|
HC TYPE III HOME STUDY
|
Facility
|
OP
|
$694.43
|
|
|
Service Code
|
CPT 95800
|
| Hospital Charge Code |
92000015
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$112.52 |
| Max. Negotiated Rate |
$694.43 |
| Rate for Payer: Aetna Commercial |
$624.99
|
| Rate for Payer: Aetna Medicare |
$215.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$268.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$268.94
|
| Rate for Payer: ASR ASR |
$673.60
|
| Rate for Payer: BCBS Complete |
$118.16
|
| Rate for Payer: BCBS MAPPO |
$215.15
|
| Rate for Payer: BCBS Trust/PPO |
$572.56
|
| Rate for Payer: BCN Commercial |
$572.56
|
| Rate for Payer: BCN Medicare Advantage |
$215.15
|
| Rate for Payer: Cash Price |
$555.54
|
| Rate for Payer: Cash Price |
$555.54
|
| Rate for Payer: Cofinity Commercial |
$652.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$555.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$215.15
|
| Rate for Payer: Healthscope Commercial |
$673.60
|
| Rate for Payer: Healthscope Whirlpool |
$694.43
|
| Rate for Payer: Humana Choice PPO Medicare |
$215.15
|
| Rate for Payer: Mclaren Commercial |
$624.99
|
| Rate for Payer: Mclaren Medicaid |
$215.15
|
| Rate for Payer: Mclaren Medicare |
$215.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$225.91
|
| Rate for Payer: Meridian Medicaid |
$118.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$247.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$236.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$590.27
|
| Rate for Payer: Nomi Health Commercial |
$569.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$520.82
|
| Rate for Payer: PACE Medicare |
$204.39
|
| Rate for Payer: PACE SWMI |
$215.15
|
| Rate for Payer: PHP Commercial |
$236.66
|
| Rate for Payer: PHP Medicaid |
$115.32
|
| Rate for Payer: PHP Medicare Advantage |
$215.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$608.46
|
| Rate for Payer: Priority Health Medicare |
$215.15
|
| Rate for Payer: Priority Health Narrow Network |
$486.80
|
| Rate for Payer: Railroad Medicare Medicare |
$215.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$611.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$215.15
|
| Rate for Payer: UHC Exchange |
$333.48
|
| Rate for Payer: UHC Medicaid |
$112.52
|
| Rate for Payer: UHCCP DNSP |
$215.15
|
| Rate for Payer: UHCCP Medicaid |
$112.52
|
| Rate for Payer: VA VA |
$215.15
|
|
|
HC TYPE III HOME STUDY W/EFFORT AND FLOW
|
Facility
|
OP
|
$762.72
|
|
|
Service Code
|
CPT 95806
|
| Hospital Charge Code |
92000014
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$112.52 |
| Max. Negotiated Rate |
$762.72 |
| Rate for Payer: Aetna Commercial |
$686.45
|
| Rate for Payer: Aetna Medicare |
$215.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$268.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$268.94
|
| Rate for Payer: ASR ASR |
$739.84
|
| Rate for Payer: BCBS Complete |
$118.16
|
| Rate for Payer: BCBS MAPPO |
$215.15
|
| Rate for Payer: BCBS Trust/PPO |
$628.86
|
| Rate for Payer: BCN Commercial |
$628.86
|
| Rate for Payer: BCN Medicare Advantage |
$215.15
|
| Rate for Payer: Cash Price |
$610.18
|
| Rate for Payer: Cash Price |
$610.18
|
| Rate for Payer: Cofinity Commercial |
$716.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$610.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$215.15
|
| Rate for Payer: Healthscope Commercial |
$739.84
|
| Rate for Payer: Healthscope Whirlpool |
$762.72
|
| Rate for Payer: Humana Choice PPO Medicare |
$215.15
|
| Rate for Payer: Mclaren Commercial |
$686.45
|
| Rate for Payer: Mclaren Medicaid |
$215.15
|
| Rate for Payer: Mclaren Medicare |
$215.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$225.91
|
| Rate for Payer: Meridian Medicaid |
$118.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$247.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$236.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$648.31
|
| Rate for Payer: Nomi Health Commercial |
$625.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$572.04
|
| Rate for Payer: PACE Medicare |
$204.39
|
| Rate for Payer: PACE SWMI |
$215.15
|
| Rate for Payer: PHP Commercial |
$236.66
|
| Rate for Payer: PHP Medicaid |
$115.32
|
| Rate for Payer: PHP Medicare Advantage |
$215.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$403.12
|
| Rate for Payer: Priority Health Medicare |
$215.15
|
| Rate for Payer: Priority Health Narrow Network |
$322.49
|
| Rate for Payer: Railroad Medicare Medicare |
$215.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$671.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$215.15
|
| Rate for Payer: UHC Exchange |
$333.48
|
| Rate for Payer: UHC Medicaid |
$112.52
|
| Rate for Payer: UHCCP DNSP |
$215.15
|
| Rate for Payer: UHCCP Medicaid |
$112.52
|
| Rate for Payer: VA VA |
$215.15
|
|
|
HC TYPE III HOME STUDY W/EFFORT AND FLOW
|
Facility
|
IP
|
$762.72
|
|
|
Service Code
|
CPT 95806
|
| Hospital Charge Code |
92000014
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$572.04 |
| Max. Negotiated Rate |
$762.72 |
| Rate for Payer: Aetna Commercial |
$686.45
|
| Rate for Payer: ASR ASR |
$739.84
|
| Rate for Payer: BCBS Trust/PPO |
$626.35
|
| Rate for Payer: BCN Commercial |
$626.35
|
| Rate for Payer: Cash Price |
$610.18
|
| Rate for Payer: Cofinity Commercial |
$716.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$610.18
|
| Rate for Payer: Healthscope Commercial |
$739.84
|
| Rate for Payer: Healthscope Whirlpool |
$762.72
|
| Rate for Payer: Mclaren Commercial |
$686.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$648.31
|
| Rate for Payer: Nomi Health Commercial |
$625.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$572.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$671.19
|
|
|
HC TYPE & SCREEN ABO
|
Facility
|
OP
|
$22.72
|
|
|
Service Code
|
CPT 86900
|
| Hospital Charge Code |
30200347
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$1.56 |
| Max. Negotiated Rate |
$72.63 |
| Rate for Payer: Aetna Commercial |
$20.45
|
| Rate for Payer: Aetna Medicare |
$2.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.74
|
| Rate for Payer: ASR ASR |
$22.04
|
| Rate for Payer: BCBS Complete |
$1.64
|
| Rate for Payer: BCBS MAPPO |
$2.99
|
| Rate for Payer: BCBS Trust/PPO |
$18.73
|
| Rate for Payer: BCN Commercial |
$18.73
|
| Rate for Payer: BCN Medicare Advantage |
$2.99
|
| Rate for Payer: Cash Price |
$18.18
|
| Rate for Payer: Cash Price |
$18.18
|
| Rate for Payer: Cofinity Commercial |
$21.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.99
|
| Rate for Payer: Healthscope Commercial |
$22.04
|
| Rate for Payer: Healthscope Whirlpool |
$22.72
|
| Rate for Payer: Humana Choice PPO Medicare |
$2.99
|
| Rate for Payer: Mclaren Commercial |
$20.45
|
| Rate for Payer: Mclaren Medicaid |
$2.99
|
| Rate for Payer: Mclaren Medicare |
$2.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.14
|
| Rate for Payer: Meridian Medicaid |
$1.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.31
|
| Rate for Payer: Nomi Health Commercial |
$18.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.04
|
| Rate for Payer: PACE Medicare |
$2.84
|
| Rate for Payer: PACE SWMI |
$2.99
|
| Rate for Payer: PHP Commercial |
$3.29
|
| Rate for Payer: PHP Medicaid |
$1.60
|
| Rate for Payer: PHP Medicare Advantage |
$2.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$72.63
|
| Rate for Payer: Priority Health Medicare |
$2.99
|
| Rate for Payer: Priority Health Narrow Network |
$58.10
|
| Rate for Payer: Railroad Medicare Medicare |
$2.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2.99
|
| Rate for Payer: UHC Exchange |
$4.63
|
| Rate for Payer: UHC Medicaid |
$1.56
|
| Rate for Payer: UHCCP DNSP |
$2.99
|
| Rate for Payer: UHCCP Medicaid |
$1.56
|
| Rate for Payer: VA VA |
$2.99
|
|
|
HC TYPE & SCREEN ABO
|
Facility
|
IP
|
$22.72
|
|
|
Service Code
|
CPT 86900
|
| Hospital Charge Code |
30200347
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$17.04 |
| Max. Negotiated Rate |
$22.72 |
| Rate for Payer: Aetna Commercial |
$20.45
|
| Rate for Payer: ASR ASR |
$22.04
|
| Rate for Payer: BCBS Trust/PPO |
$18.66
|
| Rate for Payer: BCN Commercial |
$18.66
|
| Rate for Payer: Cash Price |
$18.18
|
| Rate for Payer: Cofinity Commercial |
$21.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.18
|
| Rate for Payer: Healthscope Commercial |
$22.04
|
| Rate for Payer: Healthscope Whirlpool |
$22.72
|
| Rate for Payer: Mclaren Commercial |
$20.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.31
|
| Rate for Payer: Nomi Health Commercial |
$18.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19.99
|
|
|
HC TYPE & SCREEN ANTIBODY
|
Facility
|
IP
|
$38.61
|
|
|
Service Code
|
CPT 86850
|
| Hospital Charge Code |
30200340
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$28.96 |
| Max. Negotiated Rate |
$38.61 |
| Rate for Payer: Aetna Commercial |
$34.75
|
| Rate for Payer: ASR ASR |
$37.45
|
| Rate for Payer: BCBS Trust/PPO |
$31.71
|
| Rate for Payer: BCN Commercial |
$31.71
|
| Rate for Payer: Cash Price |
$30.89
|
| Rate for Payer: Cofinity Commercial |
$36.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.89
|
| Rate for Payer: Healthscope Commercial |
$37.45
|
| Rate for Payer: Healthscope Whirlpool |
$38.61
|
| Rate for Payer: Mclaren Commercial |
$34.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.82
|
| Rate for Payer: Nomi Health Commercial |
$31.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$33.98
|
|
|
HC TYPE & SCREEN ANTIBODY
|
Facility
|
OP
|
$38.61
|
|
|
Service Code
|
CPT 86850
|
| Hospital Charge Code |
30200340
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.11 |
| Max. Negotiated Rate |
$112.58 |
| Rate for Payer: Aetna Commercial |
$34.75
|
| Rate for Payer: Aetna Medicare |
$9.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.21
|
| Rate for Payer: ASR ASR |
$37.45
|
| Rate for Payer: BCBS Complete |
$5.37
|
| Rate for Payer: BCBS MAPPO |
$9.77
|
| Rate for Payer: BCBS Trust/PPO |
$31.83
|
| Rate for Payer: BCN Commercial |
$31.83
|
| Rate for Payer: BCN Medicare Advantage |
$9.77
|
| Rate for Payer: Cash Price |
$30.89
|
| Rate for Payer: Cash Price |
$30.89
|
| Rate for Payer: Cofinity Commercial |
$36.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.77
|
| Rate for Payer: Healthscope Commercial |
$37.45
|
| Rate for Payer: Healthscope Whirlpool |
$38.61
|
| Rate for Payer: Humana Choice PPO Medicare |
$9.77
|
| Rate for Payer: Mclaren Commercial |
$34.75
|
| Rate for Payer: Mclaren Medicaid |
$9.77
|
| Rate for Payer: Mclaren Medicare |
$9.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.26
|
| Rate for Payer: Meridian Medicaid |
$5.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.82
|
| Rate for Payer: Nomi Health Commercial |
$31.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.96
|
| Rate for Payer: PACE Medicare |
$9.28
|
| Rate for Payer: PACE SWMI |
$9.77
|
| Rate for Payer: PHP Commercial |
$10.75
|
| Rate for Payer: PHP Medicaid |
$5.24
|
| Rate for Payer: PHP Medicare Advantage |
$9.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$112.58
|
| Rate for Payer: Priority Health Medicare |
$9.77
|
| Rate for Payer: Priority Health Narrow Network |
$90.06
|
| Rate for Payer: Railroad Medicare Medicare |
$9.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$33.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$9.77
|
| Rate for Payer: UHC Exchange |
$15.14
|
| Rate for Payer: UHC Medicaid |
$5.11
|
| Rate for Payer: UHCCP DNSP |
$9.77
|
| Rate for Payer: UHCCP Medicaid |
$5.11
|
| Rate for Payer: VA VA |
$9.77
|
|
|
HC TYRX ANTIBACTERIAL POUCH
|
Facility
|
IP
|
$2,861.10
|
|
| Hospital Charge Code |
27800115
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,145.82 |
| Max. Negotiated Rate |
$2,861.10 |
| Rate for Payer: Aetna Commercial |
$2,574.99
|
| Rate for Payer: ASR ASR |
$2,775.27
|
| Rate for Payer: BCBS Trust/PPO |
$2,349.54
|
| Rate for Payer: BCN Commercial |
$2,349.54
|
| Rate for Payer: Cash Price |
$2,288.88
|
| Rate for Payer: Cofinity Commercial |
$2,689.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,288.88
|
| Rate for Payer: Healthscope Commercial |
$2,775.27
|
| Rate for Payer: Healthscope Whirlpool |
$2,861.10
|
| Rate for Payer: Mclaren Commercial |
$2,574.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,431.93
|
| Rate for Payer: Nomi Health Commercial |
$2,346.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,145.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,517.77
|
|
|
HC TYRX ANTIBACTERIAL POUCH
|
Facility
|
OP
|
$2,861.10
|
|
| Hospital Charge Code |
27800115
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,058.61 |
| Max. Negotiated Rate |
$2,861.10 |
| Rate for Payer: Aetna Commercial |
$2,574.99
|
| Rate for Payer: Aetna Medicare |
$1,058.61
|
| Rate for Payer: ASR ASR |
$2,775.27
|
| Rate for Payer: BCBS Complete |
$1,144.44
|
| Rate for Payer: BCBS Trust/PPO |
$2,358.98
|
| Rate for Payer: BCN Commercial |
$2,358.98
|
| Rate for Payer: Cash Price |
$2,288.88
|
| Rate for Payer: Cofinity Commercial |
$2,689.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,288.88
|
| Rate for Payer: Healthscope Commercial |
$2,775.27
|
| Rate for Payer: Healthscope Whirlpool |
$2,861.10
|
| Rate for Payer: Mclaren Commercial |
$2,574.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,288.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,431.93
|
| Rate for Payer: Nomi Health Commercial |
$2,346.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,145.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,506.90
|
| Rate for Payer: Priority Health Narrow Network |
$2,005.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,517.77
|
|
|
HC UA DIPSTICK AUTO
|
Facility
|
IP
|
$21.64
|
|
|
Service Code
|
CPT 81003
|
| Hospital Charge Code |
30700002
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$16.23 |
| Max. Negotiated Rate |
$21.64 |
| Rate for Payer: Aetna Commercial |
$19.48
|
| Rate for Payer: ASR ASR |
$20.99
|
| Rate for Payer: BCBS Trust/PPO |
$17.77
|
| Rate for Payer: BCN Commercial |
$17.77
|
| Rate for Payer: Cash Price |
$17.31
|
| Rate for Payer: Cofinity Commercial |
$20.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.31
|
| Rate for Payer: Healthscope Commercial |
$20.99
|
| Rate for Payer: Healthscope Whirlpool |
$21.64
|
| Rate for Payer: Mclaren Commercial |
$19.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.39
|
| Rate for Payer: Nomi Health Commercial |
$17.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19.04
|
|
|
HC UA DIPSTICK AUTO
|
Facility
|
OP
|
$21.64
|
|
|
Service Code
|
CPT 81003
|
| Hospital Charge Code |
30700002
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$1.18 |
| Max. Negotiated Rate |
$21.64 |
| Rate for Payer: Aetna Commercial |
$19.48
|
| Rate for Payer: Aetna Medicare |
$2.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.81
|
| Rate for Payer: ASR ASR |
$20.99
|
| Rate for Payer: BCBS Complete |
$1.24
|
| Rate for Payer: BCBS MAPPO |
$2.25
|
| Rate for Payer: BCBS Trust/PPO |
$17.84
|
| Rate for Payer: BCN Commercial |
$17.84
|
| Rate for Payer: BCN Medicare Advantage |
$2.25
|
| Rate for Payer: Cash Price |
$17.31
|
| Rate for Payer: Cash Price |
$17.31
|
| Rate for Payer: Cofinity Commercial |
$20.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.25
|
| Rate for Payer: Healthscope Commercial |
$20.99
|
| Rate for Payer: Healthscope Whirlpool |
$21.64
|
| Rate for Payer: Humana Choice PPO Medicare |
$2.25
|
| Rate for Payer: Mclaren Commercial |
$19.48
|
| Rate for Payer: Mclaren Medicaid |
$2.25
|
| Rate for Payer: Mclaren Medicare |
$2.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.36
|
| Rate for Payer: Meridian Medicaid |
$1.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$2.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.39
|
| Rate for Payer: Nomi Health Commercial |
$17.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.23
|
| Rate for Payer: PACE Medicare |
$2.14
|
| Rate for Payer: PACE SWMI |
$2.25
|
| Rate for Payer: PHP Commercial |
$2.48
|
| Rate for Payer: PHP Medicaid |
$1.21
|
| Rate for Payer: PHP Medicare Advantage |
$2.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$10.89
|
| Rate for Payer: Priority Health Medicare |
$2.25
|
| Rate for Payer: Priority Health Narrow Network |
$8.71
|
| Rate for Payer: Railroad Medicare Medicare |
$2.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2.25
|
| Rate for Payer: UHC Exchange |
$3.49
|
| Rate for Payer: UHC Medicaid |
$1.18
|
| Rate for Payer: UHCCP DNSP |
$2.25
|
| Rate for Payer: UHCCP Medicaid |
$1.18
|
| Rate for Payer: VA VA |
$2.25
|
|
|
HC UA DIPSTICK MANUAL
|
Facility
|
OP
|
$12.73
|
|
|
Service Code
|
CPT 81002
|
| Hospital Charge Code |
30700009
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$1.82 |
| Max. Negotiated Rate |
$12.73 |
| Rate for Payer: Aetna Commercial |
$11.46
|
| Rate for Payer: Aetna Medicare |
$3.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.35
|
| Rate for Payer: ASR ASR |
$12.35
|
| Rate for Payer: BCBS Complete |
$1.91
|
| Rate for Payer: BCBS MAPPO |
$3.48
|
| Rate for Payer: BCBS Trust/PPO |
$10.50
|
| Rate for Payer: BCN Commercial |
$10.50
|
| Rate for Payer: BCN Medicare Advantage |
$3.48
|
| Rate for Payer: Cash Price |
$10.18
|
| Rate for Payer: Cash Price |
$10.18
|
| Rate for Payer: Cofinity Commercial |
$11.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.48
|
| Rate for Payer: Healthscope Commercial |
$12.35
|
| Rate for Payer: Healthscope Whirlpool |
$12.73
|
| Rate for Payer: Humana Choice PPO Medicare |
$3.48
|
| Rate for Payer: Mclaren Commercial |
$11.46
|
| Rate for Payer: Mclaren Medicaid |
$3.48
|
| Rate for Payer: Mclaren Medicare |
$3.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.65
|
| Rate for Payer: Meridian Medicaid |
$1.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.82
|
| Rate for Payer: Nomi Health Commercial |
$10.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.55
|
| Rate for Payer: PACE Medicare |
$3.31
|
| Rate for Payer: PACE SWMI |
$3.48
|
| Rate for Payer: PHP Commercial |
$3.83
|
| Rate for Payer: PHP Medicaid |
$1.87
|
| Rate for Payer: PHP Medicare Advantage |
$3.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$8.46
|
| Rate for Payer: Priority Health Medicare |
$3.48
|
| Rate for Payer: Priority Health Narrow Network |
$6.77
|
| Rate for Payer: Railroad Medicare Medicare |
$3.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3.48
|
| Rate for Payer: UHC Exchange |
$5.39
|
| Rate for Payer: UHC Medicaid |
$1.82
|
| Rate for Payer: UHCCP DNSP |
$3.48
|
| Rate for Payer: UHCCP Medicaid |
$1.82
|
| Rate for Payer: VA VA |
$3.48
|
|
|
HC UA DIPSTICK MANUAL
|
Facility
|
IP
|
$12.73
|
|
|
Service Code
|
CPT 81002
|
| Hospital Charge Code |
30700009
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$9.55 |
| Max. Negotiated Rate |
$12.73 |
| Rate for Payer: Aetna Commercial |
$11.46
|
| Rate for Payer: ASR ASR |
$12.35
|
| Rate for Payer: BCBS Trust/PPO |
$10.45
|
| Rate for Payer: BCN Commercial |
$10.45
|
| Rate for Payer: Cash Price |
$10.18
|
| Rate for Payer: Cofinity Commercial |
$11.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.18
|
| Rate for Payer: Healthscope Commercial |
$12.35
|
| Rate for Payer: Healthscope Whirlpool |
$12.73
|
| Rate for Payer: Mclaren Commercial |
$11.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.82
|
| Rate for Payer: Nomi Health Commercial |
$10.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11.20
|
|
|
HC UA MICROSCOPIC ONLY
|
Facility
|
IP
|
$39.43
|
|
|
Service Code
|
CPT 81015
|
| Hospital Charge Code |
30700015
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$29.57 |
| Max. Negotiated Rate |
$39.43 |
| Rate for Payer: Aetna Commercial |
$35.49
|
| Rate for Payer: ASR ASR |
$38.25
|
| Rate for Payer: BCBS Trust/PPO |
$32.38
|
| Rate for Payer: BCN Commercial |
$32.38
|
| Rate for Payer: Cash Price |
$31.54
|
| Rate for Payer: Cofinity Commercial |
$37.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.54
|
| Rate for Payer: Healthscope Commercial |
$38.25
|
| Rate for Payer: Healthscope Whirlpool |
$39.43
|
| Rate for Payer: Mclaren Commercial |
$35.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.52
|
| Rate for Payer: Nomi Health Commercial |
$32.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$34.70
|
|
|
HC UA MICROSCOPIC ONLY
|
Facility
|
OP
|
$39.43
|
|
|
Service Code
|
CPT 81015
|
| Hospital Charge Code |
30700015
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$1.60 |
| Max. Negotiated Rate |
$39.43 |
| Rate for Payer: Aetna Commercial |
$35.49
|
| Rate for Payer: Aetna Medicare |
$3.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.81
|
| Rate for Payer: ASR ASR |
$38.25
|
| Rate for Payer: BCBS Complete |
$1.68
|
| Rate for Payer: BCBS MAPPO |
$3.05
|
| Rate for Payer: BCBS Trust/PPO |
$32.51
|
| Rate for Payer: BCN Commercial |
$32.51
|
| Rate for Payer: BCN Medicare Advantage |
$3.05
|
| Rate for Payer: Cash Price |
$31.54
|
| Rate for Payer: Cash Price |
$31.54
|
| Rate for Payer: Cofinity Commercial |
$37.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.05
|
| Rate for Payer: Healthscope Commercial |
$38.25
|
| Rate for Payer: Healthscope Whirlpool |
$39.43
|
| Rate for Payer: Humana Choice PPO Medicare |
$3.05
|
| Rate for Payer: Mclaren Commercial |
$35.49
|
| Rate for Payer: Mclaren Medicaid |
$3.05
|
| Rate for Payer: Mclaren Medicare |
$3.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.20
|
| Rate for Payer: Meridian Medicaid |
$1.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.52
|
| Rate for Payer: Nomi Health Commercial |
$32.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.57
|
| Rate for Payer: PACE Medicare |
$2.90
|
| Rate for Payer: PACE SWMI |
$3.05
|
| Rate for Payer: PHP Commercial |
$3.35
|
| Rate for Payer: PHP Medicaid |
$1.63
|
| Rate for Payer: PHP Medicare Advantage |
$3.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$34.55
|
| Rate for Payer: Priority Health Medicare |
$3.05
|
| Rate for Payer: Priority Health Narrow Network |
$27.64
|
| Rate for Payer: Railroad Medicare Medicare |
$3.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$34.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3.05
|
| Rate for Payer: UHC Exchange |
$4.73
|
| Rate for Payer: UHC Medicaid |
$1.60
|
| Rate for Payer: UHCCP DNSP |
$3.05
|
| Rate for Payer: UHCCP Medicaid |
$1.60
|
| Rate for Payer: VA VA |
$3.05
|
|
|
HC ULTRASOUND EACH 15 MIN
|
Facility
|
IP
|
$85.96
|
|
|
Service Code
|
CPT 97035
|
| Hospital Charge Code |
42000018
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$64.47 |
| Max. Negotiated Rate |
$85.96 |
| Rate for Payer: Aetna Commercial |
$77.36
|
| Rate for Payer: ASR ASR |
$83.38
|
| Rate for Payer: BCBS Trust/PPO |
$70.59
|
| Rate for Payer: BCN Commercial |
$70.59
|
| Rate for Payer: Cash Price |
$68.77
|
| Rate for Payer: Cofinity Commercial |
$80.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.77
|
| Rate for Payer: Healthscope Commercial |
$83.38
|
| Rate for Payer: Healthscope Whirlpool |
$85.96
|
| Rate for Payer: Mclaren Commercial |
$77.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.07
|
| Rate for Payer: Nomi Health Commercial |
$70.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$64.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$75.64
|
|
|
HC ULTRASOUND EACH 15 MIN
|
Facility
|
OP
|
$85.96
|
|
|
Service Code
|
CPT 97035
|
| Hospital Charge Code |
42000018
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$25.19 |
| Max. Negotiated Rate |
$85.96 |
| Rate for Payer: Aetna Commercial |
$77.36
|
| Rate for Payer: Aetna Medicare |
$31.81
|
| Rate for Payer: ASR ASR |
$83.38
|
| Rate for Payer: BCBS Complete |
$34.38
|
| Rate for Payer: BCBS Trust/PPO |
$70.87
|
| Rate for Payer: BCN Commercial |
$70.87
|
| Rate for Payer: Cash Price |
$68.77
|
| Rate for Payer: Cash Price |
$68.77
|
| Rate for Payer: Cofinity Commercial |
$80.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.77
|
| Rate for Payer: Healthscope Commercial |
$83.38
|
| Rate for Payer: Healthscope Whirlpool |
$85.96
|
| Rate for Payer: Mclaren Commercial |
$77.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$68.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.07
|
| Rate for Payer: Nomi Health Commercial |
$70.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$64.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$31.49
|
| Rate for Payer: Priority Health Narrow Network |
$25.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$75.64
|
|
|
HC ULTRASOUND RF UTERINE FIBROID ABLATION TRANSCERVICAL
|
Facility
|
OP
|
$9,827.84
|
|
|
Service Code
|
CPT 58580
|
| Hospital Charge Code |
36100485
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,864.33 |
| Max. Negotiated Rate |
$11,452.59 |
| Rate for Payer: Aetna Commercial |
$8,845.06
|
| Rate for Payer: Aetna Medicare |
$7,388.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,235.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,235.96
|
| Rate for Payer: ASR ASR |
$9,533.00
|
| Rate for Payer: BCBS Complete |
$4,057.91
|
| Rate for Payer: BCBS MAPPO |
$7,388.77
|
| Rate for Payer: BCBS Trust/PPO |
$8,103.05
|
| Rate for Payer: BCN Commercial |
$8,103.05
|
| Rate for Payer: BCN Medicare Advantage |
$7,388.77
|
| Rate for Payer: Cash Price |
$7,862.27
|
| Rate for Payer: Cash Price |
$7,862.27
|
| Rate for Payer: Cofinity Commercial |
$9,238.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,862.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,388.77
|
| Rate for Payer: Healthscope Commercial |
$9,533.00
|
| Rate for Payer: Healthscope Whirlpool |
$9,827.84
|
| Rate for Payer: Humana Choice PPO Medicare |
$7,388.77
|
| Rate for Payer: Mclaren Commercial |
$8,845.06
|
| Rate for Payer: Mclaren Medicaid |
$7,388.77
|
| Rate for Payer: Mclaren Medicare |
$7,388.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,758.21
|
| Rate for Payer: Meridian Medicaid |
$4,057.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,497.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$8,127.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,353.66
|
| Rate for Payer: Nomi Health Commercial |
$8,058.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,370.88
|
| Rate for Payer: PACE Medicare |
$7,019.33
|
| Rate for Payer: PACE SWMI |
$7,388.77
|
| Rate for Payer: PHP Commercial |
$8,127.65
|
| Rate for Payer: PHP Medicaid |
$3,960.38
|
| Rate for Payer: PHP Medicare Advantage |
$7,388.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,864.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$8,611.15
|
| Rate for Payer: Priority Health Medicare |
$7,388.77
|
| Rate for Payer: Priority Health Narrow Network |
$6,889.32
|
| Rate for Payer: Railroad Medicare Medicare |
$7,388.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8,648.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7,388.77
|
| Rate for Payer: UHC Exchange |
$11,452.59
|
| Rate for Payer: UHC Medicaid |
$3,864.33
|
| Rate for Payer: UHCCP DNSP |
$7,388.77
|
| Rate for Payer: UHCCP Medicaid |
$3,864.33
|
| Rate for Payer: VA VA |
$7,388.77
|
|
|
HC ULTRASOUND RF UTERINE FIBROID ABLATION TRANSCERVICAL
|
Facility
|
IP
|
$9,827.84
|
|
|
Service Code
|
CPT 58580
|
| Hospital Charge Code |
36100485
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,370.88 |
| Max. Negotiated Rate |
$9,827.84 |
| Rate for Payer: Aetna Commercial |
$8,845.06
|
| Rate for Payer: ASR ASR |
$9,533.00
|
| Rate for Payer: BCBS Trust/PPO |
$8,070.62
|
| Rate for Payer: BCN Commercial |
$8,070.62
|
| Rate for Payer: Cash Price |
$7,862.27
|
| Rate for Payer: Cofinity Commercial |
$9,238.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,862.27
|
| Rate for Payer: Healthscope Commercial |
$9,533.00
|
| Rate for Payer: Healthscope Whirlpool |
$9,827.84
|
| Rate for Payer: Mclaren Commercial |
$8,845.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,353.66
|
| Rate for Payer: Nomi Health Commercial |
$8,058.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,370.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8,648.50
|
|
|
HC ULTRATAG RBC PER STUDY
|
Facility
|
OP
|
$249.34
|
|
|
Service Code
|
HCPCS A9560
|
| Hospital Charge Code |
34300023
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$92.26 |
| Max. Negotiated Rate |
$284.49 |
| Rate for Payer: Aetna Commercial |
$224.41
|
| Rate for Payer: Aetna Medicare |
$92.26
|
| Rate for Payer: ASR ASR |
$241.86
|
| Rate for Payer: BCBS Complete |
$99.74
|
| Rate for Payer: BCBS Trust/PPO |
$205.58
|
| Rate for Payer: BCN Commercial |
$205.58
|
| Rate for Payer: Cash Price |
$199.47
|
| Rate for Payer: Cash Price |
$199.47
|
| Rate for Payer: Cofinity Commercial |
$234.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.47
|
| Rate for Payer: Healthscope Commercial |
$241.86
|
| Rate for Payer: Healthscope Whirlpool |
$249.34
|
| Rate for Payer: Mclaren Commercial |
$224.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$199.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.94
|
| Rate for Payer: Nomi Health Commercial |
$204.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$187.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$284.49
|
| Rate for Payer: Priority Health Narrow Network |
$227.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$219.42
|
|
|
HC ULTRATAG RBC PER STUDY
|
Facility
|
IP
|
$249.34
|
|
|
Service Code
|
HCPCS A9560
|
| Hospital Charge Code |
34300023
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$187.00 |
| Max. Negotiated Rate |
$249.34 |
| Rate for Payer: Aetna Commercial |
$224.41
|
| Rate for Payer: ASR ASR |
$241.86
|
| Rate for Payer: BCBS Trust/PPO |
$204.76
|
| Rate for Payer: BCN Commercial |
$204.76
|
| Rate for Payer: Cash Price |
$199.47
|
| Rate for Payer: Cofinity Commercial |
$234.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.47
|
| Rate for Payer: Healthscope Commercial |
$241.86
|
| Rate for Payer: Healthscope Whirlpool |
$249.34
|
| Rate for Payer: Mclaren Commercial |
$224.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.94
|
| Rate for Payer: Nomi Health Commercial |
$204.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$187.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$219.42
|
|
|
HC UMBILICAL ARTERY CATHETER
|
Facility
|
OP
|
$217.91
|
|
|
Service Code
|
CPT 36660
|
| Hospital Charge Code |
36100602
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$80.63 |
| Max. Negotiated Rate |
$217.91 |
| Rate for Payer: Aetna Commercial |
$196.12
|
| Rate for Payer: Aetna Medicare |
$80.63
|
| Rate for Payer: ASR ASR |
$211.37
|
| Rate for Payer: BCBS Complete |
$87.16
|
| Rate for Payer: BCBS Trust/PPO |
$179.67
|
| Rate for Payer: BCN Commercial |
$179.67
|
| Rate for Payer: Cash Price |
$174.33
|
| Rate for Payer: Cofinity Commercial |
$204.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$174.33
|
| Rate for Payer: Healthscope Commercial |
$211.37
|
| Rate for Payer: Healthscope Whirlpool |
$217.91
|
| Rate for Payer: Mclaren Commercial |
$196.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$174.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$185.22
|
| Rate for Payer: Nomi Health Commercial |
$178.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$163.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$190.93
|
| Rate for Payer: Priority Health Narrow Network |
$152.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$191.76
|
|
|
HC UMBILICAL ARTERY CATHETER
|
Facility
|
IP
|
$217.91
|
|
|
Service Code
|
CPT 36660
|
| Hospital Charge Code |
36100602
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$163.43 |
| Max. Negotiated Rate |
$217.91 |
| Rate for Payer: Aetna Commercial |
$196.12
|
| Rate for Payer: ASR ASR |
$211.37
|
| Rate for Payer: BCBS Trust/PPO |
$178.95
|
| Rate for Payer: BCN Commercial |
$178.95
|
| Rate for Payer: Cash Price |
$174.33
|
| Rate for Payer: Cofinity Commercial |
$204.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$174.33
|
| Rate for Payer: Healthscope Commercial |
$211.37
|
| Rate for Payer: Healthscope Whirlpool |
$217.91
|
| Rate for Payer: Mclaren Commercial |
$196.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$185.22
|
| Rate for Payer: Nomi Health Commercial |
$178.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$163.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$191.76
|
|
|
HC UMBILICAL VEIN CATHETER
|
Facility
|
OP
|
$217.91
|
|
|
Service Code
|
CPT 36510
|
| Hospital Charge Code |
36100584
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$80.63 |
| Max. Negotiated Rate |
$217.91 |
| Rate for Payer: Aetna Commercial |
$196.12
|
| Rate for Payer: Aetna Medicare |
$80.63
|
| Rate for Payer: ASR ASR |
$211.37
|
| Rate for Payer: BCBS Complete |
$87.16
|
| Rate for Payer: BCBS Trust/PPO |
$179.67
|
| Rate for Payer: BCN Commercial |
$179.67
|
| Rate for Payer: Cash Price |
$174.33
|
| Rate for Payer: Cofinity Commercial |
$204.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$174.33
|
| Rate for Payer: Healthscope Commercial |
$211.37
|
| Rate for Payer: Healthscope Whirlpool |
$217.91
|
| Rate for Payer: Mclaren Commercial |
$196.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$174.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$185.22
|
| Rate for Payer: Nomi Health Commercial |
$178.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$163.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$190.93
|
| Rate for Payer: Priority Health Narrow Network |
$152.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$191.76
|
|
|
HC UMBILICAL VEIN CATHETER
|
Facility
|
IP
|
$217.91
|
|
|
Service Code
|
CPT 36510
|
| Hospital Charge Code |
36100584
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$163.43 |
| Max. Negotiated Rate |
$217.91 |
| Rate for Payer: Aetna Commercial |
$196.12
|
| Rate for Payer: ASR ASR |
$211.37
|
| Rate for Payer: BCBS Trust/PPO |
$178.95
|
| Rate for Payer: BCN Commercial |
$178.95
|
| Rate for Payer: Cash Price |
$174.33
|
| Rate for Payer: Cofinity Commercial |
$204.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$174.33
|
| Rate for Payer: Healthscope Commercial |
$211.37
|
| Rate for Payer: Healthscope Whirlpool |
$217.91
|
| Rate for Payer: Mclaren Commercial |
$196.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$185.22
|
| Rate for Payer: Nomi Health Commercial |
$178.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$163.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$191.76
|
|
