|
HC STOOL CULTURE CMPT 3
|
Facility
|
IP
|
$42.55
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30600177
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$27.66 |
| Max. Negotiated Rate |
$42.55 |
| Rate for Payer: Aetna Commercial |
$38.30
|
| Rate for Payer: ASR ASR |
$41.27
|
| Rate for Payer: ASR Commercial |
$41.27
|
| Rate for Payer: BCBS Trust/PPO |
$34.67
|
| Rate for Payer: BCN Commercial |
$32.99
|
| Rate for Payer: Cash Price |
$34.04
|
| Rate for Payer: Cofinity Commercial |
$40.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.04
|
| Rate for Payer: Healthscope Commercial |
$42.55
|
| Rate for Payer: Healthscope Whirlpool |
$41.27
|
| Rate for Payer: Mclaren Commercial |
$38.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.17
|
| Rate for Payer: Nomi Health Commercial |
$34.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.44
|
|
|
HC STOOL CULTURE CMPT 3
|
Facility
|
OP
|
$42.55
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30600177
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.61 |
| Max. Negotiated Rate |
$42.55 |
| Rate for Payer: Aetna Commercial |
$38.30
|
| Rate for Payer: Aetna Medicare |
$16.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.09
|
| Rate for Payer: ASR ASR |
$41.27
|
| Rate for Payer: ASR Commercial |
$41.27
|
| Rate for Payer: BCBS Complete |
$9.04
|
| Rate for Payer: BCBS MAPPO |
$16.07
|
| Rate for Payer: BCBS Trust/PPO |
$34.84
|
| Rate for Payer: BCN Commercial |
$32.99
|
| Rate for Payer: BCN Medicare Advantage |
$16.07
|
| Rate for Payer: Cash Price |
$34.04
|
| Rate for Payer: Cash Price |
$34.04
|
| Rate for Payer: Cofinity Commercial |
$40.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.07
|
| Rate for Payer: Healthscope Commercial |
$42.55
|
| Rate for Payer: Healthscope Whirlpool |
$41.27
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.07
|
| Rate for Payer: Mclaren Commercial |
$38.30
|
| Rate for Payer: Mclaren Medicaid |
$8.61
|
| Rate for Payer: Mclaren Medicare |
$16.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.87
|
| Rate for Payer: Meridian Medicaid |
$9.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.17
|
| Rate for Payer: Nomi Health Commercial |
$34.89
|
| Rate for Payer: PACE Medicare |
$15.27
|
| Rate for Payer: PACE SWMI |
$16.07
|
| Rate for Payer: PHP Commercial |
$17.68
|
| Rate for Payer: PHP Medicaid |
$8.61
|
| Rate for Payer: PHP Medicare Advantage |
$16.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$37.28
|
| Rate for Payer: Priority Health Medicare |
$16.07
|
| Rate for Payer: Priority Health Narrow Network |
$29.83
|
| Rate for Payer: Railroad Medicare Medicare |
$16.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.07
|
| Rate for Payer: UHC Exchange |
$24.91
|
| Rate for Payer: UHC Medicare Advantage |
$16.07
|
| Rate for Payer: UHCCP DNSP |
$16.07
|
| Rate for Payer: UHCCP Medicaid |
$8.61
|
| Rate for Payer: VA VA |
$16.07
|
|
|
HC STRAPPING ANKLE AND OR FOOT
|
Facility
|
IP
|
$134.52
|
|
|
Service Code
|
CPT 29540
|
| Hospital Charge Code |
42000005
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$87.44 |
| Max. Negotiated Rate |
$134.52 |
| Rate for Payer: Aetna Commercial |
$121.07
|
| Rate for Payer: ASR ASR |
$130.48
|
| Rate for Payer: ASR Commercial |
$130.48
|
| Rate for Payer: BCBS Trust/PPO |
$109.62
|
| Rate for Payer: BCN Commercial |
$104.29
|
| Rate for Payer: Cash Price |
$107.62
|
| Rate for Payer: Cofinity Commercial |
$126.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.62
|
| Rate for Payer: Healthscope Commercial |
$134.52
|
| Rate for Payer: Healthscope Whirlpool |
$130.48
|
| Rate for Payer: Mclaren Commercial |
$121.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$114.34
|
| Rate for Payer: Nomi Health Commercial |
$110.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$87.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$118.38
|
|
|
HC STRAPPING ANKLE AND OR FOOT
|
Facility
|
OP
|
$134.52
|
|
|
Service Code
|
CPT 29540
|
| Hospital Charge Code |
42000005
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$82.49 |
| Max. Negotiated Rate |
$238.53 |
| Rate for Payer: Aetna Commercial |
$121.07
|
| Rate for Payer: Aetna Medicare |
$153.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$192.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$192.36
|
| Rate for Payer: ASR ASR |
$130.48
|
| Rate for Payer: ASR Commercial |
$130.48
|
| Rate for Payer: BCBS Complete |
$86.61
|
| Rate for Payer: BCBS MAPPO |
$153.89
|
| Rate for Payer: BCBS Trust/PPO |
$110.16
|
| Rate for Payer: BCN Commercial |
$104.29
|
| Rate for Payer: BCN Medicare Advantage |
$153.89
|
| Rate for Payer: Cash Price |
$107.62
|
| Rate for Payer: Cash Price |
$107.62
|
| Rate for Payer: Cofinity Commercial |
$126.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.89
|
| Rate for Payer: Healthscope Commercial |
$134.52
|
| Rate for Payer: Healthscope Whirlpool |
$130.48
|
| Rate for Payer: Humana Choice PPO Medicare |
$153.89
|
| Rate for Payer: Mclaren Commercial |
$121.07
|
| Rate for Payer: Mclaren Medicaid |
$82.49
|
| Rate for Payer: Mclaren Medicare |
$153.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$161.58
|
| Rate for Payer: Meridian Medicaid |
$86.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$176.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$114.34
|
| Rate for Payer: Nomi Health Commercial |
$110.31
|
| Rate for Payer: PACE Medicare |
$146.20
|
| Rate for Payer: PACE SWMI |
$153.89
|
| Rate for Payer: PHP Commercial |
$169.28
|
| Rate for Payer: PHP Medicaid |
$82.49
|
| Rate for Payer: PHP Medicare Advantage |
$153.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$87.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$117.87
|
| Rate for Payer: Priority Health Medicare |
$153.89
|
| Rate for Payer: Priority Health Narrow Network |
$94.30
|
| Rate for Payer: Railroad Medicare Medicare |
$153.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$118.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.89
|
| Rate for Payer: UHC Exchange |
$238.53
|
| Rate for Payer: UHC Medicare Advantage |
$153.89
|
| Rate for Payer: UHCCP DNSP |
$153.89
|
| Rate for Payer: UHCCP Medicaid |
$82.49
|
| Rate for Payer: VA VA |
$153.89
|
|
|
HC STRAPPING CASTING UNLISTED
|
Facility
|
IP
|
$232.22
|
|
|
Service Code
|
CPT 29799
|
| Hospital Charge Code |
42000053
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$150.94 |
| Max. Negotiated Rate |
$232.22 |
| Rate for Payer: Aetna Commercial |
$209.00
|
| Rate for Payer: ASR ASR |
$225.25
|
| Rate for Payer: ASR Commercial |
$225.25
|
| Rate for Payer: BCBS Trust/PPO |
$189.24
|
| Rate for Payer: BCN Commercial |
$180.04
|
| Rate for Payer: Cash Price |
$185.78
|
| Rate for Payer: Cofinity Commercial |
$218.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$185.78
|
| Rate for Payer: Healthscope Commercial |
$232.22
|
| Rate for Payer: Healthscope Whirlpool |
$225.25
|
| Rate for Payer: Mclaren Commercial |
$209.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$197.39
|
| Rate for Payer: Nomi Health Commercial |
$190.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$150.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$204.35
|
|
|
HC STRAPPING CASTING UNLISTED
|
Facility
|
OP
|
$232.22
|
|
|
Service Code
|
CPT 29799
|
| Hospital Charge Code |
42000053
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$82.49 |
| Max. Negotiated Rate |
$238.53 |
| Rate for Payer: Aetna Commercial |
$209.00
|
| Rate for Payer: Aetna Medicare |
$153.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$192.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$192.36
|
| Rate for Payer: ASR ASR |
$225.25
|
| Rate for Payer: ASR Commercial |
$225.25
|
| Rate for Payer: BCBS Complete |
$86.61
|
| Rate for Payer: BCBS MAPPO |
$153.89
|
| Rate for Payer: BCBS Trust/PPO |
$190.16
|
| Rate for Payer: BCN Commercial |
$180.04
|
| Rate for Payer: BCN Medicare Advantage |
$153.89
|
| Rate for Payer: Cash Price |
$185.78
|
| Rate for Payer: Cash Price |
$185.78
|
| Rate for Payer: Cofinity Commercial |
$218.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$185.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.89
|
| Rate for Payer: Healthscope Commercial |
$232.22
|
| Rate for Payer: Healthscope Whirlpool |
$225.25
|
| Rate for Payer: Humana Choice PPO Medicare |
$153.89
|
| Rate for Payer: Mclaren Commercial |
$209.00
|
| Rate for Payer: Mclaren Medicaid |
$82.49
|
| Rate for Payer: Mclaren Medicare |
$153.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$161.58
|
| Rate for Payer: Meridian Medicaid |
$86.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$176.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$197.39
|
| Rate for Payer: Nomi Health Commercial |
$190.42
|
| Rate for Payer: PACE Medicare |
$146.20
|
| Rate for Payer: PACE SWMI |
$153.89
|
| Rate for Payer: PHP Commercial |
$169.28
|
| Rate for Payer: PHP Medicaid |
$82.49
|
| Rate for Payer: PHP Medicare Advantage |
$153.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$150.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$203.47
|
| Rate for Payer: Priority Health Medicare |
$153.89
|
| Rate for Payer: Priority Health Narrow Network |
$162.79
|
| Rate for Payer: Railroad Medicare Medicare |
$153.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$204.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.89
|
| Rate for Payer: UHC Exchange |
$238.53
|
| Rate for Payer: UHC Medicare Advantage |
$153.89
|
| Rate for Payer: UHCCP DNSP |
$153.89
|
| Rate for Payer: UHCCP Medicaid |
$82.49
|
| Rate for Payer: VA VA |
$153.89
|
|
|
HC STRAPPING CHEST KINESIOTAPING
|
Facility
|
OP
|
$121.67
|
|
|
Service Code
|
CPT 29200
|
| Hospital Charge Code |
42000052
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$79.09 |
| Max. Negotiated Rate |
$238.53 |
| Rate for Payer: Aetna Commercial |
$109.50
|
| Rate for Payer: Aetna Medicare |
$153.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$192.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$192.36
|
| Rate for Payer: ASR ASR |
$118.02
|
| Rate for Payer: ASR Commercial |
$118.02
|
| Rate for Payer: BCBS Complete |
$86.61
|
| Rate for Payer: BCBS MAPPO |
$153.89
|
| Rate for Payer: BCBS Trust/PPO |
$99.64
|
| Rate for Payer: BCN Commercial |
$94.33
|
| Rate for Payer: BCN Medicare Advantage |
$153.89
|
| Rate for Payer: Cash Price |
$97.34
|
| Rate for Payer: Cash Price |
$97.34
|
| Rate for Payer: Cofinity Commercial |
$114.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.89
|
| Rate for Payer: Healthscope Commercial |
$121.67
|
| Rate for Payer: Healthscope Whirlpool |
$118.02
|
| Rate for Payer: Humana Choice PPO Medicare |
$153.89
|
| Rate for Payer: Mclaren Commercial |
$109.50
|
| Rate for Payer: Mclaren Medicaid |
$82.49
|
| Rate for Payer: Mclaren Medicare |
$153.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$161.58
|
| Rate for Payer: Meridian Medicaid |
$86.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$176.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$103.42
|
| Rate for Payer: Nomi Health Commercial |
$99.77
|
| Rate for Payer: PACE Medicare |
$146.20
|
| Rate for Payer: PACE SWMI |
$153.89
|
| Rate for Payer: PHP Commercial |
$169.28
|
| Rate for Payer: PHP Medicaid |
$82.49
|
| Rate for Payer: PHP Medicare Advantage |
$153.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$106.61
|
| Rate for Payer: Priority Health Medicare |
$153.89
|
| Rate for Payer: Priority Health Narrow Network |
$85.29
|
| Rate for Payer: Railroad Medicare Medicare |
$153.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$107.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.89
|
| Rate for Payer: UHC Exchange |
$238.53
|
| Rate for Payer: UHC Medicare Advantage |
$153.89
|
| Rate for Payer: UHCCP DNSP |
$153.89
|
| Rate for Payer: UHCCP Medicaid |
$82.49
|
| Rate for Payer: VA VA |
$153.89
|
|
|
HC STRAPPING CHEST KINESIOTAPING
|
Facility
|
IP
|
$121.67
|
|
|
Service Code
|
CPT 29200
|
| Hospital Charge Code |
42000052
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$79.09 |
| Max. Negotiated Rate |
$121.67 |
| Rate for Payer: Aetna Commercial |
$109.50
|
| Rate for Payer: ASR ASR |
$118.02
|
| Rate for Payer: ASR Commercial |
$118.02
|
| Rate for Payer: BCBS Trust/PPO |
$99.15
|
| Rate for Payer: BCN Commercial |
$94.33
|
| Rate for Payer: Cash Price |
$97.34
|
| Rate for Payer: Cofinity Commercial |
$114.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.34
|
| Rate for Payer: Healthscope Commercial |
$121.67
|
| Rate for Payer: Healthscope Whirlpool |
$118.02
|
| Rate for Payer: Mclaren Commercial |
$109.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$103.42
|
| Rate for Payer: Nomi Health Commercial |
$99.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$107.07
|
|
|
HC STRAPPING ELBOW OR WRIST
|
Facility
|
IP
|
$98.84
|
|
|
Service Code
|
CPT 29260
|
| Hospital Charge Code |
42000002
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$64.25 |
| Max. Negotiated Rate |
$98.84 |
| Rate for Payer: Aetna Commercial |
$88.96
|
| Rate for Payer: ASR ASR |
$95.87
|
| Rate for Payer: ASR Commercial |
$95.87
|
| Rate for Payer: BCBS Trust/PPO |
$80.54
|
| Rate for Payer: BCN Commercial |
$76.63
|
| Rate for Payer: Cash Price |
$79.07
|
| Rate for Payer: Cofinity Commercial |
$92.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.07
|
| Rate for Payer: Healthscope Commercial |
$98.84
|
| Rate for Payer: Healthscope Whirlpool |
$95.87
|
| Rate for Payer: Mclaren Commercial |
$88.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.01
|
| Rate for Payer: Nomi Health Commercial |
$81.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$86.98
|
|
|
HC STRAPPING ELBOW OR WRIST
|
Facility
|
OP
|
$98.84
|
|
|
Service Code
|
CPT 29260
|
| Hospital Charge Code |
42000002
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$31.05 |
| Max. Negotiated Rate |
$98.84 |
| Rate for Payer: Aetna Commercial |
$88.96
|
| Rate for Payer: Aetna Medicare |
$57.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$72.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$72.41
|
| Rate for Payer: ASR ASR |
$95.87
|
| Rate for Payer: ASR Commercial |
$95.87
|
| Rate for Payer: BCBS Complete |
$32.60
|
| Rate for Payer: BCBS MAPPO |
$57.93
|
| Rate for Payer: BCBS Trust/PPO |
$80.94
|
| Rate for Payer: BCN Commercial |
$76.63
|
| Rate for Payer: BCN Medicare Advantage |
$57.93
|
| Rate for Payer: Cash Price |
$79.07
|
| Rate for Payer: Cash Price |
$79.07
|
| Rate for Payer: Cofinity Commercial |
$92.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.93
|
| Rate for Payer: Healthscope Commercial |
$98.84
|
| Rate for Payer: Healthscope Whirlpool |
$95.87
|
| Rate for Payer: Humana Choice PPO Medicare |
$57.93
|
| Rate for Payer: Mclaren Commercial |
$88.96
|
| Rate for Payer: Mclaren Medicaid |
$31.05
|
| Rate for Payer: Mclaren Medicare |
$57.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$60.83
|
| Rate for Payer: Meridian Medicaid |
$32.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$66.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.01
|
| Rate for Payer: Nomi Health Commercial |
$81.05
|
| Rate for Payer: PACE Medicare |
$55.03
|
| Rate for Payer: PACE SWMI |
$57.93
|
| Rate for Payer: PHP Commercial |
$63.72
|
| Rate for Payer: PHP Medicaid |
$31.05
|
| Rate for Payer: PHP Medicare Advantage |
$57.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$86.60
|
| Rate for Payer: Priority Health Medicare |
$57.93
|
| Rate for Payer: Priority Health Narrow Network |
$69.29
|
| Rate for Payer: Railroad Medicare Medicare |
$57.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$86.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$57.93
|
| Rate for Payer: UHC Exchange |
$89.79
|
| Rate for Payer: UHC Medicare Advantage |
$57.93
|
| Rate for Payer: UHCCP DNSP |
$57.93
|
| Rate for Payer: UHCCP Medicaid |
$31.05
|
| Rate for Payer: VA VA |
$57.93
|
|
|
HC STRAPPING HAND OR FINGER
|
Facility
|
OP
|
$111.05
|
|
|
Service Code
|
CPT 29280
|
| Hospital Charge Code |
43000006
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$31.05 |
| Max. Negotiated Rate |
$111.05 |
| Rate for Payer: Aetna Commercial |
$99.94
|
| Rate for Payer: Aetna Medicare |
$57.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$72.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$72.41
|
| Rate for Payer: ASR ASR |
$107.72
|
| Rate for Payer: ASR Commercial |
$107.72
|
| Rate for Payer: BCBS Complete |
$32.60
|
| Rate for Payer: BCBS MAPPO |
$57.93
|
| Rate for Payer: BCBS Trust/PPO |
$90.94
|
| Rate for Payer: BCN Commercial |
$86.10
|
| Rate for Payer: BCN Medicare Advantage |
$57.93
|
| Rate for Payer: Cash Price |
$88.84
|
| Rate for Payer: Cash Price |
$88.84
|
| Rate for Payer: Cofinity Commercial |
$104.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.93
|
| Rate for Payer: Healthscope Commercial |
$111.05
|
| Rate for Payer: Healthscope Whirlpool |
$107.72
|
| Rate for Payer: Humana Choice PPO Medicare |
$57.93
|
| Rate for Payer: Mclaren Commercial |
$99.94
|
| Rate for Payer: Mclaren Medicaid |
$31.05
|
| Rate for Payer: Mclaren Medicare |
$57.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$60.83
|
| Rate for Payer: Meridian Medicaid |
$32.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$66.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.39
|
| Rate for Payer: Nomi Health Commercial |
$91.06
|
| Rate for Payer: PACE Medicare |
$55.03
|
| Rate for Payer: PACE SWMI |
$57.93
|
| Rate for Payer: PHP Commercial |
$63.72
|
| Rate for Payer: PHP Medicaid |
$31.05
|
| Rate for Payer: PHP Medicare Advantage |
$57.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$97.30
|
| Rate for Payer: Priority Health Medicare |
$57.93
|
| Rate for Payer: Priority Health Narrow Network |
$77.85
|
| Rate for Payer: Railroad Medicare Medicare |
$57.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$97.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$57.93
|
| Rate for Payer: UHC Exchange |
$89.79
|
| Rate for Payer: UHC Medicare Advantage |
$57.93
|
| Rate for Payer: UHCCP DNSP |
$57.93
|
| Rate for Payer: UHCCP Medicaid |
$31.05
|
| Rate for Payer: VA VA |
$57.93
|
|
|
HC STRAPPING HAND OR FINGER
|
Facility
|
IP
|
$111.05
|
|
|
Service Code
|
CPT 29280
|
| Hospital Charge Code |
43000006
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$72.18 |
| Max. Negotiated Rate |
$111.05 |
| Rate for Payer: Aetna Commercial |
$99.94
|
| Rate for Payer: ASR ASR |
$107.72
|
| Rate for Payer: ASR Commercial |
$107.72
|
| Rate for Payer: BCBS Trust/PPO |
$90.49
|
| Rate for Payer: BCN Commercial |
$86.10
|
| Rate for Payer: Cash Price |
$88.84
|
| Rate for Payer: Cofinity Commercial |
$104.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.84
|
| Rate for Payer: Healthscope Commercial |
$111.05
|
| Rate for Payer: Healthscope Whirlpool |
$107.72
|
| Rate for Payer: Mclaren Commercial |
$99.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.39
|
| Rate for Payer: Nomi Health Commercial |
$91.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$97.72
|
|
|
HC STRAPPING HIP
|
Facility
|
OP
|
$123.37
|
|
|
Service Code
|
CPT 29520
|
| Hospital Charge Code |
42000003
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$67.38 |
| Max. Negotiated Rate |
$194.85 |
| Rate for Payer: Aetna Commercial |
$111.03
|
| Rate for Payer: Aetna Medicare |
$125.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.14
|
| Rate for Payer: ASR ASR |
$119.67
|
| Rate for Payer: ASR Commercial |
$119.67
|
| Rate for Payer: BCBS Complete |
$70.75
|
| Rate for Payer: BCBS MAPPO |
$125.71
|
| Rate for Payer: BCBS Trust/PPO |
$101.03
|
| Rate for Payer: BCN Commercial |
$95.65
|
| Rate for Payer: BCN Medicare Advantage |
$125.71
|
| Rate for Payer: Cash Price |
$98.70
|
| Rate for Payer: Cash Price |
$98.70
|
| Rate for Payer: Cofinity Commercial |
$115.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$98.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.71
|
| Rate for Payer: Healthscope Commercial |
$123.37
|
| Rate for Payer: Healthscope Whirlpool |
$119.67
|
| Rate for Payer: Humana Choice PPO Medicare |
$125.71
|
| Rate for Payer: Mclaren Commercial |
$111.03
|
| Rate for Payer: Mclaren Medicaid |
$67.38
|
| Rate for Payer: Mclaren Medicare |
$125.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.00
|
| Rate for Payer: Meridian Medicaid |
$70.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$144.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.86
|
| Rate for Payer: Nomi Health Commercial |
$101.16
|
| Rate for Payer: PACE Medicare |
$119.42
|
| Rate for Payer: PACE SWMI |
$125.71
|
| Rate for Payer: PHP Commercial |
$138.28
|
| Rate for Payer: PHP Medicaid |
$67.38
|
| Rate for Payer: PHP Medicare Advantage |
$125.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$108.10
|
| Rate for Payer: Priority Health Medicare |
$125.71
|
| Rate for Payer: Priority Health Narrow Network |
$86.48
|
| Rate for Payer: Railroad Medicare Medicare |
$125.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$108.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.71
|
| Rate for Payer: UHC Exchange |
$194.85
|
| Rate for Payer: UHC Medicare Advantage |
$125.71
|
| Rate for Payer: UHCCP DNSP |
$125.71
|
| Rate for Payer: UHCCP Medicaid |
$67.38
|
| Rate for Payer: VA VA |
$125.71
|
|
|
HC STRAPPING HIP
|
Facility
|
IP
|
$123.37
|
|
|
Service Code
|
CPT 29520
|
| Hospital Charge Code |
42000003
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$80.19 |
| Max. Negotiated Rate |
$123.37 |
| Rate for Payer: Aetna Commercial |
$111.03
|
| Rate for Payer: ASR ASR |
$119.67
|
| Rate for Payer: ASR Commercial |
$119.67
|
| Rate for Payer: BCBS Trust/PPO |
$100.53
|
| Rate for Payer: BCN Commercial |
$95.65
|
| Rate for Payer: Cash Price |
$98.70
|
| Rate for Payer: Cofinity Commercial |
$115.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$98.70
|
| Rate for Payer: Healthscope Commercial |
$123.37
|
| Rate for Payer: Healthscope Whirlpool |
$119.67
|
| Rate for Payer: Mclaren Commercial |
$111.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.86
|
| Rate for Payer: Nomi Health Commercial |
$101.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$108.57
|
|
|
HC STRAPPING KNEE
|
Facility
|
IP
|
$156.06
|
|
|
Service Code
|
CPT 29530
|
| Hospital Charge Code |
42000004
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$101.44 |
| Max. Negotiated Rate |
$156.06 |
| Rate for Payer: Aetna Commercial |
$140.45
|
| Rate for Payer: ASR ASR |
$151.38
|
| Rate for Payer: ASR Commercial |
$151.38
|
| Rate for Payer: BCBS Trust/PPO |
$127.17
|
| Rate for Payer: BCN Commercial |
$120.99
|
| Rate for Payer: Cash Price |
$124.85
|
| Rate for Payer: Cofinity Commercial |
$146.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.85
|
| Rate for Payer: Healthscope Commercial |
$156.06
|
| Rate for Payer: Healthscope Whirlpool |
$151.38
|
| Rate for Payer: Mclaren Commercial |
$140.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132.65
|
| Rate for Payer: Nomi Health Commercial |
$127.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$101.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$137.33
|
|
|
HC STRAPPING KNEE
|
Facility
|
OP
|
$156.06
|
|
|
Service Code
|
CPT 29530
|
| Hospital Charge Code |
42000004
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$67.38 |
| Max. Negotiated Rate |
$194.85 |
| Rate for Payer: Aetna Commercial |
$140.45
|
| Rate for Payer: Aetna Medicare |
$125.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.14
|
| Rate for Payer: ASR ASR |
$151.38
|
| Rate for Payer: ASR Commercial |
$151.38
|
| Rate for Payer: BCBS Complete |
$70.75
|
| Rate for Payer: BCBS MAPPO |
$125.71
|
| Rate for Payer: BCBS Trust/PPO |
$127.80
|
| Rate for Payer: BCN Commercial |
$120.99
|
| Rate for Payer: BCN Medicare Advantage |
$125.71
|
| Rate for Payer: Cash Price |
$124.85
|
| Rate for Payer: Cash Price |
$124.85
|
| Rate for Payer: Cofinity Commercial |
$146.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.71
|
| Rate for Payer: Healthscope Commercial |
$156.06
|
| Rate for Payer: Healthscope Whirlpool |
$151.38
|
| Rate for Payer: Humana Choice PPO Medicare |
$125.71
|
| Rate for Payer: Mclaren Commercial |
$140.45
|
| Rate for Payer: Mclaren Medicaid |
$67.38
|
| Rate for Payer: Mclaren Medicare |
$125.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.00
|
| Rate for Payer: Meridian Medicaid |
$70.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$144.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132.65
|
| Rate for Payer: Nomi Health Commercial |
$127.97
|
| Rate for Payer: PACE Medicare |
$119.42
|
| Rate for Payer: PACE SWMI |
$125.71
|
| Rate for Payer: PHP Commercial |
$138.28
|
| Rate for Payer: PHP Medicaid |
$67.38
|
| Rate for Payer: PHP Medicare Advantage |
$125.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$101.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$136.74
|
| Rate for Payer: Priority Health Medicare |
$125.71
|
| Rate for Payer: Priority Health Narrow Network |
$109.40
|
| Rate for Payer: Railroad Medicare Medicare |
$125.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$137.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.71
|
| Rate for Payer: UHC Exchange |
$194.85
|
| Rate for Payer: UHC Medicare Advantage |
$125.71
|
| Rate for Payer: UHCCP DNSP |
$125.71
|
| Rate for Payer: UHCCP Medicaid |
$67.38
|
| Rate for Payer: VA VA |
$125.71
|
|
|
HC STRAPPING SHOULDER
|
Facility
|
IP
|
$108.72
|
|
|
Service Code
|
CPT 29240
|
| Hospital Charge Code |
42000001
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$70.67 |
| Max. Negotiated Rate |
$108.72 |
| Rate for Payer: Aetna Commercial |
$97.85
|
| Rate for Payer: ASR ASR |
$105.46
|
| Rate for Payer: ASR Commercial |
$105.46
|
| Rate for Payer: BCBS Trust/PPO |
$88.60
|
| Rate for Payer: BCN Commercial |
$84.29
|
| Rate for Payer: Cash Price |
$86.98
|
| Rate for Payer: Cofinity Commercial |
$102.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.98
|
| Rate for Payer: Healthscope Commercial |
$108.72
|
| Rate for Payer: Healthscope Whirlpool |
$105.46
|
| Rate for Payer: Mclaren Commercial |
$97.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$92.41
|
| Rate for Payer: Nomi Health Commercial |
$89.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$95.67
|
|
|
HC STRAPPING SHOULDER
|
Facility
|
OP
|
$108.72
|
|
|
Service Code
|
CPT 29240
|
| Hospital Charge Code |
42000001
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$67.38 |
| Max. Negotiated Rate |
$194.85 |
| Rate for Payer: Aetna Commercial |
$97.85
|
| Rate for Payer: Aetna Medicare |
$125.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.14
|
| Rate for Payer: ASR ASR |
$105.46
|
| Rate for Payer: ASR Commercial |
$105.46
|
| Rate for Payer: BCBS Complete |
$70.75
|
| Rate for Payer: BCBS MAPPO |
$125.71
|
| Rate for Payer: BCBS Trust/PPO |
$89.03
|
| Rate for Payer: BCN Commercial |
$84.29
|
| Rate for Payer: BCN Medicare Advantage |
$125.71
|
| Rate for Payer: Cash Price |
$86.98
|
| Rate for Payer: Cash Price |
$86.98
|
| Rate for Payer: Cofinity Commercial |
$102.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.71
|
| Rate for Payer: Healthscope Commercial |
$108.72
|
| Rate for Payer: Healthscope Whirlpool |
$105.46
|
| Rate for Payer: Humana Choice PPO Medicare |
$125.71
|
| Rate for Payer: Mclaren Commercial |
$97.85
|
| Rate for Payer: Mclaren Medicaid |
$67.38
|
| Rate for Payer: Mclaren Medicare |
$125.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.00
|
| Rate for Payer: Meridian Medicaid |
$70.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$144.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$92.41
|
| Rate for Payer: Nomi Health Commercial |
$89.15
|
| Rate for Payer: PACE Medicare |
$119.42
|
| Rate for Payer: PACE SWMI |
$125.71
|
| Rate for Payer: PHP Commercial |
$138.28
|
| Rate for Payer: PHP Medicaid |
$67.38
|
| Rate for Payer: PHP Medicare Advantage |
$125.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.67
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$95.26
|
| Rate for Payer: Priority Health Medicare |
$125.71
|
| Rate for Payer: Priority Health Narrow Network |
$76.21
|
| Rate for Payer: Railroad Medicare Medicare |
$125.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$95.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.71
|
| Rate for Payer: UHC Exchange |
$194.85
|
| Rate for Payer: UHC Medicare Advantage |
$125.71
|
| Rate for Payer: UHCCP DNSP |
$125.71
|
| Rate for Payer: UHCCP Medicaid |
$67.38
|
| Rate for Payer: VA VA |
$125.71
|
|
|
HC STRAPPING TOES
|
Facility
|
IP
|
$188.62
|
|
|
Service Code
|
CPT 29550
|
| Hospital Charge Code |
45000001
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$122.60 |
| Max. Negotiated Rate |
$188.62 |
| Rate for Payer: Aetna Commercial |
$169.76
|
| Rate for Payer: ASR ASR |
$182.96
|
| Rate for Payer: ASR Commercial |
$182.96
|
| Rate for Payer: BCBS Trust/PPO |
$153.71
|
| Rate for Payer: BCN Commercial |
$146.24
|
| Rate for Payer: Cash Price |
$150.90
|
| Rate for Payer: Cofinity Commercial |
$177.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$150.90
|
| Rate for Payer: Healthscope Commercial |
$188.62
|
| Rate for Payer: Healthscope Whirlpool |
$182.96
|
| Rate for Payer: Mclaren Commercial |
$169.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$160.33
|
| Rate for Payer: Nomi Health Commercial |
$154.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$122.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$165.99
|
|
|
HC STRAPPING TOES
|
Facility
|
OP
|
$188.62
|
|
|
Service Code
|
CPT 29550
|
| Hospital Charge Code |
45000001
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$31.05 |
| Max. Negotiated Rate |
$188.62 |
| Rate for Payer: Aetna Commercial |
$169.76
|
| Rate for Payer: Aetna Medicare |
$57.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$72.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$72.41
|
| Rate for Payer: ASR ASR |
$182.96
|
| Rate for Payer: ASR Commercial |
$182.96
|
| Rate for Payer: BCBS Complete |
$32.60
|
| Rate for Payer: BCBS MAPPO |
$57.93
|
| Rate for Payer: BCBS Trust/PPO |
$154.46
|
| Rate for Payer: BCN Commercial |
$146.24
|
| Rate for Payer: BCN Medicare Advantage |
$57.93
|
| Rate for Payer: Cash Price |
$150.90
|
| Rate for Payer: Cash Price |
$150.90
|
| Rate for Payer: Cofinity Commercial |
$177.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$150.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.93
|
| Rate for Payer: Healthscope Commercial |
$188.62
|
| Rate for Payer: Healthscope Whirlpool |
$182.96
|
| Rate for Payer: Humana Choice PPO Medicare |
$57.93
|
| Rate for Payer: Mclaren Commercial |
$169.76
|
| Rate for Payer: Mclaren Medicaid |
$31.05
|
| Rate for Payer: Mclaren Medicare |
$57.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$60.83
|
| Rate for Payer: Meridian Medicaid |
$32.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$66.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$160.33
|
| Rate for Payer: Nomi Health Commercial |
$154.67
|
| Rate for Payer: PACE Medicare |
$55.03
|
| Rate for Payer: PACE SWMI |
$57.93
|
| Rate for Payer: PHP Commercial |
$63.72
|
| Rate for Payer: PHP Medicaid |
$31.05
|
| Rate for Payer: PHP Medicare Advantage |
$57.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$122.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$165.27
|
| Rate for Payer: Priority Health Medicare |
$57.93
|
| Rate for Payer: Priority Health Narrow Network |
$132.22
|
| Rate for Payer: Railroad Medicare Medicare |
$57.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$165.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$57.93
|
| Rate for Payer: UHC Exchange |
$89.79
|
| Rate for Payer: UHC Medicare Advantage |
$57.93
|
| Rate for Payer: UHCCP DNSP |
$57.93
|
| Rate for Payer: UHCCP Medicaid |
$31.05
|
| Rate for Payer: VA VA |
$57.93
|
|
|
HC STRAWBERRY ALLERGEN
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200124
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$25.39 |
| Rate for Payer: Aetna Commercial |
$22.85
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: ASR ASR |
$24.63
|
| Rate for Payer: ASR Commercial |
$24.63
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$20.79
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$23.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$25.39
|
| Rate for Payer: Healthscope Whirlpool |
$24.63
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$22.85
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$5.74
|
| Rate for Payer: PHP Medicaid |
$2.80
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.25
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$17.80
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP DNSP |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.80
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC STRAWBERRY ALLERGEN
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200124
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$25.39 |
| Rate for Payer: Aetna Commercial |
$22.85
|
| Rate for Payer: ASR ASR |
$24.63
|
| Rate for Payer: ASR Commercial |
$24.63
|
| Rate for Payer: BCBS Trust/PPO |
$20.69
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$23.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$25.39
|
| Rate for Payer: Healthscope Whirlpool |
$24.63
|
| Rate for Payer: Mclaren Commercial |
$22.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.34
|
|
|
HC STREP A PCR
|
Facility
|
OP
|
$78.03
|
|
|
Service Code
|
CPT 87651
|
| Hospital Charge Code |
30600288
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$78.03 |
| Rate for Payer: Aetna Commercial |
$70.23
|
| 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 |
$75.69
|
| Rate for Payer: ASR Commercial |
$75.69
|
| Rate for Payer: BCBS Complete |
$19.75
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$63.90
|
| Rate for Payer: BCN Commercial |
$60.50
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Commercial |
$73.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$78.03
|
| Rate for Payer: Healthscope Whirlpool |
$75.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$70.23
|
| 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 |
$66.33
|
| Rate for Payer: Nomi Health Commercial |
$63.98
|
| 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 |
$50.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$68.37
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$54.70
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$68.67
|
| 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 STREP A PCR
|
Facility
|
IP
|
$78.03
|
|
|
Service Code
|
CPT 87651
|
| Hospital Charge Code |
30600288
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$50.72 |
| Max. Negotiated Rate |
$78.03 |
| Rate for Payer: Aetna Commercial |
$70.23
|
| Rate for Payer: ASR ASR |
$75.69
|
| Rate for Payer: ASR Commercial |
$75.69
|
| Rate for Payer: BCBS Trust/PPO |
$63.59
|
| Rate for Payer: BCN Commercial |
$60.50
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Commercial |
$73.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Healthscope Commercial |
$78.03
|
| Rate for Payer: Healthscope Whirlpool |
$75.69
|
| Rate for Payer: Mclaren Commercial |
$70.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Nomi Health Commercial |
$63.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$68.67
|
|
|
HC STREP PNEUMONIAE ANTIGEN
|
Facility
|
OP
|
$80.53
|
|
|
Service Code
|
CPT 87449
|
| Hospital Charge Code |
30600147
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.42 |
| Max. Negotiated Rate |
$80.53 |
| Rate for Payer: Aetna Commercial |
$72.48
|
| Rate for Payer: Aetna Medicare |
$11.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.97
|
| Rate for Payer: ASR ASR |
$78.11
|
| Rate for Payer: ASR Commercial |
$78.11
|
| Rate for Payer: BCBS Complete |
$6.74
|
| Rate for Payer: BCBS MAPPO |
$11.98
|
| Rate for Payer: BCBS Trust/PPO |
$65.95
|
| Rate for Payer: BCN Commercial |
$62.43
|
| Rate for Payer: BCN Medicare Advantage |
$11.98
|
| Rate for Payer: Cash Price |
$64.42
|
| Rate for Payer: Cash Price |
$64.42
|
| Rate for Payer: Cofinity Commercial |
$75.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.98
|
| Rate for Payer: Healthscope Commercial |
$80.53
|
| Rate for Payer: Healthscope Whirlpool |
$78.11
|
| Rate for Payer: Humana Choice PPO Medicare |
$11.98
|
| Rate for Payer: Mclaren Commercial |
$72.48
|
| Rate for Payer: Mclaren Medicaid |
$6.42
|
| Rate for Payer: Mclaren Medicare |
$11.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.58
|
| Rate for Payer: Meridian Medicaid |
$6.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.45
|
| Rate for Payer: Nomi Health Commercial |
$66.03
|
| Rate for Payer: PACE Medicare |
$11.38
|
| Rate for Payer: PACE SWMI |
$11.98
|
| Rate for Payer: PHP Commercial |
$13.18
|
| Rate for Payer: PHP Medicaid |
$6.42
|
| Rate for Payer: PHP Medicare Advantage |
$11.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$70.56
|
| Rate for Payer: Priority Health Medicare |
$11.98
|
| Rate for Payer: Priority Health Narrow Network |
$56.45
|
| Rate for Payer: Railroad Medicare Medicare |
$11.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$70.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.98
|
| Rate for Payer: UHC Exchange |
$18.57
|
| Rate for Payer: UHC Medicare Advantage |
$11.98
|
| Rate for Payer: UHCCP DNSP |
$11.98
|
| Rate for Payer: UHCCP Medicaid |
$6.42
|
| Rate for Payer: VA VA |
$11.98
|
|
