|
HC SRA, LMWH
|
Facility
|
IP
|
$332.93
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
30200424
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$216.40 |
| Max. Negotiated Rate |
$332.93 |
| Rate for Payer: Aetna Commercial |
$299.64
|
| Rate for Payer: ASR ASR |
$322.94
|
| Rate for Payer: ASR Commercial |
$322.94
|
| Rate for Payer: BCBS Trust/PPO |
$271.30
|
| Rate for Payer: BCN Commercial |
$258.12
|
| Rate for Payer: Cash Price |
$266.34
|
| Rate for Payer: Cofinity Commercial |
$312.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$266.34
|
| Rate for Payer: Healthscope Commercial |
$332.93
|
| Rate for Payer: Healthscope Whirlpool |
$322.94
|
| Rate for Payer: Mclaren Commercial |
$299.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$282.99
|
| Rate for Payer: Nomi Health Commercial |
$273.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$216.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$292.98
|
|
|
HC SRA, LMWH
|
Facility
|
OP
|
$332.93
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
30200424
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.85 |
| Max. Negotiated Rate |
$332.93 |
| Rate for Payer: Aetna Commercial |
$299.64
|
| Rate for Payer: Aetna Medicare |
$18.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.96
|
| Rate for Payer: ASR ASR |
$322.94
|
| Rate for Payer: ASR Commercial |
$322.94
|
| Rate for Payer: BCBS Complete |
$10.34
|
| Rate for Payer: BCBS MAPPO |
$18.37
|
| Rate for Payer: BCBS Trust/PPO |
$272.64
|
| Rate for Payer: BCN Commercial |
$258.12
|
| Rate for Payer: BCN Medicare Advantage |
$18.37
|
| Rate for Payer: Cash Price |
$266.34
|
| Rate for Payer: Cash Price |
$266.34
|
| Rate for Payer: Cofinity Commercial |
$312.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$266.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.37
|
| Rate for Payer: Healthscope Commercial |
$332.93
|
| Rate for Payer: Healthscope Whirlpool |
$322.94
|
| Rate for Payer: Humana Choice PPO Medicare |
$18.37
|
| Rate for Payer: Mclaren Commercial |
$299.64
|
| Rate for Payer: Mclaren Medicaid |
$9.85
|
| Rate for Payer: Mclaren Medicare |
$18.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.29
|
| Rate for Payer: Meridian Medicaid |
$10.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$282.99
|
| Rate for Payer: Nomi Health Commercial |
$273.00
|
| Rate for Payer: PACE Medicare |
$17.45
|
| Rate for Payer: PACE SWMI |
$18.37
|
| Rate for Payer: PHP Commercial |
$20.21
|
| Rate for Payer: PHP Medicaid |
$9.85
|
| Rate for Payer: PHP Medicare Advantage |
$18.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$216.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$250.89
|
| Rate for Payer: Priority Health Medicare |
$18.37
|
| Rate for Payer: Priority Health Narrow Network |
$200.71
|
| Rate for Payer: Railroad Medicare Medicare |
$18.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$292.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.37
|
| Rate for Payer: UHC Exchange |
$28.47
|
| Rate for Payer: UHC Medicare Advantage |
$18.37
|
| Rate for Payer: UHCCP DNSP |
$18.37
|
| Rate for Payer: UHCCP Medicaid |
$9.85
|
| Rate for Payer: VA VA |
$18.37
|
|
|
HC SRS CRANIAL LESION LIN ACC
|
Facility
|
IP
|
$3,101.43
|
|
|
Service Code
|
CPT 77372
|
| Hospital Charge Code |
33300032
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$2,015.93 |
| Max. Negotiated Rate |
$3,101.43 |
| Rate for Payer: Aetna Commercial |
$2,791.29
|
| Rate for Payer: ASR ASR |
$3,008.39
|
| Rate for Payer: ASR Commercial |
$3,008.39
|
| Rate for Payer: BCBS Trust/PPO |
$2,527.36
|
| Rate for Payer: BCN Commercial |
$2,404.54
|
| Rate for Payer: Cash Price |
$2,481.14
|
| Rate for Payer: Cofinity Commercial |
$2,915.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,481.14
|
| Rate for Payer: Healthscope Commercial |
$3,101.43
|
| Rate for Payer: Healthscope Whirlpool |
$3,008.39
|
| Rate for Payer: Mclaren Commercial |
$2,791.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,636.22
|
| Rate for Payer: Nomi Health Commercial |
$2,543.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,015.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,729.26
|
|
|
HC SRS CRANIAL LESION LIN ACC
|
Facility
|
OP
|
$3,101.43
|
|
|
Service Code
|
CPT 77372
|
| Hospital Charge Code |
33300032
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$2,015.93 |
| Max. Negotiated Rate |
$11,609.38 |
| Rate for Payer: Aetna Commercial |
$2,791.29
|
| Rate for Payer: Aetna Medicare |
$7,489.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,362.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,362.40
|
| Rate for Payer: ASR ASR |
$3,008.39
|
| Rate for Payer: ASR Commercial |
$3,008.39
|
| Rate for Payer: BCBS Complete |
$4,215.33
|
| Rate for Payer: BCBS MAPPO |
$7,489.92
|
| Rate for Payer: BCBS Trust/PPO |
$2,539.76
|
| Rate for Payer: BCN Commercial |
$2,404.54
|
| Rate for Payer: BCN Medicare Advantage |
$7,489.92
|
| Rate for Payer: Cash Price |
$2,481.14
|
| Rate for Payer: Cash Price |
$2,481.14
|
| Rate for Payer: Cofinity Commercial |
$2,915.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,481.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,489.92
|
| Rate for Payer: Healthscope Commercial |
$3,101.43
|
| Rate for Payer: Healthscope Whirlpool |
$3,008.39
|
| Rate for Payer: Humana Choice PPO Medicare |
$7,489.92
|
| Rate for Payer: Mclaren Commercial |
$2,791.29
|
| Rate for Payer: Mclaren Medicaid |
$4,014.60
|
| Rate for Payer: Mclaren Medicare |
$7,489.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,864.42
|
| Rate for Payer: Meridian Medicaid |
$4,215.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,613.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,636.22
|
| Rate for Payer: Nomi Health Commercial |
$2,543.17
|
| Rate for Payer: PACE Medicare |
$7,115.42
|
| Rate for Payer: PACE SWMI |
$7,489.92
|
| Rate for Payer: PHP Commercial |
$8,238.91
|
| Rate for Payer: PHP Medicaid |
$4,014.60
|
| Rate for Payer: PHP Medicare Advantage |
$7,489.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,014.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,015.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,717.47
|
| Rate for Payer: Priority Health Medicare |
$7,489.92
|
| Rate for Payer: Priority Health Narrow Network |
$2,174.10
|
| Rate for Payer: Railroad Medicare Medicare |
$7,489.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,729.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,489.92
|
| Rate for Payer: UHC Exchange |
$11,609.38
|
| Rate for Payer: UHC Medicare Advantage |
$7,489.92
|
| Rate for Payer: UHCCP DNSP |
$7,489.92
|
| Rate for Payer: UHCCP Medicaid |
$4,014.60
|
| Rate for Payer: VA VA |
$7,489.92
|
|
|
HC SRT UP TO 5 FRACTIONS
|
Facility
|
IP
|
$5,306.04
|
|
|
Service Code
|
CPT 77373
|
| Hospital Charge Code |
33300018
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$3,448.93 |
| Max. Negotiated Rate |
$5,306.04 |
| Rate for Payer: Aetna Commercial |
$4,775.44
|
| Rate for Payer: ASR ASR |
$5,146.86
|
| Rate for Payer: ASR Commercial |
$5,146.86
|
| Rate for Payer: BCBS Trust/PPO |
$4,323.89
|
| Rate for Payer: BCN Commercial |
$4,113.77
|
| Rate for Payer: Cash Price |
$4,244.83
|
| Rate for Payer: Cofinity Commercial |
$4,987.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,244.83
|
| Rate for Payer: Healthscope Commercial |
$5,306.04
|
| Rate for Payer: Healthscope Whirlpool |
$5,146.86
|
| Rate for Payer: Mclaren Commercial |
$4,775.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,510.13
|
| Rate for Payer: Nomi Health Commercial |
$4,350.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,448.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,669.32
|
|
|
HC SRT UP TO 5 FRACTIONS
|
Facility
|
OP
|
$5,306.04
|
|
|
Service Code
|
CPT 77373
|
| Hospital Charge Code |
33300018
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$922.14 |
| Max. Negotiated Rate |
$5,306.04 |
| Rate for Payer: Aetna Commercial |
$4,775.44
|
| Rate for Payer: Aetna Medicare |
$1,720.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,150.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,150.51
|
| Rate for Payer: ASR ASR |
$5,146.86
|
| Rate for Payer: ASR Commercial |
$5,146.86
|
| Rate for Payer: BCBS Complete |
$968.25
|
| Rate for Payer: BCBS MAPPO |
$1,720.41
|
| Rate for Payer: BCBS Trust/PPO |
$4,345.12
|
| Rate for Payer: BCN Commercial |
$4,113.77
|
| Rate for Payer: BCN Medicare Advantage |
$1,720.41
|
| Rate for Payer: Cash Price |
$4,244.83
|
| Rate for Payer: Cash Price |
$4,244.83
|
| Rate for Payer: Cofinity Commercial |
$4,987.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,244.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,720.41
|
| Rate for Payer: Healthscope Commercial |
$5,306.04
|
| Rate for Payer: Healthscope Whirlpool |
$5,146.86
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,720.41
|
| Rate for Payer: Mclaren Commercial |
$4,775.44
|
| Rate for Payer: Mclaren Medicaid |
$922.14
|
| Rate for Payer: Mclaren Medicare |
$1,720.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,806.43
|
| Rate for Payer: Meridian Medicaid |
$968.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,978.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,510.13
|
| Rate for Payer: Nomi Health Commercial |
$4,350.95
|
| Rate for Payer: PACE Medicare |
$1,634.39
|
| Rate for Payer: PACE SWMI |
$1,720.41
|
| Rate for Payer: PHP Commercial |
$1,892.45
|
| Rate for Payer: PHP Medicaid |
$922.14
|
| Rate for Payer: PHP Medicare Advantage |
$1,720.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$922.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,448.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,649.15
|
| Rate for Payer: Priority Health Medicare |
$1,720.41
|
| Rate for Payer: Priority Health Narrow Network |
$3,719.53
|
| Rate for Payer: Railroad Medicare Medicare |
$1,720.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,669.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,720.41
|
| Rate for Payer: UHC Exchange |
$2,666.64
|
| Rate for Payer: UHC Medicare Advantage |
$1,720.41
|
| Rate for Payer: UHCCP DNSP |
$1,720.41
|
| Rate for Payer: UHCCP Medicaid |
$922.14
|
| Rate for Payer: VA VA |
$1,720.41
|
|
|
HC SS2PC SPECIAL STAIN (BILL ONLY)
|
Facility
|
OP
|
$112.20
|
|
|
Service Code
|
CPT 88313
|
| Hospital Charge Code |
31200007
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$67.69 |
| Max. Negotiated Rate |
$195.75 |
| Rate for Payer: Aetna Commercial |
$100.98
|
| Rate for Payer: Aetna Medicare |
$126.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.86
|
| Rate for Payer: ASR ASR |
$108.83
|
| Rate for Payer: ASR Commercial |
$108.83
|
| Rate for Payer: BCBS Complete |
$71.08
|
| Rate for Payer: BCBS MAPPO |
$126.29
|
| Rate for Payer: BCBS Trust/PPO |
$91.88
|
| Rate for Payer: BCN Commercial |
$86.99
|
| Rate for Payer: BCN Medicare Advantage |
$126.29
|
| Rate for Payer: Cash Price |
$89.76
|
| Rate for Payer: Cash Price |
$89.76
|
| Rate for Payer: Cofinity Commercial |
$105.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.29
|
| Rate for Payer: Healthscope Commercial |
$112.20
|
| Rate for Payer: Healthscope Whirlpool |
$108.83
|
| Rate for Payer: Humana Choice PPO Medicare |
$126.29
|
| Rate for Payer: Mclaren Commercial |
$100.98
|
| Rate for Payer: Mclaren Medicaid |
$67.69
|
| Rate for Payer: Mclaren Medicare |
$126.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.60
|
| Rate for Payer: Meridian Medicaid |
$71.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$145.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95.37
|
| Rate for Payer: Nomi Health Commercial |
$92.00
|
| Rate for Payer: PACE Medicare |
$119.98
|
| Rate for Payer: PACE SWMI |
$126.29
|
| Rate for Payer: PHP Commercial |
$138.92
|
| Rate for Payer: PHP Medicaid |
$67.69
|
| Rate for Payer: PHP Medicare Advantage |
$126.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$119.69
|
| Rate for Payer: Priority Health Medicare |
$126.29
|
| Rate for Payer: Priority Health Narrow Network |
$95.75
|
| Rate for Payer: Railroad Medicare Medicare |
$126.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$98.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$126.29
|
| Rate for Payer: UHC Exchange |
$195.75
|
| Rate for Payer: UHC Medicare Advantage |
$126.29
|
| Rate for Payer: UHCCP DNSP |
$126.29
|
| Rate for Payer: UHCCP Medicaid |
$67.69
|
| Rate for Payer: VA VA |
$126.29
|
|
|
HC SS2PC SPECIAL STAIN (BILL ONLY)
|
Facility
|
IP
|
$112.20
|
|
|
Service Code
|
CPT 88313
|
| Hospital Charge Code |
31200007
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$72.93 |
| Max. Negotiated Rate |
$112.20 |
| Rate for Payer: Aetna Commercial |
$100.98
|
| Rate for Payer: ASR ASR |
$108.83
|
| Rate for Payer: ASR Commercial |
$108.83
|
| Rate for Payer: BCBS Trust/PPO |
$91.43
|
| Rate for Payer: BCN Commercial |
$86.99
|
| Rate for Payer: Cash Price |
$89.76
|
| Rate for Payer: Cofinity Commercial |
$105.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.76
|
| Rate for Payer: Healthscope Commercial |
$112.20
|
| Rate for Payer: Healthscope Whirlpool |
$108.83
|
| Rate for Payer: Mclaren Commercial |
$100.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95.37
|
| Rate for Payer: Nomi Health Commercial |
$92.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$98.74
|
|
|
HC STABILIZERS HEART ESTECH
|
Facility
|
IP
|
$933.30
|
|
| Hospital Charge Code |
27000292
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$606.64 |
| Max. Negotiated Rate |
$933.30 |
| Rate for Payer: Aetna Commercial |
$839.97
|
| Rate for Payer: ASR ASR |
$905.30
|
| Rate for Payer: ASR Commercial |
$905.30
|
| Rate for Payer: BCBS Trust/PPO |
$760.55
|
| Rate for Payer: BCN Commercial |
$723.59
|
| Rate for Payer: Cash Price |
$746.64
|
| Rate for Payer: Cofinity Commercial |
$877.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$746.64
|
| Rate for Payer: Healthscope Commercial |
$933.30
|
| Rate for Payer: Healthscope Whirlpool |
$905.30
|
| Rate for Payer: Mclaren Commercial |
$839.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$793.30
|
| Rate for Payer: Nomi Health Commercial |
$765.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$606.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$821.30
|
|
|
HC STABILIZERS HEART ESTECH
|
Facility
|
OP
|
$933.30
|
|
| Hospital Charge Code |
27000292
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$373.32 |
| Max. Negotiated Rate |
$933.30 |
| Rate for Payer: Aetna Commercial |
$839.97
|
| Rate for Payer: Aetna Medicare |
$466.65
|
| Rate for Payer: ASR ASR |
$905.30
|
| Rate for Payer: ASR Commercial |
$905.30
|
| Rate for Payer: BCBS Complete |
$373.32
|
| Rate for Payer: BCBS Trust/PPO |
$764.28
|
| Rate for Payer: BCN Commercial |
$723.59
|
| Rate for Payer: Cash Price |
$746.64
|
| Rate for Payer: Cofinity Commercial |
$877.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$746.64
|
| Rate for Payer: Healthscope Commercial |
$933.30
|
| Rate for Payer: Healthscope Whirlpool |
$905.30
|
| Rate for Payer: Mclaren Commercial |
$839.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$793.30
|
| Rate for Payer: Nomi Health Commercial |
$765.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$606.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$817.76
|
| Rate for Payer: Priority Health Narrow Network |
$654.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$821.30
|
|
|
HC STACLOT LA.
|
Facility
|
IP
|
$148.92
|
|
|
Service Code
|
CPT 85597
|
| Hospital Charge Code |
30500085
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$96.80 |
| Max. Negotiated Rate |
$148.92 |
| Rate for Payer: Aetna Commercial |
$134.03
|
| Rate for Payer: ASR ASR |
$144.45
|
| Rate for Payer: ASR Commercial |
$144.45
|
| Rate for Payer: BCBS Trust/PPO |
$121.35
|
| Rate for Payer: BCN Commercial |
$115.46
|
| Rate for Payer: Cash Price |
$119.14
|
| Rate for Payer: Cofinity Commercial |
$139.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$119.14
|
| Rate for Payer: Healthscope Commercial |
$148.92
|
| Rate for Payer: Healthscope Whirlpool |
$144.45
|
| Rate for Payer: Mclaren Commercial |
$134.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$126.58
|
| Rate for Payer: Nomi Health Commercial |
$122.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$96.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$131.05
|
|
|
HC STACLOT LA.
|
Facility
|
OP
|
$148.92
|
|
|
Service Code
|
CPT 85597
|
| Hospital Charge Code |
30500085
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$9.64 |
| Max. Negotiated Rate |
$148.92 |
| Rate for Payer: Aetna Commercial |
$134.03
|
| Rate for Payer: Aetna Medicare |
$17.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.48
|
| Rate for Payer: ASR ASR |
$144.45
|
| Rate for Payer: ASR Commercial |
$144.45
|
| Rate for Payer: BCBS Complete |
$10.12
|
| Rate for Payer: BCBS MAPPO |
$17.98
|
| Rate for Payer: BCBS Trust/PPO |
$121.95
|
| Rate for Payer: BCN Commercial |
$115.46
|
| Rate for Payer: BCN Medicare Advantage |
$17.98
|
| Rate for Payer: Cash Price |
$119.14
|
| Rate for Payer: Cash Price |
$119.14
|
| Rate for Payer: Cofinity Commercial |
$139.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$119.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.98
|
| Rate for Payer: Healthscope Commercial |
$148.92
|
| Rate for Payer: Healthscope Whirlpool |
$144.45
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.98
|
| Rate for Payer: Mclaren Commercial |
$134.03
|
| Rate for Payer: Mclaren Medicaid |
$9.64
|
| Rate for Payer: Mclaren Medicare |
$17.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.88
|
| Rate for Payer: Meridian Medicaid |
$10.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$126.58
|
| Rate for Payer: Nomi Health Commercial |
$122.11
|
| Rate for Payer: PACE Medicare |
$17.08
|
| Rate for Payer: PACE SWMI |
$17.98
|
| Rate for Payer: PHP Commercial |
$19.78
|
| Rate for Payer: PHP Medicaid |
$9.64
|
| Rate for Payer: PHP Medicare Advantage |
$17.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$96.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$130.48
|
| Rate for Payer: Priority Health Medicare |
$17.98
|
| Rate for Payer: Priority Health Narrow Network |
$104.39
|
| Rate for Payer: Railroad Medicare Medicare |
$17.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$131.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.98
|
| Rate for Payer: UHC Exchange |
$27.87
|
| Rate for Payer: UHC Medicare Advantage |
$17.98
|
| Rate for Payer: UHCCP DNSP |
$17.98
|
| Rate for Payer: UHCCP Medicaid |
$9.64
|
| Rate for Payer: VA VA |
$17.98
|
|
|
HC STANDBY OPEN HEART/TAVR
|
Facility
|
OP
|
$2,417.64
|
|
| Hospital Charge Code |
27000151
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$967.06 |
| Max. Negotiated Rate |
$2,417.64 |
| Rate for Payer: Aetna Commercial |
$2,175.88
|
| Rate for Payer: Aetna Medicare |
$1,208.82
|
| Rate for Payer: ASR ASR |
$2,345.11
|
| Rate for Payer: ASR Commercial |
$2,345.11
|
| Rate for Payer: BCBS Complete |
$967.06
|
| Rate for Payer: BCBS Trust/PPO |
$1,979.81
|
| Rate for Payer: BCN Commercial |
$1,874.40
|
| Rate for Payer: Cash Price |
$1,934.11
|
| Rate for Payer: Cofinity Commercial |
$2,272.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,934.11
|
| Rate for Payer: Healthscope Commercial |
$2,417.64
|
| Rate for Payer: Healthscope Whirlpool |
$2,345.11
|
| Rate for Payer: Mclaren Commercial |
$2,175.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,054.99
|
| Rate for Payer: Nomi Health Commercial |
$1,982.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,571.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,118.34
|
| Rate for Payer: Priority Health Narrow Network |
$1,694.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,127.52
|
|
|
HC STANDBY OPEN HEART/TAVR
|
Facility
|
IP
|
$2,417.64
|
|
| Hospital Charge Code |
27000151
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,571.47 |
| Max. Negotiated Rate |
$2,417.64 |
| Rate for Payer: Aetna Commercial |
$2,175.88
|
| Rate for Payer: ASR ASR |
$2,345.11
|
| Rate for Payer: ASR Commercial |
$2,345.11
|
| Rate for Payer: BCBS Trust/PPO |
$1,970.13
|
| Rate for Payer: BCN Commercial |
$1,874.40
|
| Rate for Payer: Cash Price |
$1,934.11
|
| Rate for Payer: Cofinity Commercial |
$2,272.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,934.11
|
| Rate for Payer: Healthscope Commercial |
$2,417.64
|
| Rate for Payer: Healthscope Whirlpool |
$2,345.11
|
| Rate for Payer: Mclaren Commercial |
$2,175.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,054.99
|
| Rate for Payer: Nomi Health Commercial |
$1,982.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,571.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,127.52
|
|
|
HC STAPHYLOCOCCUS AUREUS PCR
|
Facility
|
OP
|
$56.10
|
|
|
Service Code
|
CPT 87640
|
| Hospital Charge Code |
30600263
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$56.10 |
| Rate for Payer: Aetna Commercial |
$50.49
|
| Rate for Payer: Aetna Medicare |
$35.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: ASR ASR |
$54.42
|
| Rate for Payer: ASR Commercial |
$54.42
|
| Rate for Payer: BCBS Complete |
$19.75
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$45.94
|
| Rate for Payer: BCN Commercial |
$43.49
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$44.88
|
| Rate for Payer: Cash Price |
$44.88
|
| Rate for Payer: Cofinity Commercial |
$52.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$56.10
|
| Rate for Payer: Healthscope Whirlpool |
$54.42
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$50.49
|
| Rate for Payer: Mclaren Medicaid |
$18.81
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$19.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.68
|
| Rate for Payer: Nomi Health Commercial |
$46.00
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$38.60
|
| Rate for Payer: PHP Medicaid |
$18.81
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$49.15
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$39.33
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$49.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$54.39
|
| Rate for Payer: UHC Medicare Advantage |
$35.09
|
| Rate for Payer: UHCCP DNSP |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$18.81
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC STAPHYLOCOCCUS AUREUS PCR
|
Facility
|
IP
|
$56.10
|
|
|
Service Code
|
CPT 87640
|
| Hospital Charge Code |
30600263
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$36.46 |
| Max. Negotiated Rate |
$56.10 |
| Rate for Payer: Aetna Commercial |
$50.49
|
| Rate for Payer: ASR ASR |
$54.42
|
| Rate for Payer: ASR Commercial |
$54.42
|
| Rate for Payer: BCBS Trust/PPO |
$45.72
|
| Rate for Payer: BCN Commercial |
$43.49
|
| Rate for Payer: Cash Price |
$44.88
|
| Rate for Payer: Cofinity Commercial |
$52.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.88
|
| Rate for Payer: Healthscope Commercial |
$56.10
|
| Rate for Payer: Healthscope Whirlpool |
$54.42
|
| Rate for Payer: Mclaren Commercial |
$50.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.68
|
| Rate for Payer: Nomi Health Commercial |
$46.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$49.37
|
|
|
HC STAPHYLOCOCCUS AUREUS PCR METHICILLIN RESISTANT
|
Facility
|
OP
|
$61.69
|
|
|
Service Code
|
CPT 87641
|
| Hospital Charge Code |
30600264
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$61.69 |
| Rate for Payer: Aetna Commercial |
$55.52
|
| Rate for Payer: Aetna Medicare |
$35.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: ASR ASR |
$59.84
|
| Rate for Payer: ASR Commercial |
$59.84
|
| Rate for Payer: BCBS Complete |
$19.75
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$50.52
|
| Rate for Payer: BCN Commercial |
$47.83
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$49.35
|
| Rate for Payer: Cash Price |
$49.35
|
| Rate for Payer: Cofinity Commercial |
$57.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$61.69
|
| Rate for Payer: Healthscope Whirlpool |
$59.84
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$55.52
|
| Rate for Payer: Mclaren Medicaid |
$18.81
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$19.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.44
|
| Rate for Payer: Nomi Health Commercial |
$50.59
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$38.60
|
| Rate for Payer: PHP Medicaid |
$18.81
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$54.05
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$43.24
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$54.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$54.39
|
| Rate for Payer: UHC Medicare Advantage |
$35.09
|
| Rate for Payer: UHCCP DNSP |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$18.81
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC STAPHYLOCOCCUS AUREUS PCR METHICILLIN RESISTANT
|
Facility
|
IP
|
$61.69
|
|
|
Service Code
|
CPT 87641
|
| Hospital Charge Code |
30600264
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$40.10 |
| Max. Negotiated Rate |
$61.69 |
| Rate for Payer: Aetna Commercial |
$55.52
|
| Rate for Payer: ASR ASR |
$59.84
|
| Rate for Payer: ASR Commercial |
$59.84
|
| Rate for Payer: BCBS Trust/PPO |
$50.27
|
| Rate for Payer: BCN Commercial |
$47.83
|
| Rate for Payer: Cash Price |
$49.35
|
| Rate for Payer: Cofinity Commercial |
$57.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.35
|
| Rate for Payer: Healthscope Commercial |
$61.69
|
| Rate for Payer: Healthscope Whirlpool |
$59.84
|
| Rate for Payer: Mclaren Commercial |
$55.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.44
|
| Rate for Payer: Nomi Health Commercial |
$50.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$54.29
|
|
|
HC STATLOCK
|
Facility
|
OP
|
$143.69
|
|
| Hospital Charge Code |
27000152
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$57.48 |
| Max. Negotiated Rate |
$143.69 |
| Rate for Payer: Aetna Commercial |
$129.32
|
| Rate for Payer: Aetna Medicare |
$71.84
|
| Rate for Payer: ASR ASR |
$139.38
|
| Rate for Payer: ASR Commercial |
$139.38
|
| Rate for Payer: BCBS Complete |
$57.48
|
| Rate for Payer: BCBS Trust/PPO |
$117.67
|
| Rate for Payer: BCN Commercial |
$111.40
|
| Rate for Payer: Cash Price |
$114.95
|
| Rate for Payer: Cofinity Commercial |
$135.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.95
|
| Rate for Payer: Healthscope Commercial |
$143.69
|
| Rate for Payer: Healthscope Whirlpool |
$139.38
|
| Rate for Payer: Mclaren Commercial |
$129.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$122.14
|
| Rate for Payer: Nomi Health Commercial |
$117.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$93.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$125.90
|
| Rate for Payer: Priority Health Narrow Network |
$100.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$126.45
|
|
|
HC STATLOCK
|
Facility
|
IP
|
$143.69
|
|
| Hospital Charge Code |
27000152
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$93.40 |
| Max. Negotiated Rate |
$143.69 |
| Rate for Payer: Aetna Commercial |
$129.32
|
| Rate for Payer: ASR ASR |
$139.38
|
| Rate for Payer: ASR Commercial |
$139.38
|
| Rate for Payer: BCBS Trust/PPO |
$117.09
|
| Rate for Payer: BCN Commercial |
$111.40
|
| Rate for Payer: Cash Price |
$114.95
|
| Rate for Payer: Cofinity Commercial |
$135.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.95
|
| Rate for Payer: Healthscope Commercial |
$143.69
|
| Rate for Payer: Healthscope Whirlpool |
$139.38
|
| Rate for Payer: Mclaren Commercial |
$129.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$122.14
|
| Rate for Payer: Nomi Health Commercial |
$117.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$93.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$126.45
|
|
|
HC STENGER TEST PURE TONE
|
Facility
|
OP
|
$34.68
|
|
|
Service Code
|
CPT 92565
|
| Hospital Charge Code |
76100500
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$22.54 |
| Max. Negotiated Rate |
$90.21 |
| Rate for Payer: Aetna Commercial |
$31.21
|
| 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 |
$33.64
|
| Rate for Payer: ASR Commercial |
$33.64
|
| Rate for Payer: BCBS Complete |
$32.75
|
| Rate for Payer: BCBS MAPPO |
$58.20
|
| Rate for Payer: BCBS Trust/PPO |
$28.40
|
| Rate for Payer: BCN Commercial |
$26.89
|
| Rate for Payer: BCN Medicare Advantage |
$58.20
|
| Rate for Payer: Cash Price |
$27.74
|
| Rate for Payer: Cash Price |
$27.74
|
| Rate for Payer: Cofinity Commercial |
$32.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.20
|
| Rate for Payer: Healthscope Commercial |
$34.68
|
| Rate for Payer: Healthscope Whirlpool |
$33.64
|
| Rate for Payer: Humana Choice PPO Medicare |
$58.20
|
| Rate for Payer: Mclaren Commercial |
$31.21
|
| 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 |
$29.48
|
| Rate for Payer: Nomi Health Commercial |
$28.44
|
| 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 |
$22.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30.39
|
| Rate for Payer: Priority Health Medicare |
$58.20
|
| Rate for Payer: Priority Health Narrow Network |
$24.31
|
| Rate for Payer: Railroad Medicare Medicare |
$58.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$30.52
|
| 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 STENGER TEST PURE TONE
|
Facility
|
IP
|
$34.68
|
|
|
Service Code
|
CPT 92565
|
| Hospital Charge Code |
76100500
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$22.54 |
| Max. Negotiated Rate |
$34.68 |
| Rate for Payer: Aetna Commercial |
$31.21
|
| Rate for Payer: ASR ASR |
$33.64
|
| Rate for Payer: ASR Commercial |
$33.64
|
| Rate for Payer: BCBS Trust/PPO |
$28.26
|
| Rate for Payer: BCN Commercial |
$26.89
|
| Rate for Payer: Cash Price |
$27.74
|
| Rate for Payer: Cofinity Commercial |
$32.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.74
|
| Rate for Payer: Healthscope Commercial |
$34.68
|
| Rate for Payer: Healthscope Whirlpool |
$33.64
|
| Rate for Payer: Mclaren Commercial |
$31.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.48
|
| Rate for Payer: Nomi Health Commercial |
$28.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$30.52
|
|
|
HC STENGER TEST SPEECH
|
Facility
|
IP
|
$1,449.42
|
|
|
Service Code
|
CPT 92577
|
| Hospital Charge Code |
76100488
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$942.12 |
| Max. Negotiated Rate |
$1,449.42 |
| Rate for Payer: Aetna Commercial |
$1,304.48
|
| Rate for Payer: ASR ASR |
$1,405.94
|
| Rate for Payer: ASR Commercial |
$1,405.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,181.13
|
| Rate for Payer: BCN Commercial |
$1,123.74
|
| Rate for Payer: Cash Price |
$1,159.54
|
| Rate for Payer: Cofinity Commercial |
$1,362.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,159.54
|
| Rate for Payer: Healthscope Commercial |
$1,449.42
|
| Rate for Payer: Healthscope Whirlpool |
$1,405.94
|
| Rate for Payer: Mclaren Commercial |
$1,304.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,232.01
|
| Rate for Payer: Nomi Health Commercial |
$1,188.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$942.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,275.49
|
|
|
HC STENGER TEST SPEECH
|
Facility
|
OP
|
$1,449.42
|
|
|
Service Code
|
CPT 92577
|
| Hospital Charge Code |
76100488
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$278.65 |
| Max. Negotiated Rate |
$1,449.42 |
| Rate for Payer: Aetna Commercial |
$1,304.48
|
| Rate for Payer: Aetna Medicare |
$519.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$649.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$649.84
|
| Rate for Payer: ASR ASR |
$1,405.94
|
| Rate for Payer: ASR Commercial |
$1,405.94
|
| Rate for Payer: BCBS Complete |
$292.58
|
| Rate for Payer: BCBS MAPPO |
$519.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,186.93
|
| Rate for Payer: BCN Commercial |
$1,123.74
|
| Rate for Payer: BCN Medicare Advantage |
$519.87
|
| Rate for Payer: Cash Price |
$1,159.54
|
| Rate for Payer: Cash Price |
$1,159.54
|
| Rate for Payer: Cofinity Commercial |
$1,362.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,159.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$519.87
|
| Rate for Payer: Healthscope Commercial |
$1,449.42
|
| Rate for Payer: Healthscope Whirlpool |
$1,405.94
|
| Rate for Payer: Humana Choice PPO Medicare |
$519.87
|
| Rate for Payer: Mclaren Commercial |
$1,304.48
|
| Rate for Payer: Mclaren Medicaid |
$278.65
|
| Rate for Payer: Mclaren Medicare |
$519.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$545.86
|
| Rate for Payer: Meridian Medicaid |
$292.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$597.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,232.01
|
| Rate for Payer: Nomi Health Commercial |
$1,188.52
|
| Rate for Payer: PACE Medicare |
$493.88
|
| Rate for Payer: PACE SWMI |
$519.87
|
| Rate for Payer: PHP Commercial |
$571.86
|
| Rate for Payer: PHP Medicaid |
$278.65
|
| Rate for Payer: PHP Medicare Advantage |
$519.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$278.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$942.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,269.98
|
| Rate for Payer: Priority Health Medicare |
$519.87
|
| Rate for Payer: Priority Health Narrow Network |
$1,016.04
|
| Rate for Payer: Railroad Medicare Medicare |
$519.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,275.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$519.87
|
| Rate for Payer: UHC Exchange |
$805.80
|
| Rate for Payer: UHC Medicare Advantage |
$519.87
|
| Rate for Payer: UHCCP DNSP |
$519.87
|
| Rate for Payer: UHCCP Medicaid |
$278.65
|
| Rate for Payer: VA VA |
$519.87
|
|
|
HC STENT
|
Facility
|
OP
|
$953.16
|
|
|
Service Code
|
HCPCS C2617
|
| Hospital Charge Code |
27800030
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$381.26 |
| Max. Negotiated Rate |
$953.16 |
| Rate for Payer: Aetna Commercial |
$857.84
|
| Rate for Payer: Aetna Medicare |
$476.58
|
| Rate for Payer: ASR ASR |
$924.57
|
| Rate for Payer: ASR Commercial |
$924.57
|
| Rate for Payer: BCBS Complete |
$381.26
|
| Rate for Payer: BCBS Trust/PPO |
$780.54
|
| Rate for Payer: BCN Commercial |
$738.98
|
| Rate for Payer: Cash Price |
$762.53
|
| Rate for Payer: Cofinity Commercial |
$895.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$762.53
|
| Rate for Payer: Healthscope Commercial |
$953.16
|
| Rate for Payer: Healthscope Whirlpool |
$924.57
|
| Rate for Payer: Mclaren Commercial |
$857.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$810.19
|
| Rate for Payer: Nomi Health Commercial |
$781.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$619.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$835.16
|
| Rate for Payer: Priority Health Narrow Network |
$668.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$838.78
|
|
