|
HC STRAPPING KNEE
|
Facility
|
OP
|
$156.06
|
|
|
Service Code
|
CPT 29530
|
| Hospital Charge Code |
42000004
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$67.69 |
| Max. Negotiated Rate |
$195.75 |
| Rate for Payer: Aetna Commercial |
$140.45
|
| 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 |
$151.38
|
| Rate for Payer: ASR Commercial |
$151.38
|
| Rate for Payer: BCBS Complete |
$71.08
|
| Rate for Payer: BCBS MAPPO |
$126.29
|
| Rate for Payer: BCBS Trust/PPO |
$127.80
|
| Rate for Payer: BCN Commercial |
$120.99
|
| Rate for Payer: BCN Medicare Advantage |
$126.29
|
| 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 |
$126.29
|
| Rate for Payer: Healthscope Commercial |
$156.06
|
| Rate for Payer: Healthscope Whirlpool |
$151.38
|
| Rate for Payer: Humana Choice PPO Medicare |
$126.29
|
| Rate for Payer: Mclaren Commercial |
$140.45
|
| 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 |
$132.65
|
| Rate for Payer: Nomi Health Commercial |
$127.97
|
| 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 |
$101.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$169.09
|
| Rate for Payer: Priority Health Medicare |
$126.29
|
| Rate for Payer: Priority Health Narrow Network |
$135.27
|
| Rate for Payer: Railroad Medicare Medicare |
$126.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$137.33
|
| 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 STRAPPING SHOULDER
|
Facility
|
OP
|
$108.72
|
|
|
Service Code
|
CPT 29240
|
| Hospital Charge Code |
42000001
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$67.69 |
| Max. Negotiated Rate |
$195.75 |
| Rate for Payer: Aetna Commercial |
$97.85
|
| 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 |
$105.46
|
| Rate for Payer: ASR Commercial |
$105.46
|
| Rate for Payer: BCBS Complete |
$71.08
|
| Rate for Payer: BCBS MAPPO |
$126.29
|
| Rate for Payer: BCBS Trust/PPO |
$89.03
|
| Rate for Payer: BCN Commercial |
$84.29
|
| Rate for Payer: BCN Medicare Advantage |
$126.29
|
| 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 |
$126.29
|
| Rate for Payer: Healthscope Commercial |
$108.72
|
| Rate for Payer: Healthscope Whirlpool |
$105.46
|
| Rate for Payer: Humana Choice PPO Medicare |
$126.29
|
| Rate for Payer: Mclaren Commercial |
$97.85
|
| 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 |
$92.41
|
| Rate for Payer: Nomi Health Commercial |
$89.15
|
| 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 |
$70.67
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$169.09
|
| Rate for Payer: Priority Health Medicare |
$126.29
|
| Rate for Payer: Priority Health Narrow Network |
$135.27
|
| Rate for Payer: Railroad Medicare Medicare |
$126.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$95.67
|
| 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 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 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 |
$31.20 |
| Max. Negotiated Rate |
$188.62 |
| Rate for Payer: Aetna Commercial |
$169.76
|
| 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 |
$182.96
|
| Rate for Payer: ASR Commercial |
$182.96
|
| Rate for Payer: BCBS Complete |
$32.75
|
| Rate for Payer: BCBS MAPPO |
$58.20
|
| Rate for Payer: BCBS Trust/PPO |
$154.46
|
| Rate for Payer: BCN Commercial |
$146.24
|
| Rate for Payer: BCN Medicare Advantage |
$58.20
|
| 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 |
$58.20
|
| Rate for Payer: Healthscope Commercial |
$188.62
|
| Rate for Payer: Healthscope Whirlpool |
$182.96
|
| Rate for Payer: Humana Choice PPO Medicare |
$58.20
|
| Rate for Payer: Mclaren Commercial |
$169.76
|
| 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 |
$160.33
|
| Rate for Payer: Nomi Health Commercial |
$154.67
|
| 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 |
$122.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$171.81
|
| Rate for Payer: Priority Health Medicare |
$58.20
|
| Rate for Payer: Priority Health Narrow Network |
$137.45
|
| Rate for Payer: Railroad Medicare Medicare |
$58.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$165.99
|
| 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 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 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 |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| 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 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 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 PNEUMONIAE ANTIGEN
|
Facility
|
IP
|
$80.53
|
|
|
Service Code
|
CPT 87449
|
| Hospital Charge Code |
30600147
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$52.34 |
| Max. Negotiated Rate |
$80.53 |
| Rate for Payer: Aetna Commercial |
$72.48
|
| Rate for Payer: ASR ASR |
$78.11
|
| Rate for Payer: ASR Commercial |
$78.11
|
| Rate for Payer: BCBS Trust/PPO |
$65.62
|
| Rate for Payer: BCN Commercial |
$62.43
|
| 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: Healthscope Commercial |
$80.53
|
| Rate for Payer: Healthscope Whirlpool |
$78.11
|
| Rate for Payer: Mclaren Commercial |
$72.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.45
|
| Rate for Payer: Nomi Health Commercial |
$66.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$70.87
|
|
|
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 |
$14.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.98
|
| 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
|
|
|
HC STREP PNEUMONIAE IGG 7 CMPTS
|
Facility
|
IP
|
$20.81
|
|
|
Service Code
|
CPT 86317
|
| Hospital Charge Code |
30200361
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.53 |
| Max. Negotiated Rate |
$20.81 |
| Rate for Payer: Aetna Commercial |
$18.73
|
| Rate for Payer: ASR ASR |
$20.19
|
| Rate for Payer: ASR Commercial |
$20.19
|
| Rate for Payer: BCBS Trust/PPO |
$16.96
|
| Rate for Payer: BCN Commercial |
$16.13
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$19.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Healthscope Commercial |
$20.81
|
| Rate for Payer: Healthscope Whirlpool |
$20.19
|
| Rate for Payer: Mclaren Commercial |
$18.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: Nomi Health Commercial |
$17.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.31
|
|
|
HC STREP PNEUMONIAE IGG 7 CMPTS
|
Facility
|
OP
|
$20.81
|
|
|
Service Code
|
CPT 86317
|
| Hospital Charge Code |
30200361
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.03 |
| Max. Negotiated Rate |
$23.23 |
| Rate for Payer: Aetna Commercial |
$18.73
|
| Rate for Payer: Aetna Medicare |
$14.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.74
|
| Rate for Payer: ASR ASR |
$20.19
|
| Rate for Payer: ASR Commercial |
$20.19
|
| Rate for Payer: BCBS Complete |
$8.44
|
| Rate for Payer: BCBS MAPPO |
$14.99
|
| Rate for Payer: BCBS Trust/PPO |
$17.04
|
| Rate for Payer: BCN Commercial |
$16.13
|
| Rate for Payer: BCN Medicare Advantage |
$14.99
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$19.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.99
|
| Rate for Payer: Healthscope Commercial |
$20.81
|
| Rate for Payer: Healthscope Whirlpool |
$20.19
|
| Rate for Payer: Humana Choice PPO Medicare |
$14.99
|
| Rate for Payer: Mclaren Commercial |
$18.73
|
| Rate for Payer: Mclaren Medicaid |
$8.03
|
| Rate for Payer: Mclaren Medicare |
$14.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.74
|
| Rate for Payer: Meridian Medicaid |
$8.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: Nomi Health Commercial |
$17.06
|
| Rate for Payer: PACE Medicare |
$14.24
|
| Rate for Payer: PACE SWMI |
$14.99
|
| Rate for Payer: PHP Commercial |
$16.49
|
| Rate for Payer: PHP Medicaid |
$8.03
|
| Rate for Payer: PHP Medicare Advantage |
$14.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.23
|
| Rate for Payer: Priority Health Medicare |
$14.99
|
| Rate for Payer: Priority Health Narrow Network |
$14.59
|
| Rate for Payer: Railroad Medicare Medicare |
$14.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.99
|
| Rate for Payer: UHC Exchange |
$23.23
|
| Rate for Payer: UHC Medicare Advantage |
$14.99
|
| Rate for Payer: UHCCP DNSP |
$14.99
|
| Rate for Payer: UHCCP Medicaid |
$8.03
|
| Rate for Payer: VA VA |
$14.99
|
|
|
HC STREP PNEUMONIAE IGG 7 SEROTYP
|
Facility
|
IP
|
$20.81
|
|
|
Service Code
|
CPT 86317
|
| Hospital Charge Code |
30200188
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.53 |
| Max. Negotiated Rate |
$20.81 |
| Rate for Payer: Aetna Commercial |
$18.73
|
| Rate for Payer: ASR ASR |
$20.19
|
| Rate for Payer: ASR Commercial |
$20.19
|
| Rate for Payer: BCBS Trust/PPO |
$16.96
|
| Rate for Payer: BCN Commercial |
$16.13
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$19.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Healthscope Commercial |
$20.81
|
| Rate for Payer: Healthscope Whirlpool |
$20.19
|
| Rate for Payer: Mclaren Commercial |
$18.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: Nomi Health Commercial |
$17.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.31
|
|
|
HC STREP PNEUMONIAE IGG 7 SEROTYP
|
Facility
|
OP
|
$20.81
|
|
|
Service Code
|
CPT 86317
|
| Hospital Charge Code |
30200188
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.03 |
| Max. Negotiated Rate |
$23.23 |
| Rate for Payer: Aetna Commercial |
$18.73
|
| Rate for Payer: Aetna Medicare |
$14.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.74
|
| Rate for Payer: ASR ASR |
$20.19
|
| Rate for Payer: ASR Commercial |
$20.19
|
| Rate for Payer: BCBS Complete |
$8.44
|
| Rate for Payer: BCBS MAPPO |
$14.99
|
| Rate for Payer: BCBS Trust/PPO |
$17.04
|
| Rate for Payer: BCN Commercial |
$16.13
|
| Rate for Payer: BCN Medicare Advantage |
$14.99
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$19.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.99
|
| Rate for Payer: Healthscope Commercial |
$20.81
|
| Rate for Payer: Healthscope Whirlpool |
$20.19
|
| Rate for Payer: Humana Choice PPO Medicare |
$14.99
|
| Rate for Payer: Mclaren Commercial |
$18.73
|
| Rate for Payer: Mclaren Medicaid |
$8.03
|
| Rate for Payer: Mclaren Medicare |
$14.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.74
|
| Rate for Payer: Meridian Medicaid |
$8.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: Nomi Health Commercial |
$17.06
|
| Rate for Payer: PACE Medicare |
$14.24
|
| Rate for Payer: PACE SWMI |
$14.99
|
| Rate for Payer: PHP Commercial |
$16.49
|
| Rate for Payer: PHP Medicaid |
$8.03
|
| Rate for Payer: PHP Medicare Advantage |
$14.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.23
|
| Rate for Payer: Priority Health Medicare |
$14.99
|
| Rate for Payer: Priority Health Narrow Network |
$14.59
|
| Rate for Payer: Railroad Medicare Medicare |
$14.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.99
|
| Rate for Payer: UHC Exchange |
$23.23
|
| Rate for Payer: UHC Medicare Advantage |
$14.99
|
| Rate for Payer: UHCCP DNSP |
$14.99
|
| Rate for Payer: UHCCP Medicaid |
$8.03
|
| Rate for Payer: VA VA |
$14.99
|
|
|
HC STREPTOCOCCUS AGALACTIAE
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 87653
|
| Hospital Charge Code |
30600276
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$54.39 |
| Rate for Payer: Aetna Commercial |
$46.82
|
| 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 |
$50.46
|
| Rate for Payer: ASR Commercial |
$50.46
|
| Rate for Payer: BCBS Complete |
$19.75
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$42.60
|
| Rate for Payer: BCN Commercial |
$40.33
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$48.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$52.02
|
| Rate for Payer: Healthscope Whirlpool |
$50.46
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$46.82
|
| 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 |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| 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 |
$33.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45.58
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$36.47
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.78
|
| 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 STREPTOCOCCUS AGALACTIAE
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 87653
|
| Hospital Charge Code |
30600276
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$33.81 |
| Max. Negotiated Rate |
$52.02 |
| Rate for Payer: Aetna Commercial |
$46.82
|
| Rate for Payer: ASR ASR |
$50.46
|
| Rate for Payer: ASR Commercial |
$50.46
|
| Rate for Payer: BCBS Trust/PPO |
$42.39
|
| Rate for Payer: BCN Commercial |
$40.33
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$48.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$52.02
|
| Rate for Payer: Healthscope Whirlpool |
$50.46
|
| Rate for Payer: Mclaren Commercial |
$46.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.78
|
|
|
HC STREPTOCOCCUS PNEUMONIA
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600277
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$33.81 |
| Max. Negotiated Rate |
$52.02 |
| Rate for Payer: Aetna Commercial |
$46.82
|
| Rate for Payer: ASR ASR |
$50.46
|
| Rate for Payer: ASR Commercial |
$50.46
|
| Rate for Payer: BCBS Trust/PPO |
$42.39
|
| Rate for Payer: BCN Commercial |
$40.33
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$48.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$52.02
|
| Rate for Payer: Healthscope Whirlpool |
$50.46
|
| Rate for Payer: Mclaren Commercial |
$46.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.78
|
|
|
HC STREPTOCOCCUS PNEUMONIA
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600277
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$54.39 |
| Rate for Payer: Aetna Commercial |
$46.82
|
| 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 |
$50.46
|
| Rate for Payer: ASR Commercial |
$50.46
|
| Rate for Payer: BCBS Complete |
$19.75
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$42.60
|
| Rate for Payer: BCN Commercial |
$40.33
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$48.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$52.02
|
| Rate for Payer: Healthscope Whirlpool |
$50.46
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$46.82
|
| 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 |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| 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 |
$33.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45.58
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$36.47
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.78
|
| 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 STRESS COMPLETE PHYSIOLOGY ARTERIES
|
Facility
|
IP
|
$355.74
|
|
|
Service Code
|
CPT 93924
|
| Hospital Charge Code |
92100021
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$231.23 |
| Max. Negotiated Rate |
$355.74 |
| Rate for Payer: Aetna Commercial |
$320.17
|
| Rate for Payer: ASR ASR |
$345.07
|
| Rate for Payer: ASR Commercial |
$345.07
|
| Rate for Payer: BCBS Trust/PPO |
$289.89
|
| Rate for Payer: BCN Commercial |
$275.81
|
| Rate for Payer: Cash Price |
$284.59
|
| Rate for Payer: Cofinity Commercial |
$334.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$284.59
|
| Rate for Payer: Healthscope Commercial |
$355.74
|
| Rate for Payer: Healthscope Whirlpool |
$345.07
|
| Rate for Payer: Mclaren Commercial |
$320.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$302.38
|
| Rate for Payer: Nomi Health Commercial |
$291.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$231.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$313.05
|
|
|
HC STRESS COMPLETE PHYSIOLOGY ARTERIES
|
Facility
|
OP
|
$355.74
|
|
|
Service Code
|
CPT 93924
|
| Hospital Charge Code |
92100021
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$82.17 |
| Max. Negotiated Rate |
$355.74 |
| Rate for Payer: Aetna Commercial |
$320.17
|
| Rate for Payer: Aetna Medicare |
$153.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$191.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$191.62
|
| Rate for Payer: ASR ASR |
$345.07
|
| Rate for Payer: ASR Commercial |
$345.07
|
| Rate for Payer: BCBS Complete |
$86.28
|
| Rate for Payer: BCBS MAPPO |
$153.30
|
| Rate for Payer: BCBS Trust/PPO |
$291.32
|
| Rate for Payer: BCN Commercial |
$275.81
|
| Rate for Payer: BCN Medicare Advantage |
$153.30
|
| Rate for Payer: Cash Price |
$284.59
|
| Rate for Payer: Cash Price |
$284.59
|
| Rate for Payer: Cofinity Commercial |
$334.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$284.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.30
|
| Rate for Payer: Healthscope Commercial |
$355.74
|
| Rate for Payer: Healthscope Whirlpool |
$345.07
|
| Rate for Payer: Humana Choice PPO Medicare |
$153.30
|
| Rate for Payer: Mclaren Commercial |
$320.17
|
| Rate for Payer: Mclaren Medicaid |
$82.17
|
| Rate for Payer: Mclaren Medicare |
$153.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.96
|
| Rate for Payer: Meridian Medicaid |
$86.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$176.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$302.38
|
| Rate for Payer: Nomi Health Commercial |
$291.71
|
| Rate for Payer: PACE Medicare |
$145.64
|
| Rate for Payer: PACE SWMI |
$153.30
|
| Rate for Payer: PHP Commercial |
$168.63
|
| Rate for Payer: PHP Medicaid |
$82.17
|
| Rate for Payer: PHP Medicare Advantage |
$153.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$231.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$251.44
|
| Rate for Payer: Priority Health Medicare |
$153.30
|
| Rate for Payer: Priority Health Narrow Network |
$201.15
|
| Rate for Payer: Railroad Medicare Medicare |
$153.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$313.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.30
|
| Rate for Payer: UHC Exchange |
$237.62
|
| Rate for Payer: UHC Medicare Advantage |
$153.30
|
| Rate for Payer: UHCCP DNSP |
$153.30
|
| Rate for Payer: UHCCP Medicaid |
$82.17
|
| Rate for Payer: VA VA |
$153.30
|
|
|
HC STRESS ECHO
|
Facility
|
IP
|
$1,515.37
|
|
|
Service Code
|
CPT 93350
|
| Hospital Charge Code |
48000008
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$984.99 |
| Max. Negotiated Rate |
$1,515.37 |
| Rate for Payer: Aetna Commercial |
$1,363.83
|
| Rate for Payer: ASR ASR |
$1,469.91
|
| Rate for Payer: ASR Commercial |
$1,469.91
|
| Rate for Payer: BCBS Trust/PPO |
$1,234.88
|
| Rate for Payer: BCN Commercial |
$1,174.87
|
| Rate for Payer: Cash Price |
$1,212.30
|
| Rate for Payer: Cofinity Commercial |
$1,424.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,212.30
|
| Rate for Payer: Healthscope Commercial |
$1,515.37
|
| Rate for Payer: Healthscope Whirlpool |
$1,469.91
|
| Rate for Payer: Mclaren Commercial |
$1,363.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,288.06
|
| Rate for Payer: Nomi Health Commercial |
$1,242.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$984.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,333.53
|
|
|
HC STRESS ECHO
|
Facility
|
OP
|
$1,515.37
|
|
|
Service Code
|
CPT 93350
|
| Hospital Charge Code |
48000008
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$287.94 |
| Max. Negotiated Rate |
$1,515.37 |
| Rate for Payer: Aetna Commercial |
$1,363.83
|
| Rate for Payer: Aetna Medicare |
$537.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$671.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$671.51
|
| Rate for Payer: ASR ASR |
$1,469.91
|
| Rate for Payer: ASR Commercial |
$1,469.91
|
| Rate for Payer: BCBS Complete |
$302.34
|
| Rate for Payer: BCBS MAPPO |
$537.21
|
| Rate for Payer: BCBS Trust/PPO |
$1,240.94
|
| Rate for Payer: BCN Commercial |
$1,174.87
|
| Rate for Payer: BCN Medicare Advantage |
$537.21
|
| Rate for Payer: Cash Price |
$1,212.30
|
| Rate for Payer: Cash Price |
$1,212.30
|
| Rate for Payer: Cofinity Commercial |
$1,424.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,212.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$537.21
|
| Rate for Payer: Healthscope Commercial |
$1,515.37
|
| Rate for Payer: Healthscope Whirlpool |
$1,469.91
|
| Rate for Payer: Humana Choice PPO Medicare |
$537.21
|
| Rate for Payer: Mclaren Commercial |
$1,363.83
|
| Rate for Payer: Mclaren Medicaid |
$287.94
|
| Rate for Payer: Mclaren Medicare |
$537.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$564.07
|
| Rate for Payer: Meridian Medicaid |
$302.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$617.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,288.06
|
| Rate for Payer: Nomi Health Commercial |
$1,242.60
|
| Rate for Payer: PACE Medicare |
$510.35
|
| Rate for Payer: PACE SWMI |
$537.21
|
| Rate for Payer: PHP Commercial |
$590.93
|
| Rate for Payer: PHP Medicaid |
$287.94
|
| Rate for Payer: PHP Medicare Advantage |
$537.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$287.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$984.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$883.89
|
| Rate for Payer: Priority Health Medicare |
$537.21
|
| Rate for Payer: Priority Health Narrow Network |
$707.11
|
| Rate for Payer: Railroad Medicare Medicare |
$537.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,333.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$537.21
|
| Rate for Payer: UHC Exchange |
$832.68
|
| Rate for Payer: UHC Medicare Advantage |
$537.21
|
| Rate for Payer: UHCCP DNSP |
$537.21
|
| Rate for Payer: UHCCP Medicaid |
$287.94
|
| Rate for Payer: VA VA |
$537.21
|
|
|
HC STRESS TEST
|
Facility
|
IP
|
$901.94
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
48200001
|
|
Hospital Revenue Code
|
482
|
| Min. Negotiated Rate |
$586.26 |
| Max. Negotiated Rate |
$901.94 |
| Rate for Payer: Aetna Commercial |
$811.75
|
| Rate for Payer: ASR ASR |
$874.88
|
| Rate for Payer: ASR Commercial |
$874.88
|
| Rate for Payer: BCBS Trust/PPO |
$734.99
|
| Rate for Payer: BCN Commercial |
$699.27
|
| Rate for Payer: Cash Price |
$721.55
|
| Rate for Payer: Cofinity Commercial |
$847.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$721.55
|
| Rate for Payer: Healthscope Commercial |
$901.94
|
| Rate for Payer: Healthscope Whirlpool |
$874.88
|
| Rate for Payer: Mclaren Commercial |
$811.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$766.65
|
| Rate for Payer: Nomi Health Commercial |
$739.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$586.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$793.71
|
|
|
HC STRESS TEST
|
Facility
|
OP
|
$901.94
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
48200001
|
|
Hospital Revenue Code
|
482
|
| Min. Negotiated Rate |
$163.53 |
| Max. Negotiated Rate |
$909.16 |
| Rate for Payer: Aetna Commercial |
$811.75
|
| Rate for Payer: Aetna Medicare |
$305.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$381.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$381.38
|
| Rate for Payer: ASR ASR |
$874.88
|
| Rate for Payer: ASR Commercial |
$874.88
|
| Rate for Payer: BCBS Complete |
$171.71
|
| Rate for Payer: BCBS MAPPO |
$305.10
|
| Rate for Payer: BCBS Trust/PPO |
$738.60
|
| Rate for Payer: BCN Commercial |
$699.27
|
| Rate for Payer: BCN Medicare Advantage |
$305.10
|
| Rate for Payer: Cash Price |
$721.55
|
| Rate for Payer: Cash Price |
$721.55
|
| Rate for Payer: Cofinity Commercial |
$847.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$721.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.10
|
| Rate for Payer: Healthscope Commercial |
$901.94
|
| Rate for Payer: Healthscope Whirlpool |
$874.88
|
| Rate for Payer: Humana Choice PPO Medicare |
$305.10
|
| Rate for Payer: Mclaren Commercial |
$811.75
|
| Rate for Payer: Mclaren Medicaid |
$163.53
|
| Rate for Payer: Mclaren Medicare |
$305.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$320.36
|
| Rate for Payer: Meridian Medicaid |
$171.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$350.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$766.65
|
| Rate for Payer: Nomi Health Commercial |
$739.59
|
| Rate for Payer: PACE Medicare |
$289.84
|
| Rate for Payer: PACE SWMI |
$305.10
|
| Rate for Payer: PHP Commercial |
$335.61
|
| Rate for Payer: PHP Medicaid |
$163.53
|
| Rate for Payer: PHP Medicare Advantage |
$305.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$163.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$586.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$909.16
|
| Rate for Payer: Priority Health Medicare |
$305.10
|
| Rate for Payer: Priority Health Narrow Network |
$727.33
|
| Rate for Payer: Railroad Medicare Medicare |
$305.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$793.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$305.10
|
| Rate for Payer: UHC Exchange |
$472.90
|
| Rate for Payer: UHC Medicare Advantage |
$305.10
|
| Rate for Payer: UHCCP DNSP |
$305.10
|
| Rate for Payer: UHCCP Medicaid |
$163.53
|
| Rate for Payer: VA VA |
$305.10
|
|
