|
HC TRANSSEP PUNCTURE FOR PVI
|
Facility
|
IP
|
$4,922.93
|
|
|
Service Code
|
CPT 93462
|
| Hospital Charge Code |
48100021
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,199.90 |
| Max. Negotiated Rate |
$4,922.93 |
| Rate for Payer: Aetna Commercial |
$4,430.64
|
| Rate for Payer: ASR ASR |
$4,775.24
|
| Rate for Payer: ASR Commercial |
$4,775.24
|
| Rate for Payer: BCBS Trust/PPO |
$4,011.70
|
| Rate for Payer: BCN Commercial |
$3,816.75
|
| Rate for Payer: Cash Price |
$3,938.34
|
| Rate for Payer: Cofinity Commercial |
$4,627.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,938.34
|
| Rate for Payer: Healthscope Commercial |
$4,922.93
|
| Rate for Payer: Healthscope Whirlpool |
$4,775.24
|
| Rate for Payer: Mclaren Commercial |
$4,430.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,184.49
|
| Rate for Payer: Nomi Health Commercial |
$4,036.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,199.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,332.18
|
|
|
HC TRANSSEP PUNCTURE FOR PVI
|
Facility
|
OP
|
$4,922.93
|
|
|
Service Code
|
CPT 93462
|
| Hospital Charge Code |
48100021
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,969.17 |
| Max. Negotiated Rate |
$4,922.93 |
| Rate for Payer: Aetna Commercial |
$4,430.64
|
| Rate for Payer: Aetna Medicare |
$2,461.47
|
| Rate for Payer: ASR ASR |
$4,775.24
|
| Rate for Payer: ASR Commercial |
$4,775.24
|
| Rate for Payer: BCBS Complete |
$1,969.17
|
| Rate for Payer: BCBS Trust/PPO |
$4,031.39
|
| Rate for Payer: BCN Commercial |
$3,816.75
|
| Rate for Payer: Cash Price |
$3,938.34
|
| Rate for Payer: Cofinity Commercial |
$4,627.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,938.34
|
| Rate for Payer: Healthscope Commercial |
$4,922.93
|
| Rate for Payer: Healthscope Whirlpool |
$4,775.24
|
| Rate for Payer: Mclaren Commercial |
$4,430.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,184.49
|
| Rate for Payer: Nomi Health Commercial |
$4,036.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,199.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,313.47
|
| Rate for Payer: Priority Health Narrow Network |
$3,450.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,332.18
|
|
|
HC TRANSSEPTAL INTRODUCER
|
Facility
|
OP
|
$904.39
|
|
| Hospital Charge Code |
27200154
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$361.76 |
| Max. Negotiated Rate |
$904.39 |
| Rate for Payer: Aetna Commercial |
$813.95
|
| Rate for Payer: Aetna Medicare |
$452.19
|
| Rate for Payer: ASR ASR |
$877.26
|
| Rate for Payer: ASR Commercial |
$877.26
|
| Rate for Payer: BCBS Complete |
$361.76
|
| Rate for Payer: BCBS Trust/PPO |
$740.60
|
| Rate for Payer: BCN Commercial |
$701.17
|
| Rate for Payer: Cash Price |
$723.51
|
| Rate for Payer: Cofinity Commercial |
$850.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$723.51
|
| Rate for Payer: Healthscope Commercial |
$904.39
|
| Rate for Payer: Healthscope Whirlpool |
$877.26
|
| Rate for Payer: Mclaren Commercial |
$813.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$768.73
|
| Rate for Payer: Nomi Health Commercial |
$741.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$587.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$792.43
|
| Rate for Payer: Priority Health Narrow Network |
$633.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$795.86
|
|
|
HC TRANSSEPTAL INTRODUCER
|
Facility
|
IP
|
$904.39
|
|
| Hospital Charge Code |
27200154
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$587.85 |
| Max. Negotiated Rate |
$904.39 |
| Rate for Payer: Aetna Commercial |
$813.95
|
| Rate for Payer: ASR ASR |
$877.26
|
| Rate for Payer: ASR Commercial |
$877.26
|
| Rate for Payer: BCBS Trust/PPO |
$736.99
|
| Rate for Payer: BCN Commercial |
$701.17
|
| Rate for Payer: Cash Price |
$723.51
|
| Rate for Payer: Cofinity Commercial |
$850.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$723.51
|
| Rate for Payer: Healthscope Commercial |
$904.39
|
| Rate for Payer: Healthscope Whirlpool |
$877.26
|
| Rate for Payer: Mclaren Commercial |
$813.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$768.73
|
| Rate for Payer: Nomi Health Commercial |
$741.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$587.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$795.86
|
|
|
HC TRANSVERSUS ABDOMINIS PLANE (TAP) BIL
|
Facility
|
IP
|
$1,606.50
|
|
|
Service Code
|
CPT 64488
|
| Hospital Charge Code |
36100576
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,044.22 |
| Max. Negotiated Rate |
$1,606.50 |
| Rate for Payer: Aetna Commercial |
$1,445.85
|
| Rate for Payer: ASR ASR |
$1,558.31
|
| Rate for Payer: ASR Commercial |
$1,558.31
|
| Rate for Payer: BCBS Trust/PPO |
$1,309.14
|
| Rate for Payer: BCN Commercial |
$1,245.52
|
| Rate for Payer: Cash Price |
$1,285.20
|
| Rate for Payer: Cofinity Commercial |
$1,510.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,285.20
|
| Rate for Payer: Healthscope Commercial |
$1,606.50
|
| Rate for Payer: Healthscope Whirlpool |
$1,558.31
|
| Rate for Payer: Mclaren Commercial |
$1,445.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,365.53
|
| Rate for Payer: Nomi Health Commercial |
$1,317.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,044.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,413.72
|
|
|
HC TRANSVERSUS ABDOMINIS PLANE (TAP) BIL
|
Facility
|
OP
|
$1,606.50
|
|
|
Service Code
|
CPT 64488
|
| Hospital Charge Code |
36100576
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$642.60 |
| Max. Negotiated Rate |
$1,606.50 |
| Rate for Payer: Aetna Commercial |
$1,445.85
|
| Rate for Payer: Aetna Medicare |
$803.25
|
| Rate for Payer: ASR ASR |
$1,558.31
|
| Rate for Payer: ASR Commercial |
$1,558.31
|
| Rate for Payer: BCBS Complete |
$642.60
|
| Rate for Payer: BCBS Trust/PPO |
$1,315.56
|
| Rate for Payer: BCN Commercial |
$1,245.52
|
| Rate for Payer: Cash Price |
$1,285.20
|
| Rate for Payer: Cofinity Commercial |
$1,510.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,285.20
|
| Rate for Payer: Healthscope Commercial |
$1,606.50
|
| Rate for Payer: Healthscope Whirlpool |
$1,558.31
|
| Rate for Payer: Mclaren Commercial |
$1,445.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,365.53
|
| Rate for Payer: Nomi Health Commercial |
$1,317.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,044.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,407.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,126.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,413.72
|
|
|
HC TRANSVERSUS ABDOMINIS PLANE (TAP) UNI
|
Facility
|
OP
|
$1,194.38
|
|
|
Service Code
|
CPT 64486
|
| Hospital Charge Code |
36100575
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$477.75 |
| Max. Negotiated Rate |
$1,194.38 |
| Rate for Payer: Aetna Commercial |
$1,074.94
|
| Rate for Payer: Aetna Medicare |
$597.19
|
| Rate for Payer: ASR ASR |
$1,158.55
|
| Rate for Payer: ASR Commercial |
$1,158.55
|
| Rate for Payer: BCBS Complete |
$477.75
|
| Rate for Payer: BCBS Trust/PPO |
$978.08
|
| Rate for Payer: BCN Commercial |
$926.00
|
| Rate for Payer: Cash Price |
$955.50
|
| Rate for Payer: Cofinity Commercial |
$1,122.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$955.50
|
| Rate for Payer: Healthscope Commercial |
$1,194.38
|
| Rate for Payer: Healthscope Whirlpool |
$1,158.55
|
| Rate for Payer: Mclaren Commercial |
$1,074.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,015.22
|
| Rate for Payer: Nomi Health Commercial |
$979.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$776.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,046.52
|
| Rate for Payer: Priority Health Narrow Network |
$837.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,051.05
|
|
|
HC TRANSVERSUS ABDOMINIS PLANE (TAP) UNI
|
Facility
|
IP
|
$1,194.38
|
|
|
Service Code
|
CPT 64486
|
| Hospital Charge Code |
36100575
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$776.35 |
| Max. Negotiated Rate |
$1,194.38 |
| Rate for Payer: Aetna Commercial |
$1,074.94
|
| Rate for Payer: ASR ASR |
$1,158.55
|
| Rate for Payer: ASR Commercial |
$1,158.55
|
| Rate for Payer: BCBS Trust/PPO |
$973.30
|
| Rate for Payer: BCN Commercial |
$926.00
|
| Rate for Payer: Cash Price |
$955.50
|
| Rate for Payer: Cofinity Commercial |
$1,122.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$955.50
|
| Rate for Payer: Healthscope Commercial |
$1,194.38
|
| Rate for Payer: Healthscope Whirlpool |
$1,158.55
|
| Rate for Payer: Mclaren Commercial |
$1,074.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,015.22
|
| Rate for Payer: Nomi Health Commercial |
$979.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$776.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,051.05
|
|
|
HC TRANURETH DESTR PROST TISS RF WVT
|
Facility
|
OP
|
$4,903.14
|
|
|
Service Code
|
CPT 53854
|
| Hospital Charge Code |
76100306
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,802.95 |
| Max. Negotiated Rate |
$5,213.75 |
| Rate for Payer: Aetna Commercial |
$4,412.83
|
| Rate for Payer: Aetna Medicare |
$3,363.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,204.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,204.64
|
| Rate for Payer: ASR ASR |
$4,756.05
|
| Rate for Payer: ASR Commercial |
$4,756.05
|
| Rate for Payer: BCBS Complete |
$1,893.10
|
| Rate for Payer: BCBS MAPPO |
$3,363.71
|
| Rate for Payer: BCBS Trust/PPO |
$4,015.18
|
| Rate for Payer: BCN Commercial |
$3,801.40
|
| Rate for Payer: BCN Medicare Advantage |
$3,363.71
|
| Rate for Payer: Cash Price |
$3,922.51
|
| Rate for Payer: Cash Price |
$3,922.51
|
| Rate for Payer: Cofinity Commercial |
$4,608.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,922.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,363.71
|
| Rate for Payer: Healthscope Commercial |
$4,903.14
|
| Rate for Payer: Healthscope Whirlpool |
$4,756.05
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,363.71
|
| Rate for Payer: Mclaren Commercial |
$4,412.83
|
| Rate for Payer: Mclaren Medicaid |
$1,802.95
|
| Rate for Payer: Mclaren Medicare |
$3,363.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,531.90
|
| Rate for Payer: Meridian Medicaid |
$1,893.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,868.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,167.67
|
| Rate for Payer: Nomi Health Commercial |
$4,020.57
|
| Rate for Payer: PACE Medicare |
$3,195.52
|
| Rate for Payer: PACE SWMI |
$3,363.71
|
| Rate for Payer: PHP Commercial |
$3,700.08
|
| Rate for Payer: PHP Medicaid |
$1,802.95
|
| Rate for Payer: PHP Medicare Advantage |
$3,363.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,802.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,187.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,296.13
|
| Rate for Payer: Priority Health Medicare |
$3,363.71
|
| Rate for Payer: Priority Health Narrow Network |
$3,437.10
|
| Rate for Payer: Railroad Medicare Medicare |
$3,363.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,314.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,363.71
|
| Rate for Payer: UHC Exchange |
$5,213.75
|
| Rate for Payer: UHC Medicare Advantage |
$3,363.71
|
| Rate for Payer: UHCCP DNSP |
$3,363.71
|
| Rate for Payer: UHCCP Medicaid |
$1,802.95
|
| Rate for Payer: VA VA |
$3,363.71
|
|
|
HC TRANURETH DESTR PROST TISS RF WVT
|
Facility
|
IP
|
$4,903.14
|
|
|
Service Code
|
CPT 53854
|
| Hospital Charge Code |
76100306
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,187.04 |
| Max. Negotiated Rate |
$4,903.14 |
| Rate for Payer: Aetna Commercial |
$4,412.83
|
| Rate for Payer: ASR ASR |
$4,756.05
|
| Rate for Payer: ASR Commercial |
$4,756.05
|
| Rate for Payer: BCBS Trust/PPO |
$3,995.57
|
| Rate for Payer: BCN Commercial |
$3,801.40
|
| Rate for Payer: Cash Price |
$3,922.51
|
| Rate for Payer: Cofinity Commercial |
$4,608.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,922.51
|
| Rate for Payer: Healthscope Commercial |
$4,903.14
|
| Rate for Payer: Healthscope Whirlpool |
$4,756.05
|
| Rate for Payer: Mclaren Commercial |
$4,412.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,167.67
|
| Rate for Payer: Nomi Health Commercial |
$4,020.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,187.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,314.76
|
|
|
HC TREAT FINGER FRACTURE WITH MANIP EA
|
Facility
|
OP
|
$4,243.31
|
|
|
Service Code
|
CPT 26742
|
| Hospital Charge Code |
76100386
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$836.62 |
| Max. Negotiated Rate |
$4,243.31 |
| Rate for Payer: Aetna Commercial |
$3,818.98
|
| Rate for Payer: Aetna Medicare |
$1,560.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,951.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,951.06
|
| Rate for Payer: ASR ASR |
$4,116.01
|
| Rate for Payer: ASR Commercial |
$4,116.01
|
| Rate for Payer: BCBS Complete |
$878.45
|
| Rate for Payer: BCBS MAPPO |
$1,560.85
|
| Rate for Payer: BCBS Trust/PPO |
$3,474.85
|
| Rate for Payer: BCN Commercial |
$3,289.84
|
| Rate for Payer: BCN Medicare Advantage |
$1,560.85
|
| Rate for Payer: Cash Price |
$3,394.65
|
| Rate for Payer: Cash Price |
$3,394.65
|
| Rate for Payer: Cofinity Commercial |
$3,988.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,394.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,560.85
|
| Rate for Payer: Healthscope Commercial |
$4,243.31
|
| Rate for Payer: Healthscope Whirlpool |
$4,116.01
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,560.85
|
| Rate for Payer: Mclaren Commercial |
$3,818.98
|
| Rate for Payer: Mclaren Medicaid |
$836.62
|
| Rate for Payer: Mclaren Medicare |
$1,560.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,638.89
|
| Rate for Payer: Meridian Medicaid |
$878.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,794.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,606.81
|
| Rate for Payer: Nomi Health Commercial |
$3,479.51
|
| Rate for Payer: PACE Medicare |
$1,482.81
|
| Rate for Payer: PACE SWMI |
$1,560.85
|
| Rate for Payer: PHP Commercial |
$1,716.93
|
| Rate for Payer: PHP Medicaid |
$836.62
|
| Rate for Payer: PHP Medicare Advantage |
$1,560.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$836.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,758.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,717.99
|
| Rate for Payer: Priority Health Medicare |
$1,560.85
|
| Rate for Payer: Priority Health Narrow Network |
$2,974.56
|
| Rate for Payer: Railroad Medicare Medicare |
$1,560.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,734.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,560.85
|
| Rate for Payer: UHC Exchange |
$2,419.32
|
| Rate for Payer: UHC Medicare Advantage |
$1,560.85
|
| Rate for Payer: UHCCP DNSP |
$1,560.85
|
| Rate for Payer: UHCCP Medicaid |
$836.62
|
| Rate for Payer: VA VA |
$1,560.85
|
|
|
HC TREAT FINGER FRACTURE WITH MANIP EA
|
Facility
|
IP
|
$4,243.31
|
|
|
Service Code
|
CPT 26742
|
| Hospital Charge Code |
76100386
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,758.15 |
| Max. Negotiated Rate |
$4,243.31 |
| Rate for Payer: Aetna Commercial |
$3,818.98
|
| Rate for Payer: ASR ASR |
$4,116.01
|
| Rate for Payer: ASR Commercial |
$4,116.01
|
| Rate for Payer: BCBS Trust/PPO |
$3,457.87
|
| Rate for Payer: BCN Commercial |
$3,289.84
|
| Rate for Payer: Cash Price |
$3,394.65
|
| Rate for Payer: Cofinity Commercial |
$3,988.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,394.65
|
| Rate for Payer: Healthscope Commercial |
$4,243.31
|
| Rate for Payer: Healthscope Whirlpool |
$4,116.01
|
| Rate for Payer: Mclaren Commercial |
$3,818.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,606.81
|
| Rate for Payer: Nomi Health Commercial |
$3,479.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,758.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,734.11
|
|
|
HC TREPONEMA PALLIDUM AB TOTAL AND RPR
|
Facility
|
OP
|
$25.50
|
|
|
Service Code
|
CPT 0064U
|
| Hospital Charge Code |
30200436
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.57 |
| Max. Negotiated Rate |
$48.56 |
| Rate for Payer: Aetna Commercial |
$22.95
|
| Rate for Payer: Aetna Medicare |
$31.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$39.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$39.16
|
| Rate for Payer: ASR ASR |
$24.73
|
| Rate for Payer: ASR Commercial |
$24.73
|
| Rate for Payer: BCBS Complete |
$17.63
|
| Rate for Payer: BCBS MAPPO |
$31.33
|
| Rate for Payer: BCBS Trust/PPO |
$20.88
|
| Rate for Payer: BCN Commercial |
$19.77
|
| Rate for Payer: BCN Medicare Advantage |
$31.33
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$23.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.33
|
| Rate for Payer: Healthscope Commercial |
$25.50
|
| Rate for Payer: Healthscope Whirlpool |
$24.73
|
| Rate for Payer: Humana Choice PPO Medicare |
$31.33
|
| Rate for Payer: Mclaren Commercial |
$22.95
|
| Rate for Payer: Mclaren Medicaid |
$16.79
|
| Rate for Payer: Mclaren Medicare |
$31.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.90
|
| Rate for Payer: Meridian Medicaid |
$17.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.68
|
| Rate for Payer: Nomi Health Commercial |
$20.91
|
| Rate for Payer: PACE Medicare |
$29.76
|
| Rate for Payer: PACE SWMI |
$31.33
|
| Rate for Payer: PHP Commercial |
$34.46
|
| Rate for Payer: PHP Medicaid |
$16.79
|
| Rate for Payer: PHP Medicare Advantage |
$31.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.34
|
| Rate for Payer: Priority Health Medicare |
$31.33
|
| Rate for Payer: Priority Health Narrow Network |
$17.88
|
| Rate for Payer: Railroad Medicare Medicare |
$31.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$31.33
|
| Rate for Payer: UHC Exchange |
$48.56
|
| Rate for Payer: UHC Medicare Advantage |
$31.33
|
| Rate for Payer: UHCCP DNSP |
$31.33
|
| Rate for Payer: UHCCP Medicaid |
$16.79
|
| Rate for Payer: VA VA |
$31.33
|
|
|
HC TREPONEMA PALLIDUM AB TOTAL AND RPR
|
Facility
|
IP
|
$25.50
|
|
|
Service Code
|
CPT 0064U
|
| Hospital Charge Code |
30200436
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.57 |
| Max. Negotiated Rate |
$25.50 |
| Rate for Payer: Aetna Commercial |
$22.95
|
| Rate for Payer: ASR ASR |
$24.73
|
| Rate for Payer: ASR Commercial |
$24.73
|
| Rate for Payer: BCBS Trust/PPO |
$20.78
|
| Rate for Payer: BCN Commercial |
$19.77
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$23.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Healthscope Commercial |
$25.50
|
| Rate for Payer: Healthscope Whirlpool |
$24.73
|
| Rate for Payer: Mclaren Commercial |
$22.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.68
|
| Rate for Payer: Nomi Health Commercial |
$20.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.44
|
|
|
HC TREPONEMA PALLIDUM ANTIBODY
|
Facility
|
IP
|
$24.48
|
|
|
Service Code
|
CPT 86780
|
| Hospital Charge Code |
30000057
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$15.91 |
| Max. Negotiated Rate |
$24.48 |
| Rate for Payer: Aetna Commercial |
$22.03
|
| Rate for Payer: ASR ASR |
$23.75
|
| Rate for Payer: ASR Commercial |
$23.75
|
| Rate for Payer: BCBS Trust/PPO |
$19.95
|
| Rate for Payer: BCN Commercial |
$18.98
|
| Rate for Payer: Cash Price |
$19.58
|
| Rate for Payer: Cofinity Commercial |
$23.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.58
|
| Rate for Payer: Healthscope Commercial |
$24.48
|
| Rate for Payer: Healthscope Whirlpool |
$23.75
|
| Rate for Payer: Mclaren Commercial |
$22.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.81
|
| Rate for Payer: Nomi Health Commercial |
$20.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.54
|
|
|
HC TREPONEMA PALLIDUM ANTIBODY
|
Facility
|
OP
|
$24.48
|
|
|
Service Code
|
CPT 86780
|
| Hospital Charge Code |
30000057
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$7.10 |
| Max. Negotiated Rate |
$24.48 |
| Rate for Payer: Aetna Commercial |
$22.03
|
| Rate for Payer: Aetna Medicare |
$13.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.55
|
| Rate for Payer: ASR ASR |
$23.75
|
| Rate for Payer: ASR Commercial |
$23.75
|
| Rate for Payer: BCBS Complete |
$7.45
|
| Rate for Payer: BCBS MAPPO |
$13.24
|
| Rate for Payer: BCBS Trust/PPO |
$20.05
|
| Rate for Payer: BCN Commercial |
$18.98
|
| Rate for Payer: BCN Medicare Advantage |
$13.24
|
| Rate for Payer: Cash Price |
$19.58
|
| Rate for Payer: Cash Price |
$19.58
|
| Rate for Payer: Cofinity Commercial |
$23.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.24
|
| Rate for Payer: Healthscope Commercial |
$24.48
|
| Rate for Payer: Healthscope Whirlpool |
$23.75
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.24
|
| Rate for Payer: Mclaren Commercial |
$22.03
|
| Rate for Payer: Mclaren Medicaid |
$7.10
|
| Rate for Payer: Mclaren Medicare |
$13.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.90
|
| Rate for Payer: Meridian Medicaid |
$7.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.81
|
| Rate for Payer: Nomi Health Commercial |
$20.07
|
| Rate for Payer: PACE Medicare |
$12.58
|
| Rate for Payer: PACE SWMI |
$13.24
|
| Rate for Payer: PHP Commercial |
$14.56
|
| Rate for Payer: PHP Medicaid |
$7.10
|
| Rate for Payer: PHP Medicare Advantage |
$13.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.45
|
| Rate for Payer: Priority Health Medicare |
$13.24
|
| Rate for Payer: Priority Health Narrow Network |
$17.16
|
| Rate for Payer: Railroad Medicare Medicare |
$13.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.24
|
| Rate for Payer: UHC Exchange |
$20.52
|
| Rate for Payer: UHC Medicare Advantage |
$13.24
|
| Rate for Payer: UHCCP DNSP |
$13.24
|
| Rate for Payer: UHCCP Medicaid |
$7.10
|
| Rate for Payer: VA VA |
$13.24
|
|
|
HC TREPONEMA PALLIDUM ANTIBODY FT
|
Facility
|
OP
|
$70.38
|
|
|
Service Code
|
CPT 86780
|
| Hospital Charge Code |
30200325
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.10 |
| Max. Negotiated Rate |
$70.38 |
| Rate for Payer: Aetna Commercial |
$63.34
|
| Rate for Payer: Aetna Medicare |
$13.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.55
|
| Rate for Payer: ASR ASR |
$68.27
|
| Rate for Payer: ASR Commercial |
$68.27
|
| Rate for Payer: BCBS Complete |
$7.45
|
| Rate for Payer: BCBS MAPPO |
$13.24
|
| Rate for Payer: BCBS Trust/PPO |
$57.63
|
| Rate for Payer: BCN Commercial |
$54.57
|
| Rate for Payer: BCN Medicare Advantage |
$13.24
|
| Rate for Payer: Cash Price |
$56.30
|
| Rate for Payer: Cash Price |
$56.30
|
| Rate for Payer: Cofinity Commercial |
$66.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.24
|
| Rate for Payer: Healthscope Commercial |
$70.38
|
| Rate for Payer: Healthscope Whirlpool |
$68.27
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.24
|
| Rate for Payer: Mclaren Commercial |
$63.34
|
| Rate for Payer: Mclaren Medicaid |
$7.10
|
| Rate for Payer: Mclaren Medicare |
$13.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.90
|
| Rate for Payer: Meridian Medicaid |
$7.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.82
|
| Rate for Payer: Nomi Health Commercial |
$57.71
|
| Rate for Payer: PACE Medicare |
$12.58
|
| Rate for Payer: PACE SWMI |
$13.24
|
| Rate for Payer: PHP Commercial |
$14.56
|
| Rate for Payer: PHP Medicaid |
$7.10
|
| Rate for Payer: PHP Medicare Advantage |
$13.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$61.67
|
| Rate for Payer: Priority Health Medicare |
$13.24
|
| Rate for Payer: Priority Health Narrow Network |
$49.34
|
| Rate for Payer: Railroad Medicare Medicare |
$13.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$61.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.24
|
| Rate for Payer: UHC Exchange |
$20.52
|
| Rate for Payer: UHC Medicare Advantage |
$13.24
|
| Rate for Payer: UHCCP DNSP |
$13.24
|
| Rate for Payer: UHCCP Medicaid |
$7.10
|
| Rate for Payer: VA VA |
$13.24
|
|
|
HC TREPONEMA PALLIDUM ANTIBODY FT
|
Facility
|
IP
|
$70.38
|
|
|
Service Code
|
CPT 86780
|
| Hospital Charge Code |
30200325
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$45.75 |
| Max. Negotiated Rate |
$70.38 |
| Rate for Payer: Aetna Commercial |
$63.34
|
| Rate for Payer: ASR ASR |
$68.27
|
| Rate for Payer: ASR Commercial |
$68.27
|
| Rate for Payer: BCBS Trust/PPO |
$57.35
|
| Rate for Payer: BCN Commercial |
$54.57
|
| Rate for Payer: Cash Price |
$56.30
|
| Rate for Payer: Cofinity Commercial |
$66.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.30
|
| Rate for Payer: Healthscope Commercial |
$70.38
|
| Rate for Payer: Healthscope Whirlpool |
$68.27
|
| Rate for Payer: Mclaren Commercial |
$63.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.82
|
| Rate for Payer: Nomi Health Commercial |
$57.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$61.93
|
|
|
HC TRIAD CREAM
|
Facility
|
IP
|
$27.70
|
|
| Hospital Charge Code |
27000605
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$18.00 |
| Max. Negotiated Rate |
$27.70 |
| Rate for Payer: Aetna Commercial |
$24.93
|
| Rate for Payer: ASR ASR |
$26.87
|
| Rate for Payer: ASR Commercial |
$26.87
|
| Rate for Payer: BCBS Trust/PPO |
$22.57
|
| Rate for Payer: BCN Commercial |
$21.48
|
| Rate for Payer: Cash Price |
$22.16
|
| Rate for Payer: Cofinity Commercial |
$26.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.16
|
| Rate for Payer: Healthscope Commercial |
$27.70
|
| Rate for Payer: Healthscope Whirlpool |
$26.87
|
| Rate for Payer: Mclaren Commercial |
$24.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.55
|
| Rate for Payer: Nomi Health Commercial |
$22.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$24.38
|
|
|
HC TRIAD CREAM
|
Facility
|
OP
|
$27.70
|
|
| Hospital Charge Code |
27000605
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$11.08 |
| Max. Negotiated Rate |
$27.70 |
| Rate for Payer: Aetna Commercial |
$24.93
|
| Rate for Payer: Aetna Medicare |
$13.85
|
| Rate for Payer: ASR ASR |
$26.87
|
| Rate for Payer: ASR Commercial |
$26.87
|
| Rate for Payer: BCBS Complete |
$11.08
|
| Rate for Payer: BCBS Trust/PPO |
$22.68
|
| Rate for Payer: BCN Commercial |
$21.48
|
| Rate for Payer: Cash Price |
$22.16
|
| Rate for Payer: Cofinity Commercial |
$26.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.16
|
| Rate for Payer: Healthscope Commercial |
$27.70
|
| Rate for Payer: Healthscope Whirlpool |
$26.87
|
| Rate for Payer: Mclaren Commercial |
$24.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.55
|
| Rate for Payer: Nomi Health Commercial |
$22.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.27
|
| Rate for Payer: Priority Health Narrow Network |
$19.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$24.38
|
|
|
HC TRICHOMONAS VAGINALIS AMPLIFIED DNA PROBE
|
Facility
|
OP
|
$67.63
|
|
|
Service Code
|
HCPCS 87798
|
| Hospital Charge Code |
30600206
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$67.63 |
| Rate for Payer: Aetna Commercial |
$60.87
|
| Rate for Payer: Aetna Medicare |
$35.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: ASR ASR |
$65.60
|
| Rate for Payer: ASR Commercial |
$65.60
|
| Rate for Payer: BCBS Complete |
$19.75
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$55.38
|
| Rate for Payer: BCN Commercial |
$52.43
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cofinity Commercial |
$63.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$67.63
|
| Rate for Payer: Healthscope Whirlpool |
$65.60
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$60.87
|
| Rate for Payer: Mclaren Medicaid |
$18.81
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$19.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.49
|
| Rate for Payer: Nomi Health Commercial |
$55.46
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$38.60
|
| Rate for Payer: PHP Medicaid |
$18.81
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$59.26
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$47.41
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$59.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$54.39
|
| Rate for Payer: UHC Medicare Advantage |
$35.09
|
| Rate for Payer: UHCCP DNSP |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$18.81
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC TRICHOMONAS VAGINALIS AMPLIFIED DNA PROBE
|
Facility
|
OP
|
$67.63
|
|
|
Service Code
|
CPT 87661
|
| Hospital Charge Code |
30600222
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$67.63 |
| Rate for Payer: Aetna Commercial |
$60.87
|
| Rate for Payer: Aetna Medicare |
$35.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: ASR ASR |
$65.60
|
| Rate for Payer: ASR Commercial |
$65.60
|
| Rate for Payer: BCBS Complete |
$19.75
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$55.38
|
| Rate for Payer: BCN Commercial |
$52.43
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cofinity Commercial |
$63.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$67.63
|
| Rate for Payer: Healthscope Whirlpool |
$65.60
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$60.87
|
| Rate for Payer: Mclaren Medicaid |
$18.81
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$19.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.49
|
| Rate for Payer: Nomi Health Commercial |
$55.46
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$38.60
|
| Rate for Payer: PHP Medicaid |
$18.81
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$59.26
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$47.41
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$59.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$54.39
|
| Rate for Payer: UHC Medicare Advantage |
$35.09
|
| Rate for Payer: UHCCP DNSP |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$18.81
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC TRICHOMONAS VAGINALIS AMPLIFIED DNA PROBE
|
Facility
|
IP
|
$67.63
|
|
|
Service Code
|
CPT 87661
|
| Hospital Charge Code |
30600222
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$43.96 |
| Max. Negotiated Rate |
$67.63 |
| Rate for Payer: Aetna Commercial |
$60.87
|
| Rate for Payer: ASR ASR |
$65.60
|
| Rate for Payer: ASR Commercial |
$65.60
|
| Rate for Payer: BCBS Trust/PPO |
$55.11
|
| Rate for Payer: BCN Commercial |
$52.43
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cofinity Commercial |
$63.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.10
|
| Rate for Payer: Healthscope Commercial |
$67.63
|
| Rate for Payer: Healthscope Whirlpool |
$65.60
|
| Rate for Payer: Mclaren Commercial |
$60.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.49
|
| Rate for Payer: Nomi Health Commercial |
$55.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$59.51
|
|
|
HC TRICHOMONAS VAGINALIS AMPLIFIED DNA PROBE
|
Facility
|
IP
|
$67.63
|
|
|
Service Code
|
HCPCS 87798
|
| Hospital Charge Code |
30600206
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$43.96 |
| Max. Negotiated Rate |
$67.63 |
| Rate for Payer: Aetna Commercial |
$60.87
|
| Rate for Payer: ASR ASR |
$65.60
|
| Rate for Payer: ASR Commercial |
$65.60
|
| Rate for Payer: BCBS Trust/PPO |
$55.11
|
| Rate for Payer: BCN Commercial |
$52.43
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cofinity Commercial |
$63.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.10
|
| Rate for Payer: Healthscope Commercial |
$67.63
|
| Rate for Payer: Healthscope Whirlpool |
$65.60
|
| Rate for Payer: Mclaren Commercial |
$60.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.49
|
| Rate for Payer: Nomi Health Commercial |
$55.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$59.51
|
|
|
HC TRIGGER POINT INJ
|
Facility
|
IP
|
$447.35
|
|
| Hospital Charge Code |
45000088
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$290.78 |
| Max. Negotiated Rate |
$447.35 |
| Rate for Payer: Aetna Commercial |
$402.62
|
| Rate for Payer: ASR ASR |
$433.93
|
| Rate for Payer: ASR Commercial |
$433.93
|
| Rate for Payer: BCBS Trust/PPO |
$364.55
|
| Rate for Payer: BCN Commercial |
$346.83
|
| Rate for Payer: Cash Price |
$357.88
|
| Rate for Payer: Cofinity Commercial |
$420.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$357.88
|
| Rate for Payer: Healthscope Commercial |
$447.35
|
| Rate for Payer: Healthscope Whirlpool |
$433.93
|
| Rate for Payer: Mclaren Commercial |
$402.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$380.25
|
| Rate for Payer: Nomi Health Commercial |
$366.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$290.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$393.67
|
|
