|
HC STREPTOCOCCUS AGALACTIAE
|
Facility
|
OP
|
$53.06
|
|
|
Service Code
|
CPT 87653
|
| Hospital Charge Code |
30600276
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.35 |
| Max. Negotiated Rate |
$54.39 |
| Rate for Payer: Aetna Commercial |
$47.75
|
| 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 |
$51.47
|
| Rate for Payer: BCBS Complete |
$19.27
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$43.75
|
| Rate for Payer: BCN Commercial |
$43.75
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$49.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$51.47
|
| Rate for Payer: Healthscope Whirlpool |
$53.06
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$47.75
|
| 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 |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| 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 |
$46.49
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$37.20
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.69
|
| 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 STREPTOCOCCUS PNEUMONIA
|
Facility
|
IP
|
$53.06
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600277
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$39.80 |
| Max. Negotiated Rate |
$53.06 |
| Rate for Payer: Aetna Commercial |
$47.75
|
| Rate for Payer: ASR ASR |
$51.47
|
| Rate for Payer: BCBS Trust/PPO |
$43.57
|
| Rate for Payer: BCN Commercial |
$43.57
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$49.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Healthscope Commercial |
$51.47
|
| Rate for Payer: Healthscope Whirlpool |
$53.06
|
| Rate for Payer: Mclaren Commercial |
$47.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.69
|
|
|
HC STREPTOCOCCUS PNEUMONIA
|
Facility
|
OP
|
$53.06
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600277
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.35 |
| Max. Negotiated Rate |
$54.39 |
| Rate for Payer: Aetna Commercial |
$47.75
|
| 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 |
$51.47
|
| Rate for Payer: BCBS Complete |
$19.27
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$43.75
|
| Rate for Payer: BCN Commercial |
$43.75
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$49.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$51.47
|
| Rate for Payer: Healthscope Whirlpool |
$53.06
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$47.75
|
| 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 |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| 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 |
$46.49
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$37.20
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.69
|
| 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 STRESS COMPLETE PHYSIOLOGY ARTERIES
|
Facility
|
IP
|
$362.85
|
|
|
Service Code
|
CPT 93924
|
| Hospital Charge Code |
92100021
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$272.14 |
| Max. Negotiated Rate |
$362.85 |
| Rate for Payer: Aetna Commercial |
$326.56
|
| Rate for Payer: ASR ASR |
$351.96
|
| Rate for Payer: BCBS Trust/PPO |
$297.97
|
| Rate for Payer: BCN Commercial |
$297.97
|
| Rate for Payer: Cash Price |
$290.28
|
| Rate for Payer: Cofinity Commercial |
$341.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$290.28
|
| Rate for Payer: Healthscope Commercial |
$351.96
|
| Rate for Payer: Healthscope Whirlpool |
$362.85
|
| Rate for Payer: Mclaren Commercial |
$326.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$308.42
|
| Rate for Payer: Nomi Health Commercial |
$297.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$272.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$319.31
|
|
|
HC STRESS COMPLETE PHYSIOLOGY ARTERIES
|
Facility
|
OP
|
$362.85
|
|
|
Service Code
|
CPT 93924
|
| Hospital Charge Code |
92100021
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$112.52 |
| Max. Negotiated Rate |
$362.85 |
| Rate for Payer: Aetna Commercial |
$326.56
|
| Rate for Payer: Aetna Medicare |
$215.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$268.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$268.94
|
| Rate for Payer: ASR ASR |
$351.96
|
| Rate for Payer: BCBS Complete |
$118.16
|
| Rate for Payer: BCBS MAPPO |
$215.15
|
| Rate for Payer: BCBS Trust/PPO |
$299.17
|
| Rate for Payer: BCN Commercial |
$299.17
|
| Rate for Payer: BCN Medicare Advantage |
$215.15
|
| Rate for Payer: Cash Price |
$290.28
|
| Rate for Payer: Cash Price |
$290.28
|
| Rate for Payer: Cofinity Commercial |
$341.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$290.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$215.15
|
| Rate for Payer: Healthscope Commercial |
$351.96
|
| Rate for Payer: Healthscope Whirlpool |
$362.85
|
| Rate for Payer: Humana Choice PPO Medicare |
$215.15
|
| Rate for Payer: Mclaren Commercial |
$326.56
|
| Rate for Payer: Mclaren Medicaid |
$215.15
|
| Rate for Payer: Mclaren Medicare |
$215.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$225.91
|
| Rate for Payer: Meridian Medicaid |
$118.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$247.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$236.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$308.42
|
| Rate for Payer: Nomi Health Commercial |
$297.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$272.14
|
| Rate for Payer: PACE Medicare |
$204.39
|
| Rate for Payer: PACE SWMI |
$215.15
|
| Rate for Payer: PHP Commercial |
$236.66
|
| Rate for Payer: PHP Medicaid |
$115.32
|
| Rate for Payer: PHP Medicare Advantage |
$215.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$277.21
|
| Rate for Payer: Priority Health Medicare |
$215.15
|
| Rate for Payer: Priority Health Narrow Network |
$221.77
|
| Rate for Payer: Railroad Medicare Medicare |
$215.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$319.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$215.15
|
| Rate for Payer: UHC Exchange |
$333.48
|
| Rate for Payer: UHC Medicaid |
$112.52
|
| Rate for Payer: UHCCP DNSP |
$215.15
|
| Rate for Payer: UHCCP Medicaid |
$112.52
|
| Rate for Payer: VA VA |
$215.15
|
|
|
HC STRESS ECHO
|
Facility
|
IP
|
$1,545.68
|
|
|
Service Code
|
CPT 93350
|
| Hospital Charge Code |
48000008
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,159.26 |
| Max. Negotiated Rate |
$1,545.68 |
| Rate for Payer: Aetna Commercial |
$1,391.11
|
| Rate for Payer: ASR ASR |
$1,499.31
|
| Rate for Payer: BCBS Trust/PPO |
$1,269.31
|
| Rate for Payer: BCN Commercial |
$1,269.31
|
| Rate for Payer: Cash Price |
$1,236.54
|
| Rate for Payer: Cofinity Commercial |
$1,452.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,236.54
|
| Rate for Payer: Healthscope Commercial |
$1,499.31
|
| Rate for Payer: Healthscope Whirlpool |
$1,545.68
|
| Rate for Payer: Mclaren Commercial |
$1,391.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,313.83
|
| Rate for Payer: Nomi Health Commercial |
$1,267.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,159.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,360.20
|
|
|
HC STRESS ECHO
|
Facility
|
OP
|
$1,545.68
|
|
|
Service Code
|
CPT 93350
|
| Hospital Charge Code |
48000008
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$284.75 |
| Max. Negotiated Rate |
$1,545.68 |
| Rate for Payer: Aetna Commercial |
$1,391.11
|
| Rate for Payer: Aetna Medicare |
$544.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$680.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$680.56
|
| Rate for Payer: ASR ASR |
$1,499.31
|
| Rate for Payer: BCBS Complete |
$299.01
|
| Rate for Payer: BCBS MAPPO |
$544.45
|
| Rate for Payer: BCBS Trust/PPO |
$1,274.41
|
| Rate for Payer: BCN Commercial |
$1,274.41
|
| Rate for Payer: BCN Medicare Advantage |
$544.45
|
| Rate for Payer: Cash Price |
$1,236.54
|
| Rate for Payer: Cash Price |
$1,236.54
|
| Rate for Payer: Cofinity Commercial |
$1,452.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,236.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$544.45
|
| Rate for Payer: Healthscope Commercial |
$1,499.31
|
| Rate for Payer: Healthscope Whirlpool |
$1,545.68
|
| Rate for Payer: Humana Choice PPO Medicare |
$544.45
|
| Rate for Payer: Mclaren Commercial |
$1,391.11
|
| Rate for Payer: Mclaren Medicaid |
$544.45
|
| Rate for Payer: Mclaren Medicare |
$544.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$571.67
|
| Rate for Payer: Meridian Medicaid |
$299.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$626.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$598.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,313.83
|
| Rate for Payer: Nomi Health Commercial |
$1,267.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,159.26
|
| Rate for Payer: PACE Medicare |
$517.23
|
| Rate for Payer: PACE SWMI |
$544.45
|
| Rate for Payer: PHP Commercial |
$598.89
|
| Rate for Payer: PHP Medicaid |
$291.83
|
| Rate for Payer: PHP Medicare Advantage |
$544.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$284.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$974.48
|
| Rate for Payer: Priority Health Medicare |
$544.45
|
| Rate for Payer: Priority Health Narrow Network |
$779.59
|
| Rate for Payer: Railroad Medicare Medicare |
$544.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,360.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$544.45
|
| Rate for Payer: UHC Exchange |
$843.90
|
| Rate for Payer: UHC Medicaid |
$284.75
|
| Rate for Payer: UHCCP DNSP |
$544.45
|
| Rate for Payer: UHCCP Medicaid |
$284.75
|
| Rate for Payer: VA VA |
$544.45
|
|
|
HC STRESS TEST
|
Facility
|
IP
|
$919.98
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
48200001
|
|
Hospital Revenue Code
|
482
|
| Min. Negotiated Rate |
$689.99 |
| Max. Negotiated Rate |
$919.98 |
| Rate for Payer: Aetna Commercial |
$827.98
|
| Rate for Payer: ASR ASR |
$892.38
|
| Rate for Payer: BCBS Trust/PPO |
$755.49
|
| Rate for Payer: BCN Commercial |
$755.49
|
| Rate for Payer: Cash Price |
$735.98
|
| Rate for Payer: Cofinity Commercial |
$864.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$735.98
|
| Rate for Payer: Healthscope Commercial |
$892.38
|
| Rate for Payer: Healthscope Whirlpool |
$919.98
|
| Rate for Payer: Mclaren Commercial |
$827.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$781.98
|
| Rate for Payer: Nomi Health Commercial |
$754.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$689.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$809.58
|
|
|
HC STRESS TEST
|
Facility
|
OP
|
$919.98
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
48200001
|
|
Hospital Revenue Code
|
482
|
| Min. Negotiated Rate |
$112.52 |
| Max. Negotiated Rate |
$1,002.35 |
| Rate for Payer: Aetna Commercial |
$827.98
|
| Rate for Payer: Aetna Medicare |
$215.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$268.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$268.94
|
| Rate for Payer: ASR ASR |
$892.38
|
| Rate for Payer: BCBS Complete |
$118.16
|
| Rate for Payer: BCBS MAPPO |
$215.15
|
| Rate for Payer: BCBS Trust/PPO |
$758.52
|
| Rate for Payer: BCN Commercial |
$758.52
|
| Rate for Payer: BCN Medicare Advantage |
$215.15
|
| Rate for Payer: Cash Price |
$735.98
|
| Rate for Payer: Cash Price |
$735.98
|
| Rate for Payer: Cofinity Commercial |
$864.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$735.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$215.15
|
| Rate for Payer: Healthscope Commercial |
$892.38
|
| Rate for Payer: Healthscope Whirlpool |
$919.98
|
| Rate for Payer: Humana Choice PPO Medicare |
$215.15
|
| Rate for Payer: Mclaren Commercial |
$827.98
|
| Rate for Payer: Mclaren Medicaid |
$215.15
|
| Rate for Payer: Mclaren Medicare |
$215.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$225.91
|
| Rate for Payer: Meridian Medicaid |
$118.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$247.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$236.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$781.98
|
| Rate for Payer: Nomi Health Commercial |
$754.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$689.99
|
| Rate for Payer: PACE Medicare |
$204.39
|
| Rate for Payer: PACE SWMI |
$215.15
|
| Rate for Payer: PHP Commercial |
$236.66
|
| Rate for Payer: PHP Medicaid |
$115.32
|
| Rate for Payer: PHP Medicare Advantage |
$215.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,002.35
|
| Rate for Payer: Priority Health Medicare |
$215.15
|
| Rate for Payer: Priority Health Narrow Network |
$801.88
|
| Rate for Payer: Railroad Medicare Medicare |
$215.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$809.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$215.15
|
| Rate for Payer: UHC Exchange |
$333.48
|
| Rate for Payer: UHC Medicaid |
$112.52
|
| Rate for Payer: UHCCP DNSP |
$215.15
|
| Rate for Payer: UHCCP Medicaid |
$112.52
|
| Rate for Payer: VA VA |
$215.15
|
|
|
HC STRESS TEST W/ ECHO
|
Facility
|
IP
|
$967.23
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
48200007
|
|
Hospital Revenue Code
|
482
|
| Min. Negotiated Rate |
$725.42 |
| Max. Negotiated Rate |
$967.23 |
| Rate for Payer: Aetna Commercial |
$870.51
|
| Rate for Payer: ASR ASR |
$938.21
|
| Rate for Payer: BCBS Trust/PPO |
$794.29
|
| Rate for Payer: BCN Commercial |
$794.29
|
| Rate for Payer: Cash Price |
$773.78
|
| Rate for Payer: Cofinity Commercial |
$909.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$773.78
|
| Rate for Payer: Healthscope Commercial |
$938.21
|
| Rate for Payer: Healthscope Whirlpool |
$967.23
|
| Rate for Payer: Mclaren Commercial |
$870.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$822.15
|
| Rate for Payer: Nomi Health Commercial |
$793.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$725.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$851.16
|
|
|
HC STRESS TEST W/ ECHO
|
Facility
|
OP
|
$967.23
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
48200007
|
|
Hospital Revenue Code
|
482
|
| Min. Negotiated Rate |
$112.52 |
| Max. Negotiated Rate |
$1,002.35 |
| Rate for Payer: Aetna Commercial |
$870.51
|
| Rate for Payer: Aetna Medicare |
$215.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$268.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$268.94
|
| Rate for Payer: ASR ASR |
$938.21
|
| Rate for Payer: BCBS Complete |
$118.16
|
| Rate for Payer: BCBS MAPPO |
$215.15
|
| Rate for Payer: BCBS Trust/PPO |
$797.48
|
| Rate for Payer: BCN Commercial |
$797.48
|
| Rate for Payer: BCN Medicare Advantage |
$215.15
|
| Rate for Payer: Cash Price |
$773.78
|
| Rate for Payer: Cash Price |
$773.78
|
| Rate for Payer: Cofinity Commercial |
$909.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$773.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$215.15
|
| Rate for Payer: Healthscope Commercial |
$938.21
|
| Rate for Payer: Healthscope Whirlpool |
$967.23
|
| Rate for Payer: Humana Choice PPO Medicare |
$215.15
|
| Rate for Payer: Mclaren Commercial |
$870.51
|
| Rate for Payer: Mclaren Medicaid |
$215.15
|
| Rate for Payer: Mclaren Medicare |
$215.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$225.91
|
| Rate for Payer: Meridian Medicaid |
$118.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$247.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$236.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$822.15
|
| Rate for Payer: Nomi Health Commercial |
$793.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$725.42
|
| Rate for Payer: PACE Medicare |
$204.39
|
| Rate for Payer: PACE SWMI |
$215.15
|
| Rate for Payer: PHP Commercial |
$236.66
|
| Rate for Payer: PHP Medicaid |
$115.32
|
| Rate for Payer: PHP Medicare Advantage |
$215.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,002.35
|
| Rate for Payer: Priority Health Medicare |
$215.15
|
| Rate for Payer: Priority Health Narrow Network |
$801.88
|
| Rate for Payer: Railroad Medicare Medicare |
$215.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$851.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$215.15
|
| Rate for Payer: UHC Exchange |
$333.48
|
| Rate for Payer: UHC Medicaid |
$112.52
|
| Rate for Payer: UHCCP DNSP |
$215.15
|
| Rate for Payer: UHCCP Medicaid |
$112.52
|
| Rate for Payer: VA VA |
$215.15
|
|
|
HC STRIP PASTE
|
Facility
|
OP
|
$4.59
|
|
| Hospital Charge Code |
27000109
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1.70 |
| Max. Negotiated Rate |
$4.59 |
| Rate for Payer: Aetna Commercial |
$4.13
|
| Rate for Payer: Aetna Medicare |
$1.70
|
| Rate for Payer: ASR ASR |
$4.45
|
| Rate for Payer: BCBS Complete |
$1.84
|
| Rate for Payer: BCBS Trust/PPO |
$3.78
|
| Rate for Payer: BCN Commercial |
$3.78
|
| Rate for Payer: Cash Price |
$3.67
|
| Rate for Payer: Cofinity Commercial |
$4.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.67
|
| Rate for Payer: Healthscope Commercial |
$4.45
|
| Rate for Payer: Healthscope Whirlpool |
$4.59
|
| Rate for Payer: Mclaren Commercial |
$4.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.90
|
| Rate for Payer: Nomi Health Commercial |
$3.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4.02
|
| Rate for Payer: Priority Health Narrow Network |
$3.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4.04
|
|
|
HC STRIP PASTE
|
Facility
|
IP
|
$4.59
|
|
| Hospital Charge Code |
27000109
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.44 |
| Max. Negotiated Rate |
$4.59 |
| Rate for Payer: Aetna Commercial |
$4.13
|
| Rate for Payer: ASR ASR |
$4.45
|
| Rate for Payer: BCBS Trust/PPO |
$3.77
|
| Rate for Payer: BCN Commercial |
$3.77
|
| Rate for Payer: Cash Price |
$3.67
|
| Rate for Payer: Cofinity Commercial |
$4.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.67
|
| Rate for Payer: Healthscope Commercial |
$4.45
|
| Rate for Payer: Healthscope Whirlpool |
$4.59
|
| Rate for Payer: Mclaren Commercial |
$4.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.90
|
| Rate for Payer: Nomi Health Commercial |
$3.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4.04
|
|
|
HC STRONGYLOIDES ANTIBODY, IGG, SERUM
|
Facility
|
OP
|
$89.06
|
|
|
Service Code
|
CPT 86682
|
| Hospital Charge Code |
30200490
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.80 |
| Max. Negotiated Rate |
$89.06 |
| Rate for Payer: Aetna Commercial |
$80.15
|
| 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 |
$86.39
|
| Rate for Payer: BCBS Complete |
$7.15
|
| Rate for Payer: BCBS MAPPO |
$13.01
|
| Rate for Payer: BCBS Trust/PPO |
$73.43
|
| Rate for Payer: BCN Commercial |
$73.43
|
| Rate for Payer: BCN Medicare Advantage |
$13.01
|
| Rate for Payer: Cash Price |
$71.25
|
| Rate for Payer: Cash Price |
$71.25
|
| Rate for Payer: Cofinity Commercial |
$83.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.01
|
| Rate for Payer: Healthscope Commercial |
$86.39
|
| Rate for Payer: Healthscope Whirlpool |
$89.06
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.01
|
| Rate for Payer: Mclaren Commercial |
$80.15
|
| Rate for Payer: Mclaren Medicaid |
$13.01
|
| 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 |
$7.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$75.70
|
| Rate for Payer: Nomi Health Commercial |
$73.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$66.80
|
| 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 |
$6.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$78.03
|
| Rate for Payer: Priority Health Medicare |
$13.01
|
| Rate for Payer: Priority Health Narrow Network |
$62.43
|
| Rate for Payer: Railroad Medicare Medicare |
$13.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$78.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.01
|
| Rate for Payer: UHC Exchange |
$20.17
|
| Rate for Payer: UHC Medicaid |
$6.80
|
| Rate for Payer: UHCCP DNSP |
$13.01
|
| Rate for Payer: UHCCP Medicaid |
$6.80
|
| Rate for Payer: VA VA |
$13.01
|
|
|
HC STRONGYLOIDES ANTIBODY, IGG, SERUM
|
Facility
|
IP
|
$89.06
|
|
|
Service Code
|
CPT 86682
|
| Hospital Charge Code |
30200490
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$66.80 |
| Max. Negotiated Rate |
$89.06 |
| Rate for Payer: Aetna Commercial |
$80.15
|
| Rate for Payer: ASR ASR |
$86.39
|
| Rate for Payer: BCBS Trust/PPO |
$73.14
|
| Rate for Payer: BCN Commercial |
$73.14
|
| Rate for Payer: Cash Price |
$71.25
|
| Rate for Payer: Cofinity Commercial |
$83.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.25
|
| Rate for Payer: Healthscope Commercial |
$86.39
|
| Rate for Payer: Healthscope Whirlpool |
$89.06
|
| Rate for Payer: Mclaren Commercial |
$80.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$75.70
|
| Rate for Payer: Nomi Health Commercial |
$73.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$66.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$78.37
|
|
|
HC STUDY INSERT NON TUNNELED CENTRAL LINE > 5 YRS
|
Facility
|
OP
|
$39.00
|
|
|
Service Code
|
CPT 36556
|
| Hospital Charge Code |
36100588
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$29.25 |
| Max. Negotiated Rate |
$4,876.50 |
| Rate for Payer: Aetna Commercial |
$35.10
|
| Rate for Payer: Aetna Medicare |
$3,146.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: ASR ASR |
$37.83
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$32.16
|
| Rate for Payer: BCN Commercial |
$32.16
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cofinity Commercial |
$36.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$37.83
|
| Rate for Payer: Healthscope Whirlpool |
$39.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,146.13
|
| Rate for Payer: Mclaren Commercial |
$35.10
|
| Rate for Payer: Mclaren Medicaid |
$3,146.13
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$1,727.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.15
|
| Rate for Payer: Nomi Health Commercial |
$31.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.25
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$3,460.74
|
| Rate for Payer: PHP Medicaid |
$1,686.33
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,875.15
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health Narrow Network |
$1,500.12
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$34.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Exchange |
$4,876.50
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP DNSP |
$3,146.13
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: VA VA |
$3,146.13
|
|
|
HC STUDY INSERT NON TUNNELED CENTRAL LINE > 5 YRS
|
Facility
|
IP
|
$39.00
|
|
|
Service Code
|
CPT 36556
|
| Hospital Charge Code |
36100588
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$29.25 |
| Max. Negotiated Rate |
$39.00 |
| Rate for Payer: Aetna Commercial |
$35.10
|
| Rate for Payer: ASR ASR |
$37.83
|
| Rate for Payer: BCBS Trust/PPO |
$32.03
|
| Rate for Payer: BCN Commercial |
$32.03
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cofinity Commercial |
$36.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.20
|
| Rate for Payer: Healthscope Commercial |
$37.83
|
| Rate for Payer: Healthscope Whirlpool |
$39.00
|
| Rate for Payer: Mclaren Commercial |
$35.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.15
|
| Rate for Payer: Nomi Health Commercial |
$31.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$34.32
|
|
|
HC SUBCLASS IGG4, SERUM
|
Facility
|
IP
|
$135.25
|
|
|
Service Code
|
CPT 82787
|
| Hospital Charge Code |
30100720
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$101.44 |
| Max. Negotiated Rate |
$135.25 |
| Rate for Payer: Aetna Commercial |
$121.72
|
| Rate for Payer: ASR ASR |
$131.19
|
| Rate for Payer: BCBS Trust/PPO |
$111.07
|
| Rate for Payer: BCN Commercial |
$111.07
|
| Rate for Payer: Cash Price |
$108.20
|
| Rate for Payer: Cofinity Commercial |
$127.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$108.20
|
| Rate for Payer: Healthscope Commercial |
$131.19
|
| Rate for Payer: Healthscope Whirlpool |
$135.25
|
| Rate for Payer: Mclaren Commercial |
$121.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$114.96
|
| Rate for Payer: Nomi Health Commercial |
$110.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$101.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$119.02
|
|
|
HC SUBCLASS IGG4, SERUM
|
Facility
|
OP
|
$135.25
|
|
|
Service Code
|
CPT 82787
|
| Hospital Charge Code |
30100720
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.19 |
| Max. Negotiated Rate |
$135.25 |
| Rate for Payer: Aetna Commercial |
$121.72
|
| Rate for Payer: Aetna Medicare |
$8.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.03
|
| Rate for Payer: ASR ASR |
$131.19
|
| Rate for Payer: BCBS Complete |
$4.40
|
| Rate for Payer: BCBS MAPPO |
$8.02
|
| Rate for Payer: BCBS Trust/PPO |
$111.51
|
| Rate for Payer: BCN Commercial |
$111.51
|
| Rate for Payer: BCN Medicare Advantage |
$8.02
|
| Rate for Payer: Cash Price |
$108.20
|
| Rate for Payer: Cash Price |
$108.20
|
| Rate for Payer: Cofinity Commercial |
$127.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$108.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.02
|
| Rate for Payer: Healthscope Commercial |
$131.19
|
| Rate for Payer: Healthscope Whirlpool |
$135.25
|
| Rate for Payer: Humana Choice PPO Medicare |
$8.02
|
| Rate for Payer: Mclaren Commercial |
$121.72
|
| Rate for Payer: Mclaren Medicaid |
$8.02
|
| Rate for Payer: Mclaren Medicare |
$8.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.42
|
| Rate for Payer: Meridian Medicaid |
$4.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$114.96
|
| Rate for Payer: Nomi Health Commercial |
$110.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$101.44
|
| Rate for Payer: PACE Medicare |
$7.62
|
| Rate for Payer: PACE SWMI |
$8.02
|
| Rate for Payer: PHP Commercial |
$8.82
|
| Rate for Payer: PHP Medicaid |
$4.30
|
| Rate for Payer: PHP Medicare Advantage |
$8.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$118.51
|
| Rate for Payer: Priority Health Medicare |
$8.02
|
| Rate for Payer: Priority Health Narrow Network |
$94.81
|
| Rate for Payer: Railroad Medicare Medicare |
$8.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$119.02
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$8.02
|
| Rate for Payer: UHC Exchange |
$12.43
|
| Rate for Payer: UHC Medicaid |
$4.19
|
| Rate for Payer: UHCCP DNSP |
$8.02
|
| Rate for Payer: UHCCP Medicaid |
$4.19
|
| Rate for Payer: VA VA |
$8.02
|
|
|
HC SUBCUTANEOUS INF EA ADDL HR
|
Facility
|
IP
|
$135.66
|
|
|
Service Code
|
CPT 96370
|
| Hospital Charge Code |
26000014
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$101.75 |
| Max. Negotiated Rate |
$135.66 |
| Rate for Payer: Aetna Commercial |
$122.09
|
| Rate for Payer: ASR ASR |
$131.59
|
| Rate for Payer: BCBS Trust/PPO |
$111.40
|
| Rate for Payer: BCN Commercial |
$111.40
|
| Rate for Payer: Cash Price |
$108.53
|
| Rate for Payer: Cofinity Commercial |
$127.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$108.53
|
| Rate for Payer: Healthscope Commercial |
$131.59
|
| Rate for Payer: Healthscope Whirlpool |
$135.66
|
| Rate for Payer: Mclaren Commercial |
$122.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$115.31
|
| Rate for Payer: Nomi Health Commercial |
$111.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$101.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$119.38
|
|
|
HC SUBCUTANEOUS INF EA ADDL HR
|
Facility
|
OP
|
$135.66
|
|
|
Service Code
|
CPT 96370
|
| Hospital Charge Code |
26000014
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$24.40 |
| Max. Negotiated Rate |
$135.66 |
| Rate for Payer: Aetna Commercial |
$122.09
|
| Rate for Payer: Aetna Medicare |
$46.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$58.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$58.33
|
| Rate for Payer: ASR ASR |
$131.59
|
| Rate for Payer: BCBS Complete |
$25.63
|
| Rate for Payer: BCBS MAPPO |
$46.66
|
| Rate for Payer: BCBS Trust/PPO |
$111.85
|
| Rate for Payer: BCN Commercial |
$111.85
|
| Rate for Payer: BCN Medicare Advantage |
$46.66
|
| Rate for Payer: Cash Price |
$108.53
|
| Rate for Payer: Cash Price |
$108.53
|
| Rate for Payer: Cofinity Commercial |
$127.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$108.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.66
|
| Rate for Payer: Healthscope Commercial |
$131.59
|
| Rate for Payer: Healthscope Whirlpool |
$135.66
|
| Rate for Payer: Humana Choice PPO Medicare |
$46.66
|
| Rate for Payer: Mclaren Commercial |
$122.09
|
| Rate for Payer: Mclaren Medicaid |
$46.66
|
| Rate for Payer: Mclaren Medicare |
$46.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48.99
|
| Rate for Payer: Meridian Medicaid |
$25.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$53.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$51.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$115.31
|
| Rate for Payer: Nomi Health Commercial |
$111.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$101.75
|
| Rate for Payer: PACE Medicare |
$44.33
|
| Rate for Payer: PACE SWMI |
$46.66
|
| Rate for Payer: PHP Commercial |
$51.33
|
| Rate for Payer: PHP Medicaid |
$25.01
|
| Rate for Payer: PHP Medicare Advantage |
$46.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$118.87
|
| Rate for Payer: Priority Health Medicare |
$46.66
|
| Rate for Payer: Priority Health Narrow Network |
$95.10
|
| Rate for Payer: Railroad Medicare Medicare |
$46.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$119.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$46.66
|
| Rate for Payer: UHC Exchange |
$72.32
|
| Rate for Payer: UHC Medicaid |
$24.40
|
| Rate for Payer: UHCCP DNSP |
$46.66
|
| Rate for Payer: UHCCP Medicaid |
$24.40
|
| Rate for Payer: VA VA |
$46.66
|
|
|
HC SUBCUTANEOUS INF INIT HR W/PUMP SET UP
|
Facility
|
IP
|
$751.74
|
|
|
Service Code
|
CPT 96369
|
| Hospital Charge Code |
26000013
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$563.80 |
| Max. Negotiated Rate |
$751.74 |
| Rate for Payer: Aetna Commercial |
$676.57
|
| Rate for Payer: ASR ASR |
$729.19
|
| Rate for Payer: BCBS Trust/PPO |
$617.33
|
| Rate for Payer: BCN Commercial |
$617.33
|
| Rate for Payer: Cash Price |
$601.39
|
| Rate for Payer: Cofinity Commercial |
$706.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$601.39
|
| Rate for Payer: Healthscope Commercial |
$729.19
|
| Rate for Payer: Healthscope Whirlpool |
$751.74
|
| Rate for Payer: Mclaren Commercial |
$676.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$638.98
|
| Rate for Payer: Nomi Health Commercial |
$616.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$563.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$661.53
|
|
|
HC SUBCUTANEOUS INF INIT HR W/PUMP SET UP
|
Facility
|
OP
|
$751.74
|
|
|
Service Code
|
CPT 96369
|
| Hospital Charge Code |
26000013
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$110.84 |
| Max. Negotiated Rate |
$751.74 |
| Rate for Payer: Aetna Commercial |
$676.57
|
| Rate for Payer: Aetna Medicare |
$211.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$264.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$264.93
|
| Rate for Payer: ASR ASR |
$729.19
|
| Rate for Payer: BCBS Complete |
$116.40
|
| Rate for Payer: BCBS MAPPO |
$211.94
|
| Rate for Payer: BCBS Trust/PPO |
$619.81
|
| Rate for Payer: BCN Commercial |
$619.81
|
| Rate for Payer: BCN Medicare Advantage |
$211.94
|
| Rate for Payer: Cash Price |
$601.39
|
| Rate for Payer: Cash Price |
$601.39
|
| Rate for Payer: Cofinity Commercial |
$706.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$601.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$211.94
|
| Rate for Payer: Healthscope Commercial |
$729.19
|
| Rate for Payer: Healthscope Whirlpool |
$751.74
|
| Rate for Payer: Humana Choice PPO Medicare |
$211.94
|
| Rate for Payer: Mclaren Commercial |
$676.57
|
| Rate for Payer: Mclaren Medicaid |
$211.94
|
| Rate for Payer: Mclaren Medicare |
$211.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$222.54
|
| Rate for Payer: Meridian Medicaid |
$116.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$243.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$233.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$638.98
|
| Rate for Payer: Nomi Health Commercial |
$616.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$563.80
|
| Rate for Payer: PACE Medicare |
$201.34
|
| Rate for Payer: PACE SWMI |
$211.94
|
| Rate for Payer: PHP Commercial |
$233.13
|
| Rate for Payer: PHP Medicaid |
$113.60
|
| Rate for Payer: PHP Medicare Advantage |
$211.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$110.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$658.67
|
| Rate for Payer: Priority Health Medicare |
$211.94
|
| Rate for Payer: Priority Health Narrow Network |
$526.97
|
| Rate for Payer: Railroad Medicare Medicare |
$211.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$661.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$211.94
|
| Rate for Payer: UHC Exchange |
$328.51
|
| Rate for Payer: UHC Medicaid |
$110.84
|
| Rate for Payer: UHCCP DNSP |
$211.94
|
| Rate for Payer: UHCCP Medicaid |
$110.84
|
| Rate for Payer: VA VA |
$211.94
|
|
|
HC SUBMUCOUS RESCJ INFERIOR TURBINATE PRTL/COMPL
|
Facility
|
OP
|
$8,271.18
|
|
|
Service Code
|
CPT 30140
|
| Hospital Charge Code |
76100377
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,727.75 |
| Max. Negotiated Rate |
$8,271.18 |
| Rate for Payer: Aetna Commercial |
$7,444.06
|
| Rate for Payer: Aetna Medicare |
$3,303.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,129.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,129.43
|
| Rate for Payer: ASR ASR |
$8,023.04
|
| Rate for Payer: BCBS Complete |
$1,814.30
|
| Rate for Payer: BCBS MAPPO |
$3,303.54
|
| Rate for Payer: BCBS Trust/PPO |
$6,819.59
|
| Rate for Payer: BCN Commercial |
$6,819.59
|
| Rate for Payer: BCN Medicare Advantage |
$3,303.54
|
| Rate for Payer: Cash Price |
$6,616.94
|
| Rate for Payer: Cash Price |
$6,616.94
|
| Rate for Payer: Cofinity Commercial |
$7,774.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,616.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,303.54
|
| Rate for Payer: Healthscope Commercial |
$8,023.04
|
| Rate for Payer: Healthscope Whirlpool |
$8,271.18
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,303.54
|
| Rate for Payer: Mclaren Commercial |
$7,444.06
|
| Rate for Payer: Mclaren Medicaid |
$3,303.54
|
| Rate for Payer: Mclaren Medicare |
$3,303.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,468.72
|
| Rate for Payer: Meridian Medicaid |
$1,814.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,799.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,633.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,030.50
|
| Rate for Payer: Nomi Health Commercial |
$6,782.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,203.39
|
| Rate for Payer: PACE Medicare |
$3,138.36
|
| Rate for Payer: PACE SWMI |
$3,303.54
|
| Rate for Payer: PHP Commercial |
$3,633.89
|
| Rate for Payer: PHP Medicaid |
$1,770.70
|
| Rate for Payer: PHP Medicare Advantage |
$3,303.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,727.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$7,247.21
|
| Rate for Payer: Priority Health Medicare |
$3,303.54
|
| Rate for Payer: Priority Health Narrow Network |
$5,798.10
|
| Rate for Payer: Railroad Medicare Medicare |
$3,303.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,278.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,303.54
|
| Rate for Payer: UHC Exchange |
$5,120.49
|
| Rate for Payer: UHC Medicaid |
$1,727.75
|
| Rate for Payer: UHCCP DNSP |
$3,303.54
|
| Rate for Payer: UHCCP Medicaid |
$1,727.75
|
| Rate for Payer: VA VA |
$3,303.54
|
|
|
HC SUBMUCOUS RESCJ INFERIOR TURBINATE PRTL/COMPL
|
Facility
|
IP
|
$8,271.18
|
|
|
Service Code
|
CPT 30140
|
| Hospital Charge Code |
76100377
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$6,203.39 |
| Max. Negotiated Rate |
$8,271.18 |
| Rate for Payer: Aetna Commercial |
$7,444.06
|
| Rate for Payer: ASR ASR |
$8,023.04
|
| Rate for Payer: BCBS Trust/PPO |
$6,792.29
|
| Rate for Payer: BCN Commercial |
$6,792.29
|
| Rate for Payer: Cash Price |
$6,616.94
|
| Rate for Payer: Cofinity Commercial |
$7,774.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,616.94
|
| Rate for Payer: Healthscope Commercial |
$8,023.04
|
| Rate for Payer: Healthscope Whirlpool |
$8,271.18
|
| Rate for Payer: Mclaren Commercial |
$7,444.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,030.50
|
| Rate for Payer: Nomi Health Commercial |
$6,782.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,203.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,278.64
|
|
