|
HC SPEC TX PROCEDURE
|
Facility
|
IP
|
$1,587.65
|
|
|
Service Code
|
CPT 77470
|
| Hospital Charge Code |
33300026
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$1,031.97 |
| Max. Negotiated Rate |
$1,587.65 |
| Rate for Payer: Aetna Commercial |
$1,428.88
|
| Rate for Payer: ASR ASR |
$1,540.02
|
| Rate for Payer: ASR Commercial |
$1,540.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,293.78
|
| Rate for Payer: BCN Commercial |
$1,230.91
|
| Rate for Payer: Cash Price |
$1,270.12
|
| Rate for Payer: Cofinity Commercial |
$1,492.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,270.12
|
| Rate for Payer: Healthscope Commercial |
$1,587.65
|
| Rate for Payer: Healthscope Whirlpool |
$1,540.02
|
| Rate for Payer: Mclaren Commercial |
$1,428.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,349.50
|
| Rate for Payer: Nomi Health Commercial |
$1,301.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,031.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,397.13
|
|
|
HC SPEC TX PROCEDURE
|
Facility
|
OP
|
$1,587.65
|
|
|
Service Code
|
CPT 77470
|
| Hospital Charge Code |
33300026
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$303.79 |
| Max. Negotiated Rate |
$1,587.65 |
| Rate for Payer: Aetna Commercial |
$1,428.88
|
| Rate for Payer: Aetna Medicare |
$566.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$708.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$708.46
|
| Rate for Payer: ASR ASR |
$1,540.02
|
| Rate for Payer: ASR Commercial |
$1,540.02
|
| Rate for Payer: BCBS Complete |
$318.98
|
| Rate for Payer: BCBS MAPPO |
$566.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,300.13
|
| Rate for Payer: BCN Commercial |
$1,230.91
|
| Rate for Payer: BCN Medicare Advantage |
$566.77
|
| Rate for Payer: Cash Price |
$1,270.12
|
| Rate for Payer: Cash Price |
$1,270.12
|
| Rate for Payer: Cofinity Commercial |
$1,492.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,270.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$566.77
|
| Rate for Payer: Healthscope Commercial |
$1,587.65
|
| Rate for Payer: Healthscope Whirlpool |
$1,540.02
|
| Rate for Payer: Humana Choice PPO Medicare |
$566.77
|
| Rate for Payer: Mclaren Commercial |
$1,428.88
|
| Rate for Payer: Mclaren Medicaid |
$303.79
|
| Rate for Payer: Mclaren Medicare |
$566.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$595.11
|
| Rate for Payer: Meridian Medicaid |
$318.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$651.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,349.50
|
| Rate for Payer: Nomi Health Commercial |
$1,301.87
|
| Rate for Payer: PACE Medicare |
$538.43
|
| Rate for Payer: PACE SWMI |
$566.77
|
| Rate for Payer: PHP Commercial |
$623.45
|
| Rate for Payer: PHP Medicaid |
$303.79
|
| Rate for Payer: PHP Medicare Advantage |
$566.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$303.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,031.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,391.10
|
| Rate for Payer: Priority Health Medicare |
$566.77
|
| Rate for Payer: Priority Health Narrow Network |
$1,112.94
|
| Rate for Payer: Railroad Medicare Medicare |
$566.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,397.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$566.77
|
| Rate for Payer: UHC Exchange |
$878.49
|
| Rate for Payer: UHC Medicare Advantage |
$566.77
|
| Rate for Payer: UHCCP DNSP |
$566.77
|
| Rate for Payer: UHCCP Medicaid |
$303.79
|
| Rate for Payer: VA VA |
$566.77
|
|
|
HC SPEECH AUDIOMETRY COMPLETE
|
Facility
|
OP
|
$66.30
|
|
|
Service Code
|
CPT 92556
|
| Hospital Charge Code |
76100502
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$90.21 |
| Rate for Payer: Aetna Commercial |
$59.67
|
| Rate for Payer: Aetna Medicare |
$58.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$72.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$72.75
|
| Rate for Payer: ASR ASR |
$64.31
|
| Rate for Payer: ASR Commercial |
$64.31
|
| Rate for Payer: BCBS Complete |
$32.75
|
| Rate for Payer: BCBS MAPPO |
$58.20
|
| Rate for Payer: BCBS Trust/PPO |
$54.29
|
| Rate for Payer: BCN Commercial |
$51.40
|
| Rate for Payer: BCN Medicare Advantage |
$58.20
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cofinity Commercial |
$62.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.20
|
| Rate for Payer: Healthscope Commercial |
$66.30
|
| Rate for Payer: Healthscope Whirlpool |
$64.31
|
| Rate for Payer: Humana Choice PPO Medicare |
$58.20
|
| Rate for Payer: Mclaren Commercial |
$59.67
|
| Rate for Payer: Mclaren Medicaid |
$31.20
|
| Rate for Payer: Mclaren Medicare |
$58.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.11
|
| Rate for Payer: Meridian Medicaid |
$32.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$66.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.36
|
| Rate for Payer: Nomi Health Commercial |
$54.37
|
| Rate for Payer: PACE Medicare |
$55.29
|
| Rate for Payer: PACE SWMI |
$58.20
|
| Rate for Payer: PHP Commercial |
$64.02
|
| Rate for Payer: PHP Medicaid |
$31.20
|
| Rate for Payer: PHP Medicare Advantage |
$58.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$58.09
|
| Rate for Payer: Priority Health Medicare |
$58.20
|
| Rate for Payer: Priority Health Narrow Network |
$46.48
|
| Rate for Payer: Railroad Medicare Medicare |
$58.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$58.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$58.20
|
| Rate for Payer: UHC Exchange |
$90.21
|
| Rate for Payer: UHC Medicare Advantage |
$58.20
|
| Rate for Payer: UHCCP DNSP |
$58.20
|
| Rate for Payer: UHCCP Medicaid |
$31.20
|
| Rate for Payer: VA VA |
$58.20
|
|
|
HC SPEECH AUDIOMETRY COMPLETE
|
Facility
|
IP
|
$66.30
|
|
|
Service Code
|
CPT 92556
|
| Hospital Charge Code |
76100502
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$43.10 |
| Max. Negotiated Rate |
$66.30 |
| Rate for Payer: Aetna Commercial |
$59.67
|
| Rate for Payer: ASR ASR |
$64.31
|
| Rate for Payer: ASR Commercial |
$64.31
|
| Rate for Payer: BCBS Trust/PPO |
$54.03
|
| Rate for Payer: BCN Commercial |
$51.40
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cofinity Commercial |
$62.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.04
|
| Rate for Payer: Healthscope Commercial |
$66.30
|
| Rate for Payer: Healthscope Whirlpool |
$64.31
|
| Rate for Payer: Mclaren Commercial |
$59.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.36
|
| Rate for Payer: Nomi Health Commercial |
$54.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$58.34
|
|
|
HC SPEECH EVAL
|
Facility
|
OP
|
$599.67
|
|
|
Service Code
|
CPT 92523
|
| Hospital Charge Code |
44400009
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$201.18 |
| Max. Negotiated Rate |
$599.67 |
| Rate for Payer: Aetna Commercial |
$539.70
|
| Rate for Payer: Aetna Medicare |
$299.84
|
| Rate for Payer: ASR ASR |
$581.68
|
| Rate for Payer: ASR Commercial |
$581.68
|
| Rate for Payer: BCBS Complete |
$239.87
|
| Rate for Payer: BCBS Trust/PPO |
$491.07
|
| Rate for Payer: BCN Commercial |
$464.92
|
| Rate for Payer: Cash Price |
$479.74
|
| Rate for Payer: Cash Price |
$479.74
|
| Rate for Payer: Cofinity Commercial |
$563.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$479.74
|
| Rate for Payer: Healthscope Commercial |
$599.67
|
| Rate for Payer: Healthscope Whirlpool |
$581.68
|
| Rate for Payer: Mclaren Commercial |
$539.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$509.72
|
| Rate for Payer: Nomi Health Commercial |
$491.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$389.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$251.48
|
| Rate for Payer: Priority Health Narrow Network |
$201.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$527.71
|
|
|
HC SPEECH EVAL
|
Facility
|
IP
|
$599.67
|
|
|
Service Code
|
CPT 92523
|
| Hospital Charge Code |
44400009
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$389.79 |
| Max. Negotiated Rate |
$599.67 |
| Rate for Payer: Aetna Commercial |
$539.70
|
| Rate for Payer: ASR ASR |
$581.68
|
| Rate for Payer: ASR Commercial |
$581.68
|
| Rate for Payer: BCBS Trust/PPO |
$488.67
|
| Rate for Payer: BCN Commercial |
$464.92
|
| Rate for Payer: Cash Price |
$479.74
|
| Rate for Payer: Cofinity Commercial |
$563.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$479.74
|
| Rate for Payer: Healthscope Commercial |
$599.67
|
| Rate for Payer: Healthscope Whirlpool |
$581.68
|
| Rate for Payer: Mclaren Commercial |
$539.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$509.72
|
| Rate for Payer: Nomi Health Commercial |
$491.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$389.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$527.71
|
|
|
HC SPEECH FLUENCY EVAL
|
Facility
|
OP
|
$295.57
|
|
|
Service Code
|
CPT 92521
|
| Hospital Charge Code |
44400012
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$118.23 |
| Max. Negotiated Rate |
$295.57 |
| Rate for Payer: Aetna Commercial |
$266.01
|
| Rate for Payer: Aetna Medicare |
$147.78
|
| Rate for Payer: ASR ASR |
$286.70
|
| Rate for Payer: ASR Commercial |
$286.70
|
| Rate for Payer: BCBS Complete |
$118.23
|
| Rate for Payer: BCBS Trust/PPO |
$242.04
|
| Rate for Payer: BCN Commercial |
$229.16
|
| Rate for Payer: Cash Price |
$236.46
|
| Rate for Payer: Cash Price |
$236.46
|
| Rate for Payer: Cofinity Commercial |
$277.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$236.46
|
| Rate for Payer: Healthscope Commercial |
$295.57
|
| Rate for Payer: Healthscope Whirlpool |
$286.70
|
| Rate for Payer: Mclaren Commercial |
$266.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$251.23
|
| Rate for Payer: Nomi Health Commercial |
$242.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$192.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$149.12
|
| Rate for Payer: Priority Health Narrow Network |
$119.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$260.10
|
|
|
HC SPEECH FLUENCY EVAL
|
Facility
|
IP
|
$295.57
|
|
|
Service Code
|
CPT 92521
|
| Hospital Charge Code |
44400012
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$192.12 |
| Max. Negotiated Rate |
$295.57 |
| Rate for Payer: Aetna Commercial |
$266.01
|
| Rate for Payer: ASR ASR |
$286.70
|
| Rate for Payer: ASR Commercial |
$286.70
|
| Rate for Payer: BCBS Trust/PPO |
$240.86
|
| Rate for Payer: BCN Commercial |
$229.16
|
| Rate for Payer: Cash Price |
$236.46
|
| Rate for Payer: Cofinity Commercial |
$277.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$236.46
|
| Rate for Payer: Healthscope Commercial |
$295.57
|
| Rate for Payer: Healthscope Whirlpool |
$286.70
|
| Rate for Payer: Mclaren Commercial |
$266.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$251.23
|
| Rate for Payer: Nomi Health Commercial |
$242.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$192.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$260.10
|
|
|
HC SPEECH/LANGUAGE/HEARING THERAPY
|
Facility
|
IP
|
$216.40
|
|
|
Service Code
|
CPT 92507
|
| Hospital Charge Code |
44000001
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$140.66 |
| Max. Negotiated Rate |
$216.40 |
| Rate for Payer: Aetna Commercial |
$194.76
|
| Rate for Payer: ASR ASR |
$209.91
|
| Rate for Payer: ASR Commercial |
$209.91
|
| Rate for Payer: BCBS Trust/PPO |
$176.34
|
| Rate for Payer: BCN Commercial |
$167.77
|
| Rate for Payer: Cash Price |
$173.12
|
| Rate for Payer: Cofinity Commercial |
$203.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$173.12
|
| Rate for Payer: Healthscope Commercial |
$216.40
|
| Rate for Payer: Healthscope Whirlpool |
$209.91
|
| Rate for Payer: Mclaren Commercial |
$194.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$183.94
|
| Rate for Payer: Nomi Health Commercial |
$177.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$140.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$190.43
|
|
|
HC SPEECH/LANGUAGE/HEARING THERAPY
|
Facility
|
OP
|
$216.40
|
|
|
Service Code
|
CPT 92507
|
| Hospital Charge Code |
44000001
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$86.56 |
| Max. Negotiated Rate |
$216.40 |
| Rate for Payer: Aetna Commercial |
$194.76
|
| Rate for Payer: Aetna Medicare |
$108.20
|
| Rate for Payer: ASR ASR |
$209.91
|
| Rate for Payer: ASR Commercial |
$209.91
|
| Rate for Payer: BCBS Complete |
$86.56
|
| Rate for Payer: BCBS Trust/PPO |
$177.21
|
| Rate for Payer: BCN Commercial |
$167.77
|
| Rate for Payer: Cash Price |
$173.12
|
| Rate for Payer: Cash Price |
$173.12
|
| Rate for Payer: Cofinity Commercial |
$203.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$173.12
|
| Rate for Payer: Healthscope Commercial |
$216.40
|
| Rate for Payer: Healthscope Whirlpool |
$209.91
|
| Rate for Payer: Mclaren Commercial |
$194.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$183.94
|
| Rate for Payer: Nomi Health Commercial |
$177.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$140.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$204.23
|
| Rate for Payer: Priority Health Narrow Network |
$163.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$190.43
|
|
|
HC SPEECH SOUND PRODUCTION EVAL
|
Facility
|
IP
|
$259.56
|
|
|
Service Code
|
CPT 92522
|
| Hospital Charge Code |
44400010
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$168.71 |
| Max. Negotiated Rate |
$259.56 |
| Rate for Payer: Aetna Commercial |
$233.60
|
| Rate for Payer: ASR ASR |
$251.77
|
| Rate for Payer: ASR Commercial |
$251.77
|
| Rate for Payer: BCBS Trust/PPO |
$211.52
|
| Rate for Payer: BCN Commercial |
$201.24
|
| Rate for Payer: Cash Price |
$207.65
|
| Rate for Payer: Cofinity Commercial |
$243.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$207.65
|
| Rate for Payer: Healthscope Commercial |
$259.56
|
| Rate for Payer: Healthscope Whirlpool |
$251.77
|
| Rate for Payer: Mclaren Commercial |
$233.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$220.63
|
| Rate for Payer: Nomi Health Commercial |
$212.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$168.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$228.41
|
|
|
HC SPEECH SOUND PRODUCTION EVAL
|
Facility
|
OP
|
$259.56
|
|
|
Service Code
|
CPT 92522
|
| Hospital Charge Code |
44400010
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$96.85 |
| Max. Negotiated Rate |
$259.56 |
| Rate for Payer: Aetna Commercial |
$233.60
|
| Rate for Payer: Aetna Medicare |
$129.78
|
| Rate for Payer: ASR ASR |
$251.77
|
| Rate for Payer: ASR Commercial |
$251.77
|
| Rate for Payer: BCBS Complete |
$103.82
|
| Rate for Payer: BCBS Trust/PPO |
$212.55
|
| Rate for Payer: BCN Commercial |
$201.24
|
| Rate for Payer: Cash Price |
$207.65
|
| Rate for Payer: Cash Price |
$207.65
|
| Rate for Payer: Cofinity Commercial |
$243.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$207.65
|
| Rate for Payer: Healthscope Commercial |
$259.56
|
| Rate for Payer: Healthscope Whirlpool |
$251.77
|
| Rate for Payer: Mclaren Commercial |
$233.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$220.63
|
| Rate for Payer: Nomi Health Commercial |
$212.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$168.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$121.06
|
| Rate for Payer: Priority Health Narrow Network |
$96.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$228.41
|
|
|
HC SPEECH THRESHOLD AUDIOMETRY
|
Facility
|
OP
|
$50.12
|
|
|
Service Code
|
CPT 92555
|
| Hospital Charge Code |
47100011
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$90.21 |
| Rate for Payer: Aetna Commercial |
$45.11
|
| Rate for Payer: Aetna Medicare |
$58.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$72.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$72.75
|
| Rate for Payer: ASR ASR |
$48.62
|
| Rate for Payer: ASR Commercial |
$48.62
|
| Rate for Payer: BCBS Complete |
$32.75
|
| Rate for Payer: BCBS MAPPO |
$58.20
|
| Rate for Payer: BCBS Trust/PPO |
$41.04
|
| Rate for Payer: BCN Commercial |
$38.86
|
| Rate for Payer: BCN Medicare Advantage |
$58.20
|
| Rate for Payer: Cash Price |
$40.10
|
| Rate for Payer: Cash Price |
$40.10
|
| Rate for Payer: Cofinity Commercial |
$47.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.20
|
| Rate for Payer: Healthscope Commercial |
$50.12
|
| Rate for Payer: Healthscope Whirlpool |
$48.62
|
| Rate for Payer: Humana Choice PPO Medicare |
$58.20
|
| Rate for Payer: Mclaren Commercial |
$45.11
|
| Rate for Payer: Mclaren Medicaid |
$31.20
|
| Rate for Payer: Mclaren Medicare |
$58.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.11
|
| Rate for Payer: Meridian Medicaid |
$32.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$66.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.60
|
| Rate for Payer: Nomi Health Commercial |
$41.10
|
| Rate for Payer: PACE Medicare |
$55.29
|
| Rate for Payer: PACE SWMI |
$58.20
|
| Rate for Payer: PHP Commercial |
$64.02
|
| Rate for Payer: PHP Medicaid |
$31.20
|
| Rate for Payer: PHP Medicare Advantage |
$58.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$43.92
|
| Rate for Payer: Priority Health Medicare |
$58.20
|
| Rate for Payer: Priority Health Narrow Network |
$35.13
|
| Rate for Payer: Railroad Medicare Medicare |
$58.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$58.20
|
| Rate for Payer: UHC Exchange |
$90.21
|
| Rate for Payer: UHC Medicare Advantage |
$58.20
|
| Rate for Payer: UHCCP DNSP |
$58.20
|
| Rate for Payer: UHCCP Medicaid |
$31.20
|
| Rate for Payer: VA VA |
$58.20
|
|
|
HC SPEECH THRESHOLD AUDIOMETRY
|
Facility
|
IP
|
$50.12
|
|
|
Service Code
|
CPT 92555
|
| Hospital Charge Code |
47100011
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$32.58 |
| Max. Negotiated Rate |
$50.12 |
| Rate for Payer: Aetna Commercial |
$45.11
|
| Rate for Payer: ASR ASR |
$48.62
|
| Rate for Payer: ASR Commercial |
$48.62
|
| Rate for Payer: BCBS Trust/PPO |
$40.84
|
| Rate for Payer: BCN Commercial |
$38.86
|
| Rate for Payer: Cash Price |
$40.10
|
| Rate for Payer: Cofinity Commercial |
$47.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.10
|
| Rate for Payer: Healthscope Commercial |
$50.12
|
| Rate for Payer: Healthscope Whirlpool |
$48.62
|
| Rate for Payer: Mclaren Commercial |
$45.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.60
|
| Rate for Payer: Nomi Health Commercial |
$41.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.11
|
|
|
HC SPEECH VIDEO FLUORO EVAL
|
Facility
|
IP
|
$397.01
|
|
|
Service Code
|
CPT 92611
|
| Hospital Charge Code |
44000004
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$258.06 |
| Max. Negotiated Rate |
$397.01 |
| Rate for Payer: Aetna Commercial |
$357.31
|
| Rate for Payer: ASR ASR |
$385.10
|
| Rate for Payer: ASR Commercial |
$385.10
|
| Rate for Payer: BCBS Trust/PPO |
$323.52
|
| Rate for Payer: BCN Commercial |
$307.80
|
| Rate for Payer: Cash Price |
$317.61
|
| Rate for Payer: Cofinity Commercial |
$373.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$317.61
|
| Rate for Payer: Healthscope Commercial |
$397.01
|
| Rate for Payer: Healthscope Whirlpool |
$385.10
|
| Rate for Payer: Mclaren Commercial |
$357.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$337.46
|
| Rate for Payer: Nomi Health Commercial |
$325.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$258.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$349.37
|
|
|
HC SPEECH VIDEO FLUORO EVAL
|
Facility
|
OP
|
$397.01
|
|
|
Service Code
|
CPT 92611
|
| Hospital Charge Code |
44000004
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$158.80 |
| Max. Negotiated Rate |
$397.01 |
| Rate for Payer: Aetna Commercial |
$357.31
|
| Rate for Payer: Aetna Medicare |
$198.50
|
| Rate for Payer: ASR ASR |
$385.10
|
| Rate for Payer: ASR Commercial |
$385.10
|
| Rate for Payer: BCBS Complete |
$158.80
|
| Rate for Payer: BCBS Trust/PPO |
$325.11
|
| Rate for Payer: BCN Commercial |
$307.80
|
| Rate for Payer: Cash Price |
$317.61
|
| Rate for Payer: Cash Price |
$317.61
|
| Rate for Payer: Cofinity Commercial |
$373.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$317.61
|
| Rate for Payer: Healthscope Commercial |
$397.01
|
| Rate for Payer: Healthscope Whirlpool |
$385.10
|
| Rate for Payer: Mclaren Commercial |
$357.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$337.46
|
| Rate for Payer: Nomi Health Commercial |
$325.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$258.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$280.00
|
| Rate for Payer: Priority Health Narrow Network |
$224.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$349.37
|
|
|
HC SPEECH VOICE EVALUATION
|
Facility
|
OP
|
$288.45
|
|
|
Service Code
|
CPT 92524
|
| Hospital Charge Code |
44400011
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$100.97 |
| Max. Negotiated Rate |
$288.45 |
| Rate for Payer: Aetna Commercial |
$259.60
|
| Rate for Payer: Aetna Medicare |
$144.22
|
| Rate for Payer: ASR ASR |
$279.80
|
| Rate for Payer: ASR Commercial |
$279.80
|
| Rate for Payer: BCBS Complete |
$115.38
|
| Rate for Payer: BCBS Trust/PPO |
$236.21
|
| Rate for Payer: BCN Commercial |
$223.64
|
| Rate for Payer: Cash Price |
$230.76
|
| Rate for Payer: Cash Price |
$230.76
|
| Rate for Payer: Cofinity Commercial |
$271.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$230.76
|
| Rate for Payer: Healthscope Commercial |
$288.45
|
| Rate for Payer: Healthscope Whirlpool |
$279.80
|
| Rate for Payer: Mclaren Commercial |
$259.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$245.18
|
| Rate for Payer: Nomi Health Commercial |
$236.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$187.49
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$126.21
|
| Rate for Payer: Priority Health Narrow Network |
$100.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$253.84
|
|
|
HC SPEECH VOICE EVALUATION
|
Facility
|
IP
|
$288.45
|
|
|
Service Code
|
CPT 92524
|
| Hospital Charge Code |
44400011
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$187.49 |
| Max. Negotiated Rate |
$288.45 |
| Rate for Payer: Aetna Commercial |
$259.60
|
| Rate for Payer: ASR ASR |
$279.80
|
| Rate for Payer: ASR Commercial |
$279.80
|
| Rate for Payer: BCBS Trust/PPO |
$235.06
|
| Rate for Payer: BCN Commercial |
$223.64
|
| Rate for Payer: Cash Price |
$230.76
|
| Rate for Payer: Cofinity Commercial |
$271.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$230.76
|
| Rate for Payer: Healthscope Commercial |
$288.45
|
| Rate for Payer: Healthscope Whirlpool |
$279.80
|
| Rate for Payer: Mclaren Commercial |
$259.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$245.18
|
| Rate for Payer: Nomi Health Commercial |
$236.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$187.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$253.84
|
|
|
HC SPIKE BLOOD ACCESS
|
Facility
|
OP
|
$16.07
|
|
| Hospital Charge Code |
27000669
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$6.43 |
| Max. Negotiated Rate |
$16.07 |
| Rate for Payer: Aetna Commercial |
$14.46
|
| Rate for Payer: Aetna Medicare |
$8.04
|
| Rate for Payer: ASR ASR |
$15.59
|
| Rate for Payer: ASR Commercial |
$15.59
|
| Rate for Payer: BCBS Complete |
$6.43
|
| Rate for Payer: BCBS Trust/PPO |
$13.16
|
| Rate for Payer: BCN Commercial |
$12.46
|
| Rate for Payer: Cash Price |
$12.86
|
| Rate for Payer: Cofinity Commercial |
$15.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.86
|
| Rate for Payer: Healthscope Commercial |
$16.07
|
| Rate for Payer: Healthscope Whirlpool |
$15.59
|
| Rate for Payer: Mclaren Commercial |
$14.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.66
|
| Rate for Payer: Nomi Health Commercial |
$13.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14.08
|
| Rate for Payer: Priority Health Narrow Network |
$11.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14.14
|
|
|
HC SPIKE BLOOD ACCESS
|
Facility
|
IP
|
$16.07
|
|
| Hospital Charge Code |
27000669
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$10.45 |
| Max. Negotiated Rate |
$16.07 |
| Rate for Payer: Aetna Commercial |
$14.46
|
| Rate for Payer: ASR ASR |
$15.59
|
| Rate for Payer: ASR Commercial |
$15.59
|
| Rate for Payer: BCBS Trust/PPO |
$13.10
|
| Rate for Payer: BCN Commercial |
$12.46
|
| Rate for Payer: Cash Price |
$12.86
|
| Rate for Payer: Cofinity Commercial |
$15.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.86
|
| Rate for Payer: Healthscope Commercial |
$16.07
|
| Rate for Payer: Healthscope Whirlpool |
$15.59
|
| Rate for Payer: Mclaren Commercial |
$14.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.66
|
| Rate for Payer: Nomi Health Commercial |
$13.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14.14
|
|
|
HC SPINAL/EPI ADDL 15 MIN
|
Facility
|
IP
|
$159.71
|
|
| Hospital Charge Code |
37000013
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$103.81 |
| Max. Negotiated Rate |
$159.71 |
| Rate for Payer: Aetna Commercial |
$143.74
|
| Rate for Payer: ASR ASR |
$154.92
|
| Rate for Payer: ASR Commercial |
$154.92
|
| Rate for Payer: BCBS Trust/PPO |
$130.15
|
| Rate for Payer: BCN Commercial |
$123.82
|
| Rate for Payer: Cash Price |
$127.77
|
| Rate for Payer: Cofinity Commercial |
$150.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$127.77
|
| Rate for Payer: Healthscope Commercial |
$159.71
|
| Rate for Payer: Healthscope Whirlpool |
$154.92
|
| Rate for Payer: Mclaren Commercial |
$143.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$135.75
|
| Rate for Payer: Nomi Health Commercial |
$130.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$103.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$140.54
|
|
|
HC SPINAL/EPI ADDL 15 MIN
|
Facility
|
OP
|
$159.71
|
|
| Hospital Charge Code |
37000013
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$63.88 |
| Max. Negotiated Rate |
$159.71 |
| Rate for Payer: Aetna Commercial |
$143.74
|
| Rate for Payer: Aetna Medicare |
$79.86
|
| Rate for Payer: ASR ASR |
$154.92
|
| Rate for Payer: ASR Commercial |
$154.92
|
| Rate for Payer: BCBS Complete |
$63.88
|
| Rate for Payer: BCBS Trust/PPO |
$130.79
|
| Rate for Payer: BCN Commercial |
$123.82
|
| Rate for Payer: Cash Price |
$127.77
|
| Rate for Payer: Cofinity Commercial |
$150.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$127.77
|
| Rate for Payer: Healthscope Commercial |
$159.71
|
| Rate for Payer: Healthscope Whirlpool |
$154.92
|
| Rate for Payer: Mclaren Commercial |
$143.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$135.75
|
| Rate for Payer: Nomi Health Commercial |
$130.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$103.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$139.94
|
| Rate for Payer: Priority Health Narrow Network |
$111.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$140.54
|
|
|
HC SPINAL/EPI INIT 30 MIN
|
Facility
|
OP
|
$436.73
|
|
| Hospital Charge Code |
37000014
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$174.69 |
| Max. Negotiated Rate |
$436.73 |
| Rate for Payer: Aetna Commercial |
$393.06
|
| Rate for Payer: Aetna Medicare |
$218.36
|
| Rate for Payer: ASR ASR |
$423.63
|
| Rate for Payer: ASR Commercial |
$423.63
|
| Rate for Payer: BCBS Complete |
$174.69
|
| Rate for Payer: BCBS Trust/PPO |
$357.64
|
| Rate for Payer: BCN Commercial |
$338.60
|
| Rate for Payer: Cash Price |
$349.38
|
| Rate for Payer: Cofinity Commercial |
$410.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$349.38
|
| Rate for Payer: Healthscope Commercial |
$436.73
|
| Rate for Payer: Healthscope Whirlpool |
$423.63
|
| Rate for Payer: Mclaren Commercial |
$393.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$371.22
|
| Rate for Payer: Nomi Health Commercial |
$358.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$283.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$382.66
|
| Rate for Payer: Priority Health Narrow Network |
$306.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$384.32
|
|
|
HC SPINAL/EPI INIT 30 MIN
|
Facility
|
IP
|
$436.73
|
|
| Hospital Charge Code |
37000014
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$283.87 |
| Max. Negotiated Rate |
$436.73 |
| Rate for Payer: Aetna Commercial |
$393.06
|
| Rate for Payer: ASR ASR |
$423.63
|
| Rate for Payer: ASR Commercial |
$423.63
|
| Rate for Payer: BCBS Trust/PPO |
$355.89
|
| Rate for Payer: BCN Commercial |
$338.60
|
| Rate for Payer: Cash Price |
$349.38
|
| Rate for Payer: Cofinity Commercial |
$410.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$349.38
|
| Rate for Payer: Healthscope Commercial |
$436.73
|
| Rate for Payer: Healthscope Whirlpool |
$423.63
|
| Rate for Payer: Mclaren Commercial |
$393.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$371.22
|
| Rate for Payer: Nomi Health Commercial |
$358.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$283.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$384.32
|
|
|
HC SPINE JACK
|
Facility
|
IP
|
$14,119.00
|
|
|
Service Code
|
CPT C1062
|
| Hospital Charge Code |
27800148
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,177.35 |
| Max. Negotiated Rate |
$14,119.00 |
| Rate for Payer: Aetna Commercial |
$12,707.10
|
| Rate for Payer: ASR ASR |
$13,695.43
|
| Rate for Payer: ASR Commercial |
$13,695.43
|
| Rate for Payer: BCBS Trust/PPO |
$11,505.57
|
| Rate for Payer: BCN Commercial |
$10,946.46
|
| Rate for Payer: Cash Price |
$11,295.20
|
| Rate for Payer: Cofinity Commercial |
$13,271.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,295.20
|
| Rate for Payer: Healthscope Commercial |
$14,119.00
|
| Rate for Payer: Healthscope Whirlpool |
$13,695.43
|
| Rate for Payer: Mclaren Commercial |
$12,707.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,001.15
|
| Rate for Payer: Nomi Health Commercial |
$11,577.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,177.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12,424.72
|
|
