|
HC VEEG 2-12 HR INTMT MNTR
|
Facility
|
IP
|
$1,094.36
|
|
|
Service Code
|
CPT 95712
|
| Hospital Charge Code |
74000022
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$820.77 |
| Max. Negotiated Rate |
$1,094.36 |
| Rate for Payer: Aetna Commercial |
$984.92
|
| Rate for Payer: ASR ASR |
$1,061.53
|
| Rate for Payer: BCBS Trust/PPO |
$898.69
|
| Rate for Payer: BCN Commercial |
$898.69
|
| Rate for Payer: Cash Price |
$875.49
|
| Rate for Payer: Cofinity Commercial |
$1,028.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$875.49
|
| Rate for Payer: Healthscope Commercial |
$1,061.53
|
| Rate for Payer: Healthscope Whirlpool |
$1,094.36
|
| Rate for Payer: Mclaren Commercial |
$984.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$930.21
|
| Rate for Payer: Nomi Health Commercial |
$897.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$820.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$963.04
|
|
|
HC VEEG 2-12 HR UNMONITORED
|
Facility
|
OP
|
$1,998.65
|
|
|
Service Code
|
CPT 95711
|
| Hospital Charge Code |
74000026
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$112.52 |
| Max. Negotiated Rate |
$1,998.65 |
| Rate for Payer: Aetna Commercial |
$1,798.79
|
| 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 |
$1,938.69
|
| Rate for Payer: BCBS Complete |
$118.16
|
| Rate for Payer: BCBS MAPPO |
$215.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,647.89
|
| Rate for Payer: BCN Commercial |
$1,647.89
|
| Rate for Payer: BCN Medicare Advantage |
$215.15
|
| Rate for Payer: Cash Price |
$1,598.92
|
| Rate for Payer: Cash Price |
$1,598.92
|
| Rate for Payer: Cofinity Commercial |
$1,878.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,598.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$215.15
|
| Rate for Payer: Healthscope Commercial |
$1,938.69
|
| Rate for Payer: Healthscope Whirlpool |
$1,998.65
|
| Rate for Payer: Humana Choice PPO Medicare |
$215.15
|
| Rate for Payer: Mclaren Commercial |
$1,798.79
|
| 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 |
$1,698.85
|
| Rate for Payer: Nomi Health Commercial |
$1,638.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,498.99
|
| 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 |
$319.43
|
| Rate for Payer: Priority Health Medicare |
$215.15
|
| Rate for Payer: Priority Health Narrow Network |
$255.54
|
| Rate for Payer: Railroad Medicare Medicare |
$215.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,758.81
|
| 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 VEEG 2-12 HR UNMONITORED
|
Facility
|
IP
|
$1,998.65
|
|
|
Service Code
|
CPT 95711
|
| Hospital Charge Code |
74000026
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$1,498.99 |
| Max. Negotiated Rate |
$1,998.65 |
| Rate for Payer: Aetna Commercial |
$1,798.79
|
| Rate for Payer: ASR ASR |
$1,938.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,641.29
|
| Rate for Payer: BCN Commercial |
$1,641.29
|
| Rate for Payer: Cash Price |
$1,598.92
|
| Rate for Payer: Cofinity Commercial |
$1,878.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,598.92
|
| Rate for Payer: Healthscope Commercial |
$1,938.69
|
| Rate for Payer: Healthscope Whirlpool |
$1,998.65
|
| Rate for Payer: Mclaren Commercial |
$1,798.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,698.85
|
| Rate for Payer: Nomi Health Commercial |
$1,638.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,498.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,758.81
|
|
|
HC VEEG EA 12-26 HR CONT MNTR
|
Facility
|
IP
|
$4,643.22
|
|
|
Service Code
|
CPT 95716
|
| Hospital Charge Code |
74000025
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$3,482.41 |
| Max. Negotiated Rate |
$4,643.22 |
| Rate for Payer: Aetna Commercial |
$4,178.90
|
| Rate for Payer: ASR ASR |
$4,503.92
|
| Rate for Payer: BCBS Trust/PPO |
$3,813.01
|
| Rate for Payer: BCN Commercial |
$3,813.01
|
| Rate for Payer: Cash Price |
$3,714.58
|
| Rate for Payer: Cofinity Commercial |
$4,364.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,714.58
|
| Rate for Payer: Healthscope Commercial |
$4,503.92
|
| Rate for Payer: Healthscope Whirlpool |
$4,643.22
|
| Rate for Payer: Mclaren Commercial |
$4,178.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,946.74
|
| Rate for Payer: Nomi Health Commercial |
$3,807.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,482.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,086.03
|
|
|
HC VEEG EA 12-26 HR CONT MNTR
|
Facility
|
OP
|
$4,643.22
|
|
|
Service Code
|
CPT 95716
|
| Hospital Charge Code |
74000025
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$447.50 |
| Max. Negotiated Rate |
$4,643.22 |
| Rate for Payer: Aetna Commercial |
$4,178.90
|
| Rate for Payer: Aetna Medicare |
$855.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,069.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,069.56
|
| Rate for Payer: ASR ASR |
$4,503.92
|
| Rate for Payer: BCBS Complete |
$469.92
|
| Rate for Payer: BCBS MAPPO |
$855.65
|
| Rate for Payer: BCBS Trust/PPO |
$3,828.33
|
| Rate for Payer: BCN Commercial |
$3,828.33
|
| Rate for Payer: BCN Medicare Advantage |
$855.65
|
| Rate for Payer: Cash Price |
$3,714.58
|
| Rate for Payer: Cash Price |
$3,714.58
|
| Rate for Payer: Cofinity Commercial |
$4,364.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,714.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$855.65
|
| Rate for Payer: Healthscope Commercial |
$4,503.92
|
| Rate for Payer: Healthscope Whirlpool |
$4,643.22
|
| Rate for Payer: Humana Choice PPO Medicare |
$855.65
|
| Rate for Payer: Mclaren Commercial |
$4,178.90
|
| Rate for Payer: Mclaren Medicaid |
$855.65
|
| Rate for Payer: Mclaren Medicare |
$855.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$898.43
|
| Rate for Payer: Meridian Medicaid |
$469.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$984.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$941.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,946.74
|
| Rate for Payer: Nomi Health Commercial |
$3,807.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,482.41
|
| Rate for Payer: PACE Medicare |
$812.87
|
| Rate for Payer: PACE SWMI |
$855.65
|
| Rate for Payer: PHP Commercial |
$941.22
|
| Rate for Payer: PHP Medicaid |
$458.63
|
| Rate for Payer: PHP Medicare Advantage |
$855.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$447.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,147.19
|
| Rate for Payer: Priority Health Medicare |
$855.65
|
| Rate for Payer: Priority Health Narrow Network |
$917.75
|
| Rate for Payer: Railroad Medicare Medicare |
$855.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,086.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$855.65
|
| Rate for Payer: UHC Exchange |
$1,326.26
|
| Rate for Payer: UHC Medicaid |
$447.50
|
| Rate for Payer: UHCCP DNSP |
$855.65
|
| Rate for Payer: UHCCP Medicaid |
$447.50
|
| Rate for Payer: VA VA |
$855.65
|
|
|
HC VEEG EA 12-26 HR INTMT MNTR
|
Facility
|
OP
|
$2,470.23
|
|
|
Service Code
|
CPT 95715
|
| Hospital Charge Code |
74000024
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$194.46 |
| Max. Negotiated Rate |
$2,470.23 |
| Rate for Payer: Aetna Commercial |
$2,223.21
|
| Rate for Payer: Aetna Medicare |
$371.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$464.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$464.77
|
| Rate for Payer: ASR ASR |
$2,396.12
|
| Rate for Payer: BCBS Complete |
$204.20
|
| Rate for Payer: BCBS MAPPO |
$371.82
|
| Rate for Payer: BCBS Trust/PPO |
$2,036.70
|
| Rate for Payer: BCN Commercial |
$2,036.70
|
| Rate for Payer: BCN Medicare Advantage |
$371.82
|
| Rate for Payer: Cash Price |
$1,976.18
|
| Rate for Payer: Cash Price |
$1,976.18
|
| Rate for Payer: Cofinity Commercial |
$2,322.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,976.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$371.82
|
| Rate for Payer: Healthscope Commercial |
$2,396.12
|
| Rate for Payer: Healthscope Whirlpool |
$2,470.23
|
| Rate for Payer: Humana Choice PPO Medicare |
$371.82
|
| Rate for Payer: Mclaren Commercial |
$2,223.21
|
| Rate for Payer: Mclaren Medicaid |
$371.82
|
| Rate for Payer: Mclaren Medicare |
$371.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$390.41
|
| Rate for Payer: Meridian Medicaid |
$204.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$427.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$409.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,099.70
|
| Rate for Payer: Nomi Health Commercial |
$2,025.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,852.67
|
| Rate for Payer: PACE Medicare |
$353.23
|
| Rate for Payer: PACE SWMI |
$371.82
|
| Rate for Payer: PHP Commercial |
$409.00
|
| Rate for Payer: PHP Medicaid |
$199.30
|
| Rate for Payer: PHP Medicare Advantage |
$371.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$194.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$612.90
|
| Rate for Payer: Priority Health Medicare |
$371.82
|
| Rate for Payer: Priority Health Narrow Network |
$490.32
|
| Rate for Payer: Railroad Medicare Medicare |
$371.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,173.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$371.82
|
| Rate for Payer: UHC Exchange |
$576.32
|
| Rate for Payer: UHC Medicaid |
$194.46
|
| Rate for Payer: UHCCP DNSP |
$371.82
|
| Rate for Payer: UHCCP Medicaid |
$194.46
|
| Rate for Payer: VA VA |
$371.82
|
|
|
HC VEEG EA 12-26 HR INTMT MNTR
|
Facility
|
IP
|
$2,470.23
|
|
|
Service Code
|
CPT 95715
|
| Hospital Charge Code |
74000024
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$1,852.67 |
| Max. Negotiated Rate |
$2,470.23 |
| Rate for Payer: Aetna Commercial |
$2,223.21
|
| Rate for Payer: ASR ASR |
$2,396.12
|
| Rate for Payer: BCBS Trust/PPO |
$2,028.55
|
| Rate for Payer: BCN Commercial |
$2,028.55
|
| Rate for Payer: Cash Price |
$1,976.18
|
| Rate for Payer: Cofinity Commercial |
$2,322.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,976.18
|
| Rate for Payer: Healthscope Commercial |
$2,396.12
|
| Rate for Payer: Healthscope Whirlpool |
$2,470.23
|
| Rate for Payer: Mclaren Commercial |
$2,223.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,099.70
|
| Rate for Payer: Nomi Health Commercial |
$2,025.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,852.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,173.80
|
|
|
HC VEIN MAPPING BILATERAL LOWER
|
Facility
|
OP
|
$1,436.86
|
|
|
Service Code
|
CPT 93970
|
| Hospital Charge Code |
92100024
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$1,436.86 |
| Rate for Payer: Aetna Commercial |
$1,293.17
|
| Rate for Payer: Aetna Medicare |
$237.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$297.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$297.18
|
| Rate for Payer: ASR ASR |
$1,393.75
|
| Rate for Payer: BCBS Complete |
$130.57
|
| Rate for Payer: BCBS MAPPO |
$237.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,184.69
|
| Rate for Payer: BCN Commercial |
$1,184.69
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$1,149.49
|
| Rate for Payer: Cash Price |
$1,149.49
|
| Rate for Payer: Cofinity Commercial |
$1,350.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,149.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$1,393.75
|
| Rate for Payer: Healthscope Whirlpool |
$1,436.86
|
| Rate for Payer: Humana Choice PPO Medicare |
$237.74
|
| Rate for Payer: Mclaren Commercial |
$1,293.17
|
| Rate for Payer: Mclaren Medicaid |
$237.74
|
| Rate for Payer: Mclaren Medicare |
$237.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.63
|
| Rate for Payer: Meridian Medicaid |
$130.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$273.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$261.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,221.33
|
| Rate for Payer: Nomi Health Commercial |
$1,178.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,077.64
|
| Rate for Payer: PACE Medicare |
$225.85
|
| Rate for Payer: PACE SWMI |
$237.74
|
| Rate for Payer: PHP Commercial |
$261.51
|
| Rate for Payer: PHP Medicaid |
$127.43
|
| Rate for Payer: PHP Medicare Advantage |
$237.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,168.80
|
| Rate for Payer: Priority Health Medicare |
$237.74
|
| Rate for Payer: Priority Health Narrow Network |
$935.04
|
| Rate for Payer: Railroad Medicare Medicare |
$237.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,264.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$237.74
|
| Rate for Payer: UHC Exchange |
$368.50
|
| Rate for Payer: UHC Medicaid |
$124.34
|
| Rate for Payer: UHCCP DNSP |
$237.74
|
| Rate for Payer: UHCCP Medicaid |
$124.34
|
| Rate for Payer: VA VA |
$237.74
|
|
|
HC VEIN MAPPING BILATERAL LOWER
|
Facility
|
IP
|
$1,436.86
|
|
|
Service Code
|
CPT 93970
|
| Hospital Charge Code |
92100024
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$1,077.64 |
| Max. Negotiated Rate |
$1,436.86 |
| Rate for Payer: Aetna Commercial |
$1,293.17
|
| Rate for Payer: ASR ASR |
$1,393.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,179.95
|
| Rate for Payer: BCN Commercial |
$1,179.95
|
| Rate for Payer: Cash Price |
$1,149.49
|
| Rate for Payer: Cofinity Commercial |
$1,350.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,149.49
|
| Rate for Payer: Healthscope Commercial |
$1,393.75
|
| Rate for Payer: Healthscope Whirlpool |
$1,436.86
|
| Rate for Payer: Mclaren Commercial |
$1,293.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,221.33
|
| Rate for Payer: Nomi Health Commercial |
$1,178.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,077.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,264.44
|
|
|
HC VEIN MAPPING BILATERAL UPPER
|
Facility
|
OP
|
$1,436.86
|
|
|
Service Code
|
CPT 93970
|
| Hospital Charge Code |
92100025
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$1,436.86 |
| Rate for Payer: Aetna Commercial |
$1,293.17
|
| Rate for Payer: Aetna Medicare |
$237.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$297.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$297.18
|
| Rate for Payer: ASR ASR |
$1,393.75
|
| Rate for Payer: BCBS Complete |
$130.57
|
| Rate for Payer: BCBS MAPPO |
$237.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,184.69
|
| Rate for Payer: BCN Commercial |
$1,184.69
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$1,149.49
|
| Rate for Payer: Cash Price |
$1,149.49
|
| Rate for Payer: Cofinity Commercial |
$1,350.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,149.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$1,393.75
|
| Rate for Payer: Healthscope Whirlpool |
$1,436.86
|
| Rate for Payer: Humana Choice PPO Medicare |
$237.74
|
| Rate for Payer: Mclaren Commercial |
$1,293.17
|
| Rate for Payer: Mclaren Medicaid |
$237.74
|
| Rate for Payer: Mclaren Medicare |
$237.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.63
|
| Rate for Payer: Meridian Medicaid |
$130.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$273.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$261.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,221.33
|
| Rate for Payer: Nomi Health Commercial |
$1,178.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,077.64
|
| Rate for Payer: PACE Medicare |
$225.85
|
| Rate for Payer: PACE SWMI |
$237.74
|
| Rate for Payer: PHP Commercial |
$261.51
|
| Rate for Payer: PHP Medicaid |
$127.43
|
| Rate for Payer: PHP Medicare Advantage |
$237.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,168.80
|
| Rate for Payer: Priority Health Medicare |
$237.74
|
| Rate for Payer: Priority Health Narrow Network |
$935.04
|
| Rate for Payer: Railroad Medicare Medicare |
$237.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,264.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$237.74
|
| Rate for Payer: UHC Exchange |
$368.50
|
| Rate for Payer: UHC Medicaid |
$124.34
|
| Rate for Payer: UHCCP DNSP |
$237.74
|
| Rate for Payer: UHCCP Medicaid |
$124.34
|
| Rate for Payer: VA VA |
$237.74
|
|
|
HC VEIN MAPPING BILATERAL UPPER
|
Facility
|
IP
|
$1,436.86
|
|
|
Service Code
|
CPT 93970
|
| Hospital Charge Code |
92100025
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$1,077.64 |
| Max. Negotiated Rate |
$1,436.86 |
| Rate for Payer: Aetna Commercial |
$1,293.17
|
| Rate for Payer: ASR ASR |
$1,393.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,179.95
|
| Rate for Payer: BCN Commercial |
$1,179.95
|
| Rate for Payer: Cash Price |
$1,149.49
|
| Rate for Payer: Cofinity Commercial |
$1,350.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,149.49
|
| Rate for Payer: Healthscope Commercial |
$1,393.75
|
| Rate for Payer: Healthscope Whirlpool |
$1,436.86
|
| Rate for Payer: Mclaren Commercial |
$1,293.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,221.33
|
| Rate for Payer: Nomi Health Commercial |
$1,178.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,077.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,264.44
|
|
|
HC VEIN MAPPING UNILAT LOWER EXTREMITY (R OR L)
|
Facility
|
IP
|
$884.98
|
|
|
Service Code
|
CPT 93971
|
| Hospital Charge Code |
92100011
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$663.74 |
| Max. Negotiated Rate |
$884.98 |
| Rate for Payer: Aetna Commercial |
$796.48
|
| Rate for Payer: ASR ASR |
$858.43
|
| Rate for Payer: BCBS Trust/PPO |
$726.75
|
| Rate for Payer: BCN Commercial |
$726.75
|
| Rate for Payer: Cash Price |
$707.98
|
| Rate for Payer: Cofinity Commercial |
$831.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$707.98
|
| Rate for Payer: Healthscope Commercial |
$858.43
|
| Rate for Payer: Healthscope Whirlpool |
$884.98
|
| Rate for Payer: Mclaren Commercial |
$796.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$752.23
|
| Rate for Payer: Nomi Health Commercial |
$725.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$663.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$778.78
|
|
|
HC VEIN MAPPING UNILAT LOWER EXTREMITY (R OR L)
|
Facility
|
OP
|
$884.98
|
|
|
Service Code
|
CPT 93971
|
| Hospital Charge Code |
92100011
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$884.98 |
| Rate for Payer: Aetna Commercial |
$796.48
|
| Rate for Payer: Aetna Medicare |
$104.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: ASR ASR |
$858.43
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$729.67
|
| Rate for Payer: BCN Commercial |
$729.67
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$707.98
|
| Rate for Payer: Cash Price |
$707.98
|
| Rate for Payer: Cofinity Commercial |
$831.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$707.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$858.43
|
| Rate for Payer: Healthscope Whirlpool |
$884.98
|
| Rate for Payer: Humana Choice PPO Medicare |
$104.17
|
| Rate for Payer: Mclaren Commercial |
$796.48
|
| Rate for Payer: Mclaren Medicaid |
$104.17
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$57.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$752.23
|
| Rate for Payer: Nomi Health Commercial |
$725.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$663.74
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$114.59
|
| Rate for Payer: PHP Medicaid |
$55.84
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$752.36
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health Narrow Network |
$601.89
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$778.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$161.46
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP DNSP |
$104.17
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: VA VA |
$104.17
|
|
|
HC VEIN MAPPING UNILAT UPPER EXTREMITY (R OR L)
|
Facility
|
IP
|
$884.98
|
|
|
Service Code
|
CPT 93971
|
| Hospital Charge Code |
92100029
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$663.74 |
| Max. Negotiated Rate |
$884.98 |
| Rate for Payer: Aetna Commercial |
$796.48
|
| Rate for Payer: ASR ASR |
$858.43
|
| Rate for Payer: BCBS Trust/PPO |
$726.75
|
| Rate for Payer: BCN Commercial |
$726.75
|
| Rate for Payer: Cash Price |
$707.98
|
| Rate for Payer: Cofinity Commercial |
$831.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$707.98
|
| Rate for Payer: Healthscope Commercial |
$858.43
|
| Rate for Payer: Healthscope Whirlpool |
$884.98
|
| Rate for Payer: Mclaren Commercial |
$796.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$752.23
|
| Rate for Payer: Nomi Health Commercial |
$725.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$663.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$778.78
|
|
|
HC VEIN MAPPING UNILAT UPPER EXTREMITY (R OR L)
|
Facility
|
OP
|
$884.98
|
|
|
Service Code
|
CPT 93971
|
| Hospital Charge Code |
92100029
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$884.98 |
| Rate for Payer: Aetna Commercial |
$796.48
|
| Rate for Payer: Aetna Medicare |
$104.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: ASR ASR |
$858.43
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$729.67
|
| Rate for Payer: BCN Commercial |
$729.67
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$707.98
|
| Rate for Payer: Cash Price |
$707.98
|
| Rate for Payer: Cofinity Commercial |
$831.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$707.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$858.43
|
| Rate for Payer: Healthscope Whirlpool |
$884.98
|
| Rate for Payer: Humana Choice PPO Medicare |
$104.17
|
| Rate for Payer: Mclaren Commercial |
$796.48
|
| Rate for Payer: Mclaren Medicaid |
$104.17
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$57.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$752.23
|
| Rate for Payer: Nomi Health Commercial |
$725.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$663.74
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$114.59
|
| Rate for Payer: PHP Medicaid |
$55.84
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$752.36
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health Narrow Network |
$601.89
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$778.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$161.46
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP DNSP |
$104.17
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: VA VA |
$104.17
|
|
|
HC VENA CAVA FILTER LVL 5
|
Facility
|
IP
|
$2,412.96
|
|
|
Service Code
|
HCPCS C1880
|
| Hospital Charge Code |
27800093
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,809.72 |
| Max. Negotiated Rate |
$2,412.96 |
| Rate for Payer: Aetna Commercial |
$2,171.66
|
| Rate for Payer: ASR ASR |
$2,340.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,981.52
|
| Rate for Payer: BCN Commercial |
$1,981.52
|
| Rate for Payer: Cash Price |
$1,930.37
|
| Rate for Payer: Cofinity Commercial |
$2,268.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,930.37
|
| Rate for Payer: Healthscope Commercial |
$2,340.57
|
| Rate for Payer: Healthscope Whirlpool |
$2,412.96
|
| Rate for Payer: Mclaren Commercial |
$2,171.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,051.02
|
| Rate for Payer: Nomi Health Commercial |
$1,978.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,809.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,123.40
|
|
|
HC VENA CAVA FILTER LVL 5
|
Facility
|
OP
|
$2,412.96
|
|
|
Service Code
|
HCPCS C1880
|
| Hospital Charge Code |
27800093
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$892.80 |
| Max. Negotiated Rate |
$2,412.96 |
| Rate for Payer: Aetna Commercial |
$2,171.66
|
| Rate for Payer: Aetna Medicare |
$892.80
|
| Rate for Payer: ASR ASR |
$2,340.57
|
| Rate for Payer: BCBS Complete |
$965.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,989.49
|
| Rate for Payer: BCN Commercial |
$1,989.49
|
| Rate for Payer: Cash Price |
$1,930.37
|
| Rate for Payer: Cofinity Commercial |
$2,268.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,930.37
|
| Rate for Payer: Healthscope Commercial |
$2,340.57
|
| Rate for Payer: Healthscope Whirlpool |
$2,412.96
|
| Rate for Payer: Mclaren Commercial |
$2,171.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,930.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,051.02
|
| Rate for Payer: Nomi Health Commercial |
$1,978.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,809.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,114.24
|
| Rate for Payer: Priority Health Narrow Network |
$1,691.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,123.40
|
|
|
HC VENA CAVA FILTER LVL 6
|
Facility
|
OP
|
$2,948.46
|
|
|
Service Code
|
HCPCS C1880
|
| Hospital Charge Code |
27800094
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,090.93 |
| Max. Negotiated Rate |
$2,948.46 |
| Rate for Payer: Aetna Commercial |
$2,653.61
|
| Rate for Payer: Aetna Medicare |
$1,090.93
|
| Rate for Payer: ASR ASR |
$2,860.01
|
| Rate for Payer: BCBS Complete |
$1,179.38
|
| Rate for Payer: BCBS Trust/PPO |
$2,431.01
|
| Rate for Payer: BCN Commercial |
$2,431.01
|
| Rate for Payer: Cash Price |
$2,358.77
|
| Rate for Payer: Cofinity Commercial |
$2,771.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,358.77
|
| Rate for Payer: Healthscope Commercial |
$2,860.01
|
| Rate for Payer: Healthscope Whirlpool |
$2,948.46
|
| Rate for Payer: Mclaren Commercial |
$2,653.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,358.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,506.19
|
| Rate for Payer: Nomi Health Commercial |
$2,417.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,211.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,583.44
|
| Rate for Payer: Priority Health Narrow Network |
$2,066.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,594.64
|
|
|
HC VENA CAVA FILTER LVL 6
|
Facility
|
IP
|
$2,948.46
|
|
|
Service Code
|
HCPCS C1880
|
| Hospital Charge Code |
27800094
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,211.34 |
| Max. Negotiated Rate |
$2,948.46 |
| Rate for Payer: Aetna Commercial |
$2,653.61
|
| Rate for Payer: ASR ASR |
$2,860.01
|
| Rate for Payer: BCBS Trust/PPO |
$2,421.28
|
| Rate for Payer: BCN Commercial |
$2,421.28
|
| Rate for Payer: Cash Price |
$2,358.77
|
| Rate for Payer: Cofinity Commercial |
$2,771.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,358.77
|
| Rate for Payer: Healthscope Commercial |
$2,860.01
|
| Rate for Payer: Healthscope Whirlpool |
$2,948.46
|
| Rate for Payer: Mclaren Commercial |
$2,653.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,506.19
|
| Rate for Payer: Nomi Health Commercial |
$2,417.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,211.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,594.64
|
|
|
HC VEN ADDL VEIN INTRAOP
|
Facility
|
IP
|
$416.23
|
|
| Hospital Charge Code |
36000051
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$312.17 |
| Max. Negotiated Rate |
$416.23 |
| Rate for Payer: Aetna Commercial |
$374.61
|
| Rate for Payer: ASR ASR |
$403.74
|
| Rate for Payer: BCBS Trust/PPO |
$341.81
|
| Rate for Payer: BCN Commercial |
$341.81
|
| Rate for Payer: Cash Price |
$332.98
|
| Rate for Payer: Cofinity Commercial |
$391.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$332.98
|
| Rate for Payer: Healthscope Commercial |
$403.74
|
| Rate for Payer: Healthscope Whirlpool |
$416.23
|
| Rate for Payer: Mclaren Commercial |
$374.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$353.80
|
| Rate for Payer: Nomi Health Commercial |
$341.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$366.28
|
|
|
HC VEN ADDL VEIN INTRAOP
|
Facility
|
OP
|
$416.23
|
|
| Hospital Charge Code |
36000051
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$154.01 |
| Max. Negotiated Rate |
$416.23 |
| Rate for Payer: Aetna Commercial |
$374.61
|
| Rate for Payer: Aetna Medicare |
$154.01
|
| Rate for Payer: ASR ASR |
$403.74
|
| Rate for Payer: BCBS Complete |
$166.49
|
| Rate for Payer: BCBS Trust/PPO |
$343.18
|
| Rate for Payer: BCN Commercial |
$343.18
|
| Rate for Payer: Cash Price |
$332.98
|
| Rate for Payer: Cofinity Commercial |
$391.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$332.98
|
| Rate for Payer: Healthscope Commercial |
$403.74
|
| Rate for Payer: Healthscope Whirlpool |
$416.23
|
| Rate for Payer: Mclaren Commercial |
$374.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$332.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$353.80
|
| Rate for Payer: Nomi Health Commercial |
$341.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$364.70
|
| Rate for Payer: Priority Health Narrow Network |
$291.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$366.28
|
|
|
HC VENIPUNCT BY PHYS/QHP 3/> YRS
|
Facility
|
IP
|
$46.82
|
|
|
Service Code
|
CPT 36410
|
| Hospital Charge Code |
45000105
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$35.12 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$42.14
|
| Rate for Payer: ASR ASR |
$45.42
|
| Rate for Payer: BCBS Trust/PPO |
$38.45
|
| Rate for Payer: BCN Commercial |
$38.45
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Commercial |
$44.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Healthscope Commercial |
$45.42
|
| Rate for Payer: Healthscope Whirlpool |
$46.82
|
| Rate for Payer: Mclaren Commercial |
$42.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.80
|
| Rate for Payer: Nomi Health Commercial |
$38.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$41.20
|
|
|
HC VENIPUNCT BY PHYS/QHP 3/> YRS
|
Facility
|
OP
|
$46.82
|
|
|
Service Code
|
CPT 36410
|
| Hospital Charge Code |
45000105
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$17.32 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$42.14
|
| Rate for Payer: Aetna Medicare |
$17.32
|
| Rate for Payer: ASR ASR |
$45.42
|
| Rate for Payer: BCBS Complete |
$18.73
|
| Rate for Payer: BCBS Trust/PPO |
$38.60
|
| Rate for Payer: BCN Commercial |
$38.60
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Commercial |
$44.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Healthscope Commercial |
$45.42
|
| Rate for Payer: Healthscope Whirlpool |
$46.82
|
| Rate for Payer: Mclaren Commercial |
$42.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.80
|
| Rate for Payer: Nomi Health Commercial |
$38.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$38.74
|
| Rate for Payer: Priority Health Narrow Network |
$31.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$41.20
|
|
|
HC VENOGRAM ADRENAL
|
Facility
|
IP
|
$8,994.30
|
|
|
Service Code
|
CPT 75840
|
| Hospital Charge Code |
32000334
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$6,745.73 |
| Max. Negotiated Rate |
$8,994.30 |
| Rate for Payer: Aetna Commercial |
$8,094.87
|
| Rate for Payer: ASR ASR |
$8,724.47
|
| Rate for Payer: BCBS Trust/PPO |
$7,386.12
|
| Rate for Payer: BCN Commercial |
$7,386.12
|
| Rate for Payer: Cash Price |
$7,195.44
|
| Rate for Payer: Cofinity Commercial |
$8,454.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,195.44
|
| Rate for Payer: Healthscope Commercial |
$8,724.47
|
| Rate for Payer: Healthscope Whirlpool |
$8,994.30
|
| Rate for Payer: Mclaren Commercial |
$8,094.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,645.15
|
| Rate for Payer: Nomi Health Commercial |
$7,375.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,745.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,914.98
|
|
|
HC VENOGRAM ADRENAL
|
Facility
|
OP
|
$8,994.30
|
|
|
Service Code
|
CPT 75840
|
| Hospital Charge Code |
32000334
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,645.43 |
| Max. Negotiated Rate |
$8,994.30 |
| Rate for Payer: Aetna Commercial |
$8,094.87
|
| Rate for Payer: Aetna Medicare |
$3,146.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: ASR ASR |
$8,724.47
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$7,415.80
|
| Rate for Payer: BCN Commercial |
$7,415.80
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$7,195.44
|
| Rate for Payer: Cash Price |
$7,195.44
|
| Rate for Payer: Cofinity Commercial |
$8,454.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,195.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$8,724.47
|
| Rate for Payer: Healthscope Whirlpool |
$8,994.30
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,146.13
|
| Rate for Payer: Mclaren Commercial |
$8,094.87
|
| Rate for Payer: Mclaren Medicaid |
$3,146.13
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$1,727.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,645.15
|
| Rate for Payer: Nomi Health Commercial |
$7,375.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,745.73
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$3,460.74
|
| Rate for Payer: PHP Medicaid |
$1,686.33
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$7,880.81
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health Narrow Network |
$6,305.00
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,914.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Exchange |
$4,876.50
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP DNSP |
$3,146.13
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: VA VA |
$3,146.13
|
|
