|
HC THROMBO EMBO CATHETER LVL 88
|
Facility
|
IP
|
$8,810.00
|
|
|
Service Code
|
HCPCS C1757
|
| Hospital Charge Code |
27200383
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5,726.50 |
| Max. Negotiated Rate |
$8,810.00 |
| Rate for Payer: Aetna Commercial |
$7,929.00
|
| Rate for Payer: ASR ASR |
$8,545.70
|
| Rate for Payer: ASR Commercial |
$8,545.70
|
| Rate for Payer: BCBS Trust/PPO |
$7,179.27
|
| Rate for Payer: BCN Commercial |
$6,830.39
|
| Rate for Payer: Cash Price |
$7,048.00
|
| Rate for Payer: Cofinity Commercial |
$8,281.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,048.00
|
| Rate for Payer: Healthscope Commercial |
$8,810.00
|
| Rate for Payer: Healthscope Whirlpool |
$8,545.70
|
| Rate for Payer: Mclaren Commercial |
$7,929.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,488.50
|
| Rate for Payer: Nomi Health Commercial |
$7,224.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,726.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,752.80
|
|
|
HC THROMBO EMBO CATHETER LVL 88
|
Facility
|
OP
|
$8,810.00
|
|
|
Service Code
|
HCPCS C1757
|
| Hospital Charge Code |
27200383
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,524.00 |
| Max. Negotiated Rate |
$8,810.00 |
| Rate for Payer: Aetna Commercial |
$7,929.00
|
| Rate for Payer: Aetna Medicare |
$4,405.00
|
| Rate for Payer: ASR ASR |
$8,545.70
|
| Rate for Payer: ASR Commercial |
$8,545.70
|
| Rate for Payer: BCBS Complete |
$3,524.00
|
| Rate for Payer: BCBS Trust/PPO |
$7,214.51
|
| Rate for Payer: BCN Commercial |
$6,830.39
|
| Rate for Payer: Cash Price |
$7,048.00
|
| Rate for Payer: Cofinity Commercial |
$8,281.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,048.00
|
| Rate for Payer: Healthscope Commercial |
$8,810.00
|
| Rate for Payer: Healthscope Whirlpool |
$8,545.70
|
| Rate for Payer: Mclaren Commercial |
$7,929.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,488.50
|
| Rate for Payer: Nomi Health Commercial |
$7,224.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,726.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,719.32
|
| Rate for Payer: Priority Health Narrow Network |
$6,175.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,752.80
|
|
|
HC THROMBO EMBO LVL 141
|
Facility
|
IP
|
$14,159.85
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
27200225
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9,203.90 |
| Max. Negotiated Rate |
$14,159.85 |
| Rate for Payer: Aetna Commercial |
$12,743.86
|
| Rate for Payer: ASR ASR |
$13,735.05
|
| Rate for Payer: ASR Commercial |
$13,735.05
|
| Rate for Payer: BCBS Trust/PPO |
$11,538.86
|
| Rate for Payer: BCN Commercial |
$10,978.13
|
| Rate for Payer: Cash Price |
$11,327.88
|
| Rate for Payer: Cofinity Commercial |
$13,310.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,327.88
|
| Rate for Payer: Healthscope Commercial |
$14,159.85
|
| Rate for Payer: Healthscope Whirlpool |
$13,735.05
|
| Rate for Payer: Mclaren Commercial |
$12,743.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,035.87
|
| Rate for Payer: Nomi Health Commercial |
$11,611.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,203.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12,460.67
|
|
|
HC THROMBO EMBO LVL 141
|
Facility
|
OP
|
$14,159.85
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
27200225
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5,663.94 |
| Max. Negotiated Rate |
$14,159.85 |
| Rate for Payer: Aetna Commercial |
$12,743.86
|
| Rate for Payer: Aetna Medicare |
$7,079.92
|
| Rate for Payer: ASR ASR |
$13,735.05
|
| Rate for Payer: ASR Commercial |
$13,735.05
|
| Rate for Payer: BCBS Complete |
$5,663.94
|
| Rate for Payer: BCBS Trust/PPO |
$11,595.50
|
| Rate for Payer: BCN Commercial |
$10,978.13
|
| Rate for Payer: Cash Price |
$11,327.88
|
| Rate for Payer: Cofinity Commercial |
$13,310.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,327.88
|
| Rate for Payer: Healthscope Commercial |
$14,159.85
|
| Rate for Payer: Healthscope Whirlpool |
$13,735.05
|
| Rate for Payer: Mclaren Commercial |
$12,743.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,035.87
|
| Rate for Payer: Nomi Health Commercial |
$11,611.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,203.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12,406.86
|
| Rate for Payer: Priority Health Narrow Network |
$9,926.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12,460.67
|
|
|
HC THROMBOLYSIS CEREBRAL IV INFUSION
|
Facility
|
IP
|
$519.80
|
|
|
Service Code
|
CPT 37195
|
| Hospital Charge Code |
45000101
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$337.87 |
| Max. Negotiated Rate |
$519.80 |
| Rate for Payer: Aetna Commercial |
$467.82
|
| Rate for Payer: ASR ASR |
$504.21
|
| Rate for Payer: ASR Commercial |
$504.21
|
| Rate for Payer: BCBS Trust/PPO |
$423.59
|
| Rate for Payer: BCN Commercial |
$403.00
|
| Rate for Payer: Cash Price |
$415.84
|
| Rate for Payer: Cofinity Commercial |
$488.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$415.84
|
| Rate for Payer: Healthscope Commercial |
$519.80
|
| Rate for Payer: Healthscope Whirlpool |
$504.21
|
| Rate for Payer: Mclaren Commercial |
$467.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$441.83
|
| Rate for Payer: Nomi Health Commercial |
$426.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$337.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$457.42
|
|
|
HC THROMBOLYSIS CEREBRAL IV INFUSION
|
Facility
|
OP
|
$519.80
|
|
|
Service Code
|
CPT 37195
|
| Hospital Charge Code |
45000101
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$174.19 |
| Max. Negotiated Rate |
$519.80 |
| Rate for Payer: Aetna Commercial |
$467.82
|
| Rate for Payer: Aetna Medicare |
$324.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$406.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$406.22
|
| Rate for Payer: ASR ASR |
$504.21
|
| Rate for Payer: ASR Commercial |
$504.21
|
| Rate for Payer: BCBS Complete |
$182.90
|
| Rate for Payer: BCBS MAPPO |
$324.98
|
| Rate for Payer: BCBS Trust/PPO |
$425.66
|
| Rate for Payer: BCN Commercial |
$403.00
|
| Rate for Payer: BCN Medicare Advantage |
$324.98
|
| Rate for Payer: Cash Price |
$415.84
|
| Rate for Payer: Cash Price |
$415.84
|
| Rate for Payer: Cofinity Commercial |
$488.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$415.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$324.98
|
| Rate for Payer: Healthscope Commercial |
$519.80
|
| Rate for Payer: Healthscope Whirlpool |
$504.21
|
| Rate for Payer: Humana Choice PPO Medicare |
$324.98
|
| Rate for Payer: Mclaren Commercial |
$467.82
|
| Rate for Payer: Mclaren Medicaid |
$174.19
|
| Rate for Payer: Mclaren Medicare |
$324.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$341.23
|
| Rate for Payer: Meridian Medicaid |
$182.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$373.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$441.83
|
| Rate for Payer: Nomi Health Commercial |
$426.24
|
| Rate for Payer: PACE Medicare |
$308.73
|
| Rate for Payer: PACE SWMI |
$324.98
|
| Rate for Payer: PHP Commercial |
$357.48
|
| Rate for Payer: PHP Medicaid |
$174.19
|
| Rate for Payer: PHP Medicare Advantage |
$324.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$174.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$337.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$354.65
|
| Rate for Payer: Priority Health Medicare |
$324.98
|
| Rate for Payer: Priority Health Narrow Network |
$283.72
|
| Rate for Payer: Railroad Medicare Medicare |
$324.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$457.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$324.98
|
| Rate for Payer: UHC Exchange |
$503.72
|
| Rate for Payer: UHC Medicare Advantage |
$324.98
|
| Rate for Payer: UHCCP DNSP |
$324.98
|
| Rate for Payer: UHCCP Medicaid |
$174.19
|
| Rate for Payer: VA VA |
$324.98
|
|
|
HC THROMBOLYSIS CESSATION
|
Facility
|
OP
|
$4,644.53
|
|
|
Service Code
|
CPT 37214
|
| Hospital Charge Code |
36100374
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,606.62 |
| Max. Negotiated Rate |
$4,779.98 |
| Rate for Payer: Aetna Commercial |
$4,180.08
|
| Rate for Payer: Aetna Medicare |
$3,083.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,854.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,854.82
|
| Rate for Payer: ASR ASR |
$4,505.19
|
| Rate for Payer: ASR Commercial |
$4,505.19
|
| Rate for Payer: BCBS Complete |
$1,735.60
|
| Rate for Payer: BCBS MAPPO |
$3,083.86
|
| Rate for Payer: BCBS Trust/PPO |
$3,803.41
|
| Rate for Payer: BCN Commercial |
$3,600.90
|
| Rate for Payer: BCN Medicare Advantage |
$3,083.86
|
| Rate for Payer: Cash Price |
$3,715.62
|
| Rate for Payer: Cash Price |
$3,715.62
|
| Rate for Payer: Cofinity Commercial |
$4,365.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,715.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,083.86
|
| Rate for Payer: Healthscope Commercial |
$4,644.53
|
| Rate for Payer: Healthscope Whirlpool |
$4,505.19
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,083.86
|
| Rate for Payer: Mclaren Commercial |
$4,180.08
|
| Rate for Payer: Mclaren Medicaid |
$1,652.95
|
| Rate for Payer: Mclaren Medicare |
$3,083.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,238.05
|
| Rate for Payer: Meridian Medicaid |
$1,735.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,546.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,947.85
|
| Rate for Payer: Nomi Health Commercial |
$3,808.51
|
| Rate for Payer: PACE Medicare |
$2,929.67
|
| Rate for Payer: PACE SWMI |
$3,083.86
|
| Rate for Payer: PHP Commercial |
$3,392.25
|
| Rate for Payer: PHP Medicaid |
$1,652.95
|
| Rate for Payer: PHP Medicare Advantage |
$3,083.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,652.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,018.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,008.27
|
| Rate for Payer: Priority Health Medicare |
$3,083.86
|
| Rate for Payer: Priority Health Narrow Network |
$1,606.62
|
| Rate for Payer: Railroad Medicare Medicare |
$3,083.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,087.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,083.86
|
| Rate for Payer: UHC Exchange |
$4,779.98
|
| Rate for Payer: UHC Medicare Advantage |
$3,083.86
|
| Rate for Payer: UHCCP DNSP |
$3,083.86
|
| Rate for Payer: UHCCP Medicaid |
$1,652.95
|
| Rate for Payer: VA VA |
$3,083.86
|
|
|
HC THROMBOLYSIS CESSATION
|
Facility
|
IP
|
$4,644.53
|
|
|
Service Code
|
CPT 37214
|
| Hospital Charge Code |
36100374
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,018.94 |
| Max. Negotiated Rate |
$4,644.53 |
| Rate for Payer: Aetna Commercial |
$4,180.08
|
| Rate for Payer: ASR ASR |
$4,505.19
|
| Rate for Payer: ASR Commercial |
$4,505.19
|
| Rate for Payer: BCBS Trust/PPO |
$3,784.83
|
| Rate for Payer: BCN Commercial |
$3,600.90
|
| Rate for Payer: Cash Price |
$3,715.62
|
| Rate for Payer: Cofinity Commercial |
$4,365.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,715.62
|
| Rate for Payer: Healthscope Commercial |
$4,644.53
|
| Rate for Payer: Healthscope Whirlpool |
$4,505.19
|
| Rate for Payer: Mclaren Commercial |
$4,180.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,947.85
|
| Rate for Payer: Nomi Health Commercial |
$3,808.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,018.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,087.19
|
|
|
HC THSD7
|
Facility
|
OP
|
$380.36
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200493
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.46 |
| Max. Negotiated Rate |
$380.36 |
| Rate for Payer: Aetna Commercial |
$342.32
|
| Rate for Payer: Aetna Medicare |
$12.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.06
|
| Rate for Payer: ASR ASR |
$368.95
|
| Rate for Payer: ASR Commercial |
$368.95
|
| Rate for Payer: BCBS Complete |
$6.78
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCBS Trust/PPO |
$311.48
|
| Rate for Payer: BCN Commercial |
$294.89
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$304.29
|
| Rate for Payer: Cash Price |
$304.29
|
| Rate for Payer: Cofinity Commercial |
$357.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$304.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$380.36
|
| Rate for Payer: Healthscope Whirlpool |
$368.95
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.05
|
| Rate for Payer: Mclaren Commercial |
$342.32
|
| Rate for Payer: Mclaren Medicaid |
$6.46
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: Meridian Medicaid |
$6.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$323.31
|
| Rate for Payer: Nomi Health Commercial |
$311.90
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$13.26
|
| Rate for Payer: PHP Medicaid |
$6.46
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$247.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$227.29
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health Narrow Network |
$181.83
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$334.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.05
|
| Rate for Payer: UHC Exchange |
$18.68
|
| Rate for Payer: UHC Medicare Advantage |
$12.05
|
| Rate for Payer: UHCCP DNSP |
$12.05
|
| Rate for Payer: UHCCP Medicaid |
$6.46
|
| Rate for Payer: VA VA |
$12.05
|
|
|
HC THSD7
|
Facility
|
IP
|
$380.36
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200493
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$247.23 |
| Max. Negotiated Rate |
$380.36 |
| Rate for Payer: Aetna Commercial |
$342.32
|
| Rate for Payer: ASR ASR |
$368.95
|
| Rate for Payer: ASR Commercial |
$368.95
|
| Rate for Payer: BCBS Trust/PPO |
$309.96
|
| Rate for Payer: BCN Commercial |
$294.89
|
| Rate for Payer: Cash Price |
$304.29
|
| Rate for Payer: Cofinity Commercial |
$357.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$304.29
|
| Rate for Payer: Healthscope Commercial |
$380.36
|
| Rate for Payer: Healthscope Whirlpool |
$368.95
|
| Rate for Payer: Mclaren Commercial |
$342.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$323.31
|
| Rate for Payer: Nomi Health Commercial |
$311.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$247.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$334.72
|
|
|
HC THYROGLOBULIN
|
Facility
|
IP
|
$57.89
|
|
|
Service Code
|
CPT 84432
|
| Hospital Charge Code |
30100434
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$37.63 |
| Max. Negotiated Rate |
$57.89 |
| Rate for Payer: Aetna Commercial |
$52.10
|
| Rate for Payer: ASR ASR |
$56.15
|
| Rate for Payer: ASR Commercial |
$56.15
|
| Rate for Payer: BCBS Trust/PPO |
$47.17
|
| Rate for Payer: BCN Commercial |
$44.88
|
| Rate for Payer: Cash Price |
$46.31
|
| Rate for Payer: Cofinity Commercial |
$54.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.31
|
| Rate for Payer: Healthscope Commercial |
$57.89
|
| Rate for Payer: Healthscope Whirlpool |
$56.15
|
| Rate for Payer: Mclaren Commercial |
$52.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.21
|
| Rate for Payer: Nomi Health Commercial |
$47.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$50.94
|
|
|
HC THYROGLOBULIN
|
Facility
|
OP
|
$57.89
|
|
|
Service Code
|
CPT 84432
|
| Hospital Charge Code |
30100434
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.61 |
| Max. Negotiated Rate |
$60.39 |
| Rate for Payer: Aetna Commercial |
$52.10
|
| Rate for Payer: Aetna Medicare |
$16.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.08
|
| Rate for Payer: ASR ASR |
$56.15
|
| Rate for Payer: ASR Commercial |
$56.15
|
| Rate for Payer: BCBS Complete |
$9.04
|
| Rate for Payer: BCBS MAPPO |
$16.06
|
| Rate for Payer: BCBS Trust/PPO |
$47.41
|
| Rate for Payer: BCN Commercial |
$44.88
|
| Rate for Payer: BCN Medicare Advantage |
$16.06
|
| Rate for Payer: Cash Price |
$46.31
|
| Rate for Payer: Cash Price |
$46.31
|
| Rate for Payer: Cofinity Commercial |
$54.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.06
|
| Rate for Payer: Healthscope Commercial |
$57.89
|
| Rate for Payer: Healthscope Whirlpool |
$56.15
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.06
|
| Rate for Payer: Mclaren Commercial |
$52.10
|
| Rate for Payer: Mclaren Medicaid |
$8.61
|
| Rate for Payer: Mclaren Medicare |
$16.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.86
|
| Rate for Payer: Meridian Medicaid |
$9.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.21
|
| Rate for Payer: Nomi Health Commercial |
$47.47
|
| Rate for Payer: PACE Medicare |
$15.26
|
| Rate for Payer: PACE SWMI |
$16.06
|
| Rate for Payer: PHP Commercial |
$17.67
|
| Rate for Payer: PHP Medicaid |
$8.61
|
| Rate for Payer: PHP Medicare Advantage |
$16.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$60.39
|
| Rate for Payer: Priority Health Medicare |
$16.06
|
| Rate for Payer: Priority Health Narrow Network |
$48.31
|
| Rate for Payer: Railroad Medicare Medicare |
$16.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$50.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.06
|
| Rate for Payer: UHC Exchange |
$24.89
|
| Rate for Payer: UHC Medicare Advantage |
$16.06
|
| Rate for Payer: UHCCP DNSP |
$16.06
|
| Rate for Payer: UHCCP Medicaid |
$8.61
|
| Rate for Payer: VA VA |
$16.06
|
|
|
HC THYROGLOBULIN CMPT
|
Facility
|
IP
|
$60.24
|
|
|
Service Code
|
CPT 86800
|
| Hospital Charge Code |
30200335
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$39.16 |
| Max. Negotiated Rate |
$60.24 |
| Rate for Payer: Aetna Commercial |
$54.22
|
| Rate for Payer: ASR ASR |
$58.43
|
| Rate for Payer: ASR Commercial |
$58.43
|
| Rate for Payer: BCBS Trust/PPO |
$49.09
|
| Rate for Payer: BCN Commercial |
$46.70
|
| Rate for Payer: Cash Price |
$48.19
|
| Rate for Payer: Cofinity Commercial |
$56.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.19
|
| Rate for Payer: Healthscope Commercial |
$60.24
|
| Rate for Payer: Healthscope Whirlpool |
$58.43
|
| Rate for Payer: Mclaren Commercial |
$54.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51.20
|
| Rate for Payer: Nomi Health Commercial |
$49.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$53.01
|
|
|
HC THYROGLOBULIN CMPT
|
Facility
|
OP
|
$60.24
|
|
|
Service Code
|
CPT 86800
|
| Hospital Charge Code |
30200335
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.53 |
| Max. Negotiated Rate |
$60.39 |
| Rate for Payer: Aetna Commercial |
$54.22
|
| Rate for Payer: Aetna Medicare |
$15.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.89
|
| Rate for Payer: ASR ASR |
$58.43
|
| Rate for Payer: ASR Commercial |
$58.43
|
| Rate for Payer: BCBS Complete |
$8.95
|
| Rate for Payer: BCBS MAPPO |
$15.91
|
| Rate for Payer: BCBS Trust/PPO |
$49.33
|
| Rate for Payer: BCN Commercial |
$46.70
|
| Rate for Payer: BCN Medicare Advantage |
$15.91
|
| Rate for Payer: Cash Price |
$48.19
|
| Rate for Payer: Cash Price |
$48.19
|
| Rate for Payer: Cofinity Commercial |
$56.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.91
|
| Rate for Payer: Healthscope Commercial |
$60.24
|
| Rate for Payer: Healthscope Whirlpool |
$58.43
|
| Rate for Payer: Humana Choice PPO Medicare |
$15.91
|
| Rate for Payer: Mclaren Commercial |
$54.22
|
| Rate for Payer: Mclaren Medicaid |
$8.53
|
| Rate for Payer: Mclaren Medicare |
$15.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.71
|
| Rate for Payer: Meridian Medicaid |
$8.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51.20
|
| Rate for Payer: Nomi Health Commercial |
$49.40
|
| Rate for Payer: PACE Medicare |
$15.11
|
| Rate for Payer: PACE SWMI |
$15.91
|
| Rate for Payer: PHP Commercial |
$17.50
|
| Rate for Payer: PHP Medicaid |
$8.53
|
| Rate for Payer: PHP Medicare Advantage |
$15.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$60.39
|
| Rate for Payer: Priority Health Medicare |
$15.91
|
| Rate for Payer: Priority Health Narrow Network |
$48.31
|
| Rate for Payer: Railroad Medicare Medicare |
$15.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$53.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.91
|
| Rate for Payer: UHC Exchange |
$24.66
|
| Rate for Payer: UHC Medicare Advantage |
$15.91
|
| Rate for Payer: UHCCP DNSP |
$15.91
|
| Rate for Payer: UHCCP Medicaid |
$8.53
|
| Rate for Payer: VA VA |
$15.91
|
|
|
HC THYROID IMAGING W VASC FLOW
|
Facility
|
OP
|
$583.41
|
|
|
Service Code
|
CPT 78013
|
| Hospital Charge Code |
34100075
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$137.42 |
| Max. Negotiated Rate |
$610.24 |
| Rate for Payer: Aetna Commercial |
$525.07
|
| Rate for Payer: Aetna Medicare |
$393.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$492.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$492.12
|
| Rate for Payer: ASR ASR |
$565.91
|
| Rate for Payer: ASR Commercial |
$565.91
|
| Rate for Payer: BCBS Complete |
$221.57
|
| Rate for Payer: BCBS MAPPO |
$393.70
|
| Rate for Payer: BCBS Trust/PPO |
$477.75
|
| Rate for Payer: BCN Commercial |
$452.32
|
| Rate for Payer: BCN Medicare Advantage |
$393.70
|
| Rate for Payer: Cash Price |
$466.73
|
| Rate for Payer: Cash Price |
$466.73
|
| Rate for Payer: Cofinity Commercial |
$548.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$466.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$393.70
|
| Rate for Payer: Healthscope Commercial |
$583.41
|
| Rate for Payer: Healthscope Whirlpool |
$565.91
|
| Rate for Payer: Humana Choice PPO Medicare |
$393.70
|
| Rate for Payer: Mclaren Commercial |
$525.07
|
| Rate for Payer: Mclaren Medicaid |
$211.02
|
| Rate for Payer: Mclaren Medicare |
$393.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$413.38
|
| Rate for Payer: Meridian Medicaid |
$221.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$452.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$495.90
|
| Rate for Payer: Nomi Health Commercial |
$478.40
|
| Rate for Payer: PACE Medicare |
$374.02
|
| Rate for Payer: PACE SWMI |
$393.70
|
| Rate for Payer: PHP Commercial |
$433.07
|
| Rate for Payer: PHP Medicaid |
$211.02
|
| Rate for Payer: PHP Medicare Advantage |
$393.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$379.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$171.78
|
| Rate for Payer: Priority Health Medicare |
$393.70
|
| Rate for Payer: Priority Health Narrow Network |
$137.42
|
| Rate for Payer: Railroad Medicare Medicare |
$393.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$513.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$393.70
|
| Rate for Payer: UHC Exchange |
$610.24
|
| Rate for Payer: UHC Medicare Advantage |
$393.70
|
| Rate for Payer: UHCCP DNSP |
$393.70
|
| Rate for Payer: UHCCP Medicaid |
$211.02
|
| Rate for Payer: VA VA |
$393.70
|
|
|
HC THYROID IMAGING W VASC FLOW
|
Facility
|
IP
|
$583.41
|
|
|
Service Code
|
CPT 78013
|
| Hospital Charge Code |
34100075
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$379.22 |
| Max. Negotiated Rate |
$583.41 |
| Rate for Payer: Aetna Commercial |
$525.07
|
| Rate for Payer: ASR ASR |
$565.91
|
| Rate for Payer: ASR Commercial |
$565.91
|
| Rate for Payer: BCBS Trust/PPO |
$475.42
|
| Rate for Payer: BCN Commercial |
$452.32
|
| Rate for Payer: Cash Price |
$466.73
|
| Rate for Payer: Cofinity Commercial |
$548.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$466.73
|
| Rate for Payer: Healthscope Commercial |
$583.41
|
| Rate for Payer: Healthscope Whirlpool |
$565.91
|
| Rate for Payer: Mclaren Commercial |
$525.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$495.90
|
| Rate for Payer: Nomi Health Commercial |
$478.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$379.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$513.40
|
|
|
HC THYROID IMAG W VASC FLOW SNGL OR MULTI
|
Facility
|
OP
|
$1,225.64
|
|
|
Service Code
|
CPT 78014
|
| Hospital Charge Code |
34100076
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$211.02 |
| Max. Negotiated Rate |
$1,225.64 |
| Rate for Payer: Aetna Commercial |
$1,103.08
|
| Rate for Payer: Aetna Medicare |
$393.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$492.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$492.12
|
| Rate for Payer: ASR ASR |
$1,188.87
|
| Rate for Payer: ASR Commercial |
$1,188.87
|
| Rate for Payer: BCBS Complete |
$221.57
|
| Rate for Payer: BCBS MAPPO |
$393.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,003.68
|
| Rate for Payer: BCN Commercial |
$950.24
|
| Rate for Payer: BCN Medicare Advantage |
$393.70
|
| Rate for Payer: Cash Price |
$980.51
|
| Rate for Payer: Cash Price |
$980.51
|
| Rate for Payer: Cofinity Commercial |
$1,152.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$980.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$393.70
|
| Rate for Payer: Healthscope Commercial |
$1,225.64
|
| Rate for Payer: Healthscope Whirlpool |
$1,188.87
|
| Rate for Payer: Humana Choice PPO Medicare |
$393.70
|
| Rate for Payer: Mclaren Commercial |
$1,103.08
|
| Rate for Payer: Mclaren Medicaid |
$211.02
|
| Rate for Payer: Mclaren Medicare |
$393.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$413.38
|
| Rate for Payer: Meridian Medicaid |
$221.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$452.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,041.79
|
| Rate for Payer: Nomi Health Commercial |
$1,005.02
|
| Rate for Payer: PACE Medicare |
$374.02
|
| Rate for Payer: PACE SWMI |
$393.70
|
| Rate for Payer: PHP Commercial |
$433.07
|
| Rate for Payer: PHP Medicaid |
$211.02
|
| Rate for Payer: PHP Medicare Advantage |
$393.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$796.67
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$266.70
|
| Rate for Payer: Priority Health Medicare |
$393.70
|
| Rate for Payer: Priority Health Narrow Network |
$213.36
|
| Rate for Payer: Railroad Medicare Medicare |
$393.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,078.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$393.70
|
| Rate for Payer: UHC Exchange |
$610.24
|
| Rate for Payer: UHC Medicare Advantage |
$393.70
|
| Rate for Payer: UHCCP DNSP |
$393.70
|
| Rate for Payer: UHCCP Medicaid |
$211.02
|
| Rate for Payer: VA VA |
$393.70
|
|
|
HC THYROID IMAG W VASC FLOW SNGL OR MULTI
|
Facility
|
IP
|
$1,225.64
|
|
|
Service Code
|
CPT 78014
|
| Hospital Charge Code |
34100076
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$796.67 |
| Max. Negotiated Rate |
$1,225.64 |
| Rate for Payer: Aetna Commercial |
$1,103.08
|
| Rate for Payer: ASR ASR |
$1,188.87
|
| Rate for Payer: ASR Commercial |
$1,188.87
|
| Rate for Payer: BCBS Trust/PPO |
$998.77
|
| Rate for Payer: BCN Commercial |
$950.24
|
| Rate for Payer: Cash Price |
$980.51
|
| Rate for Payer: Cofinity Commercial |
$1,152.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$980.51
|
| Rate for Payer: Healthscope Commercial |
$1,225.64
|
| Rate for Payer: Healthscope Whirlpool |
$1,188.87
|
| Rate for Payer: Mclaren Commercial |
$1,103.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,041.79
|
| Rate for Payer: Nomi Health Commercial |
$1,005.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$796.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,078.56
|
|
|
HC THYROID PEROXIDASE ANTIBODY
|
Facility
|
IP
|
$85.58
|
|
|
Service Code
|
CPT 86376
|
| Hospital Charge Code |
30200209
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$55.63 |
| Max. Negotiated Rate |
$85.58 |
| Rate for Payer: Aetna Commercial |
$77.02
|
| Rate for Payer: ASR ASR |
$83.01
|
| Rate for Payer: ASR Commercial |
$83.01
|
| Rate for Payer: BCBS Trust/PPO |
$69.74
|
| Rate for Payer: BCN Commercial |
$66.35
|
| Rate for Payer: Cash Price |
$68.46
|
| Rate for Payer: Cofinity Commercial |
$80.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.46
|
| Rate for Payer: Healthscope Commercial |
$85.58
|
| Rate for Payer: Healthscope Whirlpool |
$83.01
|
| Rate for Payer: Mclaren Commercial |
$77.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.74
|
| Rate for Payer: Nomi Health Commercial |
$70.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$75.31
|
|
|
HC THYROID PEROXIDASE ANTIBODY
|
Facility
|
OP
|
$85.58
|
|
|
Service Code
|
CPT 86376
|
| Hospital Charge Code |
30200209
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.80 |
| Max. Negotiated Rate |
$85.58 |
| Rate for Payer: Aetna Commercial |
$77.02
|
| Rate for Payer: Aetna Medicare |
$14.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.19
|
| Rate for Payer: ASR ASR |
$83.01
|
| Rate for Payer: ASR Commercial |
$83.01
|
| Rate for Payer: BCBS Complete |
$8.19
|
| Rate for Payer: BCBS MAPPO |
$14.55
|
| Rate for Payer: BCBS Trust/PPO |
$70.08
|
| Rate for Payer: BCN Commercial |
$66.35
|
| Rate for Payer: BCN Medicare Advantage |
$14.55
|
| Rate for Payer: Cash Price |
$68.46
|
| Rate for Payer: Cash Price |
$68.46
|
| Rate for Payer: Cofinity Commercial |
$80.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.55
|
| Rate for Payer: Healthscope Commercial |
$85.58
|
| Rate for Payer: Healthscope Whirlpool |
$83.01
|
| Rate for Payer: Humana Choice PPO Medicare |
$14.55
|
| Rate for Payer: Mclaren Commercial |
$77.02
|
| Rate for Payer: Mclaren Medicaid |
$7.80
|
| Rate for Payer: Mclaren Medicare |
$14.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.28
|
| Rate for Payer: Meridian Medicaid |
$8.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.74
|
| Rate for Payer: Nomi Health Commercial |
$70.18
|
| Rate for Payer: PACE Medicare |
$13.82
|
| Rate for Payer: PACE SWMI |
$14.55
|
| Rate for Payer: PHP Commercial |
$16.00
|
| Rate for Payer: PHP Medicaid |
$7.80
|
| Rate for Payer: PHP Medicare Advantage |
$14.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45.01
|
| Rate for Payer: Priority Health Medicare |
$14.55
|
| Rate for Payer: Priority Health Narrow Network |
$36.01
|
| Rate for Payer: Railroad Medicare Medicare |
$14.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$75.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.55
|
| Rate for Payer: UHC Exchange |
$22.55
|
| Rate for Payer: UHC Medicare Advantage |
$14.55
|
| Rate for Payer: UHCCP DNSP |
$14.55
|
| Rate for Payer: UHCCP Medicaid |
$7.80
|
| Rate for Payer: VA VA |
$14.55
|
|
|
HC THYROID STIMULATING IMMUNOGLOB
|
Facility
|
IP
|
$85.63
|
|
|
Service Code
|
CPT 84445
|
| Hospital Charge Code |
30100439
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$55.66 |
| Max. Negotiated Rate |
$85.63 |
| Rate for Payer: Aetna Commercial |
$77.07
|
| Rate for Payer: ASR ASR |
$83.06
|
| Rate for Payer: ASR Commercial |
$83.06
|
| Rate for Payer: BCBS Trust/PPO |
$69.78
|
| Rate for Payer: BCN Commercial |
$66.39
|
| Rate for Payer: Cash Price |
$68.50
|
| Rate for Payer: Cofinity Commercial |
$80.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.50
|
| Rate for Payer: Healthscope Commercial |
$85.63
|
| Rate for Payer: Healthscope Whirlpool |
$83.06
|
| Rate for Payer: Mclaren Commercial |
$77.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.79
|
| Rate for Payer: Nomi Health Commercial |
$70.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$75.35
|
|
|
HC THYROID STIMULATING IMMUNOGLOB
|
Facility
|
OP
|
$85.63
|
|
|
Service Code
|
CPT 84445
|
| Hospital Charge Code |
30100439
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.26 |
| Max. Negotiated Rate |
$411.75 |
| Rate for Payer: Aetna Commercial |
$77.07
|
| Rate for Payer: Aetna Medicare |
$50.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$63.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$63.58
|
| Rate for Payer: ASR ASR |
$83.06
|
| Rate for Payer: ASR Commercial |
$83.06
|
| Rate for Payer: BCBS Complete |
$28.62
|
| Rate for Payer: BCBS MAPPO |
$50.86
|
| Rate for Payer: BCBS Trust/PPO |
$70.12
|
| Rate for Payer: BCN Commercial |
$66.39
|
| Rate for Payer: BCN Medicare Advantage |
$50.86
|
| Rate for Payer: Cash Price |
$68.50
|
| Rate for Payer: Cash Price |
$68.50
|
| Rate for Payer: Cofinity Commercial |
$80.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.86
|
| Rate for Payer: Healthscope Commercial |
$85.63
|
| Rate for Payer: Healthscope Whirlpool |
$83.06
|
| Rate for Payer: Humana Choice PPO Medicare |
$50.86
|
| Rate for Payer: Mclaren Commercial |
$77.07
|
| Rate for Payer: Mclaren Medicaid |
$27.26
|
| Rate for Payer: Mclaren Medicare |
$50.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.40
|
| Rate for Payer: Meridian Medicaid |
$28.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.79
|
| Rate for Payer: Nomi Health Commercial |
$70.22
|
| Rate for Payer: PACE Medicare |
$48.32
|
| Rate for Payer: PACE SWMI |
$50.86
|
| Rate for Payer: PHP Commercial |
$55.95
|
| Rate for Payer: PHP Medicaid |
$27.26
|
| Rate for Payer: PHP Medicare Advantage |
$50.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$411.75
|
| Rate for Payer: Priority Health Medicare |
$50.86
|
| Rate for Payer: Priority Health Narrow Network |
$329.40
|
| Rate for Payer: Railroad Medicare Medicare |
$50.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$75.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$50.86
|
| Rate for Payer: UHC Exchange |
$78.83
|
| Rate for Payer: UHC Medicare Advantage |
$50.86
|
| Rate for Payer: UHCCP DNSP |
$50.86
|
| Rate for Payer: UHCCP Medicaid |
$27.26
|
| Rate for Payer: VA VA |
$50.86
|
|
|
HC THYROID TC 99M PER STUDY
|
Facility
|
IP
|
$143.20
|
|
|
Service Code
|
HCPCS A9500
|
| Hospital Charge Code |
34300021
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$93.08 |
| Max. Negotiated Rate |
$143.20 |
| Rate for Payer: Aetna Commercial |
$128.88
|
| Rate for Payer: ASR ASR |
$138.90
|
| Rate for Payer: ASR Commercial |
$138.90
|
| Rate for Payer: BCBS Trust/PPO |
$116.69
|
| Rate for Payer: BCN Commercial |
$111.02
|
| Rate for Payer: Cash Price |
$114.56
|
| Rate for Payer: Cofinity Commercial |
$134.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.56
|
| Rate for Payer: Healthscope Commercial |
$143.20
|
| Rate for Payer: Healthscope Whirlpool |
$138.90
|
| Rate for Payer: Mclaren Commercial |
$128.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$121.72
|
| Rate for Payer: Nomi Health Commercial |
$117.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$93.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$126.02
|
|
|
HC THYROID TC 99M PER STUDY
|
Facility
|
OP
|
$143.20
|
|
|
Service Code
|
HCPCS A9500
|
| Hospital Charge Code |
34300021
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$57.28 |
| Max. Negotiated Rate |
$276.15 |
| Rate for Payer: Aetna Commercial |
$128.88
|
| Rate for Payer: Aetna Medicare |
$71.60
|
| Rate for Payer: ASR ASR |
$138.90
|
| Rate for Payer: ASR Commercial |
$138.90
|
| Rate for Payer: BCBS Complete |
$57.28
|
| Rate for Payer: BCBS Trust/PPO |
$117.27
|
| Rate for Payer: BCN Commercial |
$111.02
|
| Rate for Payer: Cash Price |
$114.56
|
| Rate for Payer: Cash Price |
$114.56
|
| Rate for Payer: Cofinity Commercial |
$134.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.56
|
| Rate for Payer: Healthscope Commercial |
$143.20
|
| Rate for Payer: Healthscope Whirlpool |
$138.90
|
| Rate for Payer: Mclaren Commercial |
$128.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$121.72
|
| Rate for Payer: Nomi Health Commercial |
$117.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$93.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$276.15
|
| Rate for Payer: Priority Health Narrow Network |
$220.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$126.02
|
|
|
HC THYROID UPTK SNGL OR MULTI DETER
|
Facility
|
IP
|
$1,056.63
|
|
|
Service Code
|
CPT 78012
|
| Hospital Charge Code |
34100074
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$686.81 |
| Max. Negotiated Rate |
$1,056.63 |
| Rate for Payer: Aetna Commercial |
$950.97
|
| Rate for Payer: ASR ASR |
$1,024.93
|
| Rate for Payer: ASR Commercial |
$1,024.93
|
| Rate for Payer: BCBS Trust/PPO |
$861.05
|
| Rate for Payer: BCN Commercial |
$819.21
|
| Rate for Payer: Cash Price |
$845.30
|
| Rate for Payer: Cofinity Commercial |
$993.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$845.30
|
| Rate for Payer: Healthscope Commercial |
$1,056.63
|
| Rate for Payer: Healthscope Whirlpool |
$1,024.93
|
| Rate for Payer: Mclaren Commercial |
$950.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$898.14
|
| Rate for Payer: Nomi Health Commercial |
$866.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$686.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$929.83
|
|
