|
HC TC 99M SULFUR COLLOID PER STUDY
|
Facility
|
IP
|
$250.29
|
|
|
Service Code
|
HCPCS A9541
|
| Hospital Charge Code |
34300020
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$162.69 |
| Max. Negotiated Rate |
$250.29 |
| Rate for Payer: Aetna Commercial |
$225.26
|
| Rate for Payer: ASR ASR |
$242.78
|
| Rate for Payer: ASR Commercial |
$242.78
|
| Rate for Payer: BCBS Trust/PPO |
$203.96
|
| Rate for Payer: BCN Commercial |
$194.05
|
| Rate for Payer: Cash Price |
$200.23
|
| Rate for Payer: Cofinity Commercial |
$235.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$200.23
|
| Rate for Payer: Healthscope Commercial |
$250.29
|
| Rate for Payer: Healthscope Whirlpool |
$242.78
|
| Rate for Payer: Mclaren Commercial |
$225.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$212.75
|
| Rate for Payer: Nomi Health Commercial |
$205.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$162.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$220.26
|
|
|
HC TC 99M SULFUR COLLOID PER STUDY
|
Facility
|
OP
|
$250.29
|
|
|
Service Code
|
HCPCS A9541
|
| Hospital Charge Code |
34300020
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$100.12 |
| Max. Negotiated Rate |
$250.29 |
| Rate for Payer: Aetna Commercial |
$225.26
|
| Rate for Payer: Aetna Medicare |
$125.14
|
| Rate for Payer: ASR ASR |
$242.78
|
| Rate for Payer: ASR Commercial |
$242.78
|
| Rate for Payer: BCBS Complete |
$100.12
|
| Rate for Payer: BCBS Trust/PPO |
$204.96
|
| Rate for Payer: BCN Commercial |
$194.05
|
| Rate for Payer: Cash Price |
$200.23
|
| Rate for Payer: Cofinity Commercial |
$235.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$200.23
|
| Rate for Payer: Healthscope Commercial |
$250.29
|
| Rate for Payer: Healthscope Whirlpool |
$242.78
|
| Rate for Payer: Mclaren Commercial |
$225.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$212.75
|
| Rate for Payer: Nomi Health Commercial |
$205.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$162.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$219.30
|
| Rate for Payer: Priority Health Narrow Network |
$175.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$220.26
|
|
|
HC T CELL ACUTE LYMPH LEUK
|
Facility
|
OP
|
$35.70
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000133
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$11.48 |
| Max. Negotiated Rate |
$35.70 |
| Rate for Payer: Aetna Commercial |
$32.13
|
| Rate for Payer: Aetna Medicare |
$21.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.77
|
| Rate for Payer: ASR ASR |
$34.63
|
| Rate for Payer: ASR Commercial |
$34.63
|
| Rate for Payer: BCBS Complete |
$12.06
|
| Rate for Payer: BCBS MAPPO |
$21.42
|
| Rate for Payer: BCBS Trust/PPO |
$29.23
|
| Rate for Payer: BCN Commercial |
$27.68
|
| Rate for Payer: BCN Medicare Advantage |
$21.42
|
| Rate for Payer: Cash Price |
$28.56
|
| Rate for Payer: Cash Price |
$28.56
|
| Rate for Payer: Cofinity Commercial |
$33.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.42
|
| Rate for Payer: Healthscope Commercial |
$35.70
|
| Rate for Payer: Healthscope Whirlpool |
$34.63
|
| Rate for Payer: Humana Choice PPO Medicare |
$21.42
|
| Rate for Payer: Mclaren Commercial |
$32.13
|
| Rate for Payer: Mclaren Medicaid |
$11.48
|
| Rate for Payer: Mclaren Medicare |
$21.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.49
|
| Rate for Payer: Meridian Medicaid |
$12.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.34
|
| Rate for Payer: Nomi Health Commercial |
$29.27
|
| Rate for Payer: PACE Medicare |
$20.35
|
| Rate for Payer: PACE SWMI |
$21.42
|
| Rate for Payer: PHP Commercial |
$23.56
|
| Rate for Payer: PHP Medicaid |
$11.48
|
| Rate for Payer: PHP Medicare Advantage |
$21.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$31.28
|
| Rate for Payer: Priority Health Medicare |
$21.42
|
| Rate for Payer: Priority Health Narrow Network |
$25.03
|
| Rate for Payer: Railroad Medicare Medicare |
$21.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$31.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.42
|
| Rate for Payer: UHC Exchange |
$33.20
|
| Rate for Payer: UHC Medicare Advantage |
$21.42
|
| Rate for Payer: UHCCP DNSP |
$21.42
|
| Rate for Payer: UHCCP Medicaid |
$11.48
|
| Rate for Payer: VA VA |
$21.42
|
|
|
HC T CELL ACUTE LYMPH LEUK
|
Facility
|
IP
|
$35.70
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000133
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$23.20 |
| Max. Negotiated Rate |
$35.70 |
| Rate for Payer: Aetna Commercial |
$32.13
|
| Rate for Payer: ASR ASR |
$34.63
|
| Rate for Payer: ASR Commercial |
$34.63
|
| Rate for Payer: BCBS Trust/PPO |
$29.09
|
| Rate for Payer: BCN Commercial |
$27.68
|
| Rate for Payer: Cash Price |
$28.56
|
| Rate for Payer: Cofinity Commercial |
$33.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.56
|
| Rate for Payer: Healthscope Commercial |
$35.70
|
| Rate for Payer: Healthscope Whirlpool |
$34.63
|
| Rate for Payer: Mclaren Commercial |
$32.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.34
|
| Rate for Payer: Nomi Health Commercial |
$29.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$31.42
|
|
|
HC T CELL ACUTE LYMPH LEUK CMPT1
|
Facility
|
OP
|
$118.61
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000040
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$27.44 |
| Max. Negotiated Rate |
$118.61 |
| Rate for Payer: Aetna Commercial |
$106.75
|
| Rate for Payer: Aetna Medicare |
$51.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$63.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$63.99
|
| Rate for Payer: ASR ASR |
$115.05
|
| Rate for Payer: ASR Commercial |
$115.05
|
| Rate for Payer: BCBS Complete |
$28.81
|
| Rate for Payer: BCBS MAPPO |
$51.19
|
| Rate for Payer: BCBS Trust/PPO |
$97.13
|
| Rate for Payer: BCN Commercial |
$91.96
|
| Rate for Payer: BCN Medicare Advantage |
$51.19
|
| Rate for Payer: Cash Price |
$94.89
|
| Rate for Payer: Cash Price |
$94.89
|
| Rate for Payer: Cofinity Commercial |
$111.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.19
|
| Rate for Payer: Healthscope Commercial |
$118.61
|
| Rate for Payer: Healthscope Whirlpool |
$115.05
|
| Rate for Payer: Humana Choice PPO Medicare |
$51.19
|
| Rate for Payer: Mclaren Commercial |
$106.75
|
| Rate for Payer: Mclaren Medicaid |
$27.44
|
| Rate for Payer: Mclaren Medicare |
$51.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.75
|
| Rate for Payer: Meridian Medicaid |
$28.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.82
|
| Rate for Payer: Nomi Health Commercial |
$97.26
|
| Rate for Payer: PACE Medicare |
$48.63
|
| Rate for Payer: PACE SWMI |
$51.19
|
| Rate for Payer: PHP Commercial |
$56.31
|
| Rate for Payer: PHP Medicaid |
$27.44
|
| Rate for Payer: PHP Medicare Advantage |
$51.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$103.93
|
| Rate for Payer: Priority Health Medicare |
$51.19
|
| Rate for Payer: Priority Health Narrow Network |
$83.15
|
| Rate for Payer: Railroad Medicare Medicare |
$51.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$104.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$51.19
|
| Rate for Payer: UHC Exchange |
$79.34
|
| Rate for Payer: UHC Medicare Advantage |
$51.19
|
| Rate for Payer: UHCCP DNSP |
$51.19
|
| Rate for Payer: UHCCP Medicaid |
$27.44
|
| Rate for Payer: VA VA |
$51.19
|
|
|
HC T CELL ACUTE LYMPH LEUK CMPT1
|
Facility
|
IP
|
$118.61
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000040
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$77.10 |
| Max. Negotiated Rate |
$118.61 |
| Rate for Payer: Aetna Commercial |
$106.75
|
| Rate for Payer: ASR ASR |
$115.05
|
| Rate for Payer: ASR Commercial |
$115.05
|
| Rate for Payer: BCBS Trust/PPO |
$96.66
|
| Rate for Payer: BCN Commercial |
$91.96
|
| Rate for Payer: Cash Price |
$94.89
|
| Rate for Payer: Cofinity Commercial |
$111.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.89
|
| Rate for Payer: Healthscope Commercial |
$118.61
|
| Rate for Payer: Healthscope Whirlpool |
$115.05
|
| Rate for Payer: Mclaren Commercial |
$106.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.82
|
| Rate for Payer: Nomi Health Commercial |
$97.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$104.38
|
|
|
HC T CELL ACUTE LYMPH LEUK CMPT2
|
Facility
|
IP
|
$105.08
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000029
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$68.30 |
| Max. Negotiated Rate |
$105.08 |
| Rate for Payer: Aetna Commercial |
$94.57
|
| Rate for Payer: ASR ASR |
$101.93
|
| Rate for Payer: ASR Commercial |
$101.93
|
| Rate for Payer: BCBS Trust/PPO |
$85.63
|
| Rate for Payer: BCN Commercial |
$81.47
|
| Rate for Payer: Cash Price |
$84.06
|
| Rate for Payer: Cofinity Commercial |
$98.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.06
|
| Rate for Payer: Healthscope Commercial |
$105.08
|
| Rate for Payer: Healthscope Whirlpool |
$101.93
|
| Rate for Payer: Mclaren Commercial |
$94.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.32
|
| Rate for Payer: Nomi Health Commercial |
$86.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$92.47
|
|
|
HC T CELL ACUTE LYMPH LEUK CMPT2
|
Facility
|
OP
|
$105.08
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000029
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$11.48 |
| Max. Negotiated Rate |
$105.08 |
| Rate for Payer: Aetna Commercial |
$94.57
|
| Rate for Payer: Aetna Medicare |
$21.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.77
|
| Rate for Payer: ASR ASR |
$101.93
|
| Rate for Payer: ASR Commercial |
$101.93
|
| Rate for Payer: BCBS Complete |
$12.06
|
| Rate for Payer: BCBS MAPPO |
$21.42
|
| Rate for Payer: BCBS Trust/PPO |
$86.05
|
| Rate for Payer: BCN Commercial |
$81.47
|
| Rate for Payer: BCN Medicare Advantage |
$21.42
|
| Rate for Payer: Cash Price |
$84.06
|
| Rate for Payer: Cash Price |
$84.06
|
| Rate for Payer: Cofinity Commercial |
$98.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.42
|
| Rate for Payer: Healthscope Commercial |
$105.08
|
| Rate for Payer: Healthscope Whirlpool |
$101.93
|
| Rate for Payer: Humana Choice PPO Medicare |
$21.42
|
| Rate for Payer: Mclaren Commercial |
$94.57
|
| Rate for Payer: Mclaren Medicaid |
$11.48
|
| Rate for Payer: Mclaren Medicare |
$21.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.49
|
| Rate for Payer: Meridian Medicaid |
$12.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.32
|
| Rate for Payer: Nomi Health Commercial |
$86.17
|
| Rate for Payer: PACE Medicare |
$20.35
|
| Rate for Payer: PACE SWMI |
$21.42
|
| Rate for Payer: PHP Commercial |
$23.56
|
| Rate for Payer: PHP Medicaid |
$11.48
|
| Rate for Payer: PHP Medicare Advantage |
$21.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$92.07
|
| Rate for Payer: Priority Health Medicare |
$21.42
|
| Rate for Payer: Priority Health Narrow Network |
$73.66
|
| Rate for Payer: Railroad Medicare Medicare |
$21.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$92.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.42
|
| Rate for Payer: UHC Exchange |
$33.20
|
| Rate for Payer: UHC Medicare Advantage |
$21.42
|
| Rate for Payer: UHCCP DNSP |
$21.42
|
| Rate for Payer: UHCCP Medicaid |
$11.48
|
| Rate for Payer: VA VA |
$21.42
|
|
|
HC T CELL ACUTE LYMPH LEUK FISH
|
Facility
|
OP
|
$84.66
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000039
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$27.44 |
| Max. Negotiated Rate |
$84.66 |
| Rate for Payer: Aetna Commercial |
$76.19
|
| Rate for Payer: Aetna Medicare |
$51.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$63.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$63.99
|
| Rate for Payer: ASR ASR |
$82.12
|
| Rate for Payer: ASR Commercial |
$82.12
|
| Rate for Payer: BCBS Complete |
$28.81
|
| Rate for Payer: BCBS MAPPO |
$51.19
|
| Rate for Payer: BCBS Trust/PPO |
$69.33
|
| Rate for Payer: BCN Commercial |
$65.64
|
| Rate for Payer: BCN Medicare Advantage |
$51.19
|
| Rate for Payer: Cash Price |
$67.73
|
| Rate for Payer: Cash Price |
$67.73
|
| Rate for Payer: Cofinity Commercial |
$79.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.19
|
| Rate for Payer: Healthscope Commercial |
$84.66
|
| Rate for Payer: Healthscope Whirlpool |
$82.12
|
| Rate for Payer: Humana Choice PPO Medicare |
$51.19
|
| Rate for Payer: Mclaren Commercial |
$76.19
|
| Rate for Payer: Mclaren Medicaid |
$27.44
|
| Rate for Payer: Mclaren Medicare |
$51.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.75
|
| Rate for Payer: Meridian Medicaid |
$28.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.96
|
| Rate for Payer: Nomi Health Commercial |
$69.42
|
| Rate for Payer: PACE Medicare |
$48.63
|
| Rate for Payer: PACE SWMI |
$51.19
|
| Rate for Payer: PHP Commercial |
$56.31
|
| Rate for Payer: PHP Medicaid |
$27.44
|
| Rate for Payer: PHP Medicare Advantage |
$51.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$74.18
|
| Rate for Payer: Priority Health Medicare |
$51.19
|
| Rate for Payer: Priority Health Narrow Network |
$59.35
|
| Rate for Payer: Railroad Medicare Medicare |
$51.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$74.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$51.19
|
| Rate for Payer: UHC Exchange |
$79.34
|
| Rate for Payer: UHC Medicare Advantage |
$51.19
|
| Rate for Payer: UHCCP DNSP |
$51.19
|
| Rate for Payer: UHCCP Medicaid |
$27.44
|
| Rate for Payer: VA VA |
$51.19
|
|
|
HC T CELL ACUTE LYMPH LEUK FISH
|
Facility
|
IP
|
$84.66
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000039
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$55.03 |
| Max. Negotiated Rate |
$84.66 |
| Rate for Payer: Aetna Commercial |
$76.19
|
| Rate for Payer: ASR ASR |
$82.12
|
| Rate for Payer: ASR Commercial |
$82.12
|
| Rate for Payer: BCBS Trust/PPO |
$68.99
|
| Rate for Payer: BCN Commercial |
$65.64
|
| Rate for Payer: Cash Price |
$67.73
|
| Rate for Payer: Cofinity Commercial |
$79.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.73
|
| Rate for Payer: Healthscope Commercial |
$84.66
|
| Rate for Payer: Healthscope Whirlpool |
$82.12
|
| Rate for Payer: Mclaren Commercial |
$76.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.96
|
| Rate for Payer: Nomi Health Commercial |
$69.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$74.50
|
|
|
HC T CELLS CD4 CD8 COUNT
|
Facility
|
OP
|
$76.86
|
|
|
Service Code
|
CPT 86360
|
| Hospital Charge Code |
30200207
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$25.18 |
| Max. Negotiated Rate |
$76.86 |
| Rate for Payer: Aetna Commercial |
$69.17
|
| Rate for Payer: Aetna Medicare |
$46.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$58.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$58.73
|
| Rate for Payer: ASR ASR |
$74.55
|
| Rate for Payer: ASR Commercial |
$74.55
|
| Rate for Payer: BCBS Complete |
$26.44
|
| Rate for Payer: BCBS MAPPO |
$46.98
|
| Rate for Payer: BCBS Trust/PPO |
$62.94
|
| Rate for Payer: BCN Commercial |
$59.59
|
| Rate for Payer: BCN Medicare Advantage |
$46.98
|
| Rate for Payer: Cash Price |
$61.49
|
| Rate for Payer: Cash Price |
$61.49
|
| Rate for Payer: Cofinity Commercial |
$72.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.98
|
| Rate for Payer: Healthscope Commercial |
$76.86
|
| Rate for Payer: Healthscope Whirlpool |
$74.55
|
| Rate for Payer: Humana Choice PPO Medicare |
$46.98
|
| Rate for Payer: Mclaren Commercial |
$69.17
|
| Rate for Payer: Mclaren Medicaid |
$25.18
|
| Rate for Payer: Mclaren Medicare |
$46.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$49.33
|
| Rate for Payer: Meridian Medicaid |
$26.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$54.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.33
|
| Rate for Payer: Nomi Health Commercial |
$63.03
|
| Rate for Payer: PACE Medicare |
$44.63
|
| Rate for Payer: PACE SWMI |
$46.98
|
| Rate for Payer: PHP Commercial |
$51.68
|
| Rate for Payer: PHP Medicaid |
$25.18
|
| Rate for Payer: PHP Medicare Advantage |
$46.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$67.34
|
| Rate for Payer: Priority Health Medicare |
$46.98
|
| Rate for Payer: Priority Health Narrow Network |
$53.88
|
| Rate for Payer: Railroad Medicare Medicare |
$46.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$67.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$46.98
|
| Rate for Payer: UHC Exchange |
$72.82
|
| Rate for Payer: UHC Medicare Advantage |
$46.98
|
| Rate for Payer: UHCCP DNSP |
$46.98
|
| Rate for Payer: UHCCP Medicaid |
$25.18
|
| Rate for Payer: VA VA |
$46.98
|
|
|
HC T CELLS CD4 CD8 COUNT
|
Facility
|
IP
|
$76.86
|
|
|
Service Code
|
CPT 86360
|
| Hospital Charge Code |
30200207
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$49.96 |
| Max. Negotiated Rate |
$76.86 |
| Rate for Payer: Aetna Commercial |
$69.17
|
| Rate for Payer: ASR ASR |
$74.55
|
| Rate for Payer: ASR Commercial |
$74.55
|
| Rate for Payer: BCBS Trust/PPO |
$62.63
|
| Rate for Payer: BCN Commercial |
$59.59
|
| Rate for Payer: Cash Price |
$61.49
|
| Rate for Payer: Cofinity Commercial |
$72.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.49
|
| Rate for Payer: Healthscope Commercial |
$76.86
|
| Rate for Payer: Healthscope Whirlpool |
$74.55
|
| Rate for Payer: Mclaren Commercial |
$69.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.33
|
| Rate for Payer: Nomi Health Commercial |
$63.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$67.64
|
|
|
HC T CELL TOTAL
|
Facility
|
OP
|
$61.72
|
|
|
Service Code
|
CPT 86359
|
| Hospital Charge Code |
30200205
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$20.22 |
| Max. Negotiated Rate |
$61.72 |
| Rate for Payer: Aetna Commercial |
$55.55
|
| Rate for Payer: Aetna Medicare |
$37.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$47.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$47.16
|
| Rate for Payer: ASR ASR |
$59.87
|
| Rate for Payer: ASR Commercial |
$59.87
|
| Rate for Payer: BCBS Complete |
$21.23
|
| Rate for Payer: BCBS MAPPO |
$37.73
|
| Rate for Payer: BCBS Trust/PPO |
$50.54
|
| Rate for Payer: BCN Commercial |
$47.85
|
| Rate for Payer: BCN Medicare Advantage |
$37.73
|
| Rate for Payer: Cash Price |
$49.38
|
| Rate for Payer: Cash Price |
$49.38
|
| Rate for Payer: Cofinity Commercial |
$58.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.73
|
| Rate for Payer: Healthscope Commercial |
$61.72
|
| Rate for Payer: Healthscope Whirlpool |
$59.87
|
| Rate for Payer: Humana Choice PPO Medicare |
$37.73
|
| Rate for Payer: Mclaren Commercial |
$55.55
|
| Rate for Payer: Mclaren Medicaid |
$20.22
|
| Rate for Payer: Mclaren Medicare |
$37.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.62
|
| Rate for Payer: Meridian Medicaid |
$21.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.46
|
| Rate for Payer: Nomi Health Commercial |
$50.61
|
| Rate for Payer: PACE Medicare |
$35.84
|
| Rate for Payer: PACE SWMI |
$37.73
|
| Rate for Payer: PHP Commercial |
$41.50
|
| Rate for Payer: PHP Medicaid |
$20.22
|
| Rate for Payer: PHP Medicare Advantage |
$37.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$54.08
|
| Rate for Payer: Priority Health Medicare |
$37.73
|
| Rate for Payer: Priority Health Narrow Network |
$43.27
|
| Rate for Payer: Railroad Medicare Medicare |
$37.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$54.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.73
|
| Rate for Payer: UHC Exchange |
$58.48
|
| Rate for Payer: UHC Medicare Advantage |
$37.73
|
| Rate for Payer: UHCCP DNSP |
$37.73
|
| Rate for Payer: UHCCP Medicaid |
$20.22
|
| Rate for Payer: VA VA |
$37.73
|
|
|
HC T CELL TOTAL
|
Facility
|
IP
|
$61.72
|
|
|
Service Code
|
CPT 86359
|
| Hospital Charge Code |
30200205
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$40.12 |
| Max. Negotiated Rate |
$61.72 |
| Rate for Payer: Aetna Commercial |
$55.55
|
| Rate for Payer: ASR ASR |
$59.87
|
| Rate for Payer: ASR Commercial |
$59.87
|
| Rate for Payer: BCBS Trust/PPO |
$50.30
|
| Rate for Payer: BCN Commercial |
$47.85
|
| Rate for Payer: Cash Price |
$49.38
|
| Rate for Payer: Cofinity Commercial |
$58.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.38
|
| Rate for Payer: Healthscope Commercial |
$61.72
|
| Rate for Payer: Healthscope Whirlpool |
$59.87
|
| Rate for Payer: Mclaren Commercial |
$55.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.46
|
| Rate for Payer: Nomi Health Commercial |
$50.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$54.31
|
|
|
HC TCMEPS UPPER/LOWER EXT. STIM
|
Facility
|
OP
|
$3,570.54
|
|
|
Service Code
|
CPT 95939
|
| Hospital Charge Code |
92200026
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$531.84 |
| Max. Negotiated Rate |
$3,570.54 |
| Rate for Payer: Aetna Commercial |
$3,213.49
|
| Rate for Payer: Aetna Medicare |
$992.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,240.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,240.30
|
| Rate for Payer: ASR ASR |
$3,463.42
|
| Rate for Payer: ASR Commercial |
$3,463.42
|
| Rate for Payer: BCBS Complete |
$558.43
|
| Rate for Payer: BCBS MAPPO |
$992.24
|
| Rate for Payer: BCBS Trust/PPO |
$2,923.92
|
| Rate for Payer: BCN Commercial |
$2,768.24
|
| Rate for Payer: BCN Medicare Advantage |
$992.24
|
| Rate for Payer: Cash Price |
$2,856.43
|
| Rate for Payer: Cash Price |
$2,856.43
|
| Rate for Payer: Cofinity Commercial |
$3,356.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,856.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$992.24
|
| Rate for Payer: Healthscope Commercial |
$3,570.54
|
| Rate for Payer: Healthscope Whirlpool |
$3,463.42
|
| Rate for Payer: Humana Choice PPO Medicare |
$992.24
|
| Rate for Payer: Mclaren Commercial |
$3,213.49
|
| Rate for Payer: Mclaren Medicaid |
$531.84
|
| Rate for Payer: Mclaren Medicare |
$992.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,041.85
|
| Rate for Payer: Meridian Medicaid |
$558.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,141.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,034.96
|
| Rate for Payer: Nomi Health Commercial |
$2,927.84
|
| Rate for Payer: PACE Medicare |
$942.63
|
| Rate for Payer: PACE SWMI |
$992.24
|
| Rate for Payer: PHP Commercial |
$1,091.46
|
| Rate for Payer: PHP Medicaid |
$531.84
|
| Rate for Payer: PHP Medicare Advantage |
$992.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$531.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,320.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,128.51
|
| Rate for Payer: Priority Health Medicare |
$992.24
|
| Rate for Payer: Priority Health Narrow Network |
$2,502.95
|
| Rate for Payer: Railroad Medicare Medicare |
$992.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,142.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$992.24
|
| Rate for Payer: UHC Exchange |
$1,537.97
|
| Rate for Payer: UHC Medicare Advantage |
$992.24
|
| Rate for Payer: UHCCP DNSP |
$992.24
|
| Rate for Payer: UHCCP Medicaid |
$531.84
|
| Rate for Payer: VA VA |
$992.24
|
|
|
HC TCMEPS UPPER/LOWER EXT. STIM
|
Facility
|
IP
|
$3,570.54
|
|
|
Service Code
|
CPT 95939
|
| Hospital Charge Code |
92200026
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$2,320.85 |
| Max. Negotiated Rate |
$3,570.54 |
| Rate for Payer: Aetna Commercial |
$3,213.49
|
| Rate for Payer: ASR ASR |
$3,463.42
|
| Rate for Payer: ASR Commercial |
$3,463.42
|
| Rate for Payer: BCBS Trust/PPO |
$2,909.63
|
| Rate for Payer: BCN Commercial |
$2,768.24
|
| Rate for Payer: Cash Price |
$2,856.43
|
| Rate for Payer: Cofinity Commercial |
$3,356.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,856.43
|
| Rate for Payer: Healthscope Commercial |
$3,570.54
|
| Rate for Payer: Healthscope Whirlpool |
$3,463.42
|
| Rate for Payer: Mclaren Commercial |
$3,213.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,034.96
|
| Rate for Payer: Nomi Health Commercial |
$2,927.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,320.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,142.08
|
|
|
HC TCOM INITIAL DAY
|
Facility
|
OP
|
$411.68
|
|
|
Service Code
|
CPT 94729
|
| Hospital Charge Code |
46000011
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$164.67 |
| Max. Negotiated Rate |
$411.68 |
| Rate for Payer: Aetna Commercial |
$370.51
|
| Rate for Payer: Aetna Medicare |
$205.84
|
| Rate for Payer: ASR ASR |
$399.33
|
| Rate for Payer: ASR Commercial |
$399.33
|
| Rate for Payer: BCBS Complete |
$164.67
|
| Rate for Payer: BCBS Trust/PPO |
$337.12
|
| Rate for Payer: BCN Commercial |
$319.18
|
| Rate for Payer: Cash Price |
$329.34
|
| Rate for Payer: Cofinity Commercial |
$386.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$329.34
|
| Rate for Payer: Healthscope Commercial |
$411.68
|
| Rate for Payer: Healthscope Whirlpool |
$399.33
|
| Rate for Payer: Mclaren Commercial |
$370.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$349.93
|
| Rate for Payer: Nomi Health Commercial |
$337.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$267.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$360.71
|
| Rate for Payer: Priority Health Narrow Network |
$288.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$362.28
|
|
|
HC TCOM INITIAL DAY
|
Facility
|
IP
|
$411.68
|
|
|
Service Code
|
CPT 94729
|
| Hospital Charge Code |
46000011
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$267.59 |
| Max. Negotiated Rate |
$411.68 |
| Rate for Payer: Aetna Commercial |
$370.51
|
| Rate for Payer: ASR ASR |
$399.33
|
| Rate for Payer: ASR Commercial |
$399.33
|
| Rate for Payer: BCBS Trust/PPO |
$335.48
|
| Rate for Payer: BCN Commercial |
$319.18
|
| Rate for Payer: Cash Price |
$329.34
|
| Rate for Payer: Cofinity Commercial |
$386.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$329.34
|
| Rate for Payer: Healthscope Commercial |
$411.68
|
| Rate for Payer: Healthscope Whirlpool |
$399.33
|
| Rate for Payer: Mclaren Commercial |
$370.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$349.93
|
| Rate for Payer: Nomi Health Commercial |
$337.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$267.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$362.28
|
|
|
HC TCOM SUBS DAY
|
Facility
|
IP
|
$316.14
|
|
|
Service Code
|
CPT 94729
|
| Hospital Charge Code |
46000010
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$205.49 |
| Max. Negotiated Rate |
$316.14 |
| Rate for Payer: Aetna Commercial |
$284.53
|
| Rate for Payer: ASR ASR |
$306.66
|
| Rate for Payer: ASR Commercial |
$306.66
|
| Rate for Payer: BCBS Trust/PPO |
$257.62
|
| Rate for Payer: BCN Commercial |
$245.10
|
| Rate for Payer: Cash Price |
$252.91
|
| Rate for Payer: Cofinity Commercial |
$297.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.91
|
| Rate for Payer: Healthscope Commercial |
$316.14
|
| Rate for Payer: Healthscope Whirlpool |
$306.66
|
| Rate for Payer: Mclaren Commercial |
$284.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$268.72
|
| Rate for Payer: Nomi Health Commercial |
$259.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$205.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$278.20
|
|
|
HC TCOM SUBS DAY
|
Facility
|
OP
|
$316.14
|
|
|
Service Code
|
CPT 94729
|
| Hospital Charge Code |
46000010
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$126.46 |
| Max. Negotiated Rate |
$316.14 |
| Rate for Payer: Aetna Commercial |
$284.53
|
| Rate for Payer: Aetna Medicare |
$158.07
|
| Rate for Payer: ASR ASR |
$306.66
|
| Rate for Payer: ASR Commercial |
$306.66
|
| Rate for Payer: BCBS Complete |
$126.46
|
| Rate for Payer: BCBS Trust/PPO |
$258.89
|
| Rate for Payer: BCN Commercial |
$245.10
|
| Rate for Payer: Cash Price |
$252.91
|
| Rate for Payer: Cofinity Commercial |
$297.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.91
|
| Rate for Payer: Healthscope Commercial |
$316.14
|
| Rate for Payer: Healthscope Whirlpool |
$306.66
|
| Rate for Payer: Mclaren Commercial |
$284.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$268.72
|
| Rate for Payer: Nomi Health Commercial |
$259.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$205.49
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$277.00
|
| Rate for Payer: Priority Health Narrow Network |
$221.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$278.20
|
|
|
HC TCU OBSERVATION PER HOUR
|
Facility
|
OP
|
$145.08
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200015
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$58.03 |
| Max. Negotiated Rate |
$145.08 |
| Rate for Payer: Aetna Commercial |
$130.57
|
| Rate for Payer: Aetna Medicare |
$72.54
|
| Rate for Payer: ASR ASR |
$140.73
|
| Rate for Payer: ASR Commercial |
$140.73
|
| Rate for Payer: BCBS Complete |
$58.03
|
| Rate for Payer: BCBS Trust/PPO |
$118.81
|
| Rate for Payer: BCN Commercial |
$112.48
|
| Rate for Payer: Cash Price |
$116.06
|
| Rate for Payer: Cofinity Commercial |
$136.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.06
|
| Rate for Payer: Healthscope Commercial |
$145.08
|
| Rate for Payer: Healthscope Whirlpool |
$140.73
|
| Rate for Payer: Mclaren Commercial |
$130.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.32
|
| Rate for Payer: Nomi Health Commercial |
$118.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$127.12
|
| Rate for Payer: Priority Health Narrow Network |
$101.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$127.67
|
|
|
HC TCU OBSERVATION PER HOUR
|
Facility
|
IP
|
$145.08
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200015
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$94.30 |
| Max. Negotiated Rate |
$145.08 |
| Rate for Payer: Aetna Commercial |
$130.57
|
| Rate for Payer: ASR ASR |
$140.73
|
| Rate for Payer: ASR Commercial |
$140.73
|
| Rate for Payer: BCBS Trust/PPO |
$118.23
|
| Rate for Payer: BCN Commercial |
$112.48
|
| Rate for Payer: Cash Price |
$116.06
|
| Rate for Payer: Cofinity Commercial |
$136.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.06
|
| Rate for Payer: Healthscope Commercial |
$145.08
|
| Rate for Payer: Healthscope Whirlpool |
$140.73
|
| Rate for Payer: Mclaren Commercial |
$130.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.32
|
| Rate for Payer: Nomi Health Commercial |
$118.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$127.67
|
|
|
HC TCU OR NCCU R&B
|
Facility
|
IP
|
$5,069.49
|
|
| Hospital Charge Code |
20800001
|
|
Hospital Revenue Code
|
208
|
| Min. Negotiated Rate |
$3,295.17 |
| Max. Negotiated Rate |
$5,069.49 |
| Rate for Payer: Aetna Commercial |
$4,562.54
|
| Rate for Payer: ASR ASR |
$4,917.41
|
| Rate for Payer: ASR Commercial |
$4,917.41
|
| Rate for Payer: BCBS Trust/PPO |
$4,131.13
|
| Rate for Payer: BCN Commercial |
$3,930.38
|
| Rate for Payer: Cash Price |
$4,055.59
|
| Rate for Payer: Cofinity Commercial |
$4,765.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,055.59
|
| Rate for Payer: Healthscope Commercial |
$5,069.49
|
| Rate for Payer: Healthscope Whirlpool |
$4,917.41
|
| Rate for Payer: Mclaren Commercial |
$4,562.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,309.07
|
| Rate for Payer: Nomi Health Commercial |
$4,156.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,295.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,461.15
|
|
|
HC TEE ECHOCARDIOGRAM W/DOPPLER
|
Facility
|
IP
|
$1,888.91
|
|
|
Service Code
|
CPT 93312
|
| Hospital Charge Code |
48000012
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,227.79 |
| Max. Negotiated Rate |
$1,888.91 |
| Rate for Payer: Aetna Commercial |
$1,700.02
|
| Rate for Payer: ASR ASR |
$1,832.24
|
| Rate for Payer: ASR Commercial |
$1,832.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,539.27
|
| Rate for Payer: BCN Commercial |
$1,464.47
|
| Rate for Payer: Cash Price |
$1,511.13
|
| Rate for Payer: Cofinity Commercial |
$1,775.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,511.13
|
| Rate for Payer: Healthscope Commercial |
$1,888.91
|
| Rate for Payer: Healthscope Whirlpool |
$1,832.24
|
| Rate for Payer: Mclaren Commercial |
$1,700.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,605.57
|
| Rate for Payer: Nomi Health Commercial |
$1,548.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,227.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,662.24
|
|
|
HC TEE ECHOCARDIOGRAM W/DOPPLER
|
Facility
|
OP
|
$1,888.91
|
|
|
Service Code
|
CPT 93312
|
| Hospital Charge Code |
48000012
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$286.63 |
| Max. Negotiated Rate |
$1,888.91 |
| Rate for Payer: Aetna Commercial |
$1,700.02
|
| Rate for Payer: Aetna Medicare |
$534.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$668.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$668.44
|
| Rate for Payer: ASR ASR |
$1,832.24
|
| Rate for Payer: ASR Commercial |
$1,832.24
|
| Rate for Payer: BCBS Complete |
$300.96
|
| Rate for Payer: BCBS MAPPO |
$534.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,546.83
|
| Rate for Payer: BCN Commercial |
$1,464.47
|
| Rate for Payer: BCN Medicare Advantage |
$534.75
|
| Rate for Payer: Cash Price |
$1,511.13
|
| Rate for Payer: Cash Price |
$1,511.13
|
| Rate for Payer: Cofinity Commercial |
$1,775.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,511.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$534.75
|
| Rate for Payer: Healthscope Commercial |
$1,888.91
|
| Rate for Payer: Healthscope Whirlpool |
$1,832.24
|
| Rate for Payer: Humana Choice PPO Medicare |
$534.75
|
| Rate for Payer: Mclaren Commercial |
$1,700.02
|
| Rate for Payer: Mclaren Medicaid |
$286.63
|
| Rate for Payer: Mclaren Medicare |
$534.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$561.49
|
| Rate for Payer: Meridian Medicaid |
$300.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$614.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,605.57
|
| Rate for Payer: Nomi Health Commercial |
$1,548.91
|
| Rate for Payer: PACE Medicare |
$508.01
|
| Rate for Payer: PACE SWMI |
$534.75
|
| Rate for Payer: PHP Commercial |
$588.23
|
| Rate for Payer: PHP Medicaid |
$286.63
|
| Rate for Payer: PHP Medicare Advantage |
$534.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$286.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,227.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,655.06
|
| Rate for Payer: Priority Health Medicare |
$534.75
|
| Rate for Payer: Priority Health Narrow Network |
$1,324.13
|
| Rate for Payer: Railroad Medicare Medicare |
$534.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,662.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$534.75
|
| Rate for Payer: UHC Exchange |
$828.86
|
| Rate for Payer: UHC Medicare Advantage |
$534.75
|
| Rate for Payer: UHCCP DNSP |
$534.75
|
| Rate for Payer: UHCCP Medicaid |
$286.63
|
| Rate for Payer: VA VA |
$534.75
|
|
