|
HC SQ ICD LEAD
|
Facility
|
OP
|
$14,955.75
|
|
|
Service Code
|
HCPCS C1896
|
| Hospital Charge Code |
27800123
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,533.63 |
| Max. Negotiated Rate |
$14,955.75 |
| Rate for Payer: Aetna Commercial |
$13,460.17
|
| Rate for Payer: Aetna Medicare |
$5,533.63
|
| Rate for Payer: ASR ASR |
$14,507.08
|
| Rate for Payer: BCBS Complete |
$5,982.30
|
| Rate for Payer: BCBS Trust/PPO |
$12,331.02
|
| Rate for Payer: BCN Commercial |
$12,331.02
|
| Rate for Payer: Cash Price |
$11,964.60
|
| Rate for Payer: Cofinity Commercial |
$14,058.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,964.60
|
| Rate for Payer: Healthscope Commercial |
$14,507.08
|
| Rate for Payer: Healthscope Whirlpool |
$14,955.75
|
| Rate for Payer: Mclaren Commercial |
$13,460.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,964.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,712.39
|
| Rate for Payer: Nomi Health Commercial |
$12,263.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11,216.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$13,104.23
|
| Rate for Payer: Priority Health Narrow Network |
$10,483.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$13,161.06
|
|
|
HC SQ IM CHEMO HORMONAL
|
Facility
|
IP
|
$251.44
|
|
|
Service Code
|
CPT 96402
|
| Hospital Charge Code |
33100002
|
|
Hospital Revenue Code
|
331
|
| Min. Negotiated Rate |
$188.58 |
| Max. Negotiated Rate |
$251.44 |
| Rate for Payer: Aetna Commercial |
$226.30
|
| Rate for Payer: ASR ASR |
$243.90
|
| Rate for Payer: BCBS Trust/PPO |
$206.48
|
| Rate for Payer: BCN Commercial |
$206.48
|
| Rate for Payer: Cash Price |
$201.15
|
| Rate for Payer: Cofinity Commercial |
$236.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$201.15
|
| Rate for Payer: Healthscope Commercial |
$243.90
|
| Rate for Payer: Healthscope Whirlpool |
$251.44
|
| Rate for Payer: Mclaren Commercial |
$226.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$213.72
|
| Rate for Payer: Nomi Health Commercial |
$206.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$188.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$221.27
|
|
|
HC SQ IM CHEMO HORMONAL
|
Facility
|
OP
|
$251.44
|
|
|
Service Code
|
CPT 96402
|
| Hospital Charge Code |
33100002
|
|
Hospital Revenue Code
|
331
|
| Min. Negotiated Rate |
$37.52 |
| Max. Negotiated Rate |
$251.44 |
| Rate for Payer: Aetna Commercial |
$226.30
|
| Rate for Payer: Aetna Medicare |
$71.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$89.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$89.67
|
| Rate for Payer: ASR ASR |
$243.90
|
| Rate for Payer: BCBS Complete |
$39.40
|
| Rate for Payer: BCBS MAPPO |
$71.74
|
| Rate for Payer: BCBS Trust/PPO |
$207.31
|
| Rate for Payer: BCN Commercial |
$207.31
|
| Rate for Payer: BCN Medicare Advantage |
$71.74
|
| Rate for Payer: Cash Price |
$201.15
|
| Rate for Payer: Cash Price |
$201.15
|
| Rate for Payer: Cofinity Commercial |
$236.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$201.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.74
|
| Rate for Payer: Healthscope Commercial |
$243.90
|
| Rate for Payer: Healthscope Whirlpool |
$251.44
|
| Rate for Payer: Humana Choice PPO Medicare |
$71.74
|
| Rate for Payer: Mclaren Commercial |
$226.30
|
| Rate for Payer: Mclaren Medicaid |
$71.74
|
| Rate for Payer: Mclaren Medicare |
$71.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$75.33
|
| Rate for Payer: Meridian Medicaid |
$39.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$82.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$78.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$213.72
|
| Rate for Payer: Nomi Health Commercial |
$206.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$188.58
|
| Rate for Payer: PACE Medicare |
$68.15
|
| Rate for Payer: PACE SWMI |
$71.74
|
| Rate for Payer: PHP Commercial |
$78.91
|
| Rate for Payer: PHP Medicaid |
$38.45
|
| Rate for Payer: PHP Medicare Advantage |
$71.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$89.59
|
| Rate for Payer: Priority Health Medicare |
$71.74
|
| Rate for Payer: Priority Health Narrow Network |
$71.67
|
| Rate for Payer: Railroad Medicare Medicare |
$71.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$221.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$71.74
|
| Rate for Payer: UHC Exchange |
$111.20
|
| Rate for Payer: UHC Medicaid |
$37.52
|
| Rate for Payer: UHCCP DNSP |
$71.74
|
| Rate for Payer: UHCCP Medicaid |
$37.52
|
| Rate for Payer: VA VA |
$71.74
|
|
|
HC SQ IM CHEMO NON-HORMONAL
|
Facility
|
OP
|
$508.92
|
|
|
Service Code
|
CPT 96401
|
| Hospital Charge Code |
33100001
|
|
Hospital Revenue Code
|
331
|
| Min. Negotiated Rate |
$37.52 |
| Max. Negotiated Rate |
$508.92 |
| Rate for Payer: Aetna Commercial |
$458.03
|
| Rate for Payer: Aetna Medicare |
$71.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$89.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$89.67
|
| Rate for Payer: ASR ASR |
$493.65
|
| Rate for Payer: BCBS Complete |
$39.40
|
| Rate for Payer: BCBS MAPPO |
$71.74
|
| Rate for Payer: BCBS Trust/PPO |
$419.60
|
| Rate for Payer: BCN Commercial |
$419.60
|
| Rate for Payer: BCN Medicare Advantage |
$71.74
|
| Rate for Payer: Cash Price |
$407.14
|
| Rate for Payer: Cash Price |
$407.14
|
| Rate for Payer: Cofinity Commercial |
$478.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$407.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.74
|
| Rate for Payer: Healthscope Commercial |
$493.65
|
| Rate for Payer: Healthscope Whirlpool |
$508.92
|
| Rate for Payer: Humana Choice PPO Medicare |
$71.74
|
| Rate for Payer: Mclaren Commercial |
$458.03
|
| Rate for Payer: Mclaren Medicaid |
$71.74
|
| Rate for Payer: Mclaren Medicare |
$71.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$75.33
|
| Rate for Payer: Meridian Medicaid |
$39.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$82.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$78.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$432.58
|
| Rate for Payer: Nomi Health Commercial |
$417.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$381.69
|
| Rate for Payer: PACE Medicare |
$68.15
|
| Rate for Payer: PACE SWMI |
$71.74
|
| Rate for Payer: PHP Commercial |
$78.91
|
| Rate for Payer: PHP Medicaid |
$38.45
|
| Rate for Payer: PHP Medicare Advantage |
$71.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$89.59
|
| Rate for Payer: Priority Health Medicare |
$71.74
|
| Rate for Payer: Priority Health Narrow Network |
$71.67
|
| Rate for Payer: Railroad Medicare Medicare |
$71.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$447.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$71.74
|
| Rate for Payer: UHC Exchange |
$111.20
|
| Rate for Payer: UHC Medicaid |
$37.52
|
| Rate for Payer: UHCCP DNSP |
$71.74
|
| Rate for Payer: UHCCP Medicaid |
$37.52
|
| Rate for Payer: VA VA |
$71.74
|
|
|
HC SQ IM CHEMO NON-HORMONAL
|
Facility
|
IP
|
$508.92
|
|
|
Service Code
|
CPT 96401
|
| Hospital Charge Code |
33100001
|
|
Hospital Revenue Code
|
331
|
| Min. Negotiated Rate |
$381.69 |
| Max. Negotiated Rate |
$508.92 |
| Rate for Payer: Aetna Commercial |
$458.03
|
| Rate for Payer: ASR ASR |
$493.65
|
| Rate for Payer: BCBS Trust/PPO |
$417.93
|
| Rate for Payer: BCN Commercial |
$417.93
|
| Rate for Payer: Cash Price |
$407.14
|
| Rate for Payer: Cofinity Commercial |
$478.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$407.14
|
| Rate for Payer: Healthscope Commercial |
$493.65
|
| Rate for Payer: Healthscope Whirlpool |
$508.92
|
| Rate for Payer: Mclaren Commercial |
$458.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$432.58
|
| Rate for Payer: Nomi Health Commercial |
$417.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$381.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$447.85
|
|
|
HC SQ OR IM INJECTION
|
Facility
|
OP
|
$152.79
|
|
|
Service Code
|
CPT 96372
|
| Hospital Charge Code |
51000003
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$37.52 |
| Max. Negotiated Rate |
$152.79 |
| Rate for Payer: Aetna Commercial |
$137.51
|
| Rate for Payer: Aetna Medicare |
$71.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$89.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$89.67
|
| Rate for Payer: ASR ASR |
$148.21
|
| Rate for Payer: BCBS Complete |
$39.40
|
| Rate for Payer: BCBS MAPPO |
$71.74
|
| Rate for Payer: BCBS Trust/PPO |
$125.98
|
| Rate for Payer: BCN Commercial |
$125.98
|
| Rate for Payer: BCN Medicare Advantage |
$71.74
|
| Rate for Payer: Cash Price |
$122.23
|
| Rate for Payer: Cash Price |
$122.23
|
| Rate for Payer: Cofinity Commercial |
$143.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$122.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.74
|
| Rate for Payer: Healthscope Commercial |
$148.21
|
| Rate for Payer: Healthscope Whirlpool |
$152.79
|
| Rate for Payer: Humana Choice PPO Medicare |
$71.74
|
| Rate for Payer: Mclaren Commercial |
$137.51
|
| Rate for Payer: Mclaren Medicaid |
$71.74
|
| Rate for Payer: Mclaren Medicare |
$71.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$75.33
|
| Rate for Payer: Meridian Medicaid |
$39.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$82.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$78.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$129.87
|
| Rate for Payer: Nomi Health Commercial |
$125.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$114.59
|
| Rate for Payer: PACE Medicare |
$68.15
|
| Rate for Payer: PACE SWMI |
$71.74
|
| Rate for Payer: PHP Commercial |
$78.91
|
| Rate for Payer: PHP Medicaid |
$38.45
|
| Rate for Payer: PHP Medicare Advantage |
$71.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$64.17
|
| Rate for Payer: Priority Health Medicare |
$71.74
|
| Rate for Payer: Priority Health Narrow Network |
$51.33
|
| Rate for Payer: Railroad Medicare Medicare |
$71.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$134.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$71.74
|
| Rate for Payer: UHC Exchange |
$111.20
|
| Rate for Payer: UHC Medicaid |
$37.52
|
| Rate for Payer: UHCCP DNSP |
$71.74
|
| Rate for Payer: UHCCP Medicaid |
$37.52
|
| Rate for Payer: VA VA |
$71.74
|
|
|
HC SQ OR IM INJECTION
|
Facility
|
IP
|
$152.79
|
|
|
Service Code
|
CPT 96372
|
| Hospital Charge Code |
51000003
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$114.59 |
| Max. Negotiated Rate |
$152.79 |
| Rate for Payer: Aetna Commercial |
$137.51
|
| Rate for Payer: ASR ASR |
$148.21
|
| Rate for Payer: BCBS Trust/PPO |
$125.47
|
| Rate for Payer: BCN Commercial |
$125.47
|
| Rate for Payer: Cash Price |
$122.23
|
| Rate for Payer: Cofinity Commercial |
$143.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$122.23
|
| Rate for Payer: Healthscope Commercial |
$148.21
|
| Rate for Payer: Healthscope Whirlpool |
$152.79
|
| Rate for Payer: Mclaren Commercial |
$137.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$129.87
|
| Rate for Payer: Nomi Health Commercial |
$125.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$114.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$134.46
|
|
|
HC SRA, LMWH
|
Facility
|
OP
|
$339.59
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
30200424
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.61 |
| Max. Negotiated Rate |
$339.59 |
| Rate for Payer: Aetna Commercial |
$305.63
|
| Rate for Payer: Aetna Medicare |
$18.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.96
|
| Rate for Payer: ASR ASR |
$329.40
|
| Rate for Payer: BCBS Complete |
$10.09
|
| Rate for Payer: BCBS MAPPO |
$18.37
|
| Rate for Payer: BCBS Trust/PPO |
$279.99
|
| Rate for Payer: BCN Commercial |
$279.99
|
| Rate for Payer: BCN Medicare Advantage |
$18.37
|
| Rate for Payer: Cash Price |
$271.67
|
| Rate for Payer: Cash Price |
$271.67
|
| Rate for Payer: Cofinity Commercial |
$319.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$271.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.37
|
| Rate for Payer: Healthscope Commercial |
$329.40
|
| Rate for Payer: Healthscope Whirlpool |
$339.59
|
| Rate for Payer: Humana Choice PPO Medicare |
$18.37
|
| Rate for Payer: Mclaren Commercial |
$305.63
|
| Rate for Payer: Mclaren Medicaid |
$18.37
|
| Rate for Payer: Mclaren Medicare |
$18.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.29
|
| Rate for Payer: Meridian Medicaid |
$10.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$288.65
|
| Rate for Payer: Nomi Health Commercial |
$278.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$254.69
|
| Rate for Payer: PACE Medicare |
$17.45
|
| Rate for Payer: PACE SWMI |
$18.37
|
| Rate for Payer: PHP Commercial |
$20.21
|
| Rate for Payer: PHP Medicaid |
$9.85
|
| Rate for Payer: PHP Medicare Advantage |
$18.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$276.60
|
| Rate for Payer: Priority Health Medicare |
$18.37
|
| Rate for Payer: Priority Health Narrow Network |
$221.28
|
| Rate for Payer: Railroad Medicare Medicare |
$18.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$298.84
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18.37
|
| Rate for Payer: UHC Exchange |
$28.47
|
| Rate for Payer: UHC Medicaid |
$9.61
|
| Rate for Payer: UHCCP DNSP |
$18.37
|
| Rate for Payer: UHCCP Medicaid |
$9.61
|
| Rate for Payer: VA VA |
$18.37
|
|
|
HC SRA, LMWH
|
Facility
|
IP
|
$339.59
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
30200424
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$254.69 |
| Max. Negotiated Rate |
$339.59 |
| Rate for Payer: Aetna Commercial |
$305.63
|
| Rate for Payer: ASR ASR |
$329.40
|
| Rate for Payer: BCBS Trust/PPO |
$278.87
|
| Rate for Payer: BCN Commercial |
$278.87
|
| Rate for Payer: Cash Price |
$271.67
|
| Rate for Payer: Cofinity Commercial |
$319.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$271.67
|
| Rate for Payer: Healthscope Commercial |
$329.40
|
| Rate for Payer: Healthscope Whirlpool |
$339.59
|
| Rate for Payer: Mclaren Commercial |
$305.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$288.65
|
| Rate for Payer: Nomi Health Commercial |
$278.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$254.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$298.84
|
|
|
HC SRS CRANIAL LESION LIN ACC
|
Facility
|
OP
|
$3,163.46
|
|
|
Service Code
|
CPT 77372
|
| Hospital Charge Code |
33300032
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$2,217.59 |
| Max. Negotiated Rate |
$11,375.16 |
| Rate for Payer: Aetna Commercial |
$2,847.11
|
| Rate for Payer: Aetna Medicare |
$7,338.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,173.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,173.51
|
| Rate for Payer: ASR ASR |
$3,068.56
|
| Rate for Payer: BCBS Complete |
$4,030.47
|
| Rate for Payer: BCBS MAPPO |
$7,338.81
|
| Rate for Payer: BCBS Trust/PPO |
$2,608.27
|
| Rate for Payer: BCN Commercial |
$2,608.27
|
| Rate for Payer: BCN Medicare Advantage |
$7,338.81
|
| Rate for Payer: Cash Price |
$2,530.77
|
| Rate for Payer: Cash Price |
$2,530.77
|
| Rate for Payer: Cofinity Commercial |
$2,973.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,530.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,338.81
|
| Rate for Payer: Healthscope Commercial |
$3,068.56
|
| Rate for Payer: Healthscope Whirlpool |
$3,163.46
|
| Rate for Payer: Humana Choice PPO Medicare |
$7,338.81
|
| Rate for Payer: Mclaren Commercial |
$2,847.11
|
| Rate for Payer: Mclaren Medicaid |
$7,338.81
|
| Rate for Payer: Mclaren Medicare |
$7,338.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,705.75
|
| Rate for Payer: Meridian Medicaid |
$4,030.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,439.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$8,072.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,688.94
|
| Rate for Payer: Nomi Health Commercial |
$2,594.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,372.59
|
| Rate for Payer: PACE Medicare |
$6,971.87
|
| Rate for Payer: PACE SWMI |
$7,338.81
|
| Rate for Payer: PHP Commercial |
$8,072.69
|
| Rate for Payer: PHP Medicaid |
$3,933.60
|
| Rate for Payer: PHP Medicare Advantage |
$7,338.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,838.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,771.82
|
| Rate for Payer: Priority Health Medicare |
$7,338.81
|
| Rate for Payer: Priority Health Narrow Network |
$2,217.59
|
| Rate for Payer: Railroad Medicare Medicare |
$7,338.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,783.84
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7,338.81
|
| Rate for Payer: UHC Exchange |
$11,375.16
|
| Rate for Payer: UHC Medicaid |
$3,838.20
|
| Rate for Payer: UHCCP DNSP |
$7,338.81
|
| Rate for Payer: UHCCP Medicaid |
$3,838.20
|
| Rate for Payer: VA VA |
$7,338.81
|
|
|
HC SRS CRANIAL LESION LIN ACC
|
Facility
|
IP
|
$3,163.46
|
|
|
Service Code
|
CPT 77372
|
| Hospital Charge Code |
33300032
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$2,372.59 |
| Max. Negotiated Rate |
$3,163.46 |
| Rate for Payer: Aetna Commercial |
$2,847.11
|
| Rate for Payer: ASR ASR |
$3,068.56
|
| Rate for Payer: BCBS Trust/PPO |
$2,597.83
|
| Rate for Payer: BCN Commercial |
$2,597.83
|
| Rate for Payer: Cash Price |
$2,530.77
|
| Rate for Payer: Cofinity Commercial |
$2,973.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,530.77
|
| Rate for Payer: Healthscope Commercial |
$3,068.56
|
| Rate for Payer: Healthscope Whirlpool |
$3,163.46
|
| Rate for Payer: Mclaren Commercial |
$2,847.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,688.94
|
| Rate for Payer: Nomi Health Commercial |
$2,594.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,372.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,783.84
|
|
|
HC SRT UP TO 5 FRACTIONS
|
Facility
|
IP
|
$5,412.16
|
|
|
Service Code
|
CPT 77373
|
| Hospital Charge Code |
33300018
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$4,059.12 |
| Max. Negotiated Rate |
$5,412.16 |
| Rate for Payer: Aetna Commercial |
$4,870.94
|
| Rate for Payer: ASR ASR |
$5,249.80
|
| Rate for Payer: BCBS Trust/PPO |
$4,444.47
|
| Rate for Payer: BCN Commercial |
$4,444.47
|
| Rate for Payer: Cash Price |
$4,329.73
|
| Rate for Payer: Cofinity Commercial |
$5,087.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,329.73
|
| Rate for Payer: Healthscope Commercial |
$5,249.80
|
| Rate for Payer: Healthscope Whirlpool |
$5,412.16
|
| Rate for Payer: Mclaren Commercial |
$4,870.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,600.34
|
| Rate for Payer: Nomi Health Commercial |
$4,437.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,059.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,762.70
|
|
|
HC SRT UP TO 5 FRACTIONS
|
Facility
|
OP
|
$5,412.16
|
|
|
Service Code
|
CPT 77373
|
| Hospital Charge Code |
33300018
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$931.79 |
| Max. Negotiated Rate |
$5,412.16 |
| Rate for Payer: Aetna Commercial |
$4,870.94
|
| Rate for Payer: Aetna Medicare |
$1,781.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,227.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,227.03
|
| Rate for Payer: ASR ASR |
$5,249.80
|
| Rate for Payer: BCBS Complete |
$978.47
|
| Rate for Payer: BCBS MAPPO |
$1,781.62
|
| Rate for Payer: BCBS Trust/PPO |
$4,462.33
|
| Rate for Payer: BCN Commercial |
$4,462.33
|
| Rate for Payer: BCN Medicare Advantage |
$1,781.62
|
| Rate for Payer: Cash Price |
$4,329.73
|
| Rate for Payer: Cash Price |
$4,329.73
|
| Rate for Payer: Cofinity Commercial |
$5,087.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,329.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,781.62
|
| Rate for Payer: Healthscope Commercial |
$5,249.80
|
| Rate for Payer: Healthscope Whirlpool |
$5,412.16
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,781.62
|
| Rate for Payer: Mclaren Commercial |
$4,870.94
|
| Rate for Payer: Mclaren Medicaid |
$1,781.62
|
| Rate for Payer: Mclaren Medicare |
$1,781.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,870.70
|
| Rate for Payer: Meridian Medicaid |
$978.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,048.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,959.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,600.34
|
| Rate for Payer: Nomi Health Commercial |
$4,437.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,059.12
|
| Rate for Payer: PACE Medicare |
$1,692.54
|
| Rate for Payer: PACE SWMI |
$1,781.62
|
| Rate for Payer: PHP Commercial |
$1,959.78
|
| Rate for Payer: PHP Medicaid |
$954.95
|
| Rate for Payer: PHP Medicare Advantage |
$1,781.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$931.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4,742.13
|
| Rate for Payer: Priority Health Medicare |
$1,781.62
|
| Rate for Payer: Priority Health Narrow Network |
$3,793.92
|
| Rate for Payer: Railroad Medicare Medicare |
$1,781.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,762.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,781.62
|
| Rate for Payer: UHC Exchange |
$2,761.51
|
| Rate for Payer: UHC Medicaid |
$931.79
|
| Rate for Payer: UHCCP DNSP |
$1,781.62
|
| Rate for Payer: UHCCP Medicaid |
$931.79
|
| Rate for Payer: VA VA |
$1,781.62
|
|
|
HC SS2PC SPECIAL STAIN (BILL ONLY)
|
Facility
|
OP
|
$114.44
|
|
|
Service Code
|
CPT 88313
|
| Hospital Charge Code |
31200007
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$69.33 |
| Max. Negotiated Rate |
$205.48 |
| Rate for Payer: Aetna Commercial |
$103.00
|
| Rate for Payer: Aetna Medicare |
$132.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$165.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$165.71
|
| Rate for Payer: ASR ASR |
$111.01
|
| Rate for Payer: BCBS Complete |
$72.81
|
| Rate for Payer: BCBS MAPPO |
$132.57
|
| Rate for Payer: BCBS Trust/PPO |
$94.36
|
| Rate for Payer: BCN Commercial |
$94.36
|
| Rate for Payer: BCN Medicare Advantage |
$132.57
|
| Rate for Payer: Cash Price |
$91.55
|
| Rate for Payer: Cash Price |
$91.55
|
| Rate for Payer: Cofinity Commercial |
$107.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.57
|
| Rate for Payer: Healthscope Commercial |
$111.01
|
| Rate for Payer: Healthscope Whirlpool |
$114.44
|
| Rate for Payer: Humana Choice PPO Medicare |
$132.57
|
| Rate for Payer: Mclaren Commercial |
$103.00
|
| Rate for Payer: Mclaren Medicaid |
$132.57
|
| Rate for Payer: Mclaren Medicare |
$132.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$139.20
|
| Rate for Payer: Meridian Medicaid |
$72.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$145.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.27
|
| Rate for Payer: Nomi Health Commercial |
$93.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$85.83
|
| Rate for Payer: PACE Medicare |
$125.94
|
| Rate for Payer: PACE SWMI |
$132.57
|
| Rate for Payer: PHP Commercial |
$145.83
|
| Rate for Payer: PHP Medicaid |
$71.06
|
| Rate for Payer: PHP Medicare Advantage |
$132.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$131.95
|
| Rate for Payer: Priority Health Medicare |
$132.57
|
| Rate for Payer: Priority Health Narrow Network |
$105.56
|
| Rate for Payer: Railroad Medicare Medicare |
$132.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$100.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$132.57
|
| Rate for Payer: UHC Exchange |
$205.48
|
| Rate for Payer: UHC Medicaid |
$69.33
|
| Rate for Payer: UHCCP DNSP |
$132.57
|
| Rate for Payer: UHCCP Medicaid |
$69.33
|
| Rate for Payer: VA VA |
$132.57
|
|
|
HC SS2PC SPECIAL STAIN (BILL ONLY)
|
Facility
|
IP
|
$114.44
|
|
|
Service Code
|
CPT 88313
|
| Hospital Charge Code |
31200007
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$85.83 |
| Max. Negotiated Rate |
$114.44 |
| Rate for Payer: Aetna Commercial |
$103.00
|
| Rate for Payer: ASR ASR |
$111.01
|
| Rate for Payer: BCBS Trust/PPO |
$93.98
|
| Rate for Payer: BCN Commercial |
$93.98
|
| Rate for Payer: Cash Price |
$91.55
|
| Rate for Payer: Cofinity Commercial |
$107.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.55
|
| Rate for Payer: Healthscope Commercial |
$111.01
|
| Rate for Payer: Healthscope Whirlpool |
$114.44
|
| Rate for Payer: Mclaren Commercial |
$103.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.27
|
| Rate for Payer: Nomi Health Commercial |
$93.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$85.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$100.71
|
|
|
HC STABILIZERS HEART ESTECH
|
Facility
|
IP
|
$951.97
|
|
| Hospital Charge Code |
27000292
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$713.98 |
| Max. Negotiated Rate |
$951.97 |
| Rate for Payer: Aetna Commercial |
$856.77
|
| Rate for Payer: ASR ASR |
$923.41
|
| Rate for Payer: BCBS Trust/PPO |
$781.76
|
| Rate for Payer: BCN Commercial |
$781.76
|
| Rate for Payer: Cash Price |
$761.58
|
| Rate for Payer: Cofinity Commercial |
$894.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$761.58
|
| Rate for Payer: Healthscope Commercial |
$923.41
|
| Rate for Payer: Healthscope Whirlpool |
$951.97
|
| Rate for Payer: Mclaren Commercial |
$856.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$809.17
|
| Rate for Payer: Nomi Health Commercial |
$780.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$713.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$837.73
|
|
|
HC STABILIZERS HEART ESTECH
|
Facility
|
OP
|
$951.97
|
|
| Hospital Charge Code |
27000292
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$352.23 |
| Max. Negotiated Rate |
$951.97 |
| Rate for Payer: Aetna Commercial |
$856.77
|
| Rate for Payer: Aetna Medicare |
$352.23
|
| Rate for Payer: ASR ASR |
$923.41
|
| Rate for Payer: BCBS Complete |
$380.79
|
| Rate for Payer: BCBS Trust/PPO |
$784.90
|
| Rate for Payer: BCN Commercial |
$784.90
|
| Rate for Payer: Cash Price |
$761.58
|
| Rate for Payer: Cofinity Commercial |
$894.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$761.58
|
| Rate for Payer: Healthscope Commercial |
$923.41
|
| Rate for Payer: Healthscope Whirlpool |
$951.97
|
| Rate for Payer: Mclaren Commercial |
$856.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$761.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$809.17
|
| Rate for Payer: Nomi Health Commercial |
$780.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$713.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$834.12
|
| Rate for Payer: Priority Health Narrow Network |
$667.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$837.73
|
|
|
HC STACLOT LA.
|
Facility
|
OP
|
$151.90
|
|
|
Service Code
|
CPT 85597
|
| Hospital Charge Code |
30500085
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$9.40 |
| Max. Negotiated Rate |
$151.90 |
| Rate for Payer: Aetna Commercial |
$136.71
|
| Rate for Payer: Aetna Medicare |
$17.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.48
|
| Rate for Payer: ASR ASR |
$147.34
|
| Rate for Payer: BCBS Complete |
$9.87
|
| Rate for Payer: BCBS MAPPO |
$17.98
|
| Rate for Payer: BCBS Trust/PPO |
$125.24
|
| Rate for Payer: BCN Commercial |
$125.24
|
| Rate for Payer: BCN Medicare Advantage |
$17.98
|
| Rate for Payer: Cash Price |
$121.52
|
| Rate for Payer: Cash Price |
$121.52
|
| Rate for Payer: Cofinity Commercial |
$142.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$121.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.98
|
| Rate for Payer: Healthscope Commercial |
$147.34
|
| Rate for Payer: Healthscope Whirlpool |
$151.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.98
|
| Rate for Payer: Mclaren Commercial |
$136.71
|
| Rate for Payer: Mclaren Medicaid |
$17.98
|
| Rate for Payer: Mclaren Medicare |
$17.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.88
|
| Rate for Payer: Meridian Medicaid |
$9.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$129.12
|
| Rate for Payer: Nomi Health Commercial |
$124.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$113.92
|
| Rate for Payer: PACE Medicare |
$17.08
|
| Rate for Payer: PACE SWMI |
$17.98
|
| Rate for Payer: PHP Commercial |
$19.78
|
| Rate for Payer: PHP Medicaid |
$9.64
|
| Rate for Payer: PHP Medicare Advantage |
$17.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$133.09
|
| Rate for Payer: Priority Health Medicare |
$17.98
|
| Rate for Payer: Priority Health Narrow Network |
$106.48
|
| Rate for Payer: Railroad Medicare Medicare |
$17.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$133.67
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17.98
|
| Rate for Payer: UHC Exchange |
$27.87
|
| Rate for Payer: UHC Medicaid |
$9.40
|
| Rate for Payer: UHCCP DNSP |
$17.98
|
| Rate for Payer: UHCCP Medicaid |
$9.40
|
| Rate for Payer: VA VA |
$17.98
|
|
|
HC STACLOT LA.
|
Facility
|
IP
|
$151.90
|
|
|
Service Code
|
CPT 85597
|
| Hospital Charge Code |
30500085
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$113.92 |
| Max. Negotiated Rate |
$151.90 |
| Rate for Payer: Aetna Commercial |
$136.71
|
| Rate for Payer: ASR ASR |
$147.34
|
| Rate for Payer: BCBS Trust/PPO |
$124.74
|
| Rate for Payer: BCN Commercial |
$124.74
|
| Rate for Payer: Cash Price |
$121.52
|
| Rate for Payer: Cofinity Commercial |
$142.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$121.52
|
| Rate for Payer: Healthscope Commercial |
$147.34
|
| Rate for Payer: Healthscope Whirlpool |
$151.90
|
| Rate for Payer: Mclaren Commercial |
$136.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$129.12
|
| Rate for Payer: Nomi Health Commercial |
$124.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$113.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$133.67
|
|
|
HC STANDBY OPEN HEART/TAVR
|
Facility
|
OP
|
$2,465.99
|
|
| Hospital Charge Code |
27000151
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$912.42 |
| Max. Negotiated Rate |
$2,465.99 |
| Rate for Payer: Aetna Commercial |
$2,219.39
|
| Rate for Payer: Aetna Medicare |
$912.42
|
| Rate for Payer: ASR ASR |
$2,392.01
|
| Rate for Payer: BCBS Complete |
$986.40
|
| Rate for Payer: BCBS Trust/PPO |
$2,033.21
|
| Rate for Payer: BCN Commercial |
$2,033.21
|
| Rate for Payer: Cash Price |
$1,972.79
|
| Rate for Payer: Cofinity Commercial |
$2,318.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,972.79
|
| Rate for Payer: Healthscope Commercial |
$2,392.01
|
| Rate for Payer: Healthscope Whirlpool |
$2,465.99
|
| Rate for Payer: Mclaren Commercial |
$2,219.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,972.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,096.09
|
| Rate for Payer: Nomi Health Commercial |
$2,022.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,849.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,160.70
|
| Rate for Payer: Priority Health Narrow Network |
$1,728.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,170.07
|
|
|
HC STANDBY OPEN HEART/TAVR
|
Facility
|
IP
|
$2,465.99
|
|
| Hospital Charge Code |
27000151
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,849.49 |
| Max. Negotiated Rate |
$2,465.99 |
| Rate for Payer: Aetna Commercial |
$2,219.39
|
| Rate for Payer: ASR ASR |
$2,392.01
|
| Rate for Payer: BCBS Trust/PPO |
$2,025.07
|
| Rate for Payer: BCN Commercial |
$2,025.07
|
| Rate for Payer: Cash Price |
$1,972.79
|
| Rate for Payer: Cofinity Commercial |
$2,318.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,972.79
|
| Rate for Payer: Healthscope Commercial |
$2,392.01
|
| Rate for Payer: Healthscope Whirlpool |
$2,465.99
|
| Rate for Payer: Mclaren Commercial |
$2,219.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,096.09
|
| Rate for Payer: Nomi Health Commercial |
$2,022.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,849.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,170.07
|
|
|
HC STAPHYLOCOCCUS AUREUS PCR
|
Facility
|
OP
|
$57.22
|
|
|
Service Code
|
CPT 87640
|
| Hospital Charge Code |
30600263
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.35 |
| Max. Negotiated Rate |
$57.22 |
| Rate for Payer: Aetna Commercial |
$51.50
|
| Rate for Payer: Aetna Medicare |
$35.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: ASR ASR |
$55.50
|
| Rate for Payer: BCBS Complete |
$19.27
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$47.18
|
| Rate for Payer: BCN Commercial |
$47.18
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$45.78
|
| Rate for Payer: Cash Price |
$45.78
|
| Rate for Payer: Cofinity Commercial |
$53.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$55.50
|
| Rate for Payer: Healthscope Whirlpool |
$57.22
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$51.50
|
| Rate for Payer: Mclaren Medicaid |
$35.09
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$19.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.64
|
| Rate for Payer: Nomi Health Commercial |
$46.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.91
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$38.60
|
| Rate for Payer: PHP Medicaid |
$18.81
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$50.14
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$40.11
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$50.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$35.09
|
| Rate for Payer: UHC Exchange |
$54.39
|
| Rate for Payer: UHC Medicaid |
$18.35
|
| Rate for Payer: UHCCP DNSP |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$18.35
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC STAPHYLOCOCCUS AUREUS PCR
|
Facility
|
IP
|
$57.22
|
|
|
Service Code
|
CPT 87640
|
| Hospital Charge Code |
30600263
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$42.91 |
| Max. Negotiated Rate |
$57.22 |
| Rate for Payer: Aetna Commercial |
$51.50
|
| Rate for Payer: ASR ASR |
$55.50
|
| Rate for Payer: BCBS Trust/PPO |
$46.99
|
| Rate for Payer: BCN Commercial |
$46.99
|
| Rate for Payer: Cash Price |
$45.78
|
| Rate for Payer: Cofinity Commercial |
$53.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.78
|
| Rate for Payer: Healthscope Commercial |
$55.50
|
| Rate for Payer: Healthscope Whirlpool |
$57.22
|
| Rate for Payer: Mclaren Commercial |
$51.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.64
|
| Rate for Payer: Nomi Health Commercial |
$46.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$50.35
|
|
|
HC STAPHYLOCOCCUS AUREUS PCR METHICILLIN RESISTANT
|
Facility
|
IP
|
$62.82
|
|
|
Service Code
|
CPT 87641
|
| Hospital Charge Code |
30600264
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$47.12 |
| Max. Negotiated Rate |
$62.82 |
| Rate for Payer: Aetna Commercial |
$56.54
|
| Rate for Payer: ASR ASR |
$60.94
|
| Rate for Payer: BCBS Trust/PPO |
$51.59
|
| Rate for Payer: BCN Commercial |
$51.59
|
| Rate for Payer: Cash Price |
$50.26
|
| Rate for Payer: Cofinity Commercial |
$59.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.26
|
| Rate for Payer: Healthscope Commercial |
$60.94
|
| Rate for Payer: Healthscope Whirlpool |
$62.82
|
| Rate for Payer: Mclaren Commercial |
$56.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.40
|
| Rate for Payer: Nomi Health Commercial |
$51.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$55.28
|
|
|
HC STAPHYLOCOCCUS AUREUS PCR METHICILLIN RESISTANT
|
Facility
|
OP
|
$62.82
|
|
|
Service Code
|
CPT 87641
|
| Hospital Charge Code |
30600264
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.35 |
| Max. Negotiated Rate |
$62.82 |
| Rate for Payer: Aetna Commercial |
$56.54
|
| Rate for Payer: Aetna Medicare |
$35.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: ASR ASR |
$60.94
|
| Rate for Payer: BCBS Complete |
$19.27
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$51.80
|
| Rate for Payer: BCN Commercial |
$51.80
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$50.26
|
| Rate for Payer: Cash Price |
$50.26
|
| Rate for Payer: Cofinity Commercial |
$59.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$60.94
|
| Rate for Payer: Healthscope Whirlpool |
$62.82
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$56.54
|
| Rate for Payer: Mclaren Medicaid |
$35.09
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$19.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.40
|
| Rate for Payer: Nomi Health Commercial |
$51.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.12
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$38.60
|
| Rate for Payer: PHP Medicaid |
$18.81
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$55.04
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$44.04
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$55.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$35.09
|
| Rate for Payer: UHC Exchange |
$54.39
|
| Rate for Payer: UHC Medicaid |
$18.35
|
| Rate for Payer: UHCCP DNSP |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$18.35
|
| Rate for Payer: VA VA |
$35.09
|
|
