|
HC RNA POLYMERASE III AB IGG
|
Facility
|
IP
|
$71.40
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30200413
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$46.41 |
| Max. Negotiated Rate |
$71.40 |
| Rate for Payer: Aetna Commercial |
$64.26
|
| Rate for Payer: ASR ASR |
$69.26
|
| Rate for Payer: ASR Commercial |
$69.26
|
| Rate for Payer: BCBS Trust/PPO |
$58.18
|
| Rate for Payer: BCN Commercial |
$55.36
|
| Rate for Payer: Cash Price |
$57.12
|
| Rate for Payer: Cofinity Commercial |
$67.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.12
|
| Rate for Payer: Healthscope Commercial |
$71.40
|
| Rate for Payer: Healthscope Whirlpool |
$69.26
|
| Rate for Payer: Mclaren Commercial |
$64.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.69
|
| Rate for Payer: Nomi Health Commercial |
$58.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$62.83
|
|
|
HC RNA POLYMERASE III AB IGG
|
Facility
|
OP
|
$71.40
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30200413
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.18 |
| Max. Negotiated Rate |
$210.82 |
| Rate for Payer: Aetna Commercial |
$64.26
|
| Rate for Payer: Aetna Medicare |
$11.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.41
|
| Rate for Payer: ASR ASR |
$69.26
|
| Rate for Payer: ASR Commercial |
$69.26
|
| Rate for Payer: BCBS Complete |
$6.49
|
| Rate for Payer: BCBS MAPPO |
$11.53
|
| Rate for Payer: BCBS Trust/PPO |
$58.47
|
| Rate for Payer: BCN Commercial |
$55.36
|
| Rate for Payer: BCN Medicare Advantage |
$11.53
|
| Rate for Payer: Cash Price |
$57.12
|
| Rate for Payer: Cash Price |
$57.12
|
| Rate for Payer: Cofinity Commercial |
$67.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.53
|
| Rate for Payer: Healthscope Commercial |
$71.40
|
| Rate for Payer: Healthscope Whirlpool |
$69.26
|
| Rate for Payer: Humana Choice PPO Medicare |
$11.53
|
| Rate for Payer: Mclaren Commercial |
$64.26
|
| Rate for Payer: Mclaren Medicaid |
$6.18
|
| Rate for Payer: Mclaren Medicare |
$11.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.11
|
| Rate for Payer: Meridian Medicaid |
$6.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.69
|
| Rate for Payer: Nomi Health Commercial |
$58.55
|
| Rate for Payer: PACE Medicare |
$10.95
|
| Rate for Payer: PACE SWMI |
$11.53
|
| Rate for Payer: PHP Commercial |
$12.68
|
| Rate for Payer: PHP Medicaid |
$6.18
|
| Rate for Payer: PHP Medicare Advantage |
$11.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$210.82
|
| Rate for Payer: Priority Health Medicare |
$11.53
|
| Rate for Payer: Priority Health Narrow Network |
$168.66
|
| Rate for Payer: Railroad Medicare Medicare |
$11.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$62.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.53
|
| Rate for Payer: UHC Exchange |
$17.87
|
| Rate for Payer: UHC Medicare Advantage |
$11.53
|
| Rate for Payer: UHCCP DNSP |
$11.53
|
| Rate for Payer: UHCCP Medicaid |
$6.18
|
| Rate for Payer: VA VA |
$11.53
|
|
|
HC RNP 70 ANTIBODY
|
Facility
|
IP
|
$35.17
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200164
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$22.86 |
| Max. Negotiated Rate |
$35.17 |
| Rate for Payer: Aetna Commercial |
$31.65
|
| Rate for Payer: ASR ASR |
$34.11
|
| Rate for Payer: ASR Commercial |
$34.11
|
| Rate for Payer: BCBS Trust/PPO |
$28.66
|
| Rate for Payer: BCN Commercial |
$27.27
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cofinity Commercial |
$33.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.14
|
| Rate for Payer: Healthscope Commercial |
$35.17
|
| Rate for Payer: Healthscope Whirlpool |
$34.11
|
| Rate for Payer: Mclaren Commercial |
$31.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.89
|
| Rate for Payer: Nomi Health Commercial |
$28.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$30.95
|
|
|
HC RNP 70 ANTIBODY
|
Facility
|
OP
|
$35.17
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200164
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.61 |
| Max. Negotiated Rate |
$153.73 |
| Rate for Payer: Aetna Commercial |
$31.65
|
| 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 |
$34.11
|
| Rate for Payer: ASR Commercial |
$34.11
|
| Rate for Payer: BCBS Complete |
$10.09
|
| Rate for Payer: BCBS MAPPO |
$17.93
|
| Rate for Payer: BCBS Trust/PPO |
$28.80
|
| Rate for Payer: BCN Commercial |
$27.27
|
| Rate for Payer: BCN Medicare Advantage |
$17.93
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cofinity Commercial |
$33.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.93
|
| Rate for Payer: Healthscope Commercial |
$35.17
|
| Rate for Payer: Healthscope Whirlpool |
$34.11
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.93
|
| Rate for Payer: Mclaren Commercial |
$31.65
|
| Rate for Payer: Mclaren Medicaid |
$9.61
|
| 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 |
$10.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.89
|
| Rate for Payer: Nomi Health Commercial |
$28.84
|
| 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 |
$9.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$153.73
|
| Rate for Payer: Priority Health Medicare |
$17.93
|
| Rate for Payer: Priority Health Narrow Network |
$122.98
|
| Rate for Payer: Railroad Medicare Medicare |
$17.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$30.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.93
|
| Rate for Payer: UHC Exchange |
$27.79
|
| Rate for Payer: UHC Medicare Advantage |
$17.93
|
| Rate for Payer: UHCCP DNSP |
$17.93
|
| Rate for Payer: UHCCP Medicaid |
$9.61
|
| Rate for Payer: VA VA |
$17.93
|
|
|
HC RNP ANTIBODIES, IGG
|
Facility
|
OP
|
$35.17
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200434
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.61 |
| Max. Negotiated Rate |
$153.73 |
| Rate for Payer: Aetna Commercial |
$31.65
|
| 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 |
$34.11
|
| Rate for Payer: ASR Commercial |
$34.11
|
| Rate for Payer: BCBS Complete |
$10.09
|
| Rate for Payer: BCBS MAPPO |
$17.93
|
| Rate for Payer: BCBS Trust/PPO |
$28.80
|
| Rate for Payer: BCN Commercial |
$27.27
|
| Rate for Payer: BCN Medicare Advantage |
$17.93
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cofinity Commercial |
$33.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.93
|
| Rate for Payer: Healthscope Commercial |
$35.17
|
| Rate for Payer: Healthscope Whirlpool |
$34.11
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.93
|
| Rate for Payer: Mclaren Commercial |
$31.65
|
| Rate for Payer: Mclaren Medicaid |
$9.61
|
| 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 |
$10.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.89
|
| Rate for Payer: Nomi Health Commercial |
$28.84
|
| 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 |
$9.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$153.73
|
| Rate for Payer: Priority Health Medicare |
$17.93
|
| Rate for Payer: Priority Health Narrow Network |
$122.98
|
| Rate for Payer: Railroad Medicare Medicare |
$17.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$30.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.93
|
| Rate for Payer: UHC Exchange |
$27.79
|
| Rate for Payer: UHC Medicare Advantage |
$17.93
|
| Rate for Payer: UHCCP DNSP |
$17.93
|
| Rate for Payer: UHCCP Medicaid |
$9.61
|
| Rate for Payer: VA VA |
$17.93
|
|
|
HC RNP ANTIBODIES, IGG
|
Facility
|
IP
|
$35.17
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200434
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$22.86 |
| Max. Negotiated Rate |
$35.17 |
| Rate for Payer: Aetna Commercial |
$31.65
|
| Rate for Payer: ASR ASR |
$34.11
|
| Rate for Payer: ASR Commercial |
$34.11
|
| Rate for Payer: BCBS Trust/PPO |
$28.66
|
| Rate for Payer: BCN Commercial |
$27.27
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cofinity Commercial |
$33.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.14
|
| Rate for Payer: Healthscope Commercial |
$35.17
|
| Rate for Payer: Healthscope Whirlpool |
$34.11
|
| Rate for Payer: Mclaren Commercial |
$31.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.89
|
| Rate for Payer: Nomi Health Commercial |
$28.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$30.95
|
|
|
HC RNP U1 ANTIBODY
|
Facility
|
OP
|
$35.17
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200166
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.61 |
| Max. Negotiated Rate |
$153.73 |
| Rate for Payer: Aetna Commercial |
$31.65
|
| 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 |
$34.11
|
| Rate for Payer: ASR Commercial |
$34.11
|
| Rate for Payer: BCBS Complete |
$10.09
|
| Rate for Payer: BCBS MAPPO |
$17.93
|
| Rate for Payer: BCBS Trust/PPO |
$28.80
|
| Rate for Payer: BCN Commercial |
$27.27
|
| Rate for Payer: BCN Medicare Advantage |
$17.93
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cofinity Commercial |
$33.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.93
|
| Rate for Payer: Healthscope Commercial |
$35.17
|
| Rate for Payer: Healthscope Whirlpool |
$34.11
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.93
|
| Rate for Payer: Mclaren Commercial |
$31.65
|
| Rate for Payer: Mclaren Medicaid |
$9.61
|
| 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 |
$10.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.89
|
| Rate for Payer: Nomi Health Commercial |
$28.84
|
| 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 |
$9.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$153.73
|
| Rate for Payer: Priority Health Medicare |
$17.93
|
| Rate for Payer: Priority Health Narrow Network |
$122.98
|
| Rate for Payer: Railroad Medicare Medicare |
$17.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$30.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.93
|
| Rate for Payer: UHC Exchange |
$27.79
|
| Rate for Payer: UHC Medicare Advantage |
$17.93
|
| Rate for Payer: UHCCP DNSP |
$17.93
|
| Rate for Payer: UHCCP Medicaid |
$9.61
|
| Rate for Payer: VA VA |
$17.93
|
|
|
HC RNP U1 ANTIBODY
|
Facility
|
IP
|
$35.17
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200166
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$22.86 |
| Max. Negotiated Rate |
$35.17 |
| Rate for Payer: Aetna Commercial |
$31.65
|
| Rate for Payer: ASR ASR |
$34.11
|
| Rate for Payer: ASR Commercial |
$34.11
|
| Rate for Payer: BCBS Trust/PPO |
$28.66
|
| Rate for Payer: BCN Commercial |
$27.27
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cofinity Commercial |
$33.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.14
|
| Rate for Payer: Healthscope Commercial |
$35.17
|
| Rate for Payer: Healthscope Whirlpool |
$34.11
|
| Rate for Payer: Mclaren Commercial |
$31.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.89
|
| Rate for Payer: Nomi Health Commercial |
$28.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$30.95
|
|
|
HC RO GUIDE LOC TARGET VOL TX DEL
|
Facility
|
OP
|
$223.79
|
|
|
Service Code
|
CPT 77387
|
| Hospital Charge Code |
33300061
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$89.52 |
| Max. Negotiated Rate |
$223.79 |
| Rate for Payer: Aetna Commercial |
$201.41
|
| Rate for Payer: Aetna Medicare |
$111.90
|
| Rate for Payer: ASR ASR |
$217.08
|
| Rate for Payer: ASR Commercial |
$217.08
|
| Rate for Payer: BCBS Complete |
$89.52
|
| Rate for Payer: BCBS Trust/PPO |
$183.26
|
| Rate for Payer: BCN Commercial |
$173.50
|
| Rate for Payer: Cash Price |
$179.03
|
| Rate for Payer: Cofinity Commercial |
$210.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$179.03
|
| Rate for Payer: Healthscope Commercial |
$223.79
|
| Rate for Payer: Healthscope Whirlpool |
$217.08
|
| Rate for Payer: Mclaren Commercial |
$201.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$190.22
|
| Rate for Payer: Nomi Health Commercial |
$183.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$145.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$196.08
|
| Rate for Payer: Priority Health Narrow Network |
$156.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$196.94
|
|
|
HC RO GUIDE LOC TARGET VOL TX DEL
|
Facility
|
IP
|
$223.79
|
|
|
Service Code
|
CPT 77387
|
| Hospital Charge Code |
33300061
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$145.46 |
| Max. Negotiated Rate |
$223.79 |
| Rate for Payer: Aetna Commercial |
$201.41
|
| Rate for Payer: ASR ASR |
$217.08
|
| Rate for Payer: ASR Commercial |
$217.08
|
| Rate for Payer: BCBS Trust/PPO |
$182.37
|
| Rate for Payer: BCN Commercial |
$173.50
|
| Rate for Payer: Cash Price |
$179.03
|
| Rate for Payer: Cofinity Commercial |
$210.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$179.03
|
| Rate for Payer: Healthscope Commercial |
$223.79
|
| Rate for Payer: Healthscope Whirlpool |
$217.08
|
| Rate for Payer: Mclaren Commercial |
$201.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$190.22
|
| Rate for Payer: Nomi Health Commercial |
$183.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$145.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$196.94
|
|
|
HC RO IMRT DEL COMPLEX
|
Facility
|
OP
|
$3,288.00
|
|
|
Service Code
|
CPT 77386
|
| Hospital Charge Code |
33300051
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$303.79 |
| Max. Negotiated Rate |
$3,288.00 |
| Rate for Payer: Aetna Commercial |
$2,959.20
|
| Rate for Payer: Aetna Medicare |
$566.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$708.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$708.46
|
| Rate for Payer: ASR ASR |
$3,189.36
|
| Rate for Payer: ASR Commercial |
$3,189.36
|
| Rate for Payer: BCBS Complete |
$318.98
|
| Rate for Payer: BCBS MAPPO |
$566.77
|
| Rate for Payer: BCBS Trust/PPO |
$2,692.54
|
| Rate for Payer: BCN Commercial |
$2,549.19
|
| Rate for Payer: BCN Medicare Advantage |
$566.77
|
| Rate for Payer: Cash Price |
$2,630.40
|
| Rate for Payer: Cash Price |
$2,630.40
|
| Rate for Payer: Cofinity Commercial |
$3,090.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,630.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$566.77
|
| Rate for Payer: Healthscope Commercial |
$3,288.00
|
| Rate for Payer: Healthscope Whirlpool |
$3,189.36
|
| Rate for Payer: Humana Choice PPO Medicare |
$566.77
|
| Rate for Payer: Mclaren Commercial |
$2,959.20
|
| Rate for Payer: Mclaren Medicaid |
$303.79
|
| Rate for Payer: Mclaren Medicare |
$566.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$595.11
|
| Rate for Payer: Meridian Medicaid |
$318.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$651.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,794.80
|
| Rate for Payer: Nomi Health Commercial |
$2,696.16
|
| Rate for Payer: PACE Medicare |
$538.43
|
| Rate for Payer: PACE SWMI |
$566.77
|
| Rate for Payer: PHP Commercial |
$623.45
|
| Rate for Payer: PHP Medicaid |
$303.79
|
| Rate for Payer: PHP Medicare Advantage |
$566.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$303.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,137.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,880.95
|
| Rate for Payer: Priority Health Medicare |
$566.77
|
| Rate for Payer: Priority Health Narrow Network |
$2,304.89
|
| Rate for Payer: Railroad Medicare Medicare |
$566.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,893.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$566.77
|
| Rate for Payer: UHC Exchange |
$878.49
|
| Rate for Payer: UHC Medicare Advantage |
$566.77
|
| Rate for Payer: UHCCP DNSP |
$566.77
|
| Rate for Payer: UHCCP Medicaid |
$303.79
|
| Rate for Payer: VA VA |
$566.77
|
|
|
HC RO IMRT DEL COMPLEX
|
Facility
|
IP
|
$3,288.00
|
|
|
Service Code
|
CPT 77386
|
| Hospital Charge Code |
33300051
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$2,137.20 |
| Max. Negotiated Rate |
$3,288.00 |
| Rate for Payer: Aetna Commercial |
$2,959.20
|
| Rate for Payer: ASR ASR |
$3,189.36
|
| Rate for Payer: ASR Commercial |
$3,189.36
|
| Rate for Payer: BCBS Trust/PPO |
$2,679.39
|
| Rate for Payer: BCN Commercial |
$2,549.19
|
| Rate for Payer: Cash Price |
$2,630.40
|
| Rate for Payer: Cofinity Commercial |
$3,090.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,630.40
|
| Rate for Payer: Healthscope Commercial |
$3,288.00
|
| Rate for Payer: Healthscope Whirlpool |
$3,189.36
|
| Rate for Payer: Mclaren Commercial |
$2,959.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,794.80
|
| Rate for Payer: Nomi Health Commercial |
$2,696.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,137.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,893.44
|
|
|
HC RO IMRT DEL SIMPLE
|
Facility
|
IP
|
$3,288.00
|
|
|
Service Code
|
CPT 77385
|
| Hospital Charge Code |
33300050
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$2,137.20 |
| Max. Negotiated Rate |
$3,288.00 |
| Rate for Payer: Aetna Commercial |
$2,959.20
|
| Rate for Payer: ASR ASR |
$3,189.36
|
| Rate for Payer: ASR Commercial |
$3,189.36
|
| Rate for Payer: BCBS Trust/PPO |
$2,679.39
|
| Rate for Payer: BCN Commercial |
$2,549.19
|
| Rate for Payer: Cash Price |
$2,630.40
|
| Rate for Payer: Cofinity Commercial |
$3,090.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,630.40
|
| Rate for Payer: Healthscope Commercial |
$3,288.00
|
| Rate for Payer: Healthscope Whirlpool |
$3,189.36
|
| Rate for Payer: Mclaren Commercial |
$2,959.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,794.80
|
| Rate for Payer: Nomi Health Commercial |
$2,696.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,137.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,893.44
|
|
|
HC RO IMRT DEL SIMPLE
|
Facility
|
OP
|
$3,288.00
|
|
|
Service Code
|
CPT 77385
|
| Hospital Charge Code |
33300050
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$303.79 |
| Max. Negotiated Rate |
$3,288.00 |
| Rate for Payer: Aetna Commercial |
$2,959.20
|
| Rate for Payer: Aetna Medicare |
$566.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$708.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$708.46
|
| Rate for Payer: ASR ASR |
$3,189.36
|
| Rate for Payer: ASR Commercial |
$3,189.36
|
| Rate for Payer: BCBS Complete |
$318.98
|
| Rate for Payer: BCBS MAPPO |
$566.77
|
| Rate for Payer: BCBS Trust/PPO |
$2,692.54
|
| Rate for Payer: BCN Commercial |
$2,549.19
|
| Rate for Payer: BCN Medicare Advantage |
$566.77
|
| Rate for Payer: Cash Price |
$2,630.40
|
| Rate for Payer: Cash Price |
$2,630.40
|
| Rate for Payer: Cofinity Commercial |
$3,090.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,630.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$566.77
|
| Rate for Payer: Healthscope Commercial |
$3,288.00
|
| Rate for Payer: Healthscope Whirlpool |
$3,189.36
|
| Rate for Payer: Humana Choice PPO Medicare |
$566.77
|
| Rate for Payer: Mclaren Commercial |
$2,959.20
|
| Rate for Payer: Mclaren Medicaid |
$303.79
|
| Rate for Payer: Mclaren Medicare |
$566.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$595.11
|
| Rate for Payer: Meridian Medicaid |
$318.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$651.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,794.80
|
| Rate for Payer: Nomi Health Commercial |
$2,696.16
|
| Rate for Payer: PACE Medicare |
$538.43
|
| Rate for Payer: PACE SWMI |
$566.77
|
| Rate for Payer: PHP Commercial |
$623.45
|
| Rate for Payer: PHP Medicaid |
$303.79
|
| Rate for Payer: PHP Medicare Advantage |
$566.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$303.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,137.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,880.95
|
| Rate for Payer: Priority Health Medicare |
$566.77
|
| Rate for Payer: Priority Health Narrow Network |
$2,304.89
|
| Rate for Payer: Railroad Medicare Medicare |
$566.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,893.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$566.77
|
| Rate for Payer: UHC Exchange |
$878.49
|
| Rate for Payer: UHC Medicare Advantage |
$566.77
|
| Rate for Payer: UHCCP DNSP |
$566.77
|
| Rate for Payer: UHCCP Medicaid |
$303.79
|
| Rate for Payer: VA VA |
$566.77
|
|
|
HC RO INFUS RADIOACTIVE MATERIAL
|
Facility
|
IP
|
$331.89
|
|
|
Service Code
|
CPT 77750
|
| Hospital Charge Code |
33300042
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$215.73 |
| Max. Negotiated Rate |
$331.89 |
| Rate for Payer: Aetna Commercial |
$298.70
|
| Rate for Payer: ASR ASR |
$321.93
|
| Rate for Payer: ASR Commercial |
$321.93
|
| Rate for Payer: BCBS Trust/PPO |
$270.46
|
| Rate for Payer: BCN Commercial |
$257.31
|
| Rate for Payer: Cash Price |
$265.51
|
| Rate for Payer: Cofinity Commercial |
$311.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$265.51
|
| Rate for Payer: Healthscope Commercial |
$331.89
|
| Rate for Payer: Healthscope Whirlpool |
$321.93
|
| Rate for Payer: Mclaren Commercial |
$298.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$282.11
|
| Rate for Payer: Nomi Health Commercial |
$272.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$215.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$292.06
|
|
|
HC RO INFUS RADIOACTIVE MATERIAL
|
Facility
|
OP
|
$331.89
|
|
|
Service Code
|
CPT 77750
|
| Hospital Charge Code |
33300042
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$138.11 |
| Max. Negotiated Rate |
$399.37 |
| Rate for Payer: Aetna Commercial |
$298.70
|
| Rate for Payer: Aetna Medicare |
$257.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$322.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$322.08
|
| Rate for Payer: ASR ASR |
$321.93
|
| Rate for Payer: ASR Commercial |
$321.93
|
| Rate for Payer: BCBS Complete |
$145.01
|
| Rate for Payer: BCBS MAPPO |
$257.66
|
| Rate for Payer: BCBS Trust/PPO |
$271.78
|
| Rate for Payer: BCN Commercial |
$257.31
|
| Rate for Payer: BCN Medicare Advantage |
$257.66
|
| Rate for Payer: Cash Price |
$265.51
|
| Rate for Payer: Cash Price |
$265.51
|
| Rate for Payer: Cofinity Commercial |
$311.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$265.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$257.66
|
| Rate for Payer: Healthscope Commercial |
$331.89
|
| Rate for Payer: Healthscope Whirlpool |
$321.93
|
| Rate for Payer: Humana Choice PPO Medicare |
$257.66
|
| Rate for Payer: Mclaren Commercial |
$298.70
|
| Rate for Payer: Mclaren Medicaid |
$138.11
|
| Rate for Payer: Mclaren Medicare |
$257.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$270.54
|
| Rate for Payer: Meridian Medicaid |
$145.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$296.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$282.11
|
| Rate for Payer: Nomi Health Commercial |
$272.15
|
| Rate for Payer: PACE Medicare |
$244.78
|
| Rate for Payer: PACE SWMI |
$257.66
|
| Rate for Payer: PHP Commercial |
$283.43
|
| Rate for Payer: PHP Medicaid |
$138.11
|
| Rate for Payer: PHP Medicare Advantage |
$257.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$138.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$215.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$290.80
|
| Rate for Payer: Priority Health Medicare |
$257.66
|
| Rate for Payer: Priority Health Narrow Network |
$232.65
|
| Rate for Payer: Railroad Medicare Medicare |
$257.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$292.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$257.66
|
| Rate for Payer: UHC Exchange |
$399.37
|
| Rate for Payer: UHC Medicare Advantage |
$257.66
|
| Rate for Payer: UHCCP DNSP |
$257.66
|
| Rate for Payer: UHCCP Medicaid |
$138.11
|
| Rate for Payer: VA VA |
$257.66
|
|
|
HC RO INS VAG BRACHTHER DEVICE
|
Facility
|
IP
|
$550.40
|
|
|
Service Code
|
CPT 57156
|
| Hospital Charge Code |
36100444
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$357.76 |
| Max. Negotiated Rate |
$550.40 |
| Rate for Payer: Aetna Commercial |
$495.36
|
| Rate for Payer: ASR ASR |
$533.89
|
| Rate for Payer: ASR Commercial |
$533.89
|
| Rate for Payer: BCBS Trust/PPO |
$448.52
|
| Rate for Payer: BCN Commercial |
$426.73
|
| Rate for Payer: Cash Price |
$440.32
|
| Rate for Payer: Cofinity Commercial |
$517.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$440.32
|
| Rate for Payer: Healthscope Commercial |
$550.40
|
| Rate for Payer: Healthscope Whirlpool |
$533.89
|
| Rate for Payer: Mclaren Commercial |
$495.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$467.84
|
| Rate for Payer: Nomi Health Commercial |
$451.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$357.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$484.35
|
|
|
HC RO INS VAG BRACHTHER DEVICE
|
Facility
|
OP
|
$550.40
|
|
|
Service Code
|
CPT 57156
|
| Hospital Charge Code |
36100444
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$159.75 |
| Max. Negotiated Rate |
$550.40 |
| Rate for Payer: Aetna Commercial |
$495.36
|
| Rate for Payer: Aetna Medicare |
$298.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$372.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$372.55
|
| Rate for Payer: ASR ASR |
$533.89
|
| Rate for Payer: ASR Commercial |
$533.89
|
| Rate for Payer: BCBS Complete |
$167.74
|
| Rate for Payer: BCBS MAPPO |
$298.04
|
| Rate for Payer: BCBS Trust/PPO |
$450.72
|
| Rate for Payer: BCN Commercial |
$426.73
|
| Rate for Payer: BCN Medicare Advantage |
$298.04
|
| Rate for Payer: Cash Price |
$440.32
|
| Rate for Payer: Cash Price |
$440.32
|
| Rate for Payer: Cofinity Commercial |
$517.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$440.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$298.04
|
| Rate for Payer: Healthscope Commercial |
$550.40
|
| Rate for Payer: Healthscope Whirlpool |
$533.89
|
| Rate for Payer: Humana Choice PPO Medicare |
$298.04
|
| Rate for Payer: Mclaren Commercial |
$495.36
|
| Rate for Payer: Mclaren Medicaid |
$159.75
|
| Rate for Payer: Mclaren Medicare |
$298.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$312.94
|
| Rate for Payer: Meridian Medicaid |
$167.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$342.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$467.84
|
| Rate for Payer: Nomi Health Commercial |
$451.33
|
| Rate for Payer: PACE Medicare |
$283.14
|
| Rate for Payer: PACE SWMI |
$298.04
|
| Rate for Payer: PHP Commercial |
$327.84
|
| Rate for Payer: PHP Medicaid |
$159.75
|
| Rate for Payer: PHP Medicare Advantage |
$298.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$159.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$357.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$482.26
|
| Rate for Payer: Priority Health Medicare |
$298.04
|
| Rate for Payer: Priority Health Narrow Network |
$385.83
|
| Rate for Payer: Railroad Medicare Medicare |
$298.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$484.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$298.04
|
| Rate for Payer: UHC Exchange |
$461.96
|
| Rate for Payer: UHC Medicare Advantage |
$298.04
|
| Rate for Payer: UHCCP DNSP |
$298.04
|
| Rate for Payer: UHCCP Medicaid |
$159.75
|
| Rate for Payer: VA VA |
$298.04
|
|
|
HC RO INTRSTI RADELEMENT APPL CMPLX
|
Facility
|
OP
|
$2,837.17
|
|
|
Service Code
|
CPT 77778
|
| Hospital Charge Code |
33300035
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$364.36 |
| Max. Negotiated Rate |
$2,837.17 |
| Rate for Payer: Aetna Commercial |
$2,553.45
|
| Rate for Payer: Aetna Medicare |
$679.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$849.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$849.72
|
| Rate for Payer: ASR ASR |
$2,752.05
|
| Rate for Payer: ASR Commercial |
$2,752.05
|
| Rate for Payer: BCBS Complete |
$382.58
|
| Rate for Payer: BCBS MAPPO |
$679.78
|
| Rate for Payer: BCBS Trust/PPO |
$2,323.36
|
| Rate for Payer: BCN Commercial |
$2,199.66
|
| Rate for Payer: BCN Medicare Advantage |
$679.78
|
| Rate for Payer: Cash Price |
$2,269.74
|
| Rate for Payer: Cash Price |
$2,269.74
|
| Rate for Payer: Cofinity Commercial |
$2,666.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,269.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$679.78
|
| Rate for Payer: Healthscope Commercial |
$2,837.17
|
| Rate for Payer: Healthscope Whirlpool |
$2,752.05
|
| Rate for Payer: Humana Choice PPO Medicare |
$679.78
|
| Rate for Payer: Mclaren Commercial |
$2,553.45
|
| Rate for Payer: Mclaren Medicaid |
$364.36
|
| Rate for Payer: Mclaren Medicare |
$679.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$713.77
|
| Rate for Payer: Meridian Medicaid |
$382.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$781.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,411.59
|
| Rate for Payer: Nomi Health Commercial |
$2,326.48
|
| Rate for Payer: PACE Medicare |
$645.79
|
| Rate for Payer: PACE SWMI |
$679.78
|
| Rate for Payer: PHP Commercial |
$747.76
|
| Rate for Payer: PHP Medicaid |
$364.36
|
| Rate for Payer: PHP Medicare Advantage |
$679.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$364.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,844.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,485.93
|
| Rate for Payer: Priority Health Medicare |
$679.78
|
| Rate for Payer: Priority Health Narrow Network |
$1,988.86
|
| Rate for Payer: Railroad Medicare Medicare |
$679.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,496.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$679.78
|
| Rate for Payer: UHC Exchange |
$1,053.66
|
| Rate for Payer: UHC Medicare Advantage |
$679.78
|
| Rate for Payer: UHCCP DNSP |
$679.78
|
| Rate for Payer: UHCCP Medicaid |
$364.36
|
| Rate for Payer: VA VA |
$679.78
|
|
|
HC RO INTRSTI RADELEMENT APPL CMPLX
|
Facility
|
IP
|
$2,837.17
|
|
|
Service Code
|
CPT 77778
|
| Hospital Charge Code |
33300035
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$1,844.16 |
| Max. Negotiated Rate |
$2,837.17 |
| Rate for Payer: Aetna Commercial |
$2,553.45
|
| Rate for Payer: ASR ASR |
$2,752.05
|
| Rate for Payer: ASR Commercial |
$2,752.05
|
| Rate for Payer: BCBS Trust/PPO |
$2,312.01
|
| Rate for Payer: BCN Commercial |
$2,199.66
|
| Rate for Payer: Cash Price |
$2,269.74
|
| Rate for Payer: Cofinity Commercial |
$2,666.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,269.74
|
| Rate for Payer: Healthscope Commercial |
$2,837.17
|
| Rate for Payer: Healthscope Whirlpool |
$2,752.05
|
| Rate for Payer: Mclaren Commercial |
$2,553.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,411.59
|
| Rate for Payer: Nomi Health Commercial |
$2,326.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,844.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,496.71
|
|
|
HC RO ISODOSE BRACH CALC SIMPLE
|
Facility
|
IP
|
$234.86
|
|
|
Service Code
|
CPT 77316
|
| Hospital Charge Code |
33300045
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$152.66 |
| Max. Negotiated Rate |
$234.86 |
| Rate for Payer: Aetna Commercial |
$211.37
|
| Rate for Payer: ASR ASR |
$227.81
|
| Rate for Payer: ASR Commercial |
$227.81
|
| Rate for Payer: BCBS Trust/PPO |
$191.39
|
| Rate for Payer: BCN Commercial |
$182.09
|
| Rate for Payer: Cash Price |
$187.89
|
| Rate for Payer: Cofinity Commercial |
$220.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$187.89
|
| Rate for Payer: Healthscope Commercial |
$234.86
|
| Rate for Payer: Healthscope Whirlpool |
$227.81
|
| Rate for Payer: Mclaren Commercial |
$211.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$199.63
|
| Rate for Payer: Nomi Health Commercial |
$192.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$152.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$206.68
|
|
|
HC RO ISODOSE BRACH CALC SIMPLE
|
Facility
|
OP
|
$234.86
|
|
|
Service Code
|
CPT 77316
|
| Hospital Charge Code |
33300045
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$152.66 |
| Max. Negotiated Rate |
$555.94 |
| Rate for Payer: Aetna Commercial |
$211.37
|
| Rate for Payer: Aetna Medicare |
$358.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$448.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$448.34
|
| Rate for Payer: ASR ASR |
$227.81
|
| Rate for Payer: ASR Commercial |
$227.81
|
| Rate for Payer: BCBS Complete |
$201.86
|
| Rate for Payer: BCBS MAPPO |
$358.67
|
| Rate for Payer: BCBS Trust/PPO |
$192.33
|
| Rate for Payer: BCN Commercial |
$182.09
|
| Rate for Payer: BCN Medicare Advantage |
$358.67
|
| Rate for Payer: Cash Price |
$187.89
|
| Rate for Payer: Cash Price |
$187.89
|
| Rate for Payer: Cofinity Commercial |
$220.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$187.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$358.67
|
| Rate for Payer: Healthscope Commercial |
$234.86
|
| Rate for Payer: Healthscope Whirlpool |
$227.81
|
| Rate for Payer: Humana Choice PPO Medicare |
$358.67
|
| Rate for Payer: Mclaren Commercial |
$211.37
|
| Rate for Payer: Mclaren Medicaid |
$192.25
|
| Rate for Payer: Mclaren Medicare |
$358.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$376.60
|
| Rate for Payer: Meridian Medicaid |
$201.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$412.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$199.63
|
| Rate for Payer: Nomi Health Commercial |
$192.59
|
| Rate for Payer: PACE Medicare |
$340.74
|
| Rate for Payer: PACE SWMI |
$358.67
|
| Rate for Payer: PHP Commercial |
$394.54
|
| Rate for Payer: PHP Medicaid |
$192.25
|
| Rate for Payer: PHP Medicare Advantage |
$358.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$192.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$152.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$205.78
|
| Rate for Payer: Priority Health Medicare |
$358.67
|
| Rate for Payer: Priority Health Narrow Network |
$164.64
|
| Rate for Payer: Railroad Medicare Medicare |
$358.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$206.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$358.67
|
| Rate for Payer: UHC Exchange |
$555.94
|
| Rate for Payer: UHC Medicare Advantage |
$358.67
|
| Rate for Payer: UHCCP DNSP |
$358.67
|
| Rate for Payer: UHCCP Medicaid |
$192.25
|
| Rate for Payer: VA VA |
$358.67
|
|
|
HC RO ISODOSE BRACHY CALC COMPLEX
|
Facility
|
IP
|
$684.94
|
|
|
Service Code
|
CPT 77318
|
| Hospital Charge Code |
33300047
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$445.21 |
| Max. Negotiated Rate |
$684.94 |
| Rate for Payer: Aetna Commercial |
$616.45
|
| Rate for Payer: ASR ASR |
$664.39
|
| Rate for Payer: ASR Commercial |
$664.39
|
| Rate for Payer: BCBS Trust/PPO |
$558.16
|
| Rate for Payer: BCN Commercial |
$531.03
|
| Rate for Payer: Cash Price |
$547.95
|
| Rate for Payer: Cofinity Commercial |
$643.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$547.95
|
| Rate for Payer: Healthscope Commercial |
$684.94
|
| Rate for Payer: Healthscope Whirlpool |
$664.39
|
| Rate for Payer: Mclaren Commercial |
$616.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$582.20
|
| Rate for Payer: Nomi Health Commercial |
$561.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$445.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$602.75
|
|
|
HC RO ISODOSE BRACHY CALC COMPLEX
|
Facility
|
OP
|
$684.94
|
|
|
Service Code
|
CPT 77318
|
| Hospital Charge Code |
33300047
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$192.25 |
| Max. Negotiated Rate |
$684.94 |
| Rate for Payer: Aetna Commercial |
$616.45
|
| Rate for Payer: Aetna Medicare |
$358.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$448.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$448.34
|
| Rate for Payer: ASR ASR |
$664.39
|
| Rate for Payer: ASR Commercial |
$664.39
|
| Rate for Payer: BCBS Complete |
$201.86
|
| Rate for Payer: BCBS MAPPO |
$358.67
|
| Rate for Payer: BCBS Trust/PPO |
$560.90
|
| Rate for Payer: BCN Commercial |
$531.03
|
| Rate for Payer: BCN Medicare Advantage |
$358.67
|
| Rate for Payer: Cash Price |
$547.95
|
| Rate for Payer: Cash Price |
$547.95
|
| Rate for Payer: Cofinity Commercial |
$643.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$547.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$358.67
|
| Rate for Payer: Healthscope Commercial |
$684.94
|
| Rate for Payer: Healthscope Whirlpool |
$664.39
|
| Rate for Payer: Humana Choice PPO Medicare |
$358.67
|
| Rate for Payer: Mclaren Commercial |
$616.45
|
| Rate for Payer: Mclaren Medicaid |
$192.25
|
| Rate for Payer: Mclaren Medicare |
$358.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$376.60
|
| Rate for Payer: Meridian Medicaid |
$201.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$412.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$582.20
|
| Rate for Payer: Nomi Health Commercial |
$561.65
|
| Rate for Payer: PACE Medicare |
$340.74
|
| Rate for Payer: PACE SWMI |
$358.67
|
| Rate for Payer: PHP Commercial |
$394.54
|
| Rate for Payer: PHP Medicaid |
$192.25
|
| Rate for Payer: PHP Medicare Advantage |
$358.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$192.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$445.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$600.14
|
| Rate for Payer: Priority Health Medicare |
$358.67
|
| Rate for Payer: Priority Health Narrow Network |
$480.14
|
| Rate for Payer: Railroad Medicare Medicare |
$358.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$602.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$358.67
|
| Rate for Payer: UHC Exchange |
$555.94
|
| Rate for Payer: UHC Medicare Advantage |
$358.67
|
| Rate for Payer: UHCCP DNSP |
$358.67
|
| Rate for Payer: UHCCP Medicaid |
$192.25
|
| Rate for Payer: VA VA |
$358.67
|
|
|
HC RO ISODOSE BRACHY CALC INTRM
|
Facility
|
IP
|
$622.67
|
|
|
Service Code
|
CPT 77317
|
| Hospital Charge Code |
33300046
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$404.74 |
| Max. Negotiated Rate |
$622.67 |
| Rate for Payer: Aetna Commercial |
$560.40
|
| Rate for Payer: ASR ASR |
$603.99
|
| Rate for Payer: ASR Commercial |
$603.99
|
| Rate for Payer: BCBS Trust/PPO |
$507.41
|
| Rate for Payer: BCN Commercial |
$482.76
|
| Rate for Payer: Cash Price |
$498.14
|
| Rate for Payer: Cofinity Commercial |
$585.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$498.14
|
| Rate for Payer: Healthscope Commercial |
$622.67
|
| Rate for Payer: Healthscope Whirlpool |
$603.99
|
| Rate for Payer: Mclaren Commercial |
$560.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$529.27
|
| Rate for Payer: Nomi Health Commercial |
$510.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$404.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$547.95
|
|
