|
HC SCALP ELECTRODE
|
Facility
|
OP
|
$133.77
|
|
| Hospital Charge Code |
72000005
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$53.51 |
| Max. Negotiated Rate |
$133.77 |
| Rate for Payer: Aetna Commercial |
$120.39
|
| Rate for Payer: Aetna Medicare |
$66.88
|
| Rate for Payer: ASR ASR |
$129.76
|
| Rate for Payer: ASR Commercial |
$129.76
|
| Rate for Payer: BCBS Complete |
$53.51
|
| Rate for Payer: BCBS Trust/PPO |
$109.54
|
| Rate for Payer: BCN Commercial |
$103.71
|
| Rate for Payer: Cash Price |
$107.02
|
| Rate for Payer: Cofinity Commercial |
$125.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.02
|
| Rate for Payer: Healthscope Commercial |
$133.77
|
| Rate for Payer: Healthscope Whirlpool |
$129.76
|
| Rate for Payer: Mclaren Commercial |
$120.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$113.70
|
| Rate for Payer: Nomi Health Commercial |
$109.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$86.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$117.21
|
| Rate for Payer: Priority Health Narrow Network |
$93.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$117.72
|
|
|
HC SCALP ELECTRODE
|
Facility
|
IP
|
$133.77
|
|
| Hospital Charge Code |
72000005
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$86.95 |
| Max. Negotiated Rate |
$133.77 |
| Rate for Payer: Aetna Commercial |
$120.39
|
| Rate for Payer: ASR ASR |
$129.76
|
| Rate for Payer: ASR Commercial |
$129.76
|
| Rate for Payer: BCBS Trust/PPO |
$109.01
|
| Rate for Payer: BCN Commercial |
$103.71
|
| Rate for Payer: Cash Price |
$107.02
|
| Rate for Payer: Cofinity Commercial |
$125.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.02
|
| Rate for Payer: Healthscope Commercial |
$133.77
|
| Rate for Payer: Healthscope Whirlpool |
$129.76
|
| Rate for Payer: Mclaren Commercial |
$120.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$113.70
|
| Rate for Payer: Nomi Health Commercial |
$109.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$86.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$117.72
|
|
|
HC SCHISTOSOMA SPECIES ANTIBODY, IGG, SERUM
|
Facility
|
IP
|
$99.76
|
|
|
Service Code
|
CPT 86682
|
| Hospital Charge Code |
30200489
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$64.84 |
| Max. Negotiated Rate |
$99.76 |
| Rate for Payer: Aetna Commercial |
$89.78
|
| Rate for Payer: ASR ASR |
$96.77
|
| Rate for Payer: ASR Commercial |
$96.77
|
| Rate for Payer: BCBS Trust/PPO |
$81.29
|
| Rate for Payer: BCN Commercial |
$77.34
|
| Rate for Payer: Cash Price |
$79.81
|
| Rate for Payer: Cofinity Commercial |
$93.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.81
|
| Rate for Payer: Healthscope Commercial |
$99.76
|
| Rate for Payer: Healthscope Whirlpool |
$96.77
|
| Rate for Payer: Mclaren Commercial |
$89.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.80
|
| Rate for Payer: Nomi Health Commercial |
$81.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$87.79
|
|
|
HC SCHISTOSOMA SPECIES ANTIBODY, IGG, SERUM
|
Facility
|
OP
|
$99.76
|
|
|
Service Code
|
CPT 86682
|
| Hospital Charge Code |
30200489
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.97 |
| Max. Negotiated Rate |
$99.76 |
| Rate for Payer: Aetna Commercial |
$89.78
|
| Rate for Payer: Aetna Medicare |
$13.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.26
|
| Rate for Payer: ASR ASR |
$96.77
|
| Rate for Payer: ASR Commercial |
$96.77
|
| Rate for Payer: BCBS Complete |
$7.32
|
| Rate for Payer: BCBS MAPPO |
$13.01
|
| Rate for Payer: BCBS Trust/PPO |
$81.69
|
| Rate for Payer: BCN Commercial |
$77.34
|
| Rate for Payer: BCN Medicare Advantage |
$13.01
|
| Rate for Payer: Cash Price |
$79.81
|
| Rate for Payer: Cash Price |
$79.81
|
| Rate for Payer: Cofinity Commercial |
$93.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.01
|
| Rate for Payer: Healthscope Commercial |
$99.76
|
| Rate for Payer: Healthscope Whirlpool |
$96.77
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.01
|
| Rate for Payer: Mclaren Commercial |
$89.78
|
| Rate for Payer: Mclaren Medicaid |
$6.97
|
| Rate for Payer: Mclaren Medicare |
$13.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.66
|
| Rate for Payer: Meridian Medicaid |
$7.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.80
|
| Rate for Payer: Nomi Health Commercial |
$81.80
|
| Rate for Payer: PACE Medicare |
$12.36
|
| Rate for Payer: PACE SWMI |
$13.01
|
| Rate for Payer: PHP Commercial |
$14.31
|
| Rate for Payer: PHP Medicaid |
$6.97
|
| Rate for Payer: PHP Medicare Advantage |
$13.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$87.41
|
| Rate for Payer: Priority Health Medicare |
$13.01
|
| Rate for Payer: Priority Health Narrow Network |
$69.93
|
| Rate for Payer: Railroad Medicare Medicare |
$13.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$87.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.01
|
| Rate for Payer: UHC Exchange |
$20.17
|
| Rate for Payer: UHC Medicare Advantage |
$13.01
|
| Rate for Payer: UHCCP DNSP |
$13.01
|
| Rate for Payer: UHCCP Medicaid |
$6.97
|
| Rate for Payer: VA VA |
$13.01
|
|
|
HC SCISSORS
|
Facility
|
IP
|
$17.67
|
|
| Hospital Charge Code |
27000143
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$11.49 |
| Max. Negotiated Rate |
$17.67 |
| Rate for Payer: Aetna Commercial |
$15.90
|
| Rate for Payer: ASR ASR |
$17.14
|
| Rate for Payer: ASR Commercial |
$17.14
|
| Rate for Payer: BCBS Trust/PPO |
$14.40
|
| Rate for Payer: BCN Commercial |
$13.70
|
| Rate for Payer: Cash Price |
$14.14
|
| Rate for Payer: Cofinity Commercial |
$16.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.14
|
| Rate for Payer: Healthscope Commercial |
$17.67
|
| Rate for Payer: Healthscope Whirlpool |
$17.14
|
| Rate for Payer: Mclaren Commercial |
$15.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.02
|
| Rate for Payer: Nomi Health Commercial |
$14.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15.55
|
|
|
HC SCISSORS
|
Facility
|
OP
|
$17.67
|
|
| Hospital Charge Code |
27000143
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.07 |
| Max. Negotiated Rate |
$17.67 |
| Rate for Payer: Aetna Commercial |
$15.90
|
| Rate for Payer: Aetna Medicare |
$8.84
|
| Rate for Payer: ASR ASR |
$17.14
|
| Rate for Payer: ASR Commercial |
$17.14
|
| Rate for Payer: BCBS Complete |
$7.07
|
| Rate for Payer: BCBS Trust/PPO |
$14.47
|
| Rate for Payer: BCN Commercial |
$13.70
|
| Rate for Payer: Cash Price |
$14.14
|
| Rate for Payer: Cofinity Commercial |
$16.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.14
|
| Rate for Payer: Healthscope Commercial |
$17.67
|
| Rate for Payer: Healthscope Whirlpool |
$17.14
|
| Rate for Payer: Mclaren Commercial |
$15.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.02
|
| Rate for Payer: Nomi Health Commercial |
$14.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.49
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.48
|
| Rate for Payer: Priority Health Narrow Network |
$12.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15.55
|
|
|
HC SCL70 SCLERODERMA AB
|
Facility
|
IP
|
$35.17
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200161
|
|
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 SCL70 SCLERODERMA AB
|
Facility
|
OP
|
$35.17
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200161
|
|
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 SCLEROTHERAPY OF FLUID COLLECTION
|
Facility
|
OP
|
$2,550.48
|
|
|
Service Code
|
CPT 49185
|
| Hospital Charge Code |
36100501
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$850.89 |
| Max. Negotiated Rate |
$2,550.48 |
| Rate for Payer: Aetna Commercial |
$2,295.43
|
| Rate for Payer: Aetna Medicare |
$1,587.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,984.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,984.35
|
| Rate for Payer: ASR ASR |
$2,473.97
|
| Rate for Payer: ASR Commercial |
$2,473.97
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$2,088.59
|
| Rate for Payer: BCN Commercial |
$1,977.39
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$2,040.38
|
| Rate for Payer: Cash Price |
$2,040.38
|
| Rate for Payer: Cofinity Commercial |
$2,397.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,040.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$2,550.48
|
| Rate for Payer: Healthscope Whirlpool |
$2,473.97
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,587.48
|
| Rate for Payer: Mclaren Commercial |
$2,295.43
|
| Rate for Payer: Mclaren Medicaid |
$850.89
|
| Rate for Payer: Mclaren Medicare |
$1,587.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,666.85
|
| Rate for Payer: Meridian Medicaid |
$893.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,825.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,167.91
|
| Rate for Payer: Nomi Health Commercial |
$2,091.39
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$1,746.23
|
| Rate for Payer: PHP Medicaid |
$850.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,657.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,234.73
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$1,787.89
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,244.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$2,460.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP DNSP |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
HC SCLEROTHERAPY OF FLUID COLLECTION
|
Facility
|
IP
|
$2,550.48
|
|
|
Service Code
|
CPT 49185
|
| Hospital Charge Code |
36100501
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,657.81 |
| Max. Negotiated Rate |
$2,550.48 |
| Rate for Payer: Aetna Commercial |
$2,295.43
|
| Rate for Payer: ASR ASR |
$2,473.97
|
| Rate for Payer: ASR Commercial |
$2,473.97
|
| Rate for Payer: BCBS Trust/PPO |
$2,078.39
|
| Rate for Payer: BCN Commercial |
$1,977.39
|
| Rate for Payer: Cash Price |
$2,040.38
|
| Rate for Payer: Cofinity Commercial |
$2,397.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,040.38
|
| Rate for Payer: Healthscope Commercial |
$2,550.48
|
| Rate for Payer: Healthscope Whirlpool |
$2,473.97
|
| Rate for Payer: Mclaren Commercial |
$2,295.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,167.91
|
| Rate for Payer: Nomi Health Commercial |
$2,091.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,657.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,244.42
|
|
|
HC SCREENING PAP SMEAR, OBTAIN PREP TO LAB
|
Facility
|
IP
|
$78.59
|
|
|
Service Code
|
CPT Q0091
|
| Hospital Charge Code |
31100043
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$51.08 |
| Max. Negotiated Rate |
$78.59 |
| Rate for Payer: Aetna Commercial |
$70.73
|
| Rate for Payer: ASR ASR |
$76.23
|
| Rate for Payer: ASR Commercial |
$76.23
|
| Rate for Payer: BCBS Trust/PPO |
$64.04
|
| Rate for Payer: BCN Commercial |
$60.93
|
| Rate for Payer: Cash Price |
$62.87
|
| Rate for Payer: Cofinity Commercial |
$73.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.87
|
| Rate for Payer: Healthscope Commercial |
$78.59
|
| Rate for Payer: Healthscope Whirlpool |
$76.23
|
| Rate for Payer: Mclaren Commercial |
$70.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.80
|
| Rate for Payer: Nomi Health Commercial |
$64.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$69.16
|
|
|
HC SCREENING PAP SMEAR, OBTAIN PREP TO LAB
|
Facility
|
OP
|
$78.59
|
|
|
Service Code
|
CPT Q0091
|
| Hospital Charge Code |
31100043
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$12.86 |
| Max. Negotiated Rate |
$78.59 |
| Rate for Payer: Aetna Commercial |
$70.73
|
| Rate for Payer: Aetna Medicare |
$23.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.99
|
| Rate for Payer: ASR ASR |
$76.23
|
| Rate for Payer: ASR Commercial |
$76.23
|
| Rate for Payer: BCBS Complete |
$13.50
|
| Rate for Payer: BCBS MAPPO |
$23.99
|
| Rate for Payer: BCBS Trust/PPO |
$64.36
|
| Rate for Payer: BCCCP Commercial |
$17.38
|
| Rate for Payer: BCN Commercial |
$60.93
|
| Rate for Payer: BCN Medicare Advantage |
$23.99
|
| Rate for Payer: Cash Price |
$62.87
|
| Rate for Payer: Cash Price |
$62.87
|
| Rate for Payer: Cofinity Commercial |
$73.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.99
|
| Rate for Payer: Healthscope Commercial |
$78.59
|
| Rate for Payer: Healthscope Whirlpool |
$76.23
|
| Rate for Payer: Humana Choice PPO Medicare |
$23.99
|
| Rate for Payer: Mclaren Commercial |
$70.73
|
| Rate for Payer: Mclaren Medicaid |
$12.86
|
| Rate for Payer: Mclaren Medicare |
$23.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.19
|
| Rate for Payer: Meridian Medicaid |
$13.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.80
|
| Rate for Payer: Nomi Health Commercial |
$64.44
|
| Rate for Payer: PACE Medicare |
$22.79
|
| Rate for Payer: PACE SWMI |
$23.99
|
| Rate for Payer: PHP Commercial |
$26.39
|
| Rate for Payer: PHP Medicaid |
$12.86
|
| Rate for Payer: PHP Medicare Advantage |
$23.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$68.86
|
| Rate for Payer: Priority Health Medicare |
$23.99
|
| Rate for Payer: Priority Health Narrow Network |
$55.09
|
| Rate for Payer: Railroad Medicare Medicare |
$23.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$69.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.99
|
| Rate for Payer: UHC Exchange |
$37.18
|
| Rate for Payer: UHC Medicare Advantage |
$23.99
|
| Rate for Payer: UHCCP DNSP |
$23.99
|
| Rate for Payer: UHCCP Medicaid |
$12.86
|
| Rate for Payer: VA VA |
$23.99
|
|
|
HC SCREENING TOMOSYNTHESIS
|
Facility
|
IP
|
$103.21
|
|
|
Service Code
|
CPT 77063
|
| Hospital Charge Code |
32000301
|
|
Hospital Revenue Code
|
403
|
| Min. Negotiated Rate |
$67.09 |
| Max. Negotiated Rate |
$103.21 |
| Rate for Payer: Aetna Commercial |
$92.89
|
| Rate for Payer: ASR ASR |
$100.11
|
| Rate for Payer: ASR Commercial |
$100.11
|
| Rate for Payer: BCBS Trust/PPO |
$84.11
|
| Rate for Payer: BCN Commercial |
$80.02
|
| Rate for Payer: Cash Price |
$82.57
|
| Rate for Payer: Cofinity Commercial |
$97.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.57
|
| Rate for Payer: Healthscope Commercial |
$103.21
|
| Rate for Payer: Healthscope Whirlpool |
$100.11
|
| Rate for Payer: Mclaren Commercial |
$92.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.73
|
| Rate for Payer: Nomi Health Commercial |
$84.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$90.82
|
|
|
HC SCREENING TOMOSYNTHESIS
|
Facility
|
OP
|
$103.21
|
|
|
Service Code
|
CPT 77063
|
| Hospital Charge Code |
32000301
|
|
Hospital Revenue Code
|
403
|
| Min. Negotiated Rate |
$41.28 |
| Max. Negotiated Rate |
$103.21 |
| Rate for Payer: Aetna Commercial |
$92.89
|
| Rate for Payer: Aetna Medicare |
$51.60
|
| Rate for Payer: ASR ASR |
$100.11
|
| Rate for Payer: ASR Commercial |
$100.11
|
| Rate for Payer: BCBS Complete |
$41.28
|
| Rate for Payer: BCBS Trust/PPO |
$84.52
|
| Rate for Payer: BCCCP Commercial |
$49.44
|
| Rate for Payer: BCN Commercial |
$80.02
|
| Rate for Payer: Cash Price |
$82.57
|
| Rate for Payer: Cash Price |
$82.57
|
| Rate for Payer: Cofinity Commercial |
$97.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.57
|
| Rate for Payer: Healthscope Commercial |
$103.21
|
| Rate for Payer: Healthscope Whirlpool |
$100.11
|
| Rate for Payer: Mclaren Commercial |
$92.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.73
|
| Rate for Payer: Nomi Health Commercial |
$84.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$90.43
|
| Rate for Payer: Priority Health Narrow Network |
$72.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$90.82
|
|
|
HC SDL MSLT/MWT
|
Facility
|
IP
|
$2,572.19
|
|
|
Service Code
|
CPT 95805
|
| Hospital Charge Code |
92000005
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$1,671.92 |
| Max. Negotiated Rate |
$2,572.19 |
| Rate for Payer: Aetna Commercial |
$2,314.97
|
| Rate for Payer: ASR ASR |
$2,495.02
|
| Rate for Payer: ASR Commercial |
$2,495.02
|
| Rate for Payer: BCBS Trust/PPO |
$2,096.08
|
| Rate for Payer: BCN Commercial |
$1,994.22
|
| Rate for Payer: Cash Price |
$2,057.75
|
| Rate for Payer: Cofinity Commercial |
$2,417.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,057.75
|
| Rate for Payer: Healthscope Commercial |
$2,572.19
|
| Rate for Payer: Healthscope Whirlpool |
$2,495.02
|
| Rate for Payer: Mclaren Commercial |
$2,314.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,186.36
|
| Rate for Payer: Nomi Health Commercial |
$2,109.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,671.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,263.53
|
|
|
HC SDL MSLT/MWT
|
Facility
|
OP
|
$2,572.19
|
|
|
Service Code
|
CPT 95805
|
| Hospital Charge Code |
92000005
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$278.65 |
| Max. Negotiated Rate |
$2,580.33 |
| Rate for Payer: Aetna Commercial |
$2,314.97
|
| Rate for Payer: Aetna Medicare |
$519.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$649.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$649.84
|
| Rate for Payer: ASR ASR |
$2,495.02
|
| Rate for Payer: ASR Commercial |
$2,495.02
|
| Rate for Payer: BCBS Complete |
$292.58
|
| Rate for Payer: BCBS MAPPO |
$519.87
|
| Rate for Payer: BCBS Trust/PPO |
$2,106.37
|
| Rate for Payer: BCN Commercial |
$1,994.22
|
| Rate for Payer: BCN Medicare Advantage |
$519.87
|
| Rate for Payer: Cash Price |
$2,057.75
|
| Rate for Payer: Cash Price |
$2,057.75
|
| Rate for Payer: Cofinity Commercial |
$2,417.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,057.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$519.87
|
| Rate for Payer: Healthscope Commercial |
$2,572.19
|
| Rate for Payer: Healthscope Whirlpool |
$2,495.02
|
| Rate for Payer: Humana Choice PPO Medicare |
$519.87
|
| Rate for Payer: Mclaren Commercial |
$2,314.97
|
| Rate for Payer: Mclaren Medicaid |
$278.65
|
| Rate for Payer: Mclaren Medicare |
$519.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$545.86
|
| Rate for Payer: Meridian Medicaid |
$292.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$597.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,186.36
|
| Rate for Payer: Nomi Health Commercial |
$2,109.20
|
| Rate for Payer: PACE Medicare |
$493.88
|
| Rate for Payer: PACE SWMI |
$519.87
|
| Rate for Payer: PHP Commercial |
$571.86
|
| Rate for Payer: PHP Medicaid |
$278.65
|
| Rate for Payer: PHP Medicare Advantage |
$519.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$278.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,671.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,580.33
|
| Rate for Payer: Priority Health Medicare |
$519.87
|
| Rate for Payer: Priority Health Narrow Network |
$2,064.26
|
| Rate for Payer: Railroad Medicare Medicare |
$519.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,263.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$519.87
|
| Rate for Payer: UHC Exchange |
$805.80
|
| Rate for Payer: UHC Medicare Advantage |
$519.87
|
| Rate for Payer: UHCCP DNSP |
$519.87
|
| Rate for Payer: UHCCP Medicaid |
$278.65
|
| Rate for Payer: VA VA |
$519.87
|
|
|
HC SDL POLYSOMNOGRAPHY
|
Facility
|
IP
|
$3,560.39
|
|
|
Service Code
|
CPT 95810
|
| Hospital Charge Code |
74000001
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$2,314.25 |
| Max. Negotiated Rate |
$3,560.39 |
| Rate for Payer: Aetna Commercial |
$3,204.35
|
| Rate for Payer: ASR ASR |
$3,453.58
|
| Rate for Payer: ASR Commercial |
$3,453.58
|
| Rate for Payer: BCBS Trust/PPO |
$2,901.36
|
| Rate for Payer: BCN Commercial |
$2,760.37
|
| Rate for Payer: Cash Price |
$2,848.31
|
| Rate for Payer: Cofinity Commercial |
$3,346.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,848.31
|
| Rate for Payer: Healthscope Commercial |
$3,560.39
|
| Rate for Payer: Healthscope Whirlpool |
$3,453.58
|
| Rate for Payer: Mclaren Commercial |
$3,204.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,026.33
|
| Rate for Payer: Nomi Health Commercial |
$2,919.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,314.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,133.14
|
|
|
HC SDL POLYSOMNOGRAPHY
|
Facility
|
OP
|
$3,560.39
|
|
|
Service Code
|
CPT 95810
|
| Hospital Charge Code |
74000001
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$534.30 |
| Max. Negotiated Rate |
$3,560.39 |
| Rate for Payer: Aetna Commercial |
$3,204.35
|
| Rate for Payer: Aetna Medicare |
$996.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,246.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,246.02
|
| Rate for Payer: ASR ASR |
$3,453.58
|
| Rate for Payer: ASR Commercial |
$3,453.58
|
| Rate for Payer: BCBS Complete |
$561.01
|
| Rate for Payer: BCBS MAPPO |
$996.82
|
| Rate for Payer: BCBS Trust/PPO |
$2,915.60
|
| Rate for Payer: BCN Commercial |
$2,760.37
|
| Rate for Payer: BCN Medicare Advantage |
$996.82
|
| Rate for Payer: Cash Price |
$2,848.31
|
| Rate for Payer: Cash Price |
$2,848.31
|
| Rate for Payer: Cofinity Commercial |
$3,346.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,848.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$996.82
|
| Rate for Payer: Healthscope Commercial |
$3,560.39
|
| Rate for Payer: Healthscope Whirlpool |
$3,453.58
|
| Rate for Payer: Humana Choice PPO Medicare |
$996.82
|
| Rate for Payer: Mclaren Commercial |
$3,204.35
|
| Rate for Payer: Mclaren Medicaid |
$534.30
|
| Rate for Payer: Mclaren Medicare |
$996.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,046.66
|
| Rate for Payer: Meridian Medicaid |
$561.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,146.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,026.33
|
| Rate for Payer: Nomi Health Commercial |
$2,919.52
|
| Rate for Payer: PACE Medicare |
$946.98
|
| Rate for Payer: PACE SWMI |
$996.82
|
| Rate for Payer: PHP Commercial |
$1,096.50
|
| Rate for Payer: PHP Medicaid |
$534.30
|
| Rate for Payer: PHP Medicare Advantage |
$996.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$534.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,314.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,967.92
|
| Rate for Payer: Priority Health Medicare |
$996.82
|
| Rate for Payer: Priority Health Narrow Network |
$2,374.34
|
| Rate for Payer: Railroad Medicare Medicare |
$996.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,133.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$996.82
|
| Rate for Payer: UHC Exchange |
$1,545.07
|
| Rate for Payer: UHC Medicare Advantage |
$996.82
|
| Rate for Payer: UHCCP DNSP |
$996.82
|
| Rate for Payer: UHCCP Medicaid |
$534.30
|
| Rate for Payer: VA VA |
$996.82
|
|
|
HC SDL PSG WITH CPAP/BIPAP
|
Facility
|
IP
|
$3,936.22
|
|
|
Service Code
|
CPT 95811
|
| Hospital Charge Code |
74000002
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$2,558.54 |
| Max. Negotiated Rate |
$3,936.22 |
| Rate for Payer: Aetna Commercial |
$3,542.60
|
| Rate for Payer: ASR ASR |
$3,818.13
|
| Rate for Payer: ASR Commercial |
$3,818.13
|
| Rate for Payer: BCBS Trust/PPO |
$3,207.63
|
| Rate for Payer: BCN Commercial |
$3,051.75
|
| Rate for Payer: Cash Price |
$3,148.98
|
| Rate for Payer: Cofinity Commercial |
$3,700.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,148.98
|
| Rate for Payer: Healthscope Commercial |
$3,936.22
|
| Rate for Payer: Healthscope Whirlpool |
$3,818.13
|
| Rate for Payer: Mclaren Commercial |
$3,542.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,345.79
|
| Rate for Payer: Nomi Health Commercial |
$3,227.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,558.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,463.87
|
|
|
HC SDL PSG WITH CPAP/BIPAP
|
Facility
|
OP
|
$3,936.22
|
|
|
Service Code
|
CPT 95811
|
| Hospital Charge Code |
74000002
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$534.30 |
| Max. Negotiated Rate |
$3,936.22 |
| Rate for Payer: Aetna Commercial |
$3,542.60
|
| Rate for Payer: Aetna Medicare |
$996.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,246.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,246.02
|
| Rate for Payer: ASR ASR |
$3,818.13
|
| Rate for Payer: ASR Commercial |
$3,818.13
|
| Rate for Payer: BCBS Complete |
$561.01
|
| Rate for Payer: BCBS MAPPO |
$996.82
|
| Rate for Payer: BCBS Trust/PPO |
$3,223.37
|
| Rate for Payer: BCN Commercial |
$3,051.75
|
| Rate for Payer: BCN Medicare Advantage |
$996.82
|
| Rate for Payer: Cash Price |
$3,148.98
|
| Rate for Payer: Cash Price |
$3,148.98
|
| Rate for Payer: Cofinity Commercial |
$3,700.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,148.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$996.82
|
| Rate for Payer: Healthscope Commercial |
$3,936.22
|
| Rate for Payer: Healthscope Whirlpool |
$3,818.13
|
| Rate for Payer: Humana Choice PPO Medicare |
$996.82
|
| Rate for Payer: Mclaren Commercial |
$3,542.60
|
| Rate for Payer: Mclaren Medicaid |
$534.30
|
| Rate for Payer: Mclaren Medicare |
$996.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,046.66
|
| Rate for Payer: Meridian Medicaid |
$561.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,146.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,345.79
|
| Rate for Payer: Nomi Health Commercial |
$3,227.70
|
| Rate for Payer: PACE Medicare |
$946.98
|
| Rate for Payer: PACE SWMI |
$996.82
|
| Rate for Payer: PHP Commercial |
$1,096.50
|
| Rate for Payer: PHP Medicaid |
$534.30
|
| Rate for Payer: PHP Medicare Advantage |
$996.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$534.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,558.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,967.92
|
| Rate for Payer: Priority Health Medicare |
$996.82
|
| Rate for Payer: Priority Health Narrow Network |
$2,374.34
|
| Rate for Payer: Railroad Medicare Medicare |
$996.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,463.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$996.82
|
| Rate for Payer: UHC Exchange |
$1,545.07
|
| Rate for Payer: UHC Medicare Advantage |
$996.82
|
| Rate for Payer: UHCCP DNSP |
$996.82
|
| Rate for Payer: UHCCP Medicaid |
$534.30
|
| Rate for Payer: VA VA |
$996.82
|
|
|
HC SEDATION IV / IM OR INHALANT
|
Facility
|
IP
|
$734.88
|
|
| Hospital Charge Code |
37000005
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$477.67 |
| Max. Negotiated Rate |
$734.88 |
| Rate for Payer: Aetna Commercial |
$661.39
|
| Rate for Payer: ASR ASR |
$712.83
|
| Rate for Payer: ASR Commercial |
$712.83
|
| Rate for Payer: BCBS Trust/PPO |
$598.85
|
| Rate for Payer: BCN Commercial |
$569.75
|
| Rate for Payer: Cash Price |
$587.90
|
| Rate for Payer: Cofinity Commercial |
$690.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$587.90
|
| Rate for Payer: Healthscope Commercial |
$734.88
|
| Rate for Payer: Healthscope Whirlpool |
$712.83
|
| Rate for Payer: Mclaren Commercial |
$661.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$624.65
|
| Rate for Payer: Nomi Health Commercial |
$602.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$477.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$646.69
|
|
|
HC SEDATION IV / IM OR INHALANT
|
Facility
|
OP
|
$734.88
|
|
| Hospital Charge Code |
37000005
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$293.95 |
| Max. Negotiated Rate |
$734.88 |
| Rate for Payer: Aetna Commercial |
$661.39
|
| Rate for Payer: Aetna Medicare |
$367.44
|
| Rate for Payer: ASR ASR |
$712.83
|
| Rate for Payer: ASR Commercial |
$712.83
|
| Rate for Payer: BCBS Complete |
$293.95
|
| Rate for Payer: BCBS Trust/PPO |
$601.79
|
| Rate for Payer: BCN Commercial |
$569.75
|
| Rate for Payer: Cash Price |
$587.90
|
| Rate for Payer: Cofinity Commercial |
$690.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$587.90
|
| Rate for Payer: Healthscope Commercial |
$734.88
|
| Rate for Payer: Healthscope Whirlpool |
$712.83
|
| Rate for Payer: Mclaren Commercial |
$661.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$624.65
|
| Rate for Payer: Nomi Health Commercial |
$602.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$477.67
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$643.90
|
| Rate for Payer: Priority Health Narrow Network |
$515.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$646.69
|
|
|
HC SED RATE WESTERGREN
|
Facility
|
IP
|
$15.61
|
|
|
Service Code
|
CPT 85652
|
| Hospital Charge Code |
30500060
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$10.15 |
| Max. Negotiated Rate |
$15.61 |
| Rate for Payer: Aetna Commercial |
$14.05
|
| Rate for Payer: ASR ASR |
$15.14
|
| Rate for Payer: ASR Commercial |
$15.14
|
| Rate for Payer: BCBS Trust/PPO |
$12.72
|
| Rate for Payer: BCN Commercial |
$12.10
|
| Rate for Payer: Cash Price |
$12.49
|
| Rate for Payer: Cofinity Commercial |
$14.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.49
|
| Rate for Payer: Healthscope Commercial |
$15.61
|
| Rate for Payer: Healthscope Whirlpool |
$15.14
|
| Rate for Payer: Mclaren Commercial |
$14.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.27
|
| Rate for Payer: Nomi Health Commercial |
$12.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$13.74
|
|
|
HC SED RATE WESTERGREN
|
Facility
|
OP
|
$15.61
|
|
|
Service Code
|
CPT 85652
|
| Hospital Charge Code |
30500060
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$1.45 |
| Max. Negotiated Rate |
$15.61 |
| Rate for Payer: Aetna Commercial |
$14.05
|
| Rate for Payer: Aetna Medicare |
$2.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.38
|
| Rate for Payer: ASR ASR |
$15.14
|
| Rate for Payer: ASR Commercial |
$15.14
|
| Rate for Payer: BCBS Complete |
$1.52
|
| Rate for Payer: BCBS MAPPO |
$2.70
|
| Rate for Payer: BCBS Trust/PPO |
$12.78
|
| Rate for Payer: BCN Commercial |
$12.10
|
| Rate for Payer: BCN Medicare Advantage |
$2.70
|
| Rate for Payer: Cash Price |
$12.49
|
| Rate for Payer: Cash Price |
$12.49
|
| Rate for Payer: Cofinity Commercial |
$14.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.70
|
| Rate for Payer: Healthscope Commercial |
$15.61
|
| Rate for Payer: Healthscope Whirlpool |
$15.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$2.70
|
| Rate for Payer: Mclaren Commercial |
$14.05
|
| Rate for Payer: Mclaren Medicaid |
$1.45
|
| Rate for Payer: Mclaren Medicare |
$2.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.84
|
| Rate for Payer: Meridian Medicaid |
$1.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.27
|
| Rate for Payer: Nomi Health Commercial |
$12.80
|
| Rate for Payer: PACE Medicare |
$2.56
|
| Rate for Payer: PACE SWMI |
$2.70
|
| Rate for Payer: PHP Commercial |
$2.97
|
| Rate for Payer: PHP Medicaid |
$1.45
|
| Rate for Payer: PHP Medicare Advantage |
$2.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.68
|
| Rate for Payer: Priority Health Medicare |
$2.70
|
| Rate for Payer: Priority Health Narrow Network |
$10.94
|
| Rate for Payer: Railroad Medicare Medicare |
$2.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$13.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.70
|
| Rate for Payer: UHC Exchange |
$4.18
|
| Rate for Payer: UHC Medicare Advantage |
$2.70
|
| Rate for Payer: UHCCP DNSP |
$2.70
|
| Rate for Payer: UHCCP Medicaid |
$1.45
|
| Rate for Payer: VA VA |
$2.70
|
|
|
HC SELECTIVE EACH INTRACRANIAL UNI
|
Facility
|
IP
|
$4,967.05
|
|
|
Service Code
|
CPT 36228
|
| Hospital Charge Code |
36100386
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,228.58 |
| Max. Negotiated Rate |
$4,967.05 |
| Rate for Payer: Aetna Commercial |
$4,470.34
|
| Rate for Payer: ASR ASR |
$4,818.04
|
| Rate for Payer: ASR Commercial |
$4,818.04
|
| Rate for Payer: BCBS Trust/PPO |
$4,047.65
|
| Rate for Payer: BCN Commercial |
$3,850.95
|
| Rate for Payer: Cash Price |
$3,973.64
|
| Rate for Payer: Cofinity Commercial |
$4,669.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,973.64
|
| Rate for Payer: Healthscope Commercial |
$4,967.05
|
| Rate for Payer: Healthscope Whirlpool |
$4,818.04
|
| Rate for Payer: Mclaren Commercial |
$4,470.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,221.99
|
| Rate for Payer: Nomi Health Commercial |
$4,072.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,228.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,371.00
|
|
