|
HC TENOTOMY
|
Facility
|
IP
|
$2,950.53
|
|
|
Service Code
|
CPT 27605
|
| Hospital Charge Code |
36100046
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,212.90 |
| Max. Negotiated Rate |
$2,950.53 |
| Rate for Payer: Aetna Commercial |
$2,655.48
|
| Rate for Payer: ASR ASR |
$2,862.01
|
| Rate for Payer: BCBS Trust/PPO |
$2,422.98
|
| Rate for Payer: BCN Commercial |
$2,422.98
|
| Rate for Payer: Cash Price |
$2,360.42
|
| Rate for Payer: Cofinity Commercial |
$2,773.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,360.42
|
| Rate for Payer: Healthscope Commercial |
$2,862.01
|
| Rate for Payer: Healthscope Whirlpool |
$2,950.53
|
| Rate for Payer: Mclaren Commercial |
$2,655.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,507.95
|
| Rate for Payer: Nomi Health Commercial |
$2,419.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,212.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,596.47
|
|
|
HC TENOTOMY ADDUCTOR OF HIP PERCUTANEOUS
|
Facility
|
IP
|
$4,363.48
|
|
| Hospital Charge Code |
36000096
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,272.61 |
| Max. Negotiated Rate |
$4,363.48 |
| Rate for Payer: Aetna Commercial |
$3,927.13
|
| Rate for Payer: ASR ASR |
$4,232.58
|
| Rate for Payer: BCBS Trust/PPO |
$3,583.29
|
| Rate for Payer: BCN Commercial |
$3,583.29
|
| Rate for Payer: Cash Price |
$3,490.78
|
| Rate for Payer: Cofinity Commercial |
$4,101.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,490.78
|
| Rate for Payer: Healthscope Commercial |
$4,232.58
|
| Rate for Payer: Healthscope Whirlpool |
$4,363.48
|
| Rate for Payer: Mclaren Commercial |
$3,927.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,708.96
|
| Rate for Payer: Nomi Health Commercial |
$3,578.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,272.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,839.86
|
|
|
HC TENOTOMY ADDUCTOR OF HIP PERCUTANEOUS
|
Facility
|
OP
|
$4,363.48
|
|
| Hospital Charge Code |
36000096
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,614.49 |
| Max. Negotiated Rate |
$4,363.48 |
| Rate for Payer: Aetna Commercial |
$3,927.13
|
| Rate for Payer: Aetna Medicare |
$1,614.49
|
| Rate for Payer: ASR ASR |
$4,232.58
|
| Rate for Payer: BCBS Complete |
$1,745.39
|
| Rate for Payer: BCBS Trust/PPO |
$3,597.69
|
| Rate for Payer: BCN Commercial |
$3,597.69
|
| Rate for Payer: Cash Price |
$3,490.78
|
| Rate for Payer: Cofinity Commercial |
$4,101.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,490.78
|
| Rate for Payer: Healthscope Commercial |
$4,232.58
|
| Rate for Payer: Healthscope Whirlpool |
$4,363.48
|
| Rate for Payer: Mclaren Commercial |
$3,927.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,490.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,708.96
|
| Rate for Payer: Nomi Health Commercial |
$3,578.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,272.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,823.28
|
| Rate for Payer: Priority Health Narrow Network |
$3,058.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,839.86
|
|
|
HC TENOTOMY ELBOW LATERAL/MEDIAL PERC
|
Facility
|
IP
|
$4,584.09
|
|
|
Service Code
|
CPT 24357
|
| Hospital Charge Code |
76100408
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,438.07 |
| Max. Negotiated Rate |
$4,584.09 |
| Rate for Payer: Aetna Commercial |
$4,125.68
|
| Rate for Payer: ASR ASR |
$4,446.57
|
| Rate for Payer: BCBS Trust/PPO |
$3,764.45
|
| Rate for Payer: BCN Commercial |
$3,764.45
|
| Rate for Payer: Cash Price |
$3,667.27
|
| Rate for Payer: Cofinity Commercial |
$4,309.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,667.27
|
| Rate for Payer: Healthscope Commercial |
$4,446.57
|
| Rate for Payer: Healthscope Whirlpool |
$4,584.09
|
| Rate for Payer: Mclaren Commercial |
$4,125.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,896.48
|
| Rate for Payer: Nomi Health Commercial |
$3,758.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,438.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,034.00
|
|
|
HC TENOTOMY ELBOW LATERAL/MEDIAL PERC
|
Facility
|
OP
|
$4,584.09
|
|
|
Service Code
|
CPT 24357
|
| Hospital Charge Code |
76100408
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,705.10 |
| Max. Negotiated Rate |
$5,053.36 |
| Rate for Payer: Aetna Commercial |
$4,125.68
|
| Rate for Payer: Aetna Medicare |
$3,260.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,075.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,075.29
|
| Rate for Payer: ASR ASR |
$4,446.57
|
| Rate for Payer: BCBS Complete |
$1,790.52
|
| Rate for Payer: BCBS MAPPO |
$3,260.23
|
| Rate for Payer: BCBS Trust/PPO |
$3,779.58
|
| Rate for Payer: BCN Commercial |
$3,779.58
|
| Rate for Payer: BCN Medicare Advantage |
$3,260.23
|
| Rate for Payer: Cash Price |
$3,667.27
|
| Rate for Payer: Cash Price |
$3,667.27
|
| Rate for Payer: Cofinity Commercial |
$4,309.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,667.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,260.23
|
| Rate for Payer: Healthscope Commercial |
$4,446.57
|
| Rate for Payer: Healthscope Whirlpool |
$4,584.09
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,260.23
|
| Rate for Payer: Mclaren Commercial |
$4,125.68
|
| Rate for Payer: Mclaren Medicaid |
$3,260.23
|
| Rate for Payer: Mclaren Medicare |
$3,260.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,423.24
|
| Rate for Payer: Meridian Medicaid |
$1,790.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,749.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,586.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,896.48
|
| Rate for Payer: Nomi Health Commercial |
$3,758.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,438.07
|
| Rate for Payer: PACE Medicare |
$3,097.22
|
| Rate for Payer: PACE SWMI |
$3,260.23
|
| Rate for Payer: PHP Commercial |
$3,586.25
|
| Rate for Payer: PHP Medicaid |
$1,747.48
|
| Rate for Payer: PHP Medicare Advantage |
$3,260.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,705.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4,016.58
|
| Rate for Payer: Priority Health Medicare |
$3,260.23
|
| Rate for Payer: Priority Health Narrow Network |
$3,213.45
|
| Rate for Payer: Railroad Medicare Medicare |
$3,260.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,034.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,260.23
|
| Rate for Payer: UHC Exchange |
$5,053.36
|
| Rate for Payer: UHC Medicaid |
$1,705.10
|
| Rate for Payer: UHCCP DNSP |
$3,260.23
|
| Rate for Payer: UHCCP Medicaid |
$1,705.10
|
| Rate for Payer: VA VA |
$3,260.23
|
|
|
HC TENOTOMY ELBOW LATERAL OR MEDIAL
|
Facility
|
IP
|
$4,584.09
|
|
| Hospital Charge Code |
36000093
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,438.07 |
| Max. Negotiated Rate |
$4,584.09 |
| Rate for Payer: Aetna Commercial |
$4,125.68
|
| Rate for Payer: ASR ASR |
$4,446.57
|
| Rate for Payer: BCBS Trust/PPO |
$3,764.45
|
| Rate for Payer: BCN Commercial |
$3,764.45
|
| Rate for Payer: Cash Price |
$3,667.27
|
| Rate for Payer: Cofinity Commercial |
$4,309.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,667.27
|
| Rate for Payer: Healthscope Commercial |
$4,446.57
|
| Rate for Payer: Healthscope Whirlpool |
$4,584.09
|
| Rate for Payer: Mclaren Commercial |
$4,125.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,896.48
|
| Rate for Payer: Nomi Health Commercial |
$3,758.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,438.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,034.00
|
|
|
HC TENOTOMY ELBOW LATERAL OR MEDIAL
|
Facility
|
OP
|
$4,584.09
|
|
| Hospital Charge Code |
36000093
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,696.11 |
| Max. Negotiated Rate |
$4,584.09 |
| Rate for Payer: Aetna Commercial |
$4,125.68
|
| Rate for Payer: Aetna Medicare |
$1,696.11
|
| Rate for Payer: ASR ASR |
$4,446.57
|
| Rate for Payer: BCBS Complete |
$1,833.64
|
| Rate for Payer: BCBS Trust/PPO |
$3,779.58
|
| Rate for Payer: BCN Commercial |
$3,779.58
|
| Rate for Payer: Cash Price |
$3,667.27
|
| Rate for Payer: Cofinity Commercial |
$4,309.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,667.27
|
| Rate for Payer: Healthscope Commercial |
$4,446.57
|
| Rate for Payer: Healthscope Whirlpool |
$4,584.09
|
| Rate for Payer: Mclaren Commercial |
$4,125.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,667.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,896.48
|
| Rate for Payer: Nomi Health Commercial |
$3,758.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,438.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4,016.58
|
| Rate for Payer: Priority Health Narrow Network |
$3,213.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,034.00
|
|
|
HC TENOTOMY MULTIPLE TENDONS
|
Facility
|
OP
|
$5,340.69
|
|
| Hospital Charge Code |
36000095
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,976.06 |
| Max. Negotiated Rate |
$5,340.69 |
| Rate for Payer: Aetna Commercial |
$4,806.62
|
| Rate for Payer: Aetna Medicare |
$1,976.06
|
| Rate for Payer: ASR ASR |
$5,180.47
|
| Rate for Payer: BCBS Complete |
$2,136.28
|
| Rate for Payer: BCBS Trust/PPO |
$4,403.40
|
| Rate for Payer: BCN Commercial |
$4,403.40
|
| Rate for Payer: Cash Price |
$4,272.55
|
| Rate for Payer: Cofinity Commercial |
$5,020.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,272.55
|
| Rate for Payer: Healthscope Commercial |
$5,180.47
|
| Rate for Payer: Healthscope Whirlpool |
$5,340.69
|
| Rate for Payer: Mclaren Commercial |
$4,806.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,272.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,539.59
|
| Rate for Payer: Nomi Health Commercial |
$4,379.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,005.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4,679.51
|
| Rate for Payer: Priority Health Narrow Network |
$3,743.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,699.81
|
|
|
HC TENOTOMY MULTIPLE TENDONS
|
Facility
|
IP
|
$5,340.69
|
|
| Hospital Charge Code |
36000095
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,005.52 |
| Max. Negotiated Rate |
$5,340.69 |
| Rate for Payer: Aetna Commercial |
$4,806.62
|
| Rate for Payer: ASR ASR |
$5,180.47
|
| Rate for Payer: BCBS Trust/PPO |
$4,385.77
|
| Rate for Payer: BCN Commercial |
$4,385.77
|
| Rate for Payer: Cash Price |
$4,272.55
|
| Rate for Payer: Cofinity Commercial |
$5,020.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,272.55
|
| Rate for Payer: Healthscope Commercial |
$5,180.47
|
| Rate for Payer: Healthscope Whirlpool |
$5,340.69
|
| Rate for Payer: Mclaren Commercial |
$4,806.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,539.59
|
| Rate for Payer: Nomi Health Commercial |
$4,379.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,005.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,699.81
|
|
|
HC TENOTOMY PERCUTANEOUS ACHILLES TENDON
|
Facility
|
IP
|
$3,812.64
|
|
| Hospital Charge Code |
36000097
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,859.48 |
| Max. Negotiated Rate |
$3,812.64 |
| Rate for Payer: Aetna Commercial |
$3,431.38
|
| Rate for Payer: ASR ASR |
$3,698.26
|
| Rate for Payer: BCBS Trust/PPO |
$3,130.94
|
| Rate for Payer: BCN Commercial |
$3,130.94
|
| Rate for Payer: Cash Price |
$3,050.11
|
| Rate for Payer: Cofinity Commercial |
$3,583.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,050.11
|
| Rate for Payer: Healthscope Commercial |
$3,698.26
|
| Rate for Payer: Healthscope Whirlpool |
$3,812.64
|
| Rate for Payer: Mclaren Commercial |
$3,431.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,240.74
|
| Rate for Payer: Nomi Health Commercial |
$3,126.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,859.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,355.12
|
|
|
HC TENOTOMY PERCUTANEOUS ACHILLES TENDON
|
Facility
|
OP
|
$3,812.64
|
|
| Hospital Charge Code |
36000097
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,410.68 |
| Max. Negotiated Rate |
$3,812.64 |
| Rate for Payer: Aetna Commercial |
$3,431.38
|
| Rate for Payer: Aetna Medicare |
$1,410.68
|
| Rate for Payer: ASR ASR |
$3,698.26
|
| Rate for Payer: BCBS Complete |
$1,525.06
|
| Rate for Payer: BCBS Trust/PPO |
$3,143.52
|
| Rate for Payer: BCN Commercial |
$3,143.52
|
| Rate for Payer: Cash Price |
$3,050.11
|
| Rate for Payer: Cofinity Commercial |
$3,583.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,050.11
|
| Rate for Payer: Healthscope Commercial |
$3,698.26
|
| Rate for Payer: Healthscope Whirlpool |
$3,812.64
|
| Rate for Payer: Mclaren Commercial |
$3,431.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,050.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,240.74
|
| Rate for Payer: Nomi Health Commercial |
$3,126.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,859.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,340.64
|
| Rate for Payer: Priority Health Narrow Network |
$2,672.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,355.12
|
|
|
HC TENOTOMY PERCUTANEOUS ADDUCTOR OR HAMSTRING
|
Facility
|
IP
|
$3,641.43
|
|
| Hospital Charge Code |
36000094
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,731.07 |
| Max. Negotiated Rate |
$3,641.43 |
| Rate for Payer: Aetna Commercial |
$3,277.29
|
| Rate for Payer: ASR ASR |
$3,532.19
|
| Rate for Payer: BCBS Trust/PPO |
$2,990.34
|
| Rate for Payer: BCN Commercial |
$2,990.34
|
| Rate for Payer: Cash Price |
$2,913.14
|
| Rate for Payer: Cofinity Commercial |
$3,422.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,913.14
|
| Rate for Payer: Healthscope Commercial |
$3,532.19
|
| Rate for Payer: Healthscope Whirlpool |
$3,641.43
|
| Rate for Payer: Mclaren Commercial |
$3,277.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,095.22
|
| Rate for Payer: Nomi Health Commercial |
$2,985.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,731.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,204.46
|
|
|
HC TENOTOMY PERCUTANEOUS ADDUCTOR OR HAMSTRING
|
Facility
|
OP
|
$3,641.43
|
|
| Hospital Charge Code |
36000094
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,347.33 |
| Max. Negotiated Rate |
$3,641.43 |
| Rate for Payer: Aetna Commercial |
$3,277.29
|
| Rate for Payer: Aetna Medicare |
$1,347.33
|
| Rate for Payer: ASR ASR |
$3,532.19
|
| Rate for Payer: BCBS Complete |
$1,456.57
|
| Rate for Payer: BCBS Trust/PPO |
$3,002.36
|
| Rate for Payer: BCN Commercial |
$3,002.36
|
| Rate for Payer: Cash Price |
$2,913.14
|
| Rate for Payer: Cofinity Commercial |
$3,422.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,913.14
|
| Rate for Payer: Healthscope Commercial |
$3,532.19
|
| Rate for Payer: Healthscope Whirlpool |
$3,641.43
|
| Rate for Payer: Mclaren Commercial |
$3,277.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,913.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,095.22
|
| Rate for Payer: Nomi Health Commercial |
$2,985.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,731.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,190.62
|
| Rate for Payer: Priority Health Narrow Network |
$2,552.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,204.46
|
|
|
HC TENOTOMY PERCUTANEOUS SINGLE EACH DIGIT
|
Facility
|
IP
|
$4,681.80
|
|
|
Service Code
|
CPT 26060
|
| Hospital Charge Code |
76100424
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,511.35 |
| Max. Negotiated Rate |
$4,681.80 |
| Rate for Payer: Aetna Commercial |
$4,213.62
|
| Rate for Payer: ASR ASR |
$4,541.35
|
| Rate for Payer: BCBS Trust/PPO |
$3,844.69
|
| Rate for Payer: BCN Commercial |
$3,844.69
|
| Rate for Payer: Cash Price |
$3,745.44
|
| Rate for Payer: Cofinity Commercial |
$4,400.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,745.44
|
| Rate for Payer: Healthscope Commercial |
$4,541.35
|
| Rate for Payer: Healthscope Whirlpool |
$4,681.80
|
| Rate for Payer: Mclaren Commercial |
$4,213.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,979.53
|
| Rate for Payer: Nomi Health Commercial |
$3,839.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,511.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,119.98
|
|
|
HC TENOTOMY PERCUTANEOUS SINGLE EACH DIGIT
|
Facility
|
OP
|
$4,681.80
|
|
|
Service Code
|
CPT 26060
|
| Hospital Charge Code |
76100424
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$837.96 |
| Max. Negotiated Rate |
$4,681.80 |
| Rate for Payer: Aetna Commercial |
$4,213.62
|
| Rate for Payer: Aetna Medicare |
$1,602.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,002.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,002.76
|
| Rate for Payer: ASR ASR |
$4,541.35
|
| Rate for Payer: BCBS Complete |
$879.93
|
| Rate for Payer: BCBS MAPPO |
$1,602.21
|
| Rate for Payer: BCBS Trust/PPO |
$3,860.14
|
| Rate for Payer: BCN Commercial |
$3,860.14
|
| Rate for Payer: BCN Medicare Advantage |
$1,602.21
|
| Rate for Payer: Cash Price |
$3,745.44
|
| Rate for Payer: Cash Price |
$3,745.44
|
| Rate for Payer: Cofinity Commercial |
$4,400.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,745.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,602.21
|
| Rate for Payer: Healthscope Commercial |
$4,541.35
|
| Rate for Payer: Healthscope Whirlpool |
$4,681.80
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,602.21
|
| Rate for Payer: Mclaren Commercial |
$4,213.62
|
| Rate for Payer: Mclaren Medicaid |
$1,602.21
|
| Rate for Payer: Mclaren Medicare |
$1,602.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,682.32
|
| Rate for Payer: Meridian Medicaid |
$879.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,842.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,762.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,979.53
|
| Rate for Payer: Nomi Health Commercial |
$3,839.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,511.35
|
| Rate for Payer: PACE Medicare |
$1,522.10
|
| Rate for Payer: PACE SWMI |
$1,602.21
|
| Rate for Payer: PHP Commercial |
$1,762.43
|
| Rate for Payer: PHP Medicaid |
$858.78
|
| Rate for Payer: PHP Medicare Advantage |
$1,602.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$837.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4,102.19
|
| Rate for Payer: Priority Health Medicare |
$1,602.21
|
| Rate for Payer: Priority Health Narrow Network |
$3,281.94
|
| Rate for Payer: Railroad Medicare Medicare |
$1,602.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,119.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,602.21
|
| Rate for Payer: UHC Exchange |
$2,483.43
|
| Rate for Payer: UHC Medicaid |
$837.96
|
| Rate for Payer: UHCCP DNSP |
$1,602.21
|
| Rate for Payer: UHCCP Medicaid |
$837.96
|
| Rate for Payer: VA VA |
$1,602.21
|
|
|
HC TENOTOMY SHOULDER AREA SINGLE TENDON
|
Facility
|
OP
|
$4,922.84
|
|
| Hospital Charge Code |
36000098
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,821.45 |
| Max. Negotiated Rate |
$4,922.84 |
| Rate for Payer: Aetna Commercial |
$4,430.56
|
| Rate for Payer: Aetna Medicare |
$1,821.45
|
| Rate for Payer: ASR ASR |
$4,775.15
|
| Rate for Payer: BCBS Complete |
$1,969.14
|
| Rate for Payer: BCBS Trust/PPO |
$4,058.88
|
| Rate for Payer: BCN Commercial |
$4,058.88
|
| Rate for Payer: Cash Price |
$3,938.27
|
| Rate for Payer: Cofinity Commercial |
$4,627.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,938.27
|
| Rate for Payer: Healthscope Commercial |
$4,775.15
|
| Rate for Payer: Healthscope Whirlpool |
$4,922.84
|
| Rate for Payer: Mclaren Commercial |
$4,430.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,938.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,184.41
|
| Rate for Payer: Nomi Health Commercial |
$4,036.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,692.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4,313.39
|
| Rate for Payer: Priority Health Narrow Network |
$3,450.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,332.10
|
|
|
HC TENOTOMY SHOULDER AREA SINGLE TENDON
|
Facility
|
IP
|
$4,922.84
|
|
| Hospital Charge Code |
36000098
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,692.13 |
| Max. Negotiated Rate |
$4,922.84 |
| Rate for Payer: Aetna Commercial |
$4,430.56
|
| Rate for Payer: ASR ASR |
$4,775.15
|
| Rate for Payer: BCBS Trust/PPO |
$4,042.64
|
| Rate for Payer: BCN Commercial |
$4,042.64
|
| Rate for Payer: Cash Price |
$3,938.27
|
| Rate for Payer: Cofinity Commercial |
$4,627.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,938.27
|
| Rate for Payer: Healthscope Commercial |
$4,775.15
|
| Rate for Payer: Healthscope Whirlpool |
$4,922.84
|
| Rate for Payer: Mclaren Commercial |
$4,430.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,184.41
|
| Rate for Payer: Nomi Health Commercial |
$4,036.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,692.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,332.10
|
|
|
HC TENOTOMY TOE SINGLE TENDON
|
Facility
|
IP
|
$2,263.53
|
|
|
Service Code
|
CPT 28010
|
| Hospital Charge Code |
45000092
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,697.65 |
| Max. Negotiated Rate |
$2,263.53 |
| Rate for Payer: Aetna Commercial |
$2,037.18
|
| Rate for Payer: ASR ASR |
$2,195.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,858.81
|
| Rate for Payer: BCN Commercial |
$1,858.81
|
| Rate for Payer: Cash Price |
$1,810.82
|
| Rate for Payer: Cofinity Commercial |
$2,127.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,810.82
|
| Rate for Payer: Healthscope Commercial |
$2,195.62
|
| Rate for Payer: Healthscope Whirlpool |
$2,263.53
|
| Rate for Payer: Mclaren Commercial |
$2,037.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,924.00
|
| Rate for Payer: Nomi Health Commercial |
$1,856.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,697.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,991.91
|
|
|
HC TENOTOMY TOE SINGLE TENDON
|
Facility
|
OP
|
$2,263.53
|
|
|
Service Code
|
CPT 28010
|
| Hospital Charge Code |
45000092
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$837.96 |
| Max. Negotiated Rate |
$2,483.43 |
| Rate for Payer: Aetna Commercial |
$2,037.18
|
| Rate for Payer: Aetna Medicare |
$1,602.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,002.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,002.76
|
| Rate for Payer: ASR ASR |
$2,195.62
|
| Rate for Payer: BCBS Complete |
$879.93
|
| Rate for Payer: BCBS MAPPO |
$1,602.21
|
| Rate for Payer: BCBS Trust/PPO |
$1,866.28
|
| Rate for Payer: BCN Commercial |
$1,866.28
|
| Rate for Payer: BCN Medicare Advantage |
$1,602.21
|
| Rate for Payer: Cash Price |
$1,810.82
|
| Rate for Payer: Cash Price |
$1,810.82
|
| Rate for Payer: Cofinity Commercial |
$2,127.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,810.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,602.21
|
| Rate for Payer: Healthscope Commercial |
$2,195.62
|
| Rate for Payer: Healthscope Whirlpool |
$2,263.53
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,602.21
|
| Rate for Payer: Mclaren Commercial |
$2,037.18
|
| Rate for Payer: Mclaren Medicaid |
$1,602.21
|
| Rate for Payer: Mclaren Medicare |
$1,602.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,682.32
|
| Rate for Payer: Meridian Medicaid |
$879.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,842.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,762.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,924.00
|
| Rate for Payer: Nomi Health Commercial |
$1,856.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,697.65
|
| Rate for Payer: PACE Medicare |
$1,522.10
|
| Rate for Payer: PACE SWMI |
$1,602.21
|
| Rate for Payer: PHP Commercial |
$1,762.43
|
| Rate for Payer: PHP Medicaid |
$858.78
|
| Rate for Payer: PHP Medicare Advantage |
$1,602.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$837.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,983.30
|
| Rate for Payer: Priority Health Medicare |
$1,602.21
|
| Rate for Payer: Priority Health Narrow Network |
$1,586.73
|
| Rate for Payer: Railroad Medicare Medicare |
$1,602.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,991.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,602.21
|
| Rate for Payer: UHC Exchange |
$2,483.43
|
| Rate for Payer: UHC Medicaid |
$837.96
|
| Rate for Payer: UHCCP DNSP |
$1,602.21
|
| Rate for Payer: UHCCP Medicaid |
$837.96
|
| Rate for Payer: VA VA |
$1,602.21
|
|
|
HC TESTOSTERONE BIOAVAILABLE
|
Facility
|
IP
|
$79.59
|
|
|
Service Code
|
CPT 84402
|
| Hospital Charge Code |
30100429
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$59.69 |
| Max. Negotiated Rate |
$79.59 |
| Rate for Payer: Aetna Commercial |
$71.63
|
| Rate for Payer: ASR ASR |
$77.20
|
| Rate for Payer: BCBS Trust/PPO |
$65.36
|
| Rate for Payer: BCN Commercial |
$65.36
|
| Rate for Payer: Cash Price |
$63.67
|
| Rate for Payer: Cofinity Commercial |
$74.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.67
|
| Rate for Payer: Healthscope Commercial |
$77.20
|
| Rate for Payer: Healthscope Whirlpool |
$79.59
|
| Rate for Payer: Mclaren Commercial |
$71.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.65
|
| Rate for Payer: Nomi Health Commercial |
$65.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$70.04
|
|
|
HC TESTOSTERONE BIOAVAILABLE
|
Facility
|
OP
|
$79.59
|
|
|
Service Code
|
CPT 84402
|
| Hospital Charge Code |
30100429
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.32 |
| Max. Negotiated Rate |
$101.68 |
| Rate for Payer: Aetna Commercial |
$71.63
|
| Rate for Payer: Aetna Medicare |
$25.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.84
|
| Rate for Payer: ASR ASR |
$77.20
|
| Rate for Payer: BCBS Complete |
$13.99
|
| Rate for Payer: BCBS MAPPO |
$25.47
|
| Rate for Payer: BCBS Trust/PPO |
$65.62
|
| Rate for Payer: BCN Commercial |
$65.62
|
| Rate for Payer: BCN Medicare Advantage |
$25.47
|
| Rate for Payer: Cash Price |
$63.67
|
| Rate for Payer: Cash Price |
$63.67
|
| Rate for Payer: Cofinity Commercial |
$74.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.47
|
| Rate for Payer: Healthscope Commercial |
$77.20
|
| Rate for Payer: Healthscope Whirlpool |
$79.59
|
| Rate for Payer: Humana Choice PPO Medicare |
$25.47
|
| Rate for Payer: Mclaren Commercial |
$71.63
|
| Rate for Payer: Mclaren Medicaid |
$25.47
|
| Rate for Payer: Mclaren Medicare |
$25.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.74
|
| Rate for Payer: Meridian Medicaid |
$13.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$28.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.65
|
| Rate for Payer: Nomi Health Commercial |
$65.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.69
|
| Rate for Payer: PACE Medicare |
$24.20
|
| Rate for Payer: PACE SWMI |
$25.47
|
| Rate for Payer: PHP Commercial |
$28.02
|
| Rate for Payer: PHP Medicaid |
$13.65
|
| Rate for Payer: PHP Medicare Advantage |
$25.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$101.68
|
| Rate for Payer: Priority Health Medicare |
$25.47
|
| Rate for Payer: Priority Health Narrow Network |
$81.35
|
| Rate for Payer: Railroad Medicare Medicare |
$25.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$70.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$25.47
|
| Rate for Payer: UHC Exchange |
$39.48
|
| Rate for Payer: UHC Medicaid |
$13.32
|
| Rate for Payer: UHCCP DNSP |
$25.47
|
| Rate for Payer: UHCCP Medicaid |
$13.32
|
| Rate for Payer: VA VA |
$25.47
|
|
|
HC TESTOSTERONE FREE
|
Facility
|
OP
|
$45.59
|
|
|
Service Code
|
CPT 84402
|
| Hospital Charge Code |
30100428
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.32 |
| Max. Negotiated Rate |
$101.68 |
| Rate for Payer: Aetna Commercial |
$41.03
|
| Rate for Payer: Aetna Medicare |
$25.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.84
|
| Rate for Payer: ASR ASR |
$44.22
|
| Rate for Payer: BCBS Complete |
$13.99
|
| Rate for Payer: BCBS MAPPO |
$25.47
|
| Rate for Payer: BCBS Trust/PPO |
$37.59
|
| Rate for Payer: BCN Commercial |
$37.59
|
| Rate for Payer: BCN Medicare Advantage |
$25.47
|
| Rate for Payer: Cash Price |
$36.47
|
| Rate for Payer: Cash Price |
$36.47
|
| Rate for Payer: Cofinity Commercial |
$42.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.47
|
| Rate for Payer: Healthscope Commercial |
$44.22
|
| Rate for Payer: Healthscope Whirlpool |
$45.59
|
| Rate for Payer: Humana Choice PPO Medicare |
$25.47
|
| Rate for Payer: Mclaren Commercial |
$41.03
|
| Rate for Payer: Mclaren Medicaid |
$25.47
|
| Rate for Payer: Mclaren Medicare |
$25.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.74
|
| Rate for Payer: Meridian Medicaid |
$13.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$28.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.75
|
| Rate for Payer: Nomi Health Commercial |
$37.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.19
|
| Rate for Payer: PACE Medicare |
$24.20
|
| Rate for Payer: PACE SWMI |
$25.47
|
| Rate for Payer: PHP Commercial |
$28.02
|
| Rate for Payer: PHP Medicaid |
$13.65
|
| Rate for Payer: PHP Medicare Advantage |
$25.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$101.68
|
| Rate for Payer: Priority Health Medicare |
$25.47
|
| Rate for Payer: Priority Health Narrow Network |
$81.35
|
| Rate for Payer: Railroad Medicare Medicare |
$25.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$25.47
|
| Rate for Payer: UHC Exchange |
$39.48
|
| Rate for Payer: UHC Medicaid |
$13.32
|
| Rate for Payer: UHCCP DNSP |
$25.47
|
| Rate for Payer: UHCCP Medicaid |
$13.32
|
| Rate for Payer: VA VA |
$25.47
|
|
|
HC TESTOSTERONE FREE
|
Facility
|
IP
|
$45.59
|
|
|
Service Code
|
CPT 84402
|
| Hospital Charge Code |
30100428
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$34.19 |
| Max. Negotiated Rate |
$45.59 |
| Rate for Payer: Aetna Commercial |
$41.03
|
| Rate for Payer: ASR ASR |
$44.22
|
| Rate for Payer: BCBS Trust/PPO |
$37.44
|
| Rate for Payer: BCN Commercial |
$37.44
|
| Rate for Payer: Cash Price |
$36.47
|
| Rate for Payer: Cofinity Commercial |
$42.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.47
|
| Rate for Payer: Healthscope Commercial |
$44.22
|
| Rate for Payer: Healthscope Whirlpool |
$45.59
|
| Rate for Payer: Mclaren Commercial |
$41.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.75
|
| Rate for Payer: Nomi Health Commercial |
$37.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.12
|
|
|
HC TESTOSTERONE, FREE & WKLY BOUND
|
Facility
|
OP
|
$83.23
|
|
|
Service Code
|
CPT 84410
|
| Hospital Charge Code |
30100736
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$26.82 |
| Max. Negotiated Rate |
$83.23 |
| Rate for Payer: Aetna Commercial |
$74.91
|
| Rate for Payer: Aetna Medicare |
$51.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$64.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$64.10
|
| Rate for Payer: ASR ASR |
$80.73
|
| Rate for Payer: BCBS Complete |
$28.16
|
| Rate for Payer: BCBS MAPPO |
$51.28
|
| Rate for Payer: BCBS Trust/PPO |
$68.62
|
| Rate for Payer: BCN Commercial |
$68.62
|
| Rate for Payer: BCN Medicare Advantage |
$51.28
|
| Rate for Payer: Cash Price |
$66.58
|
| Rate for Payer: Cash Price |
$66.58
|
| Rate for Payer: Cofinity Commercial |
$78.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.28
|
| Rate for Payer: Healthscope Commercial |
$80.73
|
| Rate for Payer: Healthscope Whirlpool |
$83.23
|
| Rate for Payer: Humana Choice PPO Medicare |
$51.28
|
| Rate for Payer: Mclaren Commercial |
$74.91
|
| Rate for Payer: Mclaren Medicaid |
$51.28
|
| Rate for Payer: Mclaren Medicare |
$51.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.84
|
| Rate for Payer: Meridian Medicaid |
$28.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$56.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70.75
|
| Rate for Payer: Nomi Health Commercial |
$68.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$62.42
|
| Rate for Payer: PACE Medicare |
$48.72
|
| Rate for Payer: PACE SWMI |
$51.28
|
| Rate for Payer: PHP Commercial |
$56.41
|
| Rate for Payer: PHP Medicaid |
$27.49
|
| Rate for Payer: PHP Medicare Advantage |
$51.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$72.93
|
| Rate for Payer: Priority Health Medicare |
$51.28
|
| Rate for Payer: Priority Health Narrow Network |
$58.34
|
| Rate for Payer: Railroad Medicare Medicare |
$51.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$73.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$51.28
|
| Rate for Payer: UHC Exchange |
$79.48
|
| Rate for Payer: UHC Medicaid |
$26.82
|
| Rate for Payer: UHCCP DNSP |
$51.28
|
| Rate for Payer: UHCCP Medicaid |
$26.82
|
| Rate for Payer: VA VA |
$51.28
|
|
|
HC TESTOSTERONE, FREE & WKLY BOUND
|
Facility
|
IP
|
$83.23
|
|
|
Service Code
|
CPT 84410
|
| Hospital Charge Code |
30100736
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$62.42 |
| Max. Negotiated Rate |
$83.23 |
| Rate for Payer: Aetna Commercial |
$74.91
|
| Rate for Payer: ASR ASR |
$80.73
|
| Rate for Payer: BCBS Trust/PPO |
$68.35
|
| Rate for Payer: BCN Commercial |
$68.35
|
| Rate for Payer: Cash Price |
$66.58
|
| Rate for Payer: Cofinity Commercial |
$78.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.58
|
| Rate for Payer: Healthscope Commercial |
$80.73
|
| Rate for Payer: Healthscope Whirlpool |
$83.23
|
| Rate for Payer: Mclaren Commercial |
$74.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70.75
|
| Rate for Payer: Nomi Health Commercial |
$68.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$62.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$73.24
|
|
