMOKING CESSATION 3-10 MIN
|
Facility
|
IP
|
$125.22
|
|
|
Service Code
|
CPT 99406
|
| Hospital Charge Code |
94200034
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$93.92 |
| Max. Negotiated Rate |
$125.22 |
| Rate for Payer: Aetna Commercial |
$112.70
|
| Rate for Payer: ASR ASR |
$121.46
|
| Rate for Payer: BCBS Trust/PPO |
$102.83
|
| Rate for Payer: BCN Commercial |
$102.83
|
| Rate for Payer: Cash Price |
$100.18
|
| Rate for Payer: Cofinity Commercial |
$117.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.18
|
| Rate for Payer: Healthscope Commercial |
$121.46
|
| Rate for Payer: Healthscope Whirlpool |
$125.22
|
| Rate for Payer: Mclaren Commercial |
$112.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106.44
|
| Rate for Payer: Nomi Health Commercial |
$102.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$93.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$110.19
|
|
|
HC SMOOTH MUSCLE AB TITER
|
Facility
|
OP
|
$21.58
|
|
|
Service Code
|
CPT 86015
|
| Hospital Charge Code |
30200487
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.30 |
| Max. Negotiated Rate |
$21.58 |
| Rate for Payer: Aetna Commercial |
$19.42
|
| Rate for Payer: Aetna Medicare |
$12.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.06
|
| Rate for Payer: ASR ASR |
$20.93
|
| Rate for Payer: BCBS Complete |
$6.62
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCBS Trust/PPO |
$17.79
|
| Rate for Payer: BCN Commercial |
$17.79
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$17.26
|
| Rate for Payer: Cash Price |
$17.26
|
| Rate for Payer: Cofinity Commercial |
$20.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$20.93
|
| Rate for Payer: Healthscope Whirlpool |
$21.58
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.05
|
| Rate for Payer: Mclaren Commercial |
$19.42
|
| Rate for Payer: Mclaren Medicaid |
$12.05
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: Meridian Medicaid |
$6.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.34
|
| Rate for Payer: Nomi Health Commercial |
$17.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.18
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$13.26
|
| Rate for Payer: PHP Medicaid |
$6.46
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$18.91
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health Narrow Network |
$15.13
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.05
|
| Rate for Payer: UHC Exchange |
$18.68
|
| Rate for Payer: UHC Medicaid |
$6.30
|
| Rate for Payer: UHCCP DNSP |
$12.05
|
| Rate for Payer: UHCCP Medicaid |
$6.30
|
| Rate for Payer: VA VA |
$12.05
|
|
|
HC SMOOTH MUSCLE AB TITER
|
Facility
|
IP
|
$21.58
|
|
|
Service Code
|
CPT 86015
|
| Hospital Charge Code |
30200487
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.18 |
| Max. Negotiated Rate |
$21.58 |
| Rate for Payer: Aetna Commercial |
$19.42
|
| Rate for Payer: ASR ASR |
$20.93
|
| Rate for Payer: BCBS Trust/PPO |
$17.72
|
| Rate for Payer: BCN Commercial |
$17.72
|
| Rate for Payer: Cash Price |
$17.26
|
| Rate for Payer: Cofinity Commercial |
$20.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.26
|
| Rate for Payer: Healthscope Commercial |
$20.93
|
| Rate for Payer: Healthscope Whirlpool |
$21.58
|
| Rate for Payer: Mclaren Commercial |
$19.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.34
|
| Rate for Payer: Nomi Health Commercial |
$17.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.99
|
|
|
HC SMRNP
|
Facility
|
OP
|
$35.87
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200435
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.38 |
| Max. Negotiated Rate |
$169.49 |
| Rate for Payer: Aetna Commercial |
$32.28
|
| Rate for Payer: Aetna Medicare |
$17.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.41
|
| Rate for Payer: ASR ASR |
$34.79
|
| Rate for Payer: BCBS Complete |
$9.85
|
| Rate for Payer: BCBS MAPPO |
$17.93
|
| Rate for Payer: BCBS Trust/PPO |
$29.57
|
| Rate for Payer: BCN Commercial |
$29.57
|
| Rate for Payer: BCN Medicare Advantage |
$17.93
|
| Rate for Payer: Cash Price |
$28.70
|
| Rate for Payer: Cash Price |
$28.70
|
| Rate for Payer: Cofinity Commercial |
$33.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.93
|
| Rate for Payer: Healthscope Commercial |
$34.79
|
| Rate for Payer: Healthscope Whirlpool |
$35.87
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.93
|
| Rate for Payer: Mclaren Commercial |
$32.28
|
| Rate for Payer: Mclaren Medicaid |
$17.93
|
| Rate for Payer: Mclaren Medicare |
$17.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.83
|
| Rate for Payer: Meridian Medicaid |
$9.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.49
|
| Rate for Payer: Nomi Health Commercial |
$29.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.90
|
| Rate for Payer: PACE Medicare |
$17.03
|
| Rate for Payer: PACE SWMI |
$17.93
|
| Rate for Payer: PHP Commercial |
$19.72
|
| Rate for Payer: PHP Medicaid |
$9.61
|
| Rate for Payer: PHP Medicare Advantage |
$17.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$169.49
|
| Rate for Payer: Priority Health Medicare |
$17.93
|
| Rate for Payer: Priority Health Narrow Network |
$135.59
|
| Rate for Payer: Railroad Medicare Medicare |
$17.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$31.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17.93
|
| Rate for Payer: UHC Exchange |
$27.79
|
| Rate for Payer: UHC Medicaid |
$9.38
|
| Rate for Payer: UHCCP DNSP |
$17.93
|
| Rate for Payer: UHCCP Medicaid |
$9.38
|
| Rate for Payer: VA VA |
$17.93
|
|
|
HC SMRNP
|
Facility
|
IP
|
$35.87
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200435
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$26.90 |
| Max. Negotiated Rate |
$35.87 |
| Rate for Payer: Aetna Commercial |
$32.28
|
| Rate for Payer: ASR ASR |
$34.79
|
| Rate for Payer: BCBS Trust/PPO |
$29.46
|
| Rate for Payer: BCN Commercial |
$29.46
|
| Rate for Payer: Cash Price |
$28.70
|
| Rate for Payer: Cofinity Commercial |
$33.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.70
|
| Rate for Payer: Healthscope Commercial |
$34.79
|
| Rate for Payer: Healthscope Whirlpool |
$35.87
|
| Rate for Payer: Mclaren Commercial |
$32.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.49
|
| Rate for Payer: Nomi Health Commercial |
$29.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$31.57
|
|
|
HC SNARE
|
Facility
|
IP
|
$1,315.02
|
|
|
Service Code
|
HCPCS C1773
|
| Hospital Charge Code |
27200071
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$986.26 |
| Max. Negotiated Rate |
$1,315.02 |
| Rate for Payer: Aetna Commercial |
$1,183.52
|
| Rate for Payer: ASR ASR |
$1,275.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,079.89
|
| Rate for Payer: BCN Commercial |
$1,079.89
|
| Rate for Payer: Cash Price |
$1,052.02
|
| Rate for Payer: Cofinity Commercial |
$1,236.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,052.02
|
| Rate for Payer: Healthscope Commercial |
$1,275.57
|
| Rate for Payer: Healthscope Whirlpool |
$1,315.02
|
| Rate for Payer: Mclaren Commercial |
$1,183.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,117.77
|
| Rate for Payer: Nomi Health Commercial |
$1,078.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$986.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,157.22
|
|
|
HC SNARE
|
Facility
|
OP
|
$1,315.02
|
|
|
Service Code
|
HCPCS C1773
|
| Hospital Charge Code |
27200071
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$486.56 |
| Max. Negotiated Rate |
$1,315.02 |
| Rate for Payer: Aetna Commercial |
$1,183.52
|
| Rate for Payer: Aetna Medicare |
$486.56
|
| Rate for Payer: ASR ASR |
$1,275.57
|
| Rate for Payer: BCBS Complete |
$526.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,084.23
|
| Rate for Payer: BCN Commercial |
$1,084.23
|
| Rate for Payer: Cash Price |
$1,052.02
|
| Rate for Payer: Cofinity Commercial |
$1,236.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,052.02
|
| Rate for Payer: Healthscope Commercial |
$1,275.57
|
| Rate for Payer: Healthscope Whirlpool |
$1,315.02
|
| Rate for Payer: Mclaren Commercial |
$1,183.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,052.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,117.77
|
| Rate for Payer: Nomi Health Commercial |
$1,078.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$986.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,152.22
|
| Rate for Payer: Priority Health Narrow Network |
$921.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,157.22
|
|
|
HC SODIUM BICARBONATE 4.2% SOL
|
Facility
|
IP
|
$21.85
|
|
|
Service Code
|
HCPCS J3490
|
| Hospital Charge Code |
63600214
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$16.39 |
| Max. Negotiated Rate |
$21.85 |
| Rate for Payer: Aetna Commercial |
$19.66
|
| Rate for Payer: ASR ASR |
$21.19
|
| Rate for Payer: BCBS Trust/PPO |
$17.94
|
| Rate for Payer: BCN Commercial |
$17.94
|
| Rate for Payer: Cash Price |
$17.48
|
| Rate for Payer: Cofinity Commercial |
$20.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.48
|
| Rate for Payer: Healthscope Commercial |
$21.19
|
| Rate for Payer: Healthscope Whirlpool |
$21.85
|
| Rate for Payer: Mclaren Commercial |
$19.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.57
|
| Rate for Payer: Nomi Health Commercial |
$17.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19.23
|
|
|
HC SODIUM BICARBONATE 4.2% SOL
|
Facility
|
OP
|
$21.85
|
|
|
Service Code
|
HCPCS J3490
|
| Hospital Charge Code |
63600214
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$8.08 |
| Max. Negotiated Rate |
$21.85 |
| Rate for Payer: Aetna Commercial |
$19.66
|
| Rate for Payer: Aetna Medicare |
$8.08
|
| Rate for Payer: ASR ASR |
$21.19
|
| Rate for Payer: BCBS Complete |
$8.74
|
| Rate for Payer: BCBS Trust/PPO |
$18.02
|
| Rate for Payer: BCN Commercial |
$18.02
|
| Rate for Payer: Cash Price |
$17.48
|
| Rate for Payer: Cofinity Commercial |
$20.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.48
|
| Rate for Payer: Healthscope Commercial |
$21.19
|
| Rate for Payer: Healthscope Whirlpool |
$21.85
|
| Rate for Payer: Mclaren Commercial |
$19.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.57
|
| Rate for Payer: Nomi Health Commercial |
$17.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$19.14
|
| Rate for Payer: Priority Health Narrow Network |
$15.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19.23
|
|
|
HC SODIUM LEVEL
|
Facility
|
OP
|
$21.23
|
|
|
Service Code
|
CPT 84295
|
| Hospital Charge Code |
30100423
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.52 |
| Max. Negotiated Rate |
$21.23 |
| Rate for Payer: Aetna Commercial |
$19.11
|
| Rate for Payer: Aetna Medicare |
$4.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.01
|
| Rate for Payer: ASR ASR |
$20.59
|
| Rate for Payer: BCBS Complete |
$2.64
|
| Rate for Payer: BCBS MAPPO |
$4.81
|
| Rate for Payer: BCBS Trust/PPO |
$17.50
|
| Rate for Payer: BCN Commercial |
$17.50
|
| Rate for Payer: BCN Medicare Advantage |
$4.81
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Commercial |
$19.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.81
|
| Rate for Payer: Healthscope Commercial |
$20.59
|
| Rate for Payer: Healthscope Whirlpool |
$21.23
|
| Rate for Payer: Humana Choice PPO Medicare |
$4.81
|
| Rate for Payer: Mclaren Commercial |
$19.11
|
| Rate for Payer: Mclaren Medicaid |
$4.81
|
| Rate for Payer: Mclaren Medicare |
$4.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.05
|
| Rate for Payer: Meridian Medicaid |
$2.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Nomi Health Commercial |
$17.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: PACE Medicare |
$4.57
|
| Rate for Payer: PACE SWMI |
$4.81
|
| Rate for Payer: PHP Commercial |
$5.29
|
| Rate for Payer: PHP Medicaid |
$2.58
|
| Rate for Payer: PHP Medicare Advantage |
$4.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$18.76
|
| Rate for Payer: Priority Health Medicare |
$4.81
|
| Rate for Payer: Priority Health Narrow Network |
$15.01
|
| Rate for Payer: Railroad Medicare Medicare |
$4.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$4.81
|
| Rate for Payer: UHC Exchange |
$7.46
|
| Rate for Payer: UHC Medicaid |
$2.52
|
| Rate for Payer: UHCCP DNSP |
$4.81
|
| Rate for Payer: UHCCP Medicaid |
$2.52
|
| Rate for Payer: VA VA |
$4.81
|
|
|
HC SODIUM LEVEL
|
Facility
|
IP
|
$21.23
|
|
|
Service Code
|
CPT 84295
|
| Hospital Charge Code |
30100423
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.92 |
| Max. Negotiated Rate |
$21.23 |
| Rate for Payer: Aetna Commercial |
$19.11
|
| Rate for Payer: ASR ASR |
$20.59
|
| Rate for Payer: BCBS Trust/PPO |
$17.43
|
| Rate for Payer: BCN Commercial |
$17.43
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Commercial |
$19.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Healthscope Commercial |
$20.59
|
| Rate for Payer: Healthscope Whirlpool |
$21.23
|
| Rate for Payer: Mclaren Commercial |
$19.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Nomi Health Commercial |
$17.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.68
|
|
|
HC SODIUM OTHER SOURCE
|
Facility
|
IP
|
$22.07
|
|
|
Service Code
|
CPT 84302
|
| Hospital Charge Code |
30100555
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.55 |
| Max. Negotiated Rate |
$22.07 |
| Rate for Payer: Aetna Commercial |
$19.86
|
| Rate for Payer: ASR ASR |
$21.41
|
| Rate for Payer: BCBS Trust/PPO |
$18.12
|
| Rate for Payer: BCN Commercial |
$18.12
|
| Rate for Payer: Cash Price |
$17.66
|
| Rate for Payer: Cofinity Commercial |
$20.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.66
|
| Rate for Payer: Healthscope Commercial |
$21.41
|
| Rate for Payer: Healthscope Whirlpool |
$22.07
|
| Rate for Payer: Mclaren Commercial |
$19.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.76
|
| Rate for Payer: Nomi Health Commercial |
$18.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19.42
|
|
|
HC SODIUM OTHER SOURCE
|
Facility
|
OP
|
$22.07
|
|
|
Service Code
|
CPT 84302
|
| Hospital Charge Code |
30100555
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.54 |
| Max. Negotiated Rate |
$22.07 |
| Rate for Payer: Aetna Commercial |
$19.86
|
| Rate for Payer: Aetna Medicare |
$4.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.08
|
| Rate for Payer: ASR ASR |
$21.41
|
| Rate for Payer: BCBS Complete |
$2.67
|
| Rate for Payer: BCBS MAPPO |
$4.86
|
| Rate for Payer: BCBS Trust/PPO |
$18.20
|
| Rate for Payer: BCN Commercial |
$18.20
|
| Rate for Payer: BCN Medicare Advantage |
$4.86
|
| Rate for Payer: Cash Price |
$17.66
|
| Rate for Payer: Cash Price |
$17.66
|
| Rate for Payer: Cofinity Commercial |
$20.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.86
|
| Rate for Payer: Healthscope Commercial |
$21.41
|
| Rate for Payer: Healthscope Whirlpool |
$22.07
|
| Rate for Payer: Humana Choice PPO Medicare |
$4.86
|
| Rate for Payer: Mclaren Commercial |
$19.86
|
| Rate for Payer: Mclaren Medicaid |
$4.86
|
| Rate for Payer: Mclaren Medicare |
$4.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.10
|
| Rate for Payer: Meridian Medicaid |
$2.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.76
|
| Rate for Payer: Nomi Health Commercial |
$18.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.55
|
| Rate for Payer: PACE Medicare |
$4.62
|
| Rate for Payer: PACE SWMI |
$4.86
|
| Rate for Payer: PHP Commercial |
$5.35
|
| Rate for Payer: PHP Medicaid |
$2.60
|
| Rate for Payer: PHP Medicare Advantage |
$4.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$19.34
|
| Rate for Payer: Priority Health Medicare |
$4.86
|
| Rate for Payer: Priority Health Narrow Network |
$15.47
|
| Rate for Payer: Railroad Medicare Medicare |
$4.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19.42
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$4.86
|
| Rate for Payer: UHC Exchange |
$7.53
|
| Rate for Payer: UHC Medicaid |
$2.54
|
| Rate for Payer: UHCCP DNSP |
$4.86
|
| Rate for Payer: UHCCP Medicaid |
$2.54
|
| Rate for Payer: VA VA |
$4.86
|
|
|
HC SODIUM URINE
|
Facility
|
IP
|
$35.89
|
|
|
Service Code
|
CPT 84300
|
| Hospital Charge Code |
30100424
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$26.92 |
| Max. Negotiated Rate |
$35.89 |
| Rate for Payer: Aetna Commercial |
$32.30
|
| Rate for Payer: ASR ASR |
$34.81
|
| Rate for Payer: BCBS Trust/PPO |
$29.47
|
| Rate for Payer: BCN Commercial |
$29.47
|
| Rate for Payer: Cash Price |
$28.71
|
| Rate for Payer: Cofinity Commercial |
$33.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.71
|
| Rate for Payer: Healthscope Commercial |
$34.81
|
| Rate for Payer: Healthscope Whirlpool |
$35.89
|
| Rate for Payer: Mclaren Commercial |
$32.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.51
|
| Rate for Payer: Nomi Health Commercial |
$29.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$31.58
|
|
|
HC SODIUM URINE
|
Facility
|
OP
|
$35.89
|
|
|
Service Code
|
CPT 84300
|
| Hospital Charge Code |
30100424
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.65 |
| Max. Negotiated Rate |
$35.89 |
| Rate for Payer: Aetna Commercial |
$32.30
|
| Rate for Payer: Aetna Medicare |
$5.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.33
|
| Rate for Payer: ASR ASR |
$34.81
|
| Rate for Payer: BCBS Complete |
$2.78
|
| Rate for Payer: BCBS MAPPO |
$5.06
|
| Rate for Payer: BCBS Trust/PPO |
$29.59
|
| Rate for Payer: BCN Commercial |
$29.59
|
| Rate for Payer: BCN Medicare Advantage |
$5.06
|
| Rate for Payer: Cash Price |
$28.71
|
| Rate for Payer: Cash Price |
$28.71
|
| Rate for Payer: Cofinity Commercial |
$33.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.06
|
| Rate for Payer: Healthscope Commercial |
$34.81
|
| Rate for Payer: Healthscope Whirlpool |
$35.89
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.06
|
| Rate for Payer: Mclaren Commercial |
$32.30
|
| Rate for Payer: Mclaren Medicaid |
$5.06
|
| Rate for Payer: Mclaren Medicare |
$5.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.31
|
| Rate for Payer: Meridian Medicaid |
$2.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.51
|
| Rate for Payer: Nomi Health Commercial |
$29.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.92
|
| Rate for Payer: PACE Medicare |
$4.81
|
| Rate for Payer: PACE SWMI |
$5.06
|
| Rate for Payer: PHP Commercial |
$5.57
|
| Rate for Payer: PHP Medicaid |
$2.71
|
| Rate for Payer: PHP Medicare Advantage |
$5.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$35.10
|
| Rate for Payer: Priority Health Medicare |
$5.06
|
| Rate for Payer: Priority Health Narrow Network |
$28.08
|
| Rate for Payer: Railroad Medicare Medicare |
$5.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$31.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.06
|
| Rate for Payer: UHC Exchange |
$7.84
|
| Rate for Payer: UHC Medicaid |
$2.65
|
| Rate for Payer: UHCCP DNSP |
$5.06
|
| Rate for Payer: UHCCP Medicaid |
$2.65
|
| Rate for Payer: VA VA |
$5.06
|
|
|
HC SOFTGOOD FOOT DROP PREVENT
|
Facility
|
IP
|
$199.09
|
|
| Hospital Charge Code |
27000148
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$149.32 |
| Max. Negotiated Rate |
$199.09 |
| Rate for Payer: Aetna Commercial |
$179.18
|
| Rate for Payer: ASR ASR |
$193.12
|
| Rate for Payer: BCBS Trust/PPO |
$163.49
|
| Rate for Payer: BCN Commercial |
$163.49
|
| Rate for Payer: Cash Price |
$159.27
|
| Rate for Payer: Cofinity Commercial |
$187.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$159.27
|
| Rate for Payer: Healthscope Commercial |
$193.12
|
| Rate for Payer: Healthscope Whirlpool |
$199.09
|
| Rate for Payer: Mclaren Commercial |
$179.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$169.23
|
| Rate for Payer: Nomi Health Commercial |
$163.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$149.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$175.20
|
|
|
HC SOFTGOOD FOOT DROP PREVENT
|
Facility
|
OP
|
$199.09
|
|
| Hospital Charge Code |
27000148
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$73.66 |
| Max. Negotiated Rate |
$199.09 |
| Rate for Payer: Aetna Commercial |
$179.18
|
| Rate for Payer: Aetna Medicare |
$73.66
|
| Rate for Payer: ASR ASR |
$193.12
|
| Rate for Payer: BCBS Complete |
$79.64
|
| Rate for Payer: BCBS Trust/PPO |
$164.15
|
| Rate for Payer: BCN Commercial |
$164.15
|
| Rate for Payer: Cash Price |
$159.27
|
| Rate for Payer: Cofinity Commercial |
$187.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$159.27
|
| Rate for Payer: Healthscope Commercial |
$193.12
|
| Rate for Payer: Healthscope Whirlpool |
$199.09
|
| Rate for Payer: Mclaren Commercial |
$179.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$159.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$169.23
|
| Rate for Payer: Nomi Health Commercial |
$163.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$149.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$174.44
|
| Rate for Payer: Priority Health Narrow Network |
$139.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$175.20
|
|
|
HC SOFTGOOD HIP PILLOW ABD
|
Facility
|
IP
|
$164.77
|
|
| Hospital Charge Code |
27000149
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$123.58 |
| Max. Negotiated Rate |
$164.77 |
| Rate for Payer: Aetna Commercial |
$148.29
|
| Rate for Payer: ASR ASR |
$159.83
|
| Rate for Payer: BCBS Trust/PPO |
$135.31
|
| Rate for Payer: BCN Commercial |
$135.31
|
| Rate for Payer: Cash Price |
$131.82
|
| Rate for Payer: Cofinity Commercial |
$154.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$131.82
|
| Rate for Payer: Healthscope Commercial |
$159.83
|
| Rate for Payer: Healthscope Whirlpool |
$164.77
|
| Rate for Payer: Mclaren Commercial |
$148.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$140.05
|
| Rate for Payer: Nomi Health Commercial |
$135.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$123.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$145.00
|
|
|
HC SOFTGOOD HIP PILLOW ABD
|
Facility
|
OP
|
$164.77
|
|
| Hospital Charge Code |
27000149
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$60.96 |
| Max. Negotiated Rate |
$164.77 |
| Rate for Payer: Aetna Commercial |
$148.29
|
| Rate for Payer: Aetna Medicare |
$60.96
|
| Rate for Payer: ASR ASR |
$159.83
|
| Rate for Payer: BCBS Complete |
$65.91
|
| Rate for Payer: BCBS Trust/PPO |
$135.85
|
| Rate for Payer: BCN Commercial |
$135.85
|
| Rate for Payer: Cash Price |
$131.82
|
| Rate for Payer: Cofinity Commercial |
$154.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$131.82
|
| Rate for Payer: Healthscope Commercial |
$159.83
|
| Rate for Payer: Healthscope Whirlpool |
$164.77
|
| Rate for Payer: Mclaren Commercial |
$148.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$131.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$140.05
|
| Rate for Payer: Nomi Health Commercial |
$135.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$123.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$144.37
|
| Rate for Payer: Priority Health Narrow Network |
$115.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$145.00
|
|
