|
HC SHAVE LESION TRUNK, ARM, LEGS 0.5 CM OR LESS
|
Facility
|
OP
|
$161.82
|
|
|
Service Code
|
CPT 11300
|
| Hospital Charge Code |
76100080
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$105.18 |
| Max. Negotiated Rate |
$603.96 |
| Rate for Payer: Aetna Commercial |
$145.64
|
| Rate for Payer: Aetna Medicare |
$389.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$487.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$487.06
|
| Rate for Payer: ASR ASR |
$156.97
|
| Rate for Payer: ASR Commercial |
$156.97
|
| Rate for Payer: BCBS Complete |
$219.30
|
| Rate for Payer: BCBS MAPPO |
$389.65
|
| Rate for Payer: BCBS Trust/PPO |
$132.51
|
| Rate for Payer: BCN Commercial |
$125.46
|
| Rate for Payer: BCN Medicare Advantage |
$389.65
|
| Rate for Payer: Cash Price |
$129.46
|
| Rate for Payer: Cash Price |
$129.46
|
| Rate for Payer: Cofinity Commercial |
$152.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$389.65
|
| Rate for Payer: Healthscope Commercial |
$161.82
|
| Rate for Payer: Healthscope Whirlpool |
$156.97
|
| Rate for Payer: Humana Choice PPO Medicare |
$389.65
|
| Rate for Payer: Mclaren Commercial |
$145.64
|
| Rate for Payer: Mclaren Medicaid |
$208.85
|
| Rate for Payer: Mclaren Medicare |
$389.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$409.13
|
| Rate for Payer: Meridian Medicaid |
$219.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$448.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.55
|
| Rate for Payer: Nomi Health Commercial |
$132.69
|
| Rate for Payer: PACE Medicare |
$370.17
|
| Rate for Payer: PACE SWMI |
$389.65
|
| Rate for Payer: PHP Commercial |
$428.62
|
| Rate for Payer: PHP Medicaid |
$208.85
|
| Rate for Payer: PHP Medicare Advantage |
$389.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$141.79
|
| Rate for Payer: Priority Health Medicare |
$389.65
|
| Rate for Payer: Priority Health Narrow Network |
$113.44
|
| Rate for Payer: Railroad Medicare Medicare |
$389.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$142.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$389.65
|
| Rate for Payer: UHC Exchange |
$603.96
|
| Rate for Payer: UHC Medicare Advantage |
$389.65
|
| Rate for Payer: UHCCP DNSP |
$389.65
|
| Rate for Payer: UHCCP Medicaid |
$208.85
|
| Rate for Payer: VA VA |
$389.65
|
|
|
HC SHAVE LESION TRUNK, ARM, LEGS 0.5 CM OR LESS
|
Facility
|
IP
|
$161.82
|
|
|
Service Code
|
CPT 11300
|
| Hospital Charge Code |
76100080
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$105.18 |
| Max. Negotiated Rate |
$161.82 |
| Rate for Payer: Aetna Commercial |
$145.64
|
| Rate for Payer: ASR ASR |
$156.97
|
| Rate for Payer: ASR Commercial |
$156.97
|
| Rate for Payer: BCBS Trust/PPO |
$131.87
|
| Rate for Payer: BCN Commercial |
$125.46
|
| Rate for Payer: Cash Price |
$129.46
|
| Rate for Payer: Cofinity Commercial |
$152.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.46
|
| Rate for Payer: Healthscope Commercial |
$161.82
|
| Rate for Payer: Healthscope Whirlpool |
$156.97
|
| Rate for Payer: Mclaren Commercial |
$145.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.55
|
| Rate for Payer: Nomi Health Commercial |
$132.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$142.40
|
|
|
HC SHAVE LESION TRUNK, ARM, LEGS 1.1 TO 2.0 CM
|
Facility
|
IP
|
$161.82
|
|
|
Service Code
|
CPT 11302
|
| Hospital Charge Code |
76100082
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$105.18 |
| Max. Negotiated Rate |
$161.82 |
| Rate for Payer: Aetna Commercial |
$145.64
|
| Rate for Payer: ASR ASR |
$156.97
|
| Rate for Payer: ASR Commercial |
$156.97
|
| Rate for Payer: BCBS Trust/PPO |
$131.87
|
| Rate for Payer: BCN Commercial |
$125.46
|
| Rate for Payer: Cash Price |
$129.46
|
| Rate for Payer: Cofinity Commercial |
$152.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.46
|
| Rate for Payer: Healthscope Commercial |
$161.82
|
| Rate for Payer: Healthscope Whirlpool |
$156.97
|
| Rate for Payer: Mclaren Commercial |
$145.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.55
|
| Rate for Payer: Nomi Health Commercial |
$132.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$142.40
|
|
|
HC SHAVE LESION TRUNK, ARM, LEGS 1.1 TO 2.0 CM
|
Facility
|
OP
|
$161.82
|
|
|
Service Code
|
CPT 11302
|
| Hospital Charge Code |
76100082
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$103.87 |
| Max. Negotiated Rate |
$300.37 |
| Rate for Payer: Aetna Commercial |
$145.64
|
| Rate for Payer: Aetna Medicare |
$193.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$242.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$242.24
|
| Rate for Payer: ASR ASR |
$156.97
|
| Rate for Payer: ASR Commercial |
$156.97
|
| Rate for Payer: BCBS Complete |
$109.07
|
| Rate for Payer: BCBS MAPPO |
$193.79
|
| Rate for Payer: BCBS Trust/PPO |
$132.51
|
| Rate for Payer: BCN Commercial |
$125.46
|
| Rate for Payer: BCN Medicare Advantage |
$193.79
|
| Rate for Payer: Cash Price |
$129.46
|
| Rate for Payer: Cash Price |
$129.46
|
| Rate for Payer: Cofinity Commercial |
$152.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$193.79
|
| Rate for Payer: Healthscope Commercial |
$161.82
|
| Rate for Payer: Healthscope Whirlpool |
$156.97
|
| Rate for Payer: Humana Choice PPO Medicare |
$193.79
|
| Rate for Payer: Mclaren Commercial |
$145.64
|
| Rate for Payer: Mclaren Medicaid |
$103.87
|
| Rate for Payer: Mclaren Medicare |
$193.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$203.48
|
| Rate for Payer: Meridian Medicaid |
$109.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$222.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.55
|
| Rate for Payer: Nomi Health Commercial |
$132.69
|
| Rate for Payer: PACE Medicare |
$184.10
|
| Rate for Payer: PACE SWMI |
$193.79
|
| Rate for Payer: PHP Commercial |
$213.17
|
| Rate for Payer: PHP Medicaid |
$103.87
|
| Rate for Payer: PHP Medicare Advantage |
$193.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$141.79
|
| Rate for Payer: Priority Health Medicare |
$193.79
|
| Rate for Payer: Priority Health Narrow Network |
$113.44
|
| Rate for Payer: Railroad Medicare Medicare |
$193.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$142.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$193.79
|
| Rate for Payer: UHC Exchange |
$300.37
|
| Rate for Payer: UHC Medicare Advantage |
$193.79
|
| Rate for Payer: UHCCP DNSP |
$193.79
|
| Rate for Payer: UHCCP Medicaid |
$103.87
|
| Rate for Payer: VA VA |
$193.79
|
|
|
HC SHAVE LESION TRUNK, ARM, LEGS OVER 2.0 CM
|
Facility
|
OP
|
$147.11
|
|
|
Service Code
|
CPT 11303
|
| Hospital Charge Code |
76100083
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$95.62 |
| Max. Negotiated Rate |
$603.96 |
| Rate for Payer: Aetna Commercial |
$132.40
|
| Rate for Payer: Aetna Medicare |
$389.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$487.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$487.06
|
| Rate for Payer: ASR ASR |
$142.70
|
| Rate for Payer: ASR Commercial |
$142.70
|
| Rate for Payer: BCBS Complete |
$219.30
|
| Rate for Payer: BCBS MAPPO |
$389.65
|
| Rate for Payer: BCBS Trust/PPO |
$120.47
|
| Rate for Payer: BCN Commercial |
$114.05
|
| Rate for Payer: BCN Medicare Advantage |
$389.65
|
| Rate for Payer: Cash Price |
$117.69
|
| Rate for Payer: Cash Price |
$117.69
|
| Rate for Payer: Cofinity Commercial |
$138.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$117.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$389.65
|
| Rate for Payer: Healthscope Commercial |
$147.11
|
| Rate for Payer: Healthscope Whirlpool |
$142.70
|
| Rate for Payer: Humana Choice PPO Medicare |
$389.65
|
| Rate for Payer: Mclaren Commercial |
$132.40
|
| Rate for Payer: Mclaren Medicaid |
$208.85
|
| Rate for Payer: Mclaren Medicare |
$389.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$409.13
|
| Rate for Payer: Meridian Medicaid |
$219.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$448.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$125.04
|
| Rate for Payer: Nomi Health Commercial |
$120.63
|
| Rate for Payer: PACE Medicare |
$370.17
|
| Rate for Payer: PACE SWMI |
$389.65
|
| Rate for Payer: PHP Commercial |
$428.62
|
| Rate for Payer: PHP Medicaid |
$208.85
|
| Rate for Payer: PHP Medicare Advantage |
$389.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$95.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$128.90
|
| Rate for Payer: Priority Health Medicare |
$389.65
|
| Rate for Payer: Priority Health Narrow Network |
$103.12
|
| Rate for Payer: Railroad Medicare Medicare |
$389.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$129.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$389.65
|
| Rate for Payer: UHC Exchange |
$603.96
|
| Rate for Payer: UHC Medicare Advantage |
$389.65
|
| Rate for Payer: UHCCP DNSP |
$389.65
|
| Rate for Payer: UHCCP Medicaid |
$208.85
|
| Rate for Payer: VA VA |
$389.65
|
|
|
HC SHAVE LESION TRUNK, ARM, LEGS OVER 2.0 CM
|
Facility
|
IP
|
$147.11
|
|
|
Service Code
|
CPT 11303
|
| Hospital Charge Code |
76100083
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$95.62 |
| Max. Negotiated Rate |
$147.11 |
| Rate for Payer: Aetna Commercial |
$132.40
|
| Rate for Payer: ASR ASR |
$142.70
|
| Rate for Payer: ASR Commercial |
$142.70
|
| Rate for Payer: BCBS Trust/PPO |
$119.88
|
| Rate for Payer: BCN Commercial |
$114.05
|
| Rate for Payer: Cash Price |
$117.69
|
| Rate for Payer: Cofinity Commercial |
$138.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$117.69
|
| Rate for Payer: Healthscope Commercial |
$147.11
|
| Rate for Payer: Healthscope Whirlpool |
$142.70
|
| Rate for Payer: Mclaren Commercial |
$132.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$125.04
|
| Rate for Payer: Nomi Health Commercial |
$120.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$95.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$129.46
|
|
|
HC SHEEP SORREL IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200102
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$25.39 |
| Rate for Payer: Aetna Commercial |
$22.85
|
| Rate for Payer: ASR ASR |
$24.63
|
| Rate for Payer: ASR Commercial |
$24.63
|
| Rate for Payer: BCBS Trust/PPO |
$20.69
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$23.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$25.39
|
| Rate for Payer: Healthscope Whirlpool |
$24.63
|
| Rate for Payer: Mclaren Commercial |
$22.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.34
|
|
|
HC SHEEP SORREL IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200102
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$25.39 |
| Rate for Payer: Aetna Commercial |
$22.85
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: ASR ASR |
$24.63
|
| Rate for Payer: ASR Commercial |
$24.63
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$20.79
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$23.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$25.39
|
| Rate for Payer: Healthscope Whirlpool |
$24.63
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$22.85
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$5.74
|
| Rate for Payer: PHP Medicaid |
$2.80
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.25
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$17.80
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP DNSP |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.80
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC SHINGLES VACCINE
|
Facility
|
IP
|
$276.95
|
|
|
Service Code
|
CPT 90736
|
| Hospital Charge Code |
63600063
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$180.02 |
| Max. Negotiated Rate |
$276.95 |
| Rate for Payer: Aetna Commercial |
$249.25
|
| Rate for Payer: ASR ASR |
$268.64
|
| Rate for Payer: ASR Commercial |
$268.64
|
| Rate for Payer: BCBS Trust/PPO |
$225.69
|
| Rate for Payer: BCN Commercial |
$214.72
|
| Rate for Payer: Cash Price |
$221.56
|
| Rate for Payer: Cofinity Commercial |
$260.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$221.56
|
| Rate for Payer: Healthscope Commercial |
$276.95
|
| Rate for Payer: Healthscope Whirlpool |
$268.64
|
| Rate for Payer: Mclaren Commercial |
$249.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$235.41
|
| Rate for Payer: Nomi Health Commercial |
$227.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$180.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$243.72
|
|
|
HC SHINGLES VACCINE
|
Facility
|
OP
|
$276.95
|
|
|
Service Code
|
CPT 90736
|
| Hospital Charge Code |
63600063
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$110.78 |
| Max. Negotiated Rate |
$276.95 |
| Rate for Payer: Aetna Commercial |
$249.25
|
| Rate for Payer: Aetna Medicare |
$138.47
|
| Rate for Payer: ASR ASR |
$268.64
|
| Rate for Payer: ASR Commercial |
$268.64
|
| Rate for Payer: BCBS Complete |
$110.78
|
| Rate for Payer: BCBS Trust/PPO |
$226.79
|
| Rate for Payer: BCN Commercial |
$214.72
|
| Rate for Payer: Cash Price |
$221.56
|
| Rate for Payer: Cofinity Commercial |
$260.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$221.56
|
| Rate for Payer: Healthscope Commercial |
$276.95
|
| Rate for Payer: Healthscope Whirlpool |
$268.64
|
| Rate for Payer: Mclaren Commercial |
$249.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$235.41
|
| Rate for Payer: Nomi Health Commercial |
$227.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$180.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$242.66
|
| Rate for Payer: Priority Health Narrow Network |
$194.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$243.72
|
|
|
HC SHRIMP IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200061
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$25.39 |
| Rate for Payer: Aetna Commercial |
$22.85
|
| Rate for Payer: ASR ASR |
$24.63
|
| Rate for Payer: ASR Commercial |
$24.63
|
| Rate for Payer: BCBS Trust/PPO |
$20.69
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$23.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$25.39
|
| Rate for Payer: Healthscope Whirlpool |
$24.63
|
| Rate for Payer: Mclaren Commercial |
$22.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.34
|
|
|
HC SHRIMP IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200061
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$25.39 |
| Rate for Payer: Aetna Commercial |
$22.85
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: ASR ASR |
$24.63
|
| Rate for Payer: ASR Commercial |
$24.63
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$20.79
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$23.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$25.39
|
| Rate for Payer: Healthscope Whirlpool |
$24.63
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$22.85
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$5.74
|
| Rate for Payer: PHP Medicaid |
$2.80
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.25
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$17.80
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP DNSP |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.80
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC SICKLE CELL CMS F/U
|
Facility
|
OP
|
$125.00
|
|
|
Service Code
|
CPT 99213
|
| Hospital Charge Code |
51500011
|
|
Hospital Revenue Code
|
515
|
| Min. Negotiated Rate |
$50.00 |
| Max. Negotiated Rate |
$125.00 |
| Rate for Payer: Aetna Commercial |
$112.50
|
| Rate for Payer: Aetna Medicare |
$62.50
|
| Rate for Payer: ASR ASR |
$121.25
|
| Rate for Payer: ASR Commercial |
$121.25
|
| Rate for Payer: BCBS Complete |
$50.00
|
| Rate for Payer: BCBS Trust/PPO |
$102.36
|
| Rate for Payer: BCN Commercial |
$96.91
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cofinity Commercial |
$117.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.00
|
| Rate for Payer: Healthscope Commercial |
$125.00
|
| Rate for Payer: Healthscope Whirlpool |
$121.25
|
| Rate for Payer: Mclaren Commercial |
$112.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106.25
|
| Rate for Payer: Nomi Health Commercial |
$102.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$109.53
|
| Rate for Payer: Priority Health Narrow Network |
$87.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$110.00
|
|
|
HC SICKLE CELL CMS F/U
|
Facility
|
IP
|
$125.00
|
|
|
Service Code
|
CPT 99213
|
| Hospital Charge Code |
51500011
|
|
Hospital Revenue Code
|
515
|
| Min. Negotiated Rate |
$81.25 |
| Max. Negotiated Rate |
$125.00 |
| Rate for Payer: Aetna Commercial |
$112.50
|
| Rate for Payer: ASR ASR |
$121.25
|
| Rate for Payer: ASR Commercial |
$121.25
|
| Rate for Payer: BCBS Trust/PPO |
$101.86
|
| Rate for Payer: BCN Commercial |
$96.91
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cofinity Commercial |
$117.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.00
|
| Rate for Payer: Healthscope Commercial |
$125.00
|
| Rate for Payer: Healthscope Whirlpool |
$121.25
|
| Rate for Payer: Mclaren Commercial |
$112.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106.25
|
| Rate for Payer: Nomi Health Commercial |
$102.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$110.00
|
|
|
HC SICKLE CELL CMS INITIAL COMP
|
Facility
|
IP
|
$450.00
|
|
|
Service Code
|
CPT 99215
|
| Hospital Charge Code |
51500009
|
|
Hospital Revenue Code
|
515
|
| Min. Negotiated Rate |
$292.50 |
| Max. Negotiated Rate |
$450.00 |
| Rate for Payer: Aetna Commercial |
$405.00
|
| Rate for Payer: ASR ASR |
$436.50
|
| Rate for Payer: ASR Commercial |
$436.50
|
| Rate for Payer: BCBS Trust/PPO |
$366.70
|
| Rate for Payer: BCN Commercial |
$348.88
|
| Rate for Payer: Cash Price |
$360.00
|
| Rate for Payer: Cofinity Commercial |
$423.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$360.00
|
| Rate for Payer: Healthscope Commercial |
$450.00
|
| Rate for Payer: Healthscope Whirlpool |
$436.50
|
| Rate for Payer: Mclaren Commercial |
$405.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$382.50
|
| Rate for Payer: Nomi Health Commercial |
$369.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$292.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$396.00
|
|
|
HC SICKLE CELL CMS INITIAL COMP
|
Facility
|
OP
|
$450.00
|
|
|
Service Code
|
CPT 99215
|
| Hospital Charge Code |
51500009
|
|
Hospital Revenue Code
|
515
|
| Min. Negotiated Rate |
$180.00 |
| Max. Negotiated Rate |
$450.00 |
| Rate for Payer: Aetna Commercial |
$405.00
|
| Rate for Payer: Aetna Medicare |
$225.00
|
| Rate for Payer: ASR ASR |
$436.50
|
| Rate for Payer: ASR Commercial |
$436.50
|
| Rate for Payer: BCBS Complete |
$180.00
|
| Rate for Payer: BCBS Trust/PPO |
$368.50
|
| Rate for Payer: BCN Commercial |
$348.88
|
| Rate for Payer: Cash Price |
$360.00
|
| Rate for Payer: Cofinity Commercial |
$423.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$360.00
|
| Rate for Payer: Healthscope Commercial |
$450.00
|
| Rate for Payer: Healthscope Whirlpool |
$436.50
|
| Rate for Payer: Mclaren Commercial |
$405.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$382.50
|
| Rate for Payer: Nomi Health Commercial |
$369.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$292.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$394.29
|
| Rate for Payer: Priority Health Narrow Network |
$315.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$396.00
|
|
|
HC SICKLE CELL CMS SUPP/SERV
|
Facility
|
IP
|
$75.00
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
51500012
|
|
Hospital Revenue Code
|
515
|
| Min. Negotiated Rate |
$48.75 |
| Max. Negotiated Rate |
$75.00 |
| Rate for Payer: Aetna Commercial |
$67.50
|
| Rate for Payer: ASR ASR |
$72.75
|
| Rate for Payer: ASR Commercial |
$72.75
|
| Rate for Payer: BCBS Trust/PPO |
$61.12
|
| Rate for Payer: BCN Commercial |
$58.15
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cofinity Commercial |
$70.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.00
|
| Rate for Payer: Healthscope Commercial |
$75.00
|
| Rate for Payer: Healthscope Whirlpool |
$72.75
|
| Rate for Payer: Mclaren Commercial |
$67.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.75
|
| Rate for Payer: Nomi Health Commercial |
$61.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$66.00
|
|
|
HC SICKLE CELL CMS SUPP/SERV
|
Facility
|
OP
|
$75.00
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
51500012
|
|
Hospital Revenue Code
|
515
|
| Min. Negotiated Rate |
$30.00 |
| Max. Negotiated Rate |
$75.00 |
| Rate for Payer: Aetna Commercial |
$67.50
|
| Rate for Payer: Aetna Medicare |
$37.50
|
| Rate for Payer: ASR ASR |
$72.75
|
| Rate for Payer: ASR Commercial |
$72.75
|
| Rate for Payer: BCBS Complete |
$30.00
|
| Rate for Payer: BCBS Trust/PPO |
$61.42
|
| Rate for Payer: BCN Commercial |
$58.15
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cofinity Commercial |
$70.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.00
|
| Rate for Payer: Healthscope Commercial |
$75.00
|
| Rate for Payer: Healthscope Whirlpool |
$72.75
|
| Rate for Payer: Mclaren Commercial |
$67.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.75
|
| Rate for Payer: Nomi Health Commercial |
$61.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$65.72
|
| Rate for Payer: Priority Health Narrow Network |
$52.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$66.00
|
|
|
HC SICKLE CELLS CMS COMP
|
Facility
|
IP
|
$300.00
|
|
|
Service Code
|
CPT 99215
|
| Hospital Charge Code |
51500010
|
|
Hospital Revenue Code
|
515
|
| Min. Negotiated Rate |
$195.00 |
| Max. Negotiated Rate |
$300.00 |
| Rate for Payer: Aetna Commercial |
$270.00
|
| Rate for Payer: ASR ASR |
$291.00
|
| Rate for Payer: ASR Commercial |
$291.00
|
| Rate for Payer: BCBS Trust/PPO |
$244.47
|
| Rate for Payer: BCN Commercial |
$232.59
|
| Rate for Payer: Cash Price |
$240.00
|
| Rate for Payer: Cofinity Commercial |
$282.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$240.00
|
| Rate for Payer: Healthscope Commercial |
$300.00
|
| Rate for Payer: Healthscope Whirlpool |
$291.00
|
| Rate for Payer: Mclaren Commercial |
$270.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$255.00
|
| Rate for Payer: Nomi Health Commercial |
$246.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$195.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$264.00
|
|
|
HC SICKLE CELLS CMS COMP
|
Facility
|
OP
|
$300.00
|
|
|
Service Code
|
CPT 99215
|
| Hospital Charge Code |
51500010
|
|
Hospital Revenue Code
|
515
|
| Min. Negotiated Rate |
$120.00 |
| Max. Negotiated Rate |
$300.00 |
| Rate for Payer: Aetna Commercial |
$270.00
|
| Rate for Payer: Aetna Medicare |
$150.00
|
| Rate for Payer: ASR ASR |
$291.00
|
| Rate for Payer: ASR Commercial |
$291.00
|
| Rate for Payer: BCBS Complete |
$120.00
|
| Rate for Payer: BCBS Trust/PPO |
$245.67
|
| Rate for Payer: BCN Commercial |
$232.59
|
| Rate for Payer: Cash Price |
$240.00
|
| Rate for Payer: Cofinity Commercial |
$282.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$240.00
|
| Rate for Payer: Healthscope Commercial |
$300.00
|
| Rate for Payer: Healthscope Whirlpool |
$291.00
|
| Rate for Payer: Mclaren Commercial |
$270.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$255.00
|
| Rate for Payer: Nomi Health Commercial |
$246.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$195.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$262.86
|
| Rate for Payer: Priority Health Narrow Network |
$210.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$264.00
|
|
|
HC SICKLE CELL TEST
|
Facility
|
IP
|
$31.31
|
|
|
Service Code
|
CPT 85660
|
| Hospital Charge Code |
30500061
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$20.35 |
| Max. Negotiated Rate |
$31.31 |
| Rate for Payer: Aetna Commercial |
$28.18
|
| Rate for Payer: ASR ASR |
$30.37
|
| Rate for Payer: ASR Commercial |
$30.37
|
| Rate for Payer: BCBS Trust/PPO |
$25.51
|
| Rate for Payer: BCN Commercial |
$24.27
|
| Rate for Payer: Cash Price |
$25.05
|
| Rate for Payer: Cofinity Commercial |
$29.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.05
|
| Rate for Payer: Healthscope Commercial |
$31.31
|
| Rate for Payer: Healthscope Whirlpool |
$30.37
|
| Rate for Payer: Mclaren Commercial |
$28.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.61
|
| Rate for Payer: Nomi Health Commercial |
$25.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.55
|
|
|
HC SICKLE CELL TEST
|
Facility
|
OP
|
$31.31
|
|
|
Service Code
|
CPT 85660
|
| Hospital Charge Code |
30500061
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.95 |
| Max. Negotiated Rate |
$31.31 |
| Rate for Payer: Aetna Commercial |
$28.18
|
| Rate for Payer: Aetna Medicare |
$5.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.89
|
| Rate for Payer: ASR ASR |
$30.37
|
| Rate for Payer: ASR Commercial |
$30.37
|
| Rate for Payer: BCBS Complete |
$3.10
|
| Rate for Payer: BCBS MAPPO |
$5.51
|
| Rate for Payer: BCBS Trust/PPO |
$25.64
|
| Rate for Payer: BCN Commercial |
$24.27
|
| Rate for Payer: BCN Medicare Advantage |
$5.51
|
| Rate for Payer: Cash Price |
$25.05
|
| Rate for Payer: Cash Price |
$25.05
|
| Rate for Payer: Cofinity Commercial |
$29.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.51
|
| Rate for Payer: Healthscope Commercial |
$31.31
|
| Rate for Payer: Healthscope Whirlpool |
$30.37
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.51
|
| Rate for Payer: Mclaren Commercial |
$28.18
|
| Rate for Payer: Mclaren Medicaid |
$2.95
|
| Rate for Payer: Mclaren Medicare |
$5.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.79
|
| Rate for Payer: Meridian Medicaid |
$3.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.61
|
| Rate for Payer: Nomi Health Commercial |
$25.67
|
| Rate for Payer: PACE Medicare |
$5.23
|
| Rate for Payer: PACE SWMI |
$5.51
|
| Rate for Payer: PHP Commercial |
$6.06
|
| Rate for Payer: PHP Medicaid |
$2.95
|
| Rate for Payer: PHP Medicare Advantage |
$5.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$27.43
|
| Rate for Payer: Priority Health Medicare |
$5.51
|
| Rate for Payer: Priority Health Narrow Network |
$21.95
|
| Rate for Payer: Railroad Medicare Medicare |
$5.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.51
|
| Rate for Payer: UHC Exchange |
$8.54
|
| Rate for Payer: UHC Medicare Advantage |
$5.51
|
| Rate for Payer: UHCCP DNSP |
$5.51
|
| Rate for Payer: UHCCP Medicaid |
$2.95
|
| Rate for Payer: VA VA |
$5.51
|
|
|
HC SIGMOIDOSCOPY FLX DX W/COLL SPEC BR/WA
|
Facility
|
IP
|
$1,162.48
|
|
|
Service Code
|
CPT 45330
|
| Hospital Charge Code |
76100186
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$755.61 |
| Max. Negotiated Rate |
$1,162.48 |
| Rate for Payer: Aetna Commercial |
$1,046.23
|
| Rate for Payer: ASR ASR |
$1,127.61
|
| Rate for Payer: ASR Commercial |
$1,127.61
|
| Rate for Payer: BCBS Trust/PPO |
$947.30
|
| Rate for Payer: BCN Commercial |
$901.27
|
| Rate for Payer: Cash Price |
$929.98
|
| Rate for Payer: Cofinity Commercial |
$1,092.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$929.98
|
| Rate for Payer: Healthscope Commercial |
$1,162.48
|
| Rate for Payer: Healthscope Whirlpool |
$1,127.61
|
| Rate for Payer: Mclaren Commercial |
$1,046.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$988.11
|
| Rate for Payer: Nomi Health Commercial |
$953.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$755.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,022.98
|
|
|
HC SIGMOIDOSCOPY FLX DX W/COLL SPEC BR/WA
|
Facility
|
OP
|
$1,162.48
|
|
|
Service Code
|
CPT 45330
|
| Hospital Charge Code |
76100186
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$476.60 |
| Max. Negotiated Rate |
$1,378.21 |
| Rate for Payer: Aetna Commercial |
$1,046.23
|
| Rate for Payer: Aetna Medicare |
$889.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,111.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,111.46
|
| Rate for Payer: ASR ASR |
$1,127.61
|
| Rate for Payer: ASR Commercial |
$1,127.61
|
| Rate for Payer: BCBS Complete |
$500.42
|
| Rate for Payer: BCBS MAPPO |
$889.17
|
| Rate for Payer: BCBS Trust/PPO |
$951.95
|
| Rate for Payer: BCN Commercial |
$901.27
|
| Rate for Payer: BCN Medicare Advantage |
$889.17
|
| Rate for Payer: Cash Price |
$929.98
|
| Rate for Payer: Cash Price |
$929.98
|
| Rate for Payer: Cofinity Commercial |
$1,092.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$929.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$889.17
|
| Rate for Payer: Healthscope Commercial |
$1,162.48
|
| Rate for Payer: Healthscope Whirlpool |
$1,127.61
|
| Rate for Payer: Humana Choice PPO Medicare |
$889.17
|
| Rate for Payer: Mclaren Commercial |
$1,046.23
|
| Rate for Payer: Mclaren Medicaid |
$476.60
|
| Rate for Payer: Mclaren Medicare |
$889.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$933.63
|
| Rate for Payer: Meridian Medicaid |
$500.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,022.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$988.11
|
| Rate for Payer: Nomi Health Commercial |
$953.23
|
| Rate for Payer: PACE Medicare |
$844.71
|
| Rate for Payer: PACE SWMI |
$889.17
|
| Rate for Payer: PHP Commercial |
$978.09
|
| Rate for Payer: PHP Medicaid |
$476.60
|
| Rate for Payer: PHP Medicare Advantage |
$889.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$476.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$755.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,018.56
|
| Rate for Payer: Priority Health Medicare |
$889.17
|
| Rate for Payer: Priority Health Narrow Network |
$814.90
|
| Rate for Payer: Railroad Medicare Medicare |
$889.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,022.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$889.17
|
| Rate for Payer: UHC Exchange |
$1,378.21
|
| Rate for Payer: UHC Medicare Advantage |
$889.17
|
| Rate for Payer: UHCCP DNSP |
$889.17
|
| Rate for Payer: UHCCP Medicaid |
$476.60
|
| Rate for Payer: VA VA |
$889.17
|
|
|
HC SIGMOIDOSCOPY W EUS EXAM
|
Facility
|
OP
|
$2,621.12
|
|
| Hospital Charge Code |
36000082
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,048.45 |
| Max. Negotiated Rate |
$2,621.12 |
| Rate for Payer: Aetna Commercial |
$2,359.01
|
| Rate for Payer: Aetna Medicare |
$1,310.56
|
| Rate for Payer: ASR ASR |
$2,542.49
|
| Rate for Payer: ASR Commercial |
$2,542.49
|
| Rate for Payer: BCBS Complete |
$1,048.45
|
| Rate for Payer: BCBS Trust/PPO |
$2,146.44
|
| Rate for Payer: BCN Commercial |
$2,032.15
|
| Rate for Payer: Cash Price |
$2,096.90
|
| Rate for Payer: Cofinity Commercial |
$2,463.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,096.90
|
| Rate for Payer: Healthscope Commercial |
$2,621.12
|
| Rate for Payer: Healthscope Whirlpool |
$2,542.49
|
| Rate for Payer: Mclaren Commercial |
$2,359.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,227.95
|
| Rate for Payer: Nomi Health Commercial |
$2,149.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,703.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,296.63
|
| Rate for Payer: Priority Health Narrow Network |
$1,837.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,306.59
|
|
