|
HC TC 99M SULFUR COLLOID PER STUDY
|
Facility
|
OP
|
$255.30
|
|
|
Service Code
|
HCPCS A9541
|
| Hospital Charge Code |
34300020
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$94.46 |
| Max. Negotiated Rate |
$255.30 |
| Rate for Payer: Aetna Commercial |
$229.77
|
| Rate for Payer: Aetna Medicare |
$94.46
|
| Rate for Payer: ASR ASR |
$247.64
|
| Rate for Payer: BCBS Complete |
$102.12
|
| Rate for Payer: BCBS Trust/PPO |
$210.49
|
| Rate for Payer: BCN Commercial |
$210.49
|
| Rate for Payer: Cash Price |
$204.24
|
| Rate for Payer: Cash Price |
$204.24
|
| Rate for Payer: Cofinity Commercial |
$239.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$204.24
|
| Rate for Payer: Healthscope Commercial |
$247.64
|
| Rate for Payer: Healthscope Whirlpool |
$255.30
|
| Rate for Payer: Mclaren Commercial |
$229.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$204.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$217.00
|
| Rate for Payer: Nomi Health Commercial |
$209.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$191.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$165.85
|
| Rate for Payer: Priority Health Narrow Network |
$132.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$224.66
|
|
|
HC TC 99M SULFUR COLLOID PER STUDY
|
Facility
|
IP
|
$255.30
|
|
|
Service Code
|
HCPCS A9541
|
| Hospital Charge Code |
34300020
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$191.47 |
| Max. Negotiated Rate |
$255.30 |
| Rate for Payer: Aetna Commercial |
$229.77
|
| Rate for Payer: ASR ASR |
$247.64
|
| Rate for Payer: BCBS Trust/PPO |
$209.65
|
| Rate for Payer: BCN Commercial |
$209.65
|
| Rate for Payer: Cash Price |
$204.24
|
| Rate for Payer: Cofinity Commercial |
$239.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$204.24
|
| Rate for Payer: Healthscope Commercial |
$247.64
|
| Rate for Payer: Healthscope Whirlpool |
$255.30
|
| Rate for Payer: Mclaren Commercial |
$229.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$217.00
|
| Rate for Payer: Nomi Health Commercial |
$209.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$191.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$224.66
|
|
|
HC T CELL ACUTE LYMPH LEUK
|
Facility
|
OP
|
$36.41
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000133
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$11.20 |
| Max. Negotiated Rate |
$36.41 |
| Rate for Payer: Aetna Commercial |
$32.77
|
| Rate for Payer: Aetna Medicare |
$21.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.77
|
| Rate for Payer: ASR ASR |
$35.32
|
| Rate for Payer: BCBS Complete |
$11.76
|
| Rate for Payer: BCBS MAPPO |
$21.42
|
| Rate for Payer: BCBS Trust/PPO |
$30.02
|
| Rate for Payer: BCN Commercial |
$30.02
|
| Rate for Payer: BCN Medicare Advantage |
$21.42
|
| Rate for Payer: Cash Price |
$29.13
|
| Rate for Payer: Cash Price |
$29.13
|
| Rate for Payer: Cofinity Commercial |
$34.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.42
|
| Rate for Payer: Healthscope Commercial |
$35.32
|
| Rate for Payer: Healthscope Whirlpool |
$36.41
|
| Rate for Payer: Humana Choice PPO Medicare |
$21.42
|
| Rate for Payer: Mclaren Commercial |
$32.77
|
| Rate for Payer: Mclaren Medicaid |
$21.42
|
| Rate for Payer: Mclaren Medicare |
$21.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.49
|
| Rate for Payer: Meridian Medicaid |
$11.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$23.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.95
|
| Rate for Payer: Nomi Health Commercial |
$29.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.31
|
| Rate for Payer: PACE Medicare |
$20.35
|
| Rate for Payer: PACE SWMI |
$21.42
|
| Rate for Payer: PHP Commercial |
$23.56
|
| Rate for Payer: PHP Medicaid |
$11.48
|
| Rate for Payer: PHP Medicare Advantage |
$21.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$31.90
|
| Rate for Payer: Priority Health Medicare |
$21.42
|
| Rate for Payer: Priority Health Narrow Network |
$25.52
|
| Rate for Payer: Railroad Medicare Medicare |
$21.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$32.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$21.42
|
| Rate for Payer: UHC Exchange |
$33.20
|
| Rate for Payer: UHC Medicaid |
$11.20
|
| Rate for Payer: UHCCP DNSP |
$21.42
|
| Rate for Payer: UHCCP Medicaid |
$11.20
|
| Rate for Payer: VA VA |
$21.42
|
|
|
HC T CELL ACUTE LYMPH LEUK
|
Facility
|
IP
|
$36.41
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000133
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$27.31 |
| Max. Negotiated Rate |
$36.41 |
| Rate for Payer: Aetna Commercial |
$32.77
|
| Rate for Payer: ASR ASR |
$35.32
|
| Rate for Payer: BCBS Trust/PPO |
$29.90
|
| Rate for Payer: BCN Commercial |
$29.90
|
| Rate for Payer: Cash Price |
$29.13
|
| Rate for Payer: Cofinity Commercial |
$34.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.13
|
| Rate for Payer: Healthscope Commercial |
$35.32
|
| Rate for Payer: Healthscope Whirlpool |
$36.41
|
| Rate for Payer: Mclaren Commercial |
$32.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.95
|
| Rate for Payer: Nomi Health Commercial |
$29.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$32.04
|
|
|
HC T CELL ACUTE LYMPH LEUK CMPT1
|
Facility
|
OP
|
$120.98
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000040
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$26.77 |
| Max. Negotiated Rate |
$120.98 |
| Rate for Payer: Aetna Commercial |
$108.88
|
| Rate for Payer: Aetna Medicare |
$51.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$63.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$63.99
|
| Rate for Payer: ASR ASR |
$117.35
|
| Rate for Payer: BCBS Complete |
$28.11
|
| Rate for Payer: BCBS MAPPO |
$51.19
|
| Rate for Payer: BCBS Trust/PPO |
$99.75
|
| Rate for Payer: BCN Commercial |
$99.75
|
| Rate for Payer: BCN Medicare Advantage |
$51.19
|
| Rate for Payer: Cash Price |
$96.78
|
| Rate for Payer: Cash Price |
$96.78
|
| Rate for Payer: Cofinity Commercial |
$113.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.19
|
| Rate for Payer: Healthscope Commercial |
$117.35
|
| Rate for Payer: Healthscope Whirlpool |
$120.98
|
| Rate for Payer: Humana Choice PPO Medicare |
$51.19
|
| Rate for Payer: Mclaren Commercial |
$108.88
|
| Rate for Payer: Mclaren Medicaid |
$51.19
|
| Rate for Payer: Mclaren Medicare |
$51.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.75
|
| Rate for Payer: Meridian Medicaid |
$28.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$56.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$102.83
|
| Rate for Payer: Nomi Health Commercial |
$99.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$90.73
|
| Rate for Payer: PACE Medicare |
$48.63
|
| Rate for Payer: PACE SWMI |
$51.19
|
| Rate for Payer: PHP Commercial |
$56.31
|
| Rate for Payer: PHP Medicaid |
$27.44
|
| Rate for Payer: PHP Medicare Advantage |
$51.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$106.00
|
| Rate for Payer: Priority Health Medicare |
$51.19
|
| Rate for Payer: Priority Health Narrow Network |
$84.81
|
| Rate for Payer: Railroad Medicare Medicare |
$51.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$106.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$51.19
|
| Rate for Payer: UHC Exchange |
$79.34
|
| Rate for Payer: UHC Medicaid |
$26.77
|
| Rate for Payer: UHCCP DNSP |
$51.19
|
| Rate for Payer: UHCCP Medicaid |
$26.77
|
| Rate for Payer: VA VA |
$51.19
|
|
|
HC T CELL ACUTE LYMPH LEUK CMPT1
|
Facility
|
IP
|
$120.98
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000040
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$90.73 |
| Max. Negotiated Rate |
$120.98 |
| Rate for Payer: Aetna Commercial |
$108.88
|
| Rate for Payer: ASR ASR |
$117.35
|
| Rate for Payer: BCBS Trust/PPO |
$99.35
|
| Rate for Payer: BCN Commercial |
$99.35
|
| Rate for Payer: Cash Price |
$96.78
|
| Rate for Payer: Cofinity Commercial |
$113.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.78
|
| Rate for Payer: Healthscope Commercial |
$117.35
|
| Rate for Payer: Healthscope Whirlpool |
$120.98
|
| Rate for Payer: Mclaren Commercial |
$108.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$102.83
|
| Rate for Payer: Nomi Health Commercial |
$99.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$90.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$106.46
|
|
|
HC T CELL ACUTE LYMPH LEUK CMPT2
|
Facility
|
OP
|
$107.18
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000029
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$11.20 |
| Max. Negotiated Rate |
$107.18 |
| Rate for Payer: Aetna Commercial |
$96.46
|
| Rate for Payer: Aetna Medicare |
$21.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.77
|
| Rate for Payer: ASR ASR |
$103.96
|
| Rate for Payer: BCBS Complete |
$11.76
|
| Rate for Payer: BCBS MAPPO |
$21.42
|
| Rate for Payer: BCBS Trust/PPO |
$88.37
|
| Rate for Payer: BCN Commercial |
$88.37
|
| Rate for Payer: BCN Medicare Advantage |
$21.42
|
| Rate for Payer: Cash Price |
$85.74
|
| Rate for Payer: Cash Price |
$85.74
|
| Rate for Payer: Cofinity Commercial |
$100.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.42
|
| Rate for Payer: Healthscope Commercial |
$103.96
|
| Rate for Payer: Healthscope Whirlpool |
$107.18
|
| Rate for Payer: Humana Choice PPO Medicare |
$21.42
|
| Rate for Payer: Mclaren Commercial |
$96.46
|
| Rate for Payer: Mclaren Medicaid |
$21.42
|
| Rate for Payer: Mclaren Medicare |
$21.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.49
|
| Rate for Payer: Meridian Medicaid |
$11.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$23.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.10
|
| Rate for Payer: Nomi Health Commercial |
$87.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$80.39
|
| Rate for Payer: PACE Medicare |
$20.35
|
| Rate for Payer: PACE SWMI |
$21.42
|
| Rate for Payer: PHP Commercial |
$23.56
|
| Rate for Payer: PHP Medicaid |
$11.48
|
| Rate for Payer: PHP Medicare Advantage |
$21.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$93.91
|
| Rate for Payer: Priority Health Medicare |
$21.42
|
| Rate for Payer: Priority Health Narrow Network |
$75.13
|
| Rate for Payer: Railroad Medicare Medicare |
$21.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$94.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$21.42
|
| Rate for Payer: UHC Exchange |
$33.20
|
| Rate for Payer: UHC Medicaid |
$11.20
|
| Rate for Payer: UHCCP DNSP |
$21.42
|
| Rate for Payer: UHCCP Medicaid |
$11.20
|
| Rate for Payer: VA VA |
$21.42
|
|
|
HC T CELL ACUTE LYMPH LEUK CMPT2
|
Facility
|
IP
|
$107.18
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000029
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$80.39 |
| Max. Negotiated Rate |
$107.18 |
| Rate for Payer: Aetna Commercial |
$96.46
|
| Rate for Payer: ASR ASR |
$103.96
|
| Rate for Payer: BCBS Trust/PPO |
$88.02
|
| Rate for Payer: BCN Commercial |
$88.02
|
| Rate for Payer: Cash Price |
$85.74
|
| Rate for Payer: Cofinity Commercial |
$100.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.74
|
| Rate for Payer: Healthscope Commercial |
$103.96
|
| Rate for Payer: Healthscope Whirlpool |
$107.18
|
| Rate for Payer: Mclaren Commercial |
$96.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.10
|
| Rate for Payer: Nomi Health Commercial |
$87.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$80.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$94.32
|
|
|
HC T CELL ACUTE LYMPH LEUK FISH
|
Facility
|
IP
|
$86.35
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000039
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$64.76 |
| Max. Negotiated Rate |
$86.35 |
| Rate for Payer: Aetna Commercial |
$77.72
|
| Rate for Payer: ASR ASR |
$83.76
|
| Rate for Payer: BCBS Trust/PPO |
$70.91
|
| Rate for Payer: BCN Commercial |
$70.91
|
| Rate for Payer: Cash Price |
$69.08
|
| Rate for Payer: Cofinity Commercial |
$81.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.08
|
| Rate for Payer: Healthscope Commercial |
$83.76
|
| Rate for Payer: Healthscope Whirlpool |
$86.35
|
| Rate for Payer: Mclaren Commercial |
$77.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.40
|
| Rate for Payer: Nomi Health Commercial |
$70.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$64.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$75.99
|
|
|
HC T CELL ACUTE LYMPH LEUK FISH
|
Facility
|
OP
|
$86.35
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000039
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$26.77 |
| Max. Negotiated Rate |
$86.35 |
| Rate for Payer: Aetna Commercial |
$77.72
|
| Rate for Payer: Aetna Medicare |
$51.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$63.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$63.99
|
| Rate for Payer: ASR ASR |
$83.76
|
| Rate for Payer: BCBS Complete |
$28.11
|
| Rate for Payer: BCBS MAPPO |
$51.19
|
| Rate for Payer: BCBS Trust/PPO |
$71.20
|
| Rate for Payer: BCN Commercial |
$71.20
|
| Rate for Payer: BCN Medicare Advantage |
$51.19
|
| Rate for Payer: Cash Price |
$69.08
|
| Rate for Payer: Cash Price |
$69.08
|
| Rate for Payer: Cofinity Commercial |
$81.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.19
|
| Rate for Payer: Healthscope Commercial |
$83.76
|
| Rate for Payer: Healthscope Whirlpool |
$86.35
|
| Rate for Payer: Humana Choice PPO Medicare |
$51.19
|
| Rate for Payer: Mclaren Commercial |
$77.72
|
| Rate for Payer: Mclaren Medicaid |
$51.19
|
| Rate for Payer: Mclaren Medicare |
$51.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.75
|
| Rate for Payer: Meridian Medicaid |
$28.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$56.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.40
|
| Rate for Payer: Nomi Health Commercial |
$70.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$64.76
|
| Rate for Payer: PACE Medicare |
$48.63
|
| Rate for Payer: PACE SWMI |
$51.19
|
| Rate for Payer: PHP Commercial |
$56.31
|
| Rate for Payer: PHP Medicaid |
$27.44
|
| Rate for Payer: PHP Medicare Advantage |
$51.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$75.66
|
| Rate for Payer: Priority Health Medicare |
$51.19
|
| Rate for Payer: Priority Health Narrow Network |
$60.53
|
| Rate for Payer: Railroad Medicare Medicare |
$51.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$75.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$51.19
|
| Rate for Payer: UHC Exchange |
$79.34
|
| Rate for Payer: UHC Medicaid |
$26.77
|
| Rate for Payer: UHCCP DNSP |
$51.19
|
| Rate for Payer: UHCCP Medicaid |
$26.77
|
| Rate for Payer: VA VA |
$51.19
|
|
|
HC T CELLS CD4 CD8 COUNT
|
Facility
|
OP
|
$84.11
|
|
|
Service Code
|
CPT 86360
|
| Hospital Charge Code |
30200207
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$24.57 |
| Max. Negotiated Rate |
$347.44 |
| Rate for Payer: Aetna Commercial |
$75.70
|
| Rate for Payer: Aetna Medicare |
$46.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$58.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$58.73
|
| Rate for Payer: ASR ASR |
$81.59
|
| Rate for Payer: BCBS Complete |
$25.80
|
| Rate for Payer: BCBS MAPPO |
$46.98
|
| Rate for Payer: BCBS Trust/PPO |
$69.35
|
| Rate for Payer: BCN Commercial |
$69.35
|
| Rate for Payer: BCN Medicare Advantage |
$46.98
|
| Rate for Payer: Cash Price |
$67.29
|
| Rate for Payer: Cash Price |
$67.29
|
| Rate for Payer: Cofinity Commercial |
$79.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.98
|
| Rate for Payer: Healthscope Commercial |
$81.59
|
| Rate for Payer: Healthscope Whirlpool |
$84.11
|
| Rate for Payer: Humana Choice PPO Medicare |
$46.98
|
| Rate for Payer: Mclaren Commercial |
$75.70
|
| Rate for Payer: Mclaren Medicaid |
$46.98
|
| Rate for Payer: Mclaren Medicare |
$46.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$49.33
|
| Rate for Payer: Meridian Medicaid |
$25.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$54.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$51.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.49
|
| Rate for Payer: Nomi Health Commercial |
$68.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$63.08
|
| Rate for Payer: PACE Medicare |
$44.63
|
| Rate for Payer: PACE SWMI |
$46.98
|
| Rate for Payer: PHP Commercial |
$51.68
|
| Rate for Payer: PHP Medicaid |
$25.18
|
| Rate for Payer: PHP Medicare Advantage |
$46.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$347.44
|
| Rate for Payer: Priority Health Medicare |
$46.98
|
| Rate for Payer: Priority Health Narrow Network |
$277.96
|
| Rate for Payer: Railroad Medicare Medicare |
$46.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$74.02
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$46.98
|
| Rate for Payer: UHC Exchange |
$72.82
|
| Rate for Payer: UHC Medicaid |
$24.57
|
| Rate for Payer: UHCCP DNSP |
$46.98
|
| Rate for Payer: UHCCP Medicaid |
$24.57
|
| Rate for Payer: VA VA |
$46.98
|
|
|
HC T CELLS CD4 CD8 COUNT
|
Facility
|
IP
|
$84.11
|
|
|
Service Code
|
CPT 86360
|
| Hospital Charge Code |
30200207
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$63.08 |
| Max. Negotiated Rate |
$84.11 |
| Rate for Payer: Aetna Commercial |
$75.70
|
| Rate for Payer: ASR ASR |
$81.59
|
| Rate for Payer: BCBS Trust/PPO |
$69.07
|
| Rate for Payer: BCN Commercial |
$69.07
|
| Rate for Payer: Cash Price |
$67.29
|
| Rate for Payer: Cofinity Commercial |
$79.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.29
|
| Rate for Payer: Healthscope Commercial |
$81.59
|
| Rate for Payer: Healthscope Whirlpool |
$84.11
|
| Rate for Payer: Mclaren Commercial |
$75.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.49
|
| Rate for Payer: Nomi Health Commercial |
$68.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$63.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$74.02
|
|
|
HC T CELL TOTAL
|
Facility
|
OP
|
$67.55
|
|
|
Service Code
|
CPT 86359
|
| Hospital Charge Code |
30200205
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.73 |
| Max. Negotiated Rate |
$347.44 |
| Rate for Payer: Aetna Commercial |
$60.80
|
| Rate for Payer: Aetna Medicare |
$37.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$47.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$47.16
|
| Rate for Payer: ASR ASR |
$65.52
|
| Rate for Payer: BCBS Complete |
$20.72
|
| Rate for Payer: BCBS MAPPO |
$37.73
|
| Rate for Payer: BCBS Trust/PPO |
$55.69
|
| Rate for Payer: BCN Commercial |
$55.69
|
| Rate for Payer: BCN Medicare Advantage |
$37.73
|
| Rate for Payer: Cash Price |
$54.04
|
| Rate for Payer: Cash Price |
$54.04
|
| Rate for Payer: Cofinity Commercial |
$63.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.73
|
| Rate for Payer: Healthscope Commercial |
$65.52
|
| Rate for Payer: Healthscope Whirlpool |
$67.55
|
| Rate for Payer: Humana Choice PPO Medicare |
$37.73
|
| Rate for Payer: Mclaren Commercial |
$60.80
|
| Rate for Payer: Mclaren Medicaid |
$37.73
|
| Rate for Payer: Mclaren Medicare |
$37.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.62
|
| Rate for Payer: Meridian Medicaid |
$20.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$41.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.42
|
| Rate for Payer: Nomi Health Commercial |
$55.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.66
|
| Rate for Payer: PACE Medicare |
$35.84
|
| Rate for Payer: PACE SWMI |
$37.73
|
| Rate for Payer: PHP Commercial |
$41.50
|
| Rate for Payer: PHP Medicaid |
$20.22
|
| Rate for Payer: PHP Medicare Advantage |
$37.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$347.44
|
| Rate for Payer: Priority Health Medicare |
$37.73
|
| Rate for Payer: Priority Health Narrow Network |
$277.96
|
| Rate for Payer: Railroad Medicare Medicare |
$37.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$59.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$37.73
|
| Rate for Payer: UHC Exchange |
$58.48
|
| Rate for Payer: UHC Medicaid |
$19.73
|
| Rate for Payer: UHCCP DNSP |
$37.73
|
| Rate for Payer: UHCCP Medicaid |
$19.73
|
| Rate for Payer: VA VA |
$37.73
|
|
|
HC T CELL TOTAL
|
Facility
|
IP
|
$67.55
|
|
|
Service Code
|
CPT 86359
|
| Hospital Charge Code |
30200205
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$50.66 |
| Max. Negotiated Rate |
$67.55 |
| Rate for Payer: Aetna Commercial |
$60.80
|
| Rate for Payer: ASR ASR |
$65.52
|
| Rate for Payer: BCBS Trust/PPO |
$55.47
|
| Rate for Payer: BCN Commercial |
$55.47
|
| Rate for Payer: Cash Price |
$54.04
|
| Rate for Payer: Cofinity Commercial |
$63.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.04
|
| Rate for Payer: Healthscope Commercial |
$65.52
|
| Rate for Payer: Healthscope Whirlpool |
$67.55
|
| Rate for Payer: Mclaren Commercial |
$60.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.42
|
| Rate for Payer: Nomi Health Commercial |
$55.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$59.44
|
|
|
HC TCMEPS UPPER/LOWER EXT. STIM
|
Facility
|
OP
|
$3,641.95
|
|
|
Service Code
|
CPT 95939
|
| Hospital Charge Code |
92200026
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$447.50 |
| Max. Negotiated Rate |
$3,641.95 |
| Rate for Payer: Aetna Commercial |
$3,277.76
|
| Rate for Payer: Aetna Medicare |
$855.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,069.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,069.56
|
| Rate for Payer: ASR ASR |
$3,532.69
|
| Rate for Payer: BCBS Complete |
$469.92
|
| Rate for Payer: BCBS MAPPO |
$855.65
|
| Rate for Payer: BCBS Trust/PPO |
$3,002.79
|
| Rate for Payer: BCN Commercial |
$3,002.79
|
| Rate for Payer: BCN Medicare Advantage |
$855.65
|
| Rate for Payer: Cash Price |
$2,913.56
|
| Rate for Payer: Cash Price |
$2,913.56
|
| Rate for Payer: Cofinity Commercial |
$3,423.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,913.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$855.65
|
| Rate for Payer: Healthscope Commercial |
$3,532.69
|
| Rate for Payer: Healthscope Whirlpool |
$3,641.95
|
| Rate for Payer: Humana Choice PPO Medicare |
$855.65
|
| Rate for Payer: Mclaren Commercial |
$3,277.76
|
| Rate for Payer: Mclaren Medicaid |
$855.65
|
| Rate for Payer: Mclaren Medicare |
$855.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$898.43
|
| Rate for Payer: Meridian Medicaid |
$469.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$984.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$941.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,095.66
|
| Rate for Payer: Nomi Health Commercial |
$2,986.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,731.46
|
| Rate for Payer: PACE Medicare |
$812.87
|
| Rate for Payer: PACE SWMI |
$855.65
|
| Rate for Payer: PHP Commercial |
$941.22
|
| Rate for Payer: PHP Medicaid |
$458.63
|
| Rate for Payer: PHP Medicare Advantage |
$855.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$447.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,191.08
|
| Rate for Payer: Priority Health Medicare |
$855.65
|
| Rate for Payer: Priority Health Narrow Network |
$2,553.01
|
| Rate for Payer: Railroad Medicare Medicare |
$855.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,204.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$855.65
|
| Rate for Payer: UHC Exchange |
$1,326.26
|
| Rate for Payer: UHC Medicaid |
$447.50
|
| Rate for Payer: UHCCP DNSP |
$855.65
|
| Rate for Payer: UHCCP Medicaid |
$447.50
|
| Rate for Payer: VA VA |
$855.65
|
|
|
HC TCMEPS UPPER/LOWER EXT. STIM
|
Facility
|
IP
|
$3,641.95
|
|
|
Service Code
|
CPT 95939
|
| Hospital Charge Code |
92200026
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$2,731.46 |
| Max. Negotiated Rate |
$3,641.95 |
| Rate for Payer: Aetna Commercial |
$3,277.76
|
| Rate for Payer: ASR ASR |
$3,532.69
|
| Rate for Payer: BCBS Trust/PPO |
$2,990.77
|
| Rate for Payer: BCN Commercial |
$2,990.77
|
| Rate for Payer: Cash Price |
$2,913.56
|
| Rate for Payer: Cofinity Commercial |
$3,423.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,913.56
|
| Rate for Payer: Healthscope Commercial |
$3,532.69
|
| Rate for Payer: Healthscope Whirlpool |
$3,641.95
|
| Rate for Payer: Mclaren Commercial |
$3,277.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,095.66
|
| Rate for Payer: Nomi Health Commercial |
$2,986.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,731.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,204.92
|
|
|
HC TCOM INITIAL DAY
|
Facility
|
OP
|
$419.91
|
|
|
Service Code
|
CPT 94729
|
| Hospital Charge Code |
46000011
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$155.37 |
| Max. Negotiated Rate |
$419.91 |
| Rate for Payer: Aetna Commercial |
$377.92
|
| Rate for Payer: Aetna Medicare |
$155.37
|
| Rate for Payer: ASR ASR |
$407.31
|
| Rate for Payer: BCBS Complete |
$167.96
|
| Rate for Payer: BCBS Trust/PPO |
$346.22
|
| Rate for Payer: BCN Commercial |
$346.22
|
| Rate for Payer: Cash Price |
$335.93
|
| Rate for Payer: Cash Price |
$335.93
|
| Rate for Payer: Cofinity Commercial |
$394.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$335.93
|
| Rate for Payer: Healthscope Commercial |
$407.31
|
| Rate for Payer: Healthscope Whirlpool |
$419.91
|
| Rate for Payer: Mclaren Commercial |
$377.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$335.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$356.92
|
| Rate for Payer: Nomi Health Commercial |
$344.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$314.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$237.27
|
| Rate for Payer: Priority Health Narrow Network |
$189.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$369.52
|
|
|
HC TCOM INITIAL DAY
|
Facility
|
IP
|
$419.91
|
|
|
Service Code
|
CPT 94729
|
| Hospital Charge Code |
46000011
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$314.93 |
| Max. Negotiated Rate |
$419.91 |
| Rate for Payer: Aetna Commercial |
$377.92
|
| Rate for Payer: ASR ASR |
$407.31
|
| Rate for Payer: BCBS Trust/PPO |
$344.83
|
| Rate for Payer: BCN Commercial |
$344.83
|
| Rate for Payer: Cash Price |
$335.93
|
| Rate for Payer: Cofinity Commercial |
$394.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$335.93
|
| Rate for Payer: Healthscope Commercial |
$407.31
|
| Rate for Payer: Healthscope Whirlpool |
$419.91
|
| Rate for Payer: Mclaren Commercial |
$377.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$356.92
|
| Rate for Payer: Nomi Health Commercial |
$344.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$314.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$369.52
|
|
|
HC TCOM SUBS DAY
|
Facility
|
IP
|
$322.46
|
|
|
Service Code
|
CPT 94729
|
| Hospital Charge Code |
46000010
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$241.84 |
| Max. Negotiated Rate |
$322.46 |
| Rate for Payer: Aetna Commercial |
$290.21
|
| Rate for Payer: ASR ASR |
$312.79
|
| Rate for Payer: BCBS Trust/PPO |
$264.80
|
| Rate for Payer: BCN Commercial |
$264.80
|
| Rate for Payer: Cash Price |
$257.97
|
| Rate for Payer: Cofinity Commercial |
$303.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$257.97
|
| Rate for Payer: Healthscope Commercial |
$312.79
|
| Rate for Payer: Healthscope Whirlpool |
$322.46
|
| Rate for Payer: Mclaren Commercial |
$290.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$274.09
|
| Rate for Payer: Nomi Health Commercial |
$264.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$241.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$283.76
|
|
|
HC TCOM SUBS DAY
|
Facility
|
OP
|
$322.46
|
|
|
Service Code
|
CPT 94729
|
| Hospital Charge Code |
46000010
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$119.31 |
| Max. Negotiated Rate |
$322.46 |
| Rate for Payer: Aetna Commercial |
$290.21
|
| Rate for Payer: Aetna Medicare |
$119.31
|
| Rate for Payer: ASR ASR |
$312.79
|
| Rate for Payer: BCBS Complete |
$128.98
|
| Rate for Payer: BCBS Trust/PPO |
$265.87
|
| Rate for Payer: BCN Commercial |
$265.87
|
| Rate for Payer: Cash Price |
$257.97
|
| Rate for Payer: Cash Price |
$257.97
|
| Rate for Payer: Cofinity Commercial |
$303.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$257.97
|
| Rate for Payer: Healthscope Commercial |
$312.79
|
| Rate for Payer: Healthscope Whirlpool |
$322.46
|
| Rate for Payer: Mclaren Commercial |
$290.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$257.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$274.09
|
| Rate for Payer: Nomi Health Commercial |
$264.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$241.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$237.27
|
| Rate for Payer: Priority Health Narrow Network |
$189.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$283.76
|
|
|
HC TCU OBSERVATION PER HOUR
|
Facility
|
OP
|
$160.00
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200015
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$54.44 |
| Max. Negotiated Rate |
$1,608.00 |
| Rate for Payer: Aetna Commercial |
$144.00
|
| Rate for Payer: Aetna Medicare |
$59.20
|
| Rate for Payer: ASR ASR |
$155.20
|
| Rate for Payer: BCBS Complete |
$64.00
|
| Rate for Payer: BCBS Trust/PPO |
$131.92
|
| Rate for Payer: BCN Commercial |
$131.92
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cofinity Commercial |
$150.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.00
|
| Rate for Payer: Healthscope Commercial |
$155.20
|
| Rate for Payer: Healthscope Whirlpool |
$160.00
|
| Rate for Payer: Mclaren Commercial |
$144.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$128.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.00
|
| Rate for Payer: Nomi Health Commercial |
$131.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$120.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$68.05
|
| Rate for Payer: Priority Health Narrow Network |
$54.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$140.80
|
| Rate for Payer: UHC Medicaid |
$1,608.00
|
|
|
HC TCU OBSERVATION PER HOUR
|
Facility
|
IP
|
$160.00
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200015
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$120.00 |
| Max. Negotiated Rate |
$160.00 |
| Rate for Payer: Aetna Commercial |
$144.00
|
| Rate for Payer: ASR ASR |
$155.20
|
| Rate for Payer: BCBS Trust/PPO |
$131.39
|
| Rate for Payer: BCN Commercial |
$131.39
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cofinity Commercial |
$150.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.00
|
| Rate for Payer: Healthscope Commercial |
$155.20
|
| Rate for Payer: Healthscope Whirlpool |
$160.00
|
| Rate for Payer: Mclaren Commercial |
$144.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.00
|
| Rate for Payer: Nomi Health Commercial |
$131.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$120.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$140.80
|
|
|
HC TCU OR NCCU R&B
|
Facility
|
IP
|
$5,170.88
|
|
| Hospital Charge Code |
20800001
|
|
Hospital Revenue Code
|
208
|
| Min. Negotiated Rate |
$3,878.16 |
| Max. Negotiated Rate |
$5,170.88 |
| Rate for Payer: Aetna Commercial |
$4,653.79
|
| Rate for Payer: ASR ASR |
$5,015.75
|
| Rate for Payer: BCBS Trust/PPO |
$4,246.33
|
| Rate for Payer: BCN Commercial |
$4,246.33
|
| Rate for Payer: Cash Price |
$4,136.70
|
| Rate for Payer: Cofinity Commercial |
$4,860.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,136.70
|
| Rate for Payer: Healthscope Commercial |
$5,015.75
|
| Rate for Payer: Healthscope Whirlpool |
$5,170.88
|
| Rate for Payer: Mclaren Commercial |
$4,653.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,395.25
|
| Rate for Payer: Nomi Health Commercial |
$4,240.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,878.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,550.37
|
|
|
HC TEE ECHOCARDIOGRAM W/DOPPLER
|
Facility
|
OP
|
$1,926.69
|
|
|
Service Code
|
CPT 93312
|
| Hospital Charge Code |
48000012
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$284.75 |
| Max. Negotiated Rate |
$1,926.69 |
| Rate for Payer: Aetna Commercial |
$1,734.02
|
| 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 |
$1,868.89
|
| Rate for Payer: BCBS Complete |
$299.01
|
| Rate for Payer: BCBS MAPPO |
$544.45
|
| Rate for Payer: BCBS Trust/PPO |
$1,588.56
|
| Rate for Payer: BCN Commercial |
$1,588.56
|
| Rate for Payer: BCN Medicare Advantage |
$544.45
|
| Rate for Payer: Cash Price |
$1,541.35
|
| Rate for Payer: Cash Price |
$1,541.35
|
| Rate for Payer: Cofinity Commercial |
$1,811.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,541.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$544.45
|
| Rate for Payer: Healthscope Commercial |
$1,868.89
|
| Rate for Payer: Healthscope Whirlpool |
$1,926.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$544.45
|
| Rate for Payer: Mclaren Commercial |
$1,734.02
|
| 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 |
$1,637.69
|
| Rate for Payer: Nomi Health Commercial |
$1,579.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,445.02
|
| 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 |
$1,688.17
|
| Rate for Payer: Priority Health Medicare |
$544.45
|
| Rate for Payer: Priority Health Narrow Network |
$1,350.61
|
| Rate for Payer: Railroad Medicare Medicare |
$544.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,695.49
|
| 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 TEE ECHOCARDIOGRAM W/DOPPLER
|
Facility
|
IP
|
$1,926.69
|
|
|
Service Code
|
CPT 93312
|
| Hospital Charge Code |
48000012
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,445.02 |
| Max. Negotiated Rate |
$1,926.69 |
| Rate for Payer: Aetna Commercial |
$1,734.02
|
| Rate for Payer: ASR ASR |
$1,868.89
|
| Rate for Payer: BCBS Trust/PPO |
$1,582.20
|
| Rate for Payer: BCN Commercial |
$1,582.20
|
| Rate for Payer: Cash Price |
$1,541.35
|
| Rate for Payer: Cofinity Commercial |
$1,811.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,541.35
|
| Rate for Payer: Healthscope Commercial |
$1,868.89
|
| Rate for Payer: Healthscope Whirlpool |
$1,926.69
|
| Rate for Payer: Mclaren Commercial |
$1,734.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,637.69
|
| Rate for Payer: Nomi Health Commercial |
$1,579.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,445.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,695.49
|
|
