|
HC TRANSHEPATIC PORTOGRAPHY
|
Facility
|
OP
|
$3,231.49
|
|
|
Service Code
|
CPT 75887
|
| Hospital Charge Code |
32000321
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,645.43 |
| Max. Negotiated Rate |
$4,876.50 |
| Rate for Payer: Aetna Commercial |
$2,908.34
|
| Rate for Payer: Aetna Medicare |
$3,146.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: ASR ASR |
$3,134.55
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$2,664.36
|
| Rate for Payer: BCN Commercial |
$2,664.36
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$2,585.19
|
| Rate for Payer: Cash Price |
$2,585.19
|
| Rate for Payer: Cofinity Commercial |
$3,037.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,585.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$3,134.55
|
| Rate for Payer: Healthscope Whirlpool |
$3,231.49
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,146.13
|
| Rate for Payer: Mclaren Commercial |
$2,908.34
|
| Rate for Payer: Mclaren Medicaid |
$3,146.13
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$1,727.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,746.77
|
| Rate for Payer: Nomi Health Commercial |
$2,649.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,423.62
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$3,460.74
|
| Rate for Payer: PHP Medicaid |
$1,686.33
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,831.43
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health Narrow Network |
$2,265.27
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,843.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Exchange |
$4,876.50
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP DNSP |
$3,146.13
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: VA VA |
$3,146.13
|
|
|
HC TRANSPERINEAL PLMT BIODEGRADABLE MATRL
|
Facility
|
OP
|
$6,377.86
|
|
|
Service Code
|
CPT 55874
|
| Hospital Charge Code |
36100574
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,794.14 |
| Max. Negotiated Rate |
$8,280.91 |
| Rate for Payer: Aetna Commercial |
$5,740.07
|
| Rate for Payer: Aetna Medicare |
$5,342.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,678.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,678.15
|
| Rate for Payer: ASR ASR |
$6,186.52
|
| Rate for Payer: BCBS Complete |
$2,934.11
|
| Rate for Payer: BCBS MAPPO |
$5,342.52
|
| Rate for Payer: BCBS Trust/PPO |
$5,258.55
|
| Rate for Payer: BCN Commercial |
$5,258.55
|
| Rate for Payer: BCN Medicare Advantage |
$5,342.52
|
| Rate for Payer: Cash Price |
$5,102.29
|
| Rate for Payer: Cash Price |
$5,102.29
|
| Rate for Payer: Cofinity Commercial |
$5,995.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,102.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,342.52
|
| Rate for Payer: Healthscope Commercial |
$6,186.52
|
| Rate for Payer: Healthscope Whirlpool |
$6,377.86
|
| Rate for Payer: Humana Choice PPO Medicare |
$5,342.52
|
| Rate for Payer: Mclaren Commercial |
$5,740.07
|
| Rate for Payer: Mclaren Medicaid |
$5,342.52
|
| Rate for Payer: Mclaren Medicare |
$5,342.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,609.65
|
| Rate for Payer: Meridian Medicaid |
$2,934.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,143.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$5,876.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,421.18
|
| Rate for Payer: Nomi Health Commercial |
$5,229.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,783.40
|
| Rate for Payer: PACE Medicare |
$5,075.39
|
| Rate for Payer: PACE SWMI |
$5,342.52
|
| Rate for Payer: PHP Commercial |
$5,876.77
|
| Rate for Payer: PHP Medicaid |
$2,863.59
|
| Rate for Payer: PHP Medicare Advantage |
$5,342.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,794.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4,677.61
|
| Rate for Payer: Priority Health Medicare |
$5,342.52
|
| Rate for Payer: Priority Health Narrow Network |
$3,742.09
|
| Rate for Payer: Railroad Medicare Medicare |
$5,342.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,612.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5,342.52
|
| Rate for Payer: UHC Exchange |
$8,280.91
|
| Rate for Payer: UHC Medicaid |
$2,794.14
|
| Rate for Payer: UHCCP DNSP |
$5,342.52
|
| Rate for Payer: UHCCP Medicaid |
$2,794.14
|
| Rate for Payer: VA VA |
$5,342.52
|
|
|
HC TRANSPERINEAL PLMT BIODEGRADABLE MATRL
|
Facility
|
IP
|
$6,377.86
|
|
|
Service Code
|
CPT 55874
|
| Hospital Charge Code |
36100574
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,783.40 |
| Max. Negotiated Rate |
$6,377.86 |
| Rate for Payer: Aetna Commercial |
$5,740.07
|
| Rate for Payer: ASR ASR |
$6,186.52
|
| Rate for Payer: BCBS Trust/PPO |
$5,237.50
|
| Rate for Payer: BCN Commercial |
$5,237.50
|
| Rate for Payer: Cash Price |
$5,102.29
|
| Rate for Payer: Cofinity Commercial |
$5,995.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,102.29
|
| Rate for Payer: Healthscope Commercial |
$6,186.52
|
| Rate for Payer: Healthscope Whirlpool |
$6,377.86
|
| Rate for Payer: Mclaren Commercial |
$5,740.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,421.18
|
| Rate for Payer: Nomi Health Commercial |
$5,229.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,783.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,612.52
|
|
|
HC TRANSSEP INTRO AGILIS
|
Facility
|
IP
|
$3,767.42
|
|
|
Service Code
|
HCPCS C1766
|
| Hospital Charge Code |
27200075
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,825.57 |
| Max. Negotiated Rate |
$3,767.42 |
| Rate for Payer: Aetna Commercial |
$3,390.68
|
| Rate for Payer: ASR ASR |
$3,654.40
|
| Rate for Payer: BCBS Trust/PPO |
$3,093.81
|
| Rate for Payer: BCN Commercial |
$3,093.81
|
| Rate for Payer: Cash Price |
$3,013.94
|
| Rate for Payer: Cofinity Commercial |
$3,541.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,013.94
|
| Rate for Payer: Healthscope Commercial |
$3,654.40
|
| Rate for Payer: Healthscope Whirlpool |
$3,767.42
|
| Rate for Payer: Mclaren Commercial |
$3,390.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,202.31
|
| Rate for Payer: Nomi Health Commercial |
$3,089.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,825.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,315.33
|
|
|
HC TRANSSEP INTRO AGILIS
|
Facility
|
OP
|
$3,767.42
|
|
|
Service Code
|
HCPCS C1766
|
| Hospital Charge Code |
27200075
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,393.95 |
| Max. Negotiated Rate |
$3,767.42 |
| Rate for Payer: Aetna Commercial |
$3,390.68
|
| Rate for Payer: Aetna Medicare |
$1,393.95
|
| Rate for Payer: ASR ASR |
$3,654.40
|
| Rate for Payer: BCBS Complete |
$1,506.97
|
| Rate for Payer: BCBS Trust/PPO |
$3,106.24
|
| Rate for Payer: BCN Commercial |
$3,106.24
|
| Rate for Payer: Cash Price |
$3,013.94
|
| Rate for Payer: Cofinity Commercial |
$3,541.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,013.94
|
| Rate for Payer: Healthscope Commercial |
$3,654.40
|
| Rate for Payer: Healthscope Whirlpool |
$3,767.42
|
| Rate for Payer: Mclaren Commercial |
$3,390.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,013.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,202.31
|
| Rate for Payer: Nomi Health Commercial |
$3,089.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,825.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,301.01
|
| Rate for Payer: Priority Health Narrow Network |
$2,640.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,315.33
|
|
|
HC TRANSSEP PUNCTURE FOR PVI
|
Facility
|
IP
|
$5,021.39
|
|
|
Service Code
|
CPT 93462
|
| Hospital Charge Code |
48100021
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,766.04 |
| Max. Negotiated Rate |
$5,021.39 |
| Rate for Payer: Aetna Commercial |
$4,519.25
|
| Rate for Payer: ASR ASR |
$4,870.75
|
| Rate for Payer: BCBS Trust/PPO |
$4,123.57
|
| Rate for Payer: BCN Commercial |
$4,123.57
|
| Rate for Payer: Cash Price |
$4,017.11
|
| Rate for Payer: Cofinity Commercial |
$4,720.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,017.11
|
| Rate for Payer: Healthscope Commercial |
$4,870.75
|
| Rate for Payer: Healthscope Whirlpool |
$5,021.39
|
| Rate for Payer: Mclaren Commercial |
$4,519.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,268.18
|
| Rate for Payer: Nomi Health Commercial |
$4,117.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,766.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,418.82
|
|
|
HC TRANSSEP PUNCTURE FOR PVI
|
Facility
|
OP
|
$5,021.39
|
|
|
Service Code
|
CPT 93462
|
| Hospital Charge Code |
48100021
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,857.91 |
| Max. Negotiated Rate |
$5,021.39 |
| Rate for Payer: Aetna Commercial |
$4,519.25
|
| Rate for Payer: Aetna Medicare |
$1,857.91
|
| Rate for Payer: ASR ASR |
$4,870.75
|
| Rate for Payer: BCBS Complete |
$2,008.56
|
| Rate for Payer: BCBS Trust/PPO |
$4,140.14
|
| Rate for Payer: BCN Commercial |
$4,140.14
|
| Rate for Payer: Cash Price |
$4,017.11
|
| Rate for Payer: Cofinity Commercial |
$4,720.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,017.11
|
| Rate for Payer: Healthscope Commercial |
$4,870.75
|
| Rate for Payer: Healthscope Whirlpool |
$5,021.39
|
| Rate for Payer: Mclaren Commercial |
$4,519.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,017.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,268.18
|
| Rate for Payer: Nomi Health Commercial |
$4,117.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,766.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4,399.74
|
| Rate for Payer: Priority Health Narrow Network |
$3,519.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,418.82
|
|
|
HC TRANSSEPTAL INTRODUCER
|
Facility
|
IP
|
$922.48
|
|
| Hospital Charge Code |
27200154
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$691.86 |
| Max. Negotiated Rate |
$922.48 |
| Rate for Payer: Aetna Commercial |
$830.23
|
| Rate for Payer: ASR ASR |
$894.81
|
| Rate for Payer: BCBS Trust/PPO |
$757.54
|
| Rate for Payer: BCN Commercial |
$757.54
|
| Rate for Payer: Cash Price |
$737.98
|
| Rate for Payer: Cofinity Commercial |
$867.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$737.98
|
| Rate for Payer: Healthscope Commercial |
$894.81
|
| Rate for Payer: Healthscope Whirlpool |
$922.48
|
| Rate for Payer: Mclaren Commercial |
$830.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$784.11
|
| Rate for Payer: Nomi Health Commercial |
$756.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$691.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$811.78
|
|
|
HC TRANSSEPTAL INTRODUCER
|
Facility
|
OP
|
$922.48
|
|
| Hospital Charge Code |
27200154
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$341.32 |
| Max. Negotiated Rate |
$922.48 |
| Rate for Payer: Aetna Commercial |
$830.23
|
| Rate for Payer: Aetna Medicare |
$341.32
|
| Rate for Payer: ASR ASR |
$894.81
|
| Rate for Payer: BCBS Complete |
$368.99
|
| Rate for Payer: BCBS Trust/PPO |
$760.58
|
| Rate for Payer: BCN Commercial |
$760.58
|
| Rate for Payer: Cash Price |
$737.98
|
| Rate for Payer: Cofinity Commercial |
$867.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$737.98
|
| Rate for Payer: Healthscope Commercial |
$894.81
|
| Rate for Payer: Healthscope Whirlpool |
$922.48
|
| Rate for Payer: Mclaren Commercial |
$830.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$737.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$784.11
|
| Rate for Payer: Nomi Health Commercial |
$756.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$691.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$808.28
|
| Rate for Payer: Priority Health Narrow Network |
$646.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$811.78
|
|
|
HC TRANSVERSUS ABDOMINIS PLANE (TAP) BIL
|
Facility
|
OP
|
$1,686.83
|
|
|
Service Code
|
CPT 64488
|
| Hospital Charge Code |
36100576
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$624.13 |
| Max. Negotiated Rate |
$1,686.83 |
| Rate for Payer: Aetna Commercial |
$1,518.15
|
| Rate for Payer: Aetna Medicare |
$624.13
|
| Rate for Payer: ASR ASR |
$1,636.23
|
| Rate for Payer: BCBS Complete |
$674.73
|
| Rate for Payer: BCBS Trust/PPO |
$1,390.79
|
| Rate for Payer: BCN Commercial |
$1,390.79
|
| Rate for Payer: Cash Price |
$1,349.46
|
| Rate for Payer: Cofinity Commercial |
$1,585.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,349.46
|
| Rate for Payer: Healthscope Commercial |
$1,636.23
|
| Rate for Payer: Healthscope Whirlpool |
$1,686.83
|
| Rate for Payer: Mclaren Commercial |
$1,518.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,349.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,433.81
|
| Rate for Payer: Nomi Health Commercial |
$1,383.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,265.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,478.00
|
| Rate for Payer: Priority Health Narrow Network |
$1,182.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,484.41
|
|
|
HC TRANSVERSUS ABDOMINIS PLANE (TAP) BIL
|
Facility
|
IP
|
$1,686.83
|
|
|
Service Code
|
CPT 64488
|
| Hospital Charge Code |
36100576
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,265.12 |
| Max. Negotiated Rate |
$1,686.83 |
| Rate for Payer: Aetna Commercial |
$1,518.15
|
| Rate for Payer: ASR ASR |
$1,636.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,385.22
|
| Rate for Payer: BCN Commercial |
$1,385.22
|
| Rate for Payer: Cash Price |
$1,349.46
|
| Rate for Payer: Cofinity Commercial |
$1,585.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,349.46
|
| Rate for Payer: Healthscope Commercial |
$1,636.23
|
| Rate for Payer: Healthscope Whirlpool |
$1,686.83
|
| Rate for Payer: Mclaren Commercial |
$1,518.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,433.81
|
| Rate for Payer: Nomi Health Commercial |
$1,383.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,265.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,484.41
|
|
|
HC TRANSVERSUS ABDOMINIS PLANE (TAP) BILAT CONT
|
Facility
|
OP
|
$2,001.00
|
|
|
Service Code
|
CPT 64489
|
| Hospital Charge Code |
37000032
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$740.37 |
| Max. Negotiated Rate |
$2,001.00 |
| Rate for Payer: Aetna Commercial |
$1,800.90
|
| Rate for Payer: Aetna Medicare |
$740.37
|
| Rate for Payer: ASR ASR |
$1,940.97
|
| Rate for Payer: BCBS Complete |
$800.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,649.82
|
| Rate for Payer: BCN Commercial |
$1,649.82
|
| Rate for Payer: Cash Price |
$1,600.80
|
| Rate for Payer: Cofinity Commercial |
$1,880.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,600.80
|
| Rate for Payer: Healthscope Commercial |
$1,940.97
|
| Rate for Payer: Healthscope Whirlpool |
$2,001.00
|
| Rate for Payer: Mclaren Commercial |
$1,800.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,600.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,700.85
|
| Rate for Payer: Nomi Health Commercial |
$1,640.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,500.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,753.28
|
| Rate for Payer: Priority Health Narrow Network |
$1,402.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,760.88
|
|
|
HC TRANSVERSUS ABDOMINIS PLANE (TAP) BILAT CONT
|
Facility
|
IP
|
$2,001.00
|
|
|
Service Code
|
CPT 64489
|
| Hospital Charge Code |
37000032
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$1,500.75 |
| Max. Negotiated Rate |
$2,001.00 |
| Rate for Payer: Aetna Commercial |
$1,800.90
|
| Rate for Payer: ASR ASR |
$1,940.97
|
| Rate for Payer: BCBS Trust/PPO |
$1,643.22
|
| Rate for Payer: BCN Commercial |
$1,643.22
|
| Rate for Payer: Cash Price |
$1,600.80
|
| Rate for Payer: Cofinity Commercial |
$1,880.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,600.80
|
| Rate for Payer: Healthscope Commercial |
$1,940.97
|
| Rate for Payer: Healthscope Whirlpool |
$2,001.00
|
| Rate for Payer: Mclaren Commercial |
$1,800.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,700.85
|
| Rate for Payer: Nomi Health Commercial |
$1,640.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,500.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,760.88
|
|
|
HC TRANSVERSUS ABDOMINIS PLANE (TAP) UNI
|
Facility
|
OP
|
$1,218.27
|
|
|
Service Code
|
CPT 64486
|
| Hospital Charge Code |
36100575
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$450.76 |
| Max. Negotiated Rate |
$1,218.27 |
| Rate for Payer: Aetna Commercial |
$1,096.44
|
| Rate for Payer: Aetna Medicare |
$450.76
|
| Rate for Payer: ASR ASR |
$1,181.72
|
| Rate for Payer: BCBS Complete |
$487.31
|
| Rate for Payer: BCBS Trust/PPO |
$1,004.46
|
| Rate for Payer: BCN Commercial |
$1,004.46
|
| Rate for Payer: Cash Price |
$974.62
|
| Rate for Payer: Cofinity Commercial |
$1,145.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$974.62
|
| Rate for Payer: Healthscope Commercial |
$1,181.72
|
| Rate for Payer: Healthscope Whirlpool |
$1,218.27
|
| Rate for Payer: Mclaren Commercial |
$1,096.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$974.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,035.53
|
| Rate for Payer: Nomi Health Commercial |
$998.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$913.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,067.45
|
| Rate for Payer: Priority Health Narrow Network |
$854.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,072.08
|
|
|
HC TRANSVERSUS ABDOMINIS PLANE (TAP) UNI
|
Facility
|
IP
|
$1,218.27
|
|
|
Service Code
|
CPT 64486
|
| Hospital Charge Code |
36100575
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$913.70 |
| Max. Negotiated Rate |
$1,218.27 |
| Rate for Payer: Aetna Commercial |
$1,096.44
|
| Rate for Payer: ASR ASR |
$1,181.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,000.44
|
| Rate for Payer: BCN Commercial |
$1,000.44
|
| Rate for Payer: Cash Price |
$974.62
|
| Rate for Payer: Cofinity Commercial |
$1,145.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$974.62
|
| Rate for Payer: Healthscope Commercial |
$1,181.72
|
| Rate for Payer: Healthscope Whirlpool |
$1,218.27
|
| Rate for Payer: Mclaren Commercial |
$1,096.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,035.53
|
| Rate for Payer: Nomi Health Commercial |
$998.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$913.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,072.08
|
|
|
HC TRANSVERSUS ABDOMINIS PLANE (TAP) UNILAT CONT
|
Facility
|
IP
|
$1,334.00
|
|
|
Service Code
|
CPT 64487
|
| Hospital Charge Code |
37000031
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$1,000.50 |
| Max. Negotiated Rate |
$1,334.00 |
| Rate for Payer: Aetna Commercial |
$1,200.60
|
| Rate for Payer: ASR ASR |
$1,293.98
|
| Rate for Payer: BCBS Trust/PPO |
$1,095.48
|
| Rate for Payer: BCN Commercial |
$1,095.48
|
| Rate for Payer: Cash Price |
$1,067.20
|
| Rate for Payer: Cofinity Commercial |
$1,253.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,067.20
|
| Rate for Payer: Healthscope Commercial |
$1,293.98
|
| Rate for Payer: Healthscope Whirlpool |
$1,334.00
|
| Rate for Payer: Mclaren Commercial |
$1,200.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,133.90
|
| Rate for Payer: Nomi Health Commercial |
$1,093.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,000.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,173.92
|
|
|
HC TRANSVERSUS ABDOMINIS PLANE (TAP) UNILAT CONT
|
Facility
|
OP
|
$1,334.00
|
|
|
Service Code
|
CPT 64487
|
| Hospital Charge Code |
37000031
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$493.58 |
| Max. Negotiated Rate |
$1,334.00 |
| Rate for Payer: Aetna Commercial |
$1,200.60
|
| Rate for Payer: Aetna Medicare |
$493.58
|
| Rate for Payer: ASR ASR |
$1,293.98
|
| Rate for Payer: BCBS Complete |
$533.60
|
| Rate for Payer: BCBS Trust/PPO |
$1,099.88
|
| Rate for Payer: BCN Commercial |
$1,099.88
|
| Rate for Payer: Cash Price |
$1,067.20
|
| Rate for Payer: Cofinity Commercial |
$1,253.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,067.20
|
| Rate for Payer: Healthscope Commercial |
$1,293.98
|
| Rate for Payer: Healthscope Whirlpool |
$1,334.00
|
| Rate for Payer: Mclaren Commercial |
$1,200.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,067.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,133.90
|
| Rate for Payer: Nomi Health Commercial |
$1,093.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,000.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,168.85
|
| Rate for Payer: Priority Health Narrow Network |
$935.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,173.92
|
|
|
HC TRANURETH DESTR PROST TISS RF WVT
|
Facility
|
OP
|
$5,001.20
|
|
|
Service Code
|
CPT 53854
|
| Hospital Charge Code |
76100306
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,756.80 |
| Max. Negotiated Rate |
$5,444.08 |
| Rate for Payer: Aetna Commercial |
$4,501.08
|
| Rate for Payer: Aetna Medicare |
$3,512.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,390.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,390.39
|
| Rate for Payer: ASR ASR |
$4,851.16
|
| Rate for Payer: BCBS Complete |
$1,928.96
|
| Rate for Payer: BCBS MAPPO |
$3,512.31
|
| Rate for Payer: BCBS Trust/PPO |
$4,123.49
|
| Rate for Payer: BCN Commercial |
$4,123.49
|
| Rate for Payer: BCN Medicare Advantage |
$3,512.31
|
| Rate for Payer: Cash Price |
$4,000.96
|
| Rate for Payer: Cash Price |
$4,000.96
|
| Rate for Payer: Cofinity Commercial |
$4,701.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,000.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,512.31
|
| Rate for Payer: Healthscope Commercial |
$4,851.16
|
| Rate for Payer: Healthscope Whirlpool |
$5,001.20
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,512.31
|
| Rate for Payer: Mclaren Commercial |
$4,501.08
|
| Rate for Payer: Mclaren Medicaid |
$3,512.31
|
| Rate for Payer: Mclaren Medicare |
$3,512.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,687.93
|
| Rate for Payer: Meridian Medicaid |
$1,928.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,039.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,863.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,251.02
|
| Rate for Payer: Nomi Health Commercial |
$4,100.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,750.90
|
| Rate for Payer: PACE Medicare |
$3,336.69
|
| Rate for Payer: PACE SWMI |
$3,512.31
|
| Rate for Payer: PHP Commercial |
$3,863.54
|
| Rate for Payer: PHP Medicaid |
$1,882.60
|
| Rate for Payer: PHP Medicare Advantage |
$3,512.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,836.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,196.00
|
| Rate for Payer: Priority Health Medicare |
$3,512.31
|
| Rate for Payer: Priority Health Narrow Network |
$1,756.80
|
| Rate for Payer: Railroad Medicare Medicare |
$3,512.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,401.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,512.31
|
| Rate for Payer: UHC Exchange |
$5,444.08
|
| Rate for Payer: UHC Medicaid |
$1,836.94
|
| Rate for Payer: UHCCP DNSP |
$3,512.31
|
| Rate for Payer: UHCCP Medicaid |
$1,836.94
|
| Rate for Payer: VA VA |
$3,512.31
|
|
|
HC TRANURETH DESTR PROST TISS RF WVT
|
Facility
|
IP
|
$5,001.20
|
|
|
Service Code
|
CPT 53854
|
| Hospital Charge Code |
76100306
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,750.90 |
| Max. Negotiated Rate |
$5,001.20 |
| Rate for Payer: Aetna Commercial |
$4,501.08
|
| Rate for Payer: ASR ASR |
$4,851.16
|
| Rate for Payer: BCBS Trust/PPO |
$4,106.99
|
| Rate for Payer: BCN Commercial |
$4,106.99
|
| Rate for Payer: Cash Price |
$4,000.96
|
| Rate for Payer: Cofinity Commercial |
$4,701.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,000.96
|
| Rate for Payer: Healthscope Commercial |
$4,851.16
|
| Rate for Payer: Healthscope Whirlpool |
$5,001.20
|
| Rate for Payer: Mclaren Commercial |
$4,501.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,251.02
|
| Rate for Payer: Nomi Health Commercial |
$4,100.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,750.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,401.06
|
|
|
HC TREAT FINGER FRACTURE WITH MANIP EA
|
Facility
|
OP
|
$4,328.18
|
|
|
Service Code
|
CPT 26742
|
| Hospital Charge Code |
76100386
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$240.84 |
| Max. Negotiated Rate |
$4,328.18 |
| Rate for Payer: Aetna Commercial |
$3,895.36
|
| Rate for Payer: Aetna Medicare |
$1,602.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,002.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,002.76
|
| Rate for Payer: ASR ASR |
$4,198.33
|
| Rate for Payer: BCBS Complete |
$879.93
|
| Rate for Payer: BCBS MAPPO |
$1,602.21
|
| Rate for Payer: BCBS Trust/PPO |
$3,568.58
|
| Rate for Payer: BCN Commercial |
$3,568.58
|
| Rate for Payer: BCN Medicare Advantage |
$1,602.21
|
| Rate for Payer: Cash Price |
$3,462.54
|
| Rate for Payer: Cash Price |
$3,462.54
|
| Rate for Payer: Cofinity Commercial |
$4,068.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,462.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,602.21
|
| Rate for Payer: Healthscope Commercial |
$4,198.33
|
| Rate for Payer: Healthscope Whirlpool |
$4,328.18
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,602.21
|
| Rate for Payer: Mclaren Commercial |
$3,895.36
|
| Rate for Payer: Mclaren Medicaid |
$1,602.21
|
| Rate for Payer: Mclaren Medicare |
$1,602.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,682.32
|
| Rate for Payer: Meridian Medicaid |
$879.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,842.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,762.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,678.95
|
| Rate for Payer: Nomi Health Commercial |
$3,549.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,246.14
|
| Rate for Payer: PACE Medicare |
$1,522.10
|
| Rate for Payer: PACE SWMI |
$1,602.21
|
| Rate for Payer: PHP Commercial |
$1,762.43
|
| Rate for Payer: PHP Medicaid |
$858.78
|
| Rate for Payer: PHP Medicare Advantage |
$1,602.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$837.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$301.05
|
| Rate for Payer: Priority Health Medicare |
$1,602.21
|
| Rate for Payer: Priority Health Narrow Network |
$240.84
|
| Rate for Payer: Railroad Medicare Medicare |
$1,602.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,808.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,602.21
|
| Rate for Payer: UHC Exchange |
$2,483.43
|
| Rate for Payer: UHC Medicaid |
$837.96
|
| Rate for Payer: UHCCP DNSP |
$1,602.21
|
| Rate for Payer: UHCCP Medicaid |
$837.96
|
| Rate for Payer: VA VA |
$1,602.21
|
|
|
HC TREAT FINGER FRACTURE WITH MANIP EA
|
Facility
|
IP
|
$4,328.18
|
|
|
Service Code
|
CPT 26742
|
| Hospital Charge Code |
76100386
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,246.14 |
| Max. Negotiated Rate |
$4,328.18 |
| Rate for Payer: Aetna Commercial |
$3,895.36
|
| Rate for Payer: ASR ASR |
$4,198.33
|
| Rate for Payer: BCBS Trust/PPO |
$3,554.30
|
| Rate for Payer: BCN Commercial |
$3,554.30
|
| Rate for Payer: Cash Price |
$3,462.54
|
| Rate for Payer: Cofinity Commercial |
$4,068.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,462.54
|
| Rate for Payer: Healthscope Commercial |
$4,198.33
|
| Rate for Payer: Healthscope Whirlpool |
$4,328.18
|
| Rate for Payer: Mclaren Commercial |
$3,895.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,678.95
|
| Rate for Payer: Nomi Health Commercial |
$3,549.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,246.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,808.80
|
|
|
HC TREPONEMA PALLIDUM AB TOTAL AND RPR
|
Facility
|
OP
|
$26.01
|
|
|
Service Code
|
CPT 0064U
|
| Hospital Charge Code |
30200436
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.39 |
| Max. Negotiated Rate |
$48.56 |
| Rate for Payer: Aetna Commercial |
$23.41
|
| Rate for Payer: Aetna Medicare |
$31.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$39.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$39.16
|
| Rate for Payer: ASR ASR |
$25.23
|
| Rate for Payer: BCBS Complete |
$17.21
|
| Rate for Payer: BCBS MAPPO |
$31.33
|
| Rate for Payer: BCBS Trust/PPO |
$21.45
|
| Rate for Payer: BCN Commercial |
$21.45
|
| Rate for Payer: BCN Medicare Advantage |
$31.33
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$24.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.33
|
| Rate for Payer: Healthscope Commercial |
$25.23
|
| Rate for Payer: Healthscope Whirlpool |
$26.01
|
| Rate for Payer: Humana Choice PPO Medicare |
$31.33
|
| Rate for Payer: Mclaren Commercial |
$23.41
|
| Rate for Payer: Mclaren Medicaid |
$31.33
|
| Rate for Payer: Mclaren Medicare |
$31.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.90
|
| Rate for Payer: Meridian Medicaid |
$17.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$34.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: Nomi Health Commercial |
$21.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.51
|
| Rate for Payer: PACE Medicare |
$29.76
|
| Rate for Payer: PACE SWMI |
$31.33
|
| Rate for Payer: PHP Commercial |
$34.46
|
| Rate for Payer: PHP Medicaid |
$16.79
|
| Rate for Payer: PHP Medicare Advantage |
$31.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$22.79
|
| Rate for Payer: Priority Health Medicare |
$31.33
|
| Rate for Payer: Priority Health Narrow Network |
$18.23
|
| Rate for Payer: Railroad Medicare Medicare |
$31.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.89
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$31.33
|
| Rate for Payer: UHC Exchange |
$48.56
|
| Rate for Payer: UHC Medicaid |
$16.39
|
| Rate for Payer: UHCCP DNSP |
$31.33
|
| Rate for Payer: UHCCP Medicaid |
$16.39
|
| Rate for Payer: VA VA |
$31.33
|
|
|
HC TREPONEMA PALLIDUM AB TOTAL AND RPR
|
Facility
|
IP
|
$26.01
|
|
|
Service Code
|
CPT 0064U
|
| Hospital Charge Code |
30200436
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.51 |
| Max. Negotiated Rate |
$26.01 |
| Rate for Payer: Aetna Commercial |
$23.41
|
| Rate for Payer: ASR ASR |
$25.23
|
| Rate for Payer: BCBS Trust/PPO |
$21.36
|
| Rate for Payer: BCN Commercial |
$21.36
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$24.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$25.23
|
| Rate for Payer: Healthscope Whirlpool |
$26.01
|
| Rate for Payer: Mclaren Commercial |
$23.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: Nomi Health Commercial |
$21.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.89
|
|
|
HC TREPONEMA PALLIDUM ANTIBODY
|
Facility
|
OP
|
$24.97
|
|
|
Service Code
|
CPT 86780
|
| Hospital Charge Code |
30000057
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.92 |
| Max. Negotiated Rate |
$62.96 |
| Rate for Payer: Aetna Commercial |
$22.47
|
| Rate for Payer: Aetna Medicare |
$13.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.55
|
| Rate for Payer: ASR ASR |
$24.22
|
| Rate for Payer: BCBS Complete |
$7.27
|
| Rate for Payer: BCBS MAPPO |
$13.24
|
| Rate for Payer: BCBS Trust/PPO |
$20.59
|
| Rate for Payer: BCN Commercial |
$20.59
|
| Rate for Payer: BCN Medicare Advantage |
$13.24
|
| Rate for Payer: Cash Price |
$19.98
|
| Rate for Payer: Cash Price |
$19.98
|
| Rate for Payer: Cofinity Commercial |
$23.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.24
|
| Rate for Payer: Healthscope Commercial |
$24.22
|
| Rate for Payer: Healthscope Whirlpool |
$24.97
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.24
|
| Rate for Payer: Mclaren Commercial |
$22.47
|
| Rate for Payer: Mclaren Medicaid |
$13.24
|
| Rate for Payer: Mclaren Medicare |
$13.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.90
|
| Rate for Payer: Meridian Medicaid |
$7.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.22
|
| Rate for Payer: Nomi Health Commercial |
$20.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.73
|
| Rate for Payer: PACE Medicare |
$12.58
|
| Rate for Payer: PACE SWMI |
$13.24
|
| Rate for Payer: PHP Commercial |
$14.56
|
| Rate for Payer: PHP Medicaid |
$7.10
|
| Rate for Payer: PHP Medicare Advantage |
$13.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$62.96
|
| Rate for Payer: Priority Health Medicare |
$13.24
|
| Rate for Payer: Priority Health Narrow Network |
$50.37
|
| Rate for Payer: Railroad Medicare Medicare |
$13.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.24
|
| Rate for Payer: UHC Exchange |
$20.52
|
| Rate for Payer: UHC Medicaid |
$6.92
|
| Rate for Payer: UHCCP DNSP |
$13.24
|
| Rate for Payer: UHCCP Medicaid |
$6.92
|
| Rate for Payer: VA VA |
$13.24
|
|
|
HC TREPONEMA PALLIDUM ANTIBODY
|
Facility
|
IP
|
$24.97
|
|
|
Service Code
|
CPT 86780
|
| Hospital Charge Code |
30000057
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$18.73 |
| Max. Negotiated Rate |
$24.97 |
| Rate for Payer: Aetna Commercial |
$22.47
|
| Rate for Payer: ASR ASR |
$24.22
|
| Rate for Payer: BCBS Trust/PPO |
$20.51
|
| Rate for Payer: BCN Commercial |
$20.51
|
| Rate for Payer: Cash Price |
$19.98
|
| Rate for Payer: Cofinity Commercial |
$23.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.98
|
| Rate for Payer: Healthscope Commercial |
$24.22
|
| Rate for Payer: Healthscope Whirlpool |
$24.97
|
| Rate for Payer: Mclaren Commercial |
$22.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.22
|
| Rate for Payer: Nomi Health Commercial |
$20.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.97
|
|
