|
HC VON WILLEBRAND MULTIMETRIC ANALYSIS
|
Facility
|
OP
|
$97.80
|
|
|
Service Code
|
CPT 85247
|
| Hospital Charge Code |
30500028
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$97.80 |
| Rate for Payer: Aetna Commercial |
$88.02
|
| Rate for Payer: Aetna Medicare |
$22.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.68
|
| Rate for Payer: ASR ASR |
$94.87
|
| Rate for Payer: BCBS Complete |
$12.60
|
| Rate for Payer: BCBS MAPPO |
$22.94
|
| Rate for Payer: BCBS Trust/PPO |
$80.64
|
| Rate for Payer: BCN Commercial |
$80.64
|
| Rate for Payer: BCN Medicare Advantage |
$22.94
|
| Rate for Payer: Cash Price |
$78.24
|
| Rate for Payer: Cash Price |
$78.24
|
| Rate for Payer: Cofinity Commercial |
$91.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.94
|
| Rate for Payer: Healthscope Commercial |
$94.87
|
| Rate for Payer: Healthscope Whirlpool |
$97.80
|
| Rate for Payer: Humana Choice PPO Medicare |
$22.94
|
| Rate for Payer: Mclaren Commercial |
$88.02
|
| Rate for Payer: Mclaren Medicaid |
$22.94
|
| Rate for Payer: Mclaren Medicare |
$22.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.09
|
| Rate for Payer: Meridian Medicaid |
$12.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$25.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.13
|
| Rate for Payer: Nomi Health Commercial |
$80.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$73.35
|
| Rate for Payer: PACE Medicare |
$21.79
|
| Rate for Payer: PACE SWMI |
$22.94
|
| Rate for Payer: PHP Commercial |
$25.23
|
| Rate for Payer: PHP Medicaid |
$12.30
|
| Rate for Payer: PHP Medicare Advantage |
$22.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$85.69
|
| Rate for Payer: Priority Health Medicare |
$22.94
|
| Rate for Payer: Priority Health Narrow Network |
$68.56
|
| Rate for Payer: Railroad Medicare Medicare |
$22.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$86.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$22.94
|
| Rate for Payer: UHC Exchange |
$35.56
|
| Rate for Payer: UHC Medicaid |
$12.00
|
| Rate for Payer: UHCCP DNSP |
$22.94
|
| Rate for Payer: UHCCP Medicaid |
$12.00
|
| Rate for Payer: VA VA |
$22.94
|
|
|
HC VON WILLEBRAND MULTIMETRIC ANALYSIS
|
Facility
|
IP
|
$97.80
|
|
|
Service Code
|
CPT 85247
|
| Hospital Charge Code |
30500028
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$73.35 |
| Max. Negotiated Rate |
$97.80 |
| Rate for Payer: Aetna Commercial |
$88.02
|
| Rate for Payer: ASR ASR |
$94.87
|
| Rate for Payer: BCBS Trust/PPO |
$80.31
|
| Rate for Payer: BCN Commercial |
$80.31
|
| Rate for Payer: Cash Price |
$78.24
|
| Rate for Payer: Cofinity Commercial |
$91.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.24
|
| Rate for Payer: Healthscope Commercial |
$94.87
|
| Rate for Payer: Healthscope Whirlpool |
$97.80
|
| Rate for Payer: Mclaren Commercial |
$88.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.13
|
| Rate for Payer: Nomi Health Commercial |
$80.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$73.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$86.06
|
|
|
HC VON WILLEBRAND PANEL
|
Facility
|
OP
|
$131.59
|
|
|
Service Code
|
CPT 85397
|
| Hospital Charge Code |
31000001
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$16.14 |
| Max. Negotiated Rate |
$131.59 |
| Rate for Payer: Aetna Commercial |
$118.43
|
| Rate for Payer: Aetna Medicare |
$30.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$38.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$38.58
|
| Rate for Payer: ASR ASR |
$127.64
|
| Rate for Payer: BCBS Complete |
$16.95
|
| Rate for Payer: BCBS MAPPO |
$30.86
|
| Rate for Payer: BCBS Trust/PPO |
$108.50
|
| Rate for Payer: BCN Commercial |
$108.50
|
| Rate for Payer: BCN Medicare Advantage |
$30.86
|
| Rate for Payer: Cash Price |
$105.27
|
| Rate for Payer: Cash Price |
$105.27
|
| Rate for Payer: Cofinity Commercial |
$123.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.86
|
| Rate for Payer: Healthscope Commercial |
$127.64
|
| Rate for Payer: Healthscope Whirlpool |
$131.59
|
| Rate for Payer: Humana Choice PPO Medicare |
$30.86
|
| Rate for Payer: Mclaren Commercial |
$118.43
|
| Rate for Payer: Mclaren Medicaid |
$30.86
|
| Rate for Payer: Mclaren Medicare |
$30.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.40
|
| Rate for Payer: Meridian Medicaid |
$16.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$33.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.85
|
| Rate for Payer: Nomi Health Commercial |
$107.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$98.69
|
| Rate for Payer: PACE Medicare |
$29.32
|
| Rate for Payer: PACE SWMI |
$30.86
|
| Rate for Payer: PHP Commercial |
$33.95
|
| Rate for Payer: PHP Medicaid |
$16.54
|
| Rate for Payer: PHP Medicare Advantage |
$30.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$115.30
|
| Rate for Payer: Priority Health Medicare |
$30.86
|
| Rate for Payer: Priority Health Narrow Network |
$92.24
|
| Rate for Payer: Railroad Medicare Medicare |
$30.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$115.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$30.86
|
| Rate for Payer: UHC Exchange |
$47.83
|
| Rate for Payer: UHC Medicaid |
$16.14
|
| Rate for Payer: UHCCP DNSP |
$30.86
|
| Rate for Payer: UHCCP Medicaid |
$16.14
|
| Rate for Payer: VA VA |
$30.86
|
|
|
HC VON WILLEBRAND PANEL
|
Facility
|
IP
|
$131.59
|
|
|
Service Code
|
CPT 85397
|
| Hospital Charge Code |
31000001
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$98.69 |
| Max. Negotiated Rate |
$131.59 |
| Rate for Payer: Aetna Commercial |
$118.43
|
| Rate for Payer: ASR ASR |
$127.64
|
| Rate for Payer: BCBS Trust/PPO |
$108.06
|
| Rate for Payer: BCN Commercial |
$108.06
|
| Rate for Payer: Cash Price |
$105.27
|
| Rate for Payer: Cofinity Commercial |
$123.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.27
|
| Rate for Payer: Healthscope Commercial |
$127.64
|
| Rate for Payer: Healthscope Whirlpool |
$131.59
|
| Rate for Payer: Mclaren Commercial |
$118.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.85
|
| Rate for Payer: Nomi Health Commercial |
$107.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$98.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$115.80
|
|
|
HC VON WILLEBRAND PANEL CMPT1
|
Facility
|
OP
|
$99.76
|
|
|
Service Code
|
CPT 85240
|
| Hospital Charge Code |
30500020
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$9.36 |
| Max. Negotiated Rate |
$99.76 |
| Rate for Payer: Aetna Commercial |
$89.78
|
| Rate for Payer: Aetna Medicare |
$17.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.38
|
| Rate for Payer: ASR ASR |
$96.77
|
| Rate for Payer: BCBS Complete |
$9.83
|
| Rate for Payer: BCBS MAPPO |
$17.90
|
| Rate for Payer: BCBS Trust/PPO |
$82.25
|
| Rate for Payer: BCN Commercial |
$82.25
|
| Rate for Payer: BCN Medicare Advantage |
$17.90
|
| Rate for Payer: Cash Price |
$79.81
|
| Rate for Payer: Cash Price |
$79.81
|
| Rate for Payer: Cofinity Commercial |
$93.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.90
|
| Rate for Payer: Healthscope Commercial |
$96.77
|
| Rate for Payer: Healthscope Whirlpool |
$99.76
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.90
|
| Rate for Payer: Mclaren Commercial |
$89.78
|
| Rate for Payer: Mclaren Medicaid |
$17.90
|
| Rate for Payer: Mclaren Medicare |
$17.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.80
|
| Rate for Payer: Meridian Medicaid |
$9.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.80
|
| Rate for Payer: Nomi Health Commercial |
$81.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.82
|
| Rate for Payer: PACE Medicare |
$17.00
|
| Rate for Payer: PACE SWMI |
$17.90
|
| Rate for Payer: PHP Commercial |
$19.69
|
| Rate for Payer: PHP Medicaid |
$9.59
|
| Rate for Payer: PHP Medicare Advantage |
$17.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$87.41
|
| Rate for Payer: Priority Health Medicare |
$17.90
|
| Rate for Payer: Priority Health Narrow Network |
$69.93
|
| Rate for Payer: Railroad Medicare Medicare |
$17.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$87.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17.90
|
| Rate for Payer: UHC Exchange |
$27.75
|
| Rate for Payer: UHC Medicaid |
$9.36
|
| Rate for Payer: UHCCP DNSP |
$17.90
|
| Rate for Payer: UHCCP Medicaid |
$9.36
|
| Rate for Payer: VA VA |
$17.90
|
|
|
HC VON WILLEBRAND PANEL CMPT1
|
Facility
|
IP
|
$99.76
|
|
|
Service Code
|
CPT 85240
|
| Hospital Charge Code |
30500020
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$74.82 |
| Max. Negotiated Rate |
$99.76 |
| Rate for Payer: Aetna Commercial |
$89.78
|
| Rate for Payer: ASR ASR |
$96.77
|
| Rate for Payer: BCBS Trust/PPO |
$81.92
|
| Rate for Payer: BCN Commercial |
$81.92
|
| Rate for Payer: Cash Price |
$79.81
|
| Rate for Payer: Cofinity Commercial |
$93.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.81
|
| Rate for Payer: Healthscope Commercial |
$96.77
|
| Rate for Payer: Healthscope Whirlpool |
$99.76
|
| Rate for Payer: Mclaren Commercial |
$89.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.80
|
| Rate for Payer: Nomi Health Commercial |
$81.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$87.79
|
|
|
HC VON WILLEBRAND PANEL CMPT2
|
Facility
|
OP
|
$132.65
|
|
|
Service Code
|
CPT 85245
|
| Hospital Charge Code |
30500022
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$132.65 |
| Rate for Payer: Aetna Commercial |
$119.39
|
| Rate for Payer: Aetna Medicare |
$22.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.68
|
| Rate for Payer: ASR ASR |
$128.67
|
| Rate for Payer: BCBS Complete |
$12.60
|
| Rate for Payer: BCBS MAPPO |
$22.94
|
| Rate for Payer: BCBS Trust/PPO |
$109.37
|
| Rate for Payer: BCN Commercial |
$109.37
|
| Rate for Payer: BCN Medicare Advantage |
$22.94
|
| Rate for Payer: Cash Price |
$106.12
|
| Rate for Payer: Cash Price |
$106.12
|
| Rate for Payer: Cofinity Commercial |
$124.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.94
|
| Rate for Payer: Healthscope Commercial |
$128.67
|
| Rate for Payer: Healthscope Whirlpool |
$132.65
|
| Rate for Payer: Humana Choice PPO Medicare |
$22.94
|
| Rate for Payer: Mclaren Commercial |
$119.39
|
| Rate for Payer: Mclaren Medicaid |
$22.94
|
| Rate for Payer: Mclaren Medicare |
$22.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.09
|
| Rate for Payer: Meridian Medicaid |
$12.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$25.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$112.75
|
| Rate for Payer: Nomi Health Commercial |
$108.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$99.49
|
| Rate for Payer: PACE Medicare |
$21.79
|
| Rate for Payer: PACE SWMI |
$22.94
|
| Rate for Payer: PHP Commercial |
$25.23
|
| Rate for Payer: PHP Medicaid |
$12.30
|
| Rate for Payer: PHP Medicare Advantage |
$22.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$116.23
|
| Rate for Payer: Priority Health Medicare |
$22.94
|
| Rate for Payer: Priority Health Narrow Network |
$92.99
|
| Rate for Payer: Railroad Medicare Medicare |
$22.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$116.73
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$22.94
|
| Rate for Payer: UHC Exchange |
$35.56
|
| Rate for Payer: UHC Medicaid |
$12.00
|
| Rate for Payer: UHCCP DNSP |
$22.94
|
| Rate for Payer: UHCCP Medicaid |
$12.00
|
| Rate for Payer: VA VA |
$22.94
|
|
|
HC VON WILLEBRAND PANEL CMPT2
|
Facility
|
IP
|
$132.65
|
|
|
Service Code
|
CPT 85245
|
| Hospital Charge Code |
30500022
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$99.49 |
| Max. Negotiated Rate |
$132.65 |
| Rate for Payer: Aetna Commercial |
$119.39
|
| Rate for Payer: ASR ASR |
$128.67
|
| Rate for Payer: BCBS Trust/PPO |
$108.93
|
| Rate for Payer: BCN Commercial |
$108.93
|
| Rate for Payer: Cash Price |
$106.12
|
| Rate for Payer: Cofinity Commercial |
$124.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.12
|
| Rate for Payer: Healthscope Commercial |
$128.67
|
| Rate for Payer: Healthscope Whirlpool |
$132.65
|
| Rate for Payer: Mclaren Commercial |
$119.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$112.75
|
| Rate for Payer: Nomi Health Commercial |
$108.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$99.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$116.73
|
|
|
HC VON WILLEBRAND PANEL CMPT3
|
Facility
|
IP
|
$129.01
|
|
|
Service Code
|
CPT 85246
|
| Hospital Charge Code |
30500026
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$96.76 |
| Max. Negotiated Rate |
$129.01 |
| Rate for Payer: Aetna Commercial |
$116.11
|
| Rate for Payer: ASR ASR |
$125.14
|
| Rate for Payer: BCBS Trust/PPO |
$105.94
|
| Rate for Payer: BCN Commercial |
$105.94
|
| Rate for Payer: Cash Price |
$103.21
|
| Rate for Payer: Cofinity Commercial |
$121.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.21
|
| Rate for Payer: Healthscope Commercial |
$125.14
|
| Rate for Payer: Healthscope Whirlpool |
$129.01
|
| Rate for Payer: Mclaren Commercial |
$116.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$109.66
|
| Rate for Payer: Nomi Health Commercial |
$105.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$96.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$113.53
|
|
|
HC VON WILLEBRAND PANEL CMPT3
|
Facility
|
OP
|
$129.01
|
|
|
Service Code
|
CPT 85246
|
| Hospital Charge Code |
30500026
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$217.90 |
| Rate for Payer: Aetna Commercial |
$116.11
|
| Rate for Payer: Aetna Medicare |
$22.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.68
|
| Rate for Payer: ASR ASR |
$125.14
|
| Rate for Payer: BCBS Complete |
$12.60
|
| Rate for Payer: BCBS MAPPO |
$22.94
|
| Rate for Payer: BCBS Trust/PPO |
$106.37
|
| Rate for Payer: BCN Commercial |
$106.37
|
| Rate for Payer: BCN Medicare Advantage |
$22.94
|
| Rate for Payer: Cash Price |
$103.21
|
| Rate for Payer: Cash Price |
$103.21
|
| Rate for Payer: Cofinity Commercial |
$121.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.94
|
| Rate for Payer: Healthscope Commercial |
$125.14
|
| Rate for Payer: Healthscope Whirlpool |
$129.01
|
| Rate for Payer: Humana Choice PPO Medicare |
$22.94
|
| Rate for Payer: Mclaren Commercial |
$116.11
|
| Rate for Payer: Mclaren Medicaid |
$22.94
|
| Rate for Payer: Mclaren Medicare |
$22.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.09
|
| Rate for Payer: Meridian Medicaid |
$12.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$25.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$109.66
|
| Rate for Payer: Nomi Health Commercial |
$105.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$96.76
|
| Rate for Payer: PACE Medicare |
$21.79
|
| Rate for Payer: PACE SWMI |
$22.94
|
| Rate for Payer: PHP Commercial |
$25.23
|
| Rate for Payer: PHP Medicaid |
$12.30
|
| Rate for Payer: PHP Medicare Advantage |
$22.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$217.90
|
| Rate for Payer: Priority Health Medicare |
$22.94
|
| Rate for Payer: Priority Health Narrow Network |
$174.32
|
| Rate for Payer: Railroad Medicare Medicare |
$22.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$113.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$22.94
|
| Rate for Payer: UHC Exchange |
$35.56
|
| Rate for Payer: UHC Medicaid |
$12.00
|
| Rate for Payer: UHCCP DNSP |
$22.94
|
| Rate for Payer: UHCCP Medicaid |
$12.00
|
| Rate for Payer: VA VA |
$22.94
|
|
|
HC VORICONAZOLE, S
|
Facility
|
OP
|
$93.64
|
|
|
Service Code
|
CPT 80285
|
| Hospital Charge Code |
30100707
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.18 |
| Max. Negotiated Rate |
$93.64 |
| Rate for Payer: Aetna Commercial |
$84.28
|
| Rate for Payer: Aetna Medicare |
$27.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.89
|
| Rate for Payer: ASR ASR |
$90.83
|
| Rate for Payer: BCBS Complete |
$14.89
|
| Rate for Payer: BCBS MAPPO |
$27.11
|
| Rate for Payer: BCBS Trust/PPO |
$77.21
|
| Rate for Payer: BCN Commercial |
$77.21
|
| Rate for Payer: BCN Medicare Advantage |
$27.11
|
| Rate for Payer: Cash Price |
$74.91
|
| Rate for Payer: Cash Price |
$74.91
|
| Rate for Payer: Cofinity Commercial |
$88.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.11
|
| Rate for Payer: Healthscope Commercial |
$90.83
|
| Rate for Payer: Healthscope Whirlpool |
$93.64
|
| Rate for Payer: Humana Choice PPO Medicare |
$27.11
|
| Rate for Payer: Mclaren Commercial |
$84.28
|
| Rate for Payer: Mclaren Medicaid |
$27.11
|
| Rate for Payer: Mclaren Medicare |
$27.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.47
|
| Rate for Payer: Meridian Medicaid |
$14.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$29.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.59
|
| Rate for Payer: Nomi Health Commercial |
$76.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.23
|
| Rate for Payer: PACE Medicare |
$25.75
|
| Rate for Payer: PACE SWMI |
$27.11
|
| Rate for Payer: PHP Commercial |
$29.82
|
| Rate for Payer: PHP Medicaid |
$14.53
|
| Rate for Payer: PHP Medicare Advantage |
$27.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$34.22
|
| Rate for Payer: Priority Health Medicare |
$27.11
|
| Rate for Payer: Priority Health Narrow Network |
$27.38
|
| Rate for Payer: Railroad Medicare Medicare |
$27.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$82.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$27.11
|
| Rate for Payer: UHC Exchange |
$42.02
|
| Rate for Payer: UHC Medicaid |
$14.18
|
| Rate for Payer: UHCCP DNSP |
$27.11
|
| Rate for Payer: UHCCP Medicaid |
$14.18
|
| Rate for Payer: VA VA |
$27.11
|
|
|
HC VORICONAZOLE, S
|
Facility
|
IP
|
$93.64
|
|
|
Service Code
|
CPT 80285
|
| Hospital Charge Code |
30100707
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$70.23 |
| Max. Negotiated Rate |
$93.64 |
| Rate for Payer: Aetna Commercial |
$84.28
|
| Rate for Payer: ASR ASR |
$90.83
|
| Rate for Payer: BCBS Trust/PPO |
$76.90
|
| Rate for Payer: BCN Commercial |
$76.90
|
| Rate for Payer: Cash Price |
$74.91
|
| Rate for Payer: Cofinity Commercial |
$88.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.91
|
| Rate for Payer: Healthscope Commercial |
$90.83
|
| Rate for Payer: Healthscope Whirlpool |
$93.64
|
| Rate for Payer: Mclaren Commercial |
$84.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.59
|
| Rate for Payer: Nomi Health Commercial |
$76.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$82.40
|
|
|
HC VULVECTOMY SIMPLE PARTIAL
|
Facility
|
OP
|
$8,104.44
|
|
|
Service Code
|
CPT 56620
|
| Hospital Charge Code |
36100618
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,686.93 |
| Max. Negotiated Rate |
$8,104.44 |
| Rate for Payer: Aetna Commercial |
$7,294.00
|
| Rate for Payer: Aetna Medicare |
$3,225.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,031.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,031.86
|
| Rate for Payer: ASR ASR |
$7,861.31
|
| Rate for Payer: BCBS Complete |
$1,771.44
|
| Rate for Payer: BCBS MAPPO |
$3,225.49
|
| Rate for Payer: BCBS Trust/PPO |
$6,682.11
|
| Rate for Payer: BCN Commercial |
$6,682.11
|
| Rate for Payer: BCN Medicare Advantage |
$3,225.49
|
| Rate for Payer: Cash Price |
$6,483.55
|
| Rate for Payer: Cash Price |
$6,483.55
|
| Rate for Payer: Cofinity Commercial |
$7,618.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,483.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,225.49
|
| Rate for Payer: Healthscope Commercial |
$7,861.31
|
| Rate for Payer: Healthscope Whirlpool |
$8,104.44
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,225.49
|
| Rate for Payer: Mclaren Commercial |
$7,294.00
|
| Rate for Payer: Mclaren Medicaid |
$3,225.49
|
| Rate for Payer: Mclaren Medicare |
$3,225.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,386.76
|
| Rate for Payer: Meridian Medicaid |
$1,771.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,709.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,548.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,888.77
|
| Rate for Payer: Nomi Health Commercial |
$6,645.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,078.33
|
| Rate for Payer: PACE Medicare |
$3,064.22
|
| Rate for Payer: PACE SWMI |
$3,225.49
|
| Rate for Payer: PHP Commercial |
$3,548.04
|
| Rate for Payer: PHP Medicaid |
$1,728.86
|
| Rate for Payer: PHP Medicare Advantage |
$3,225.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,686.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$7,101.11
|
| Rate for Payer: Priority Health Medicare |
$3,225.49
|
| Rate for Payer: Priority Health Narrow Network |
$5,681.21
|
| Rate for Payer: Railroad Medicare Medicare |
$3,225.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,131.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,225.49
|
| Rate for Payer: UHC Exchange |
$4,999.51
|
| Rate for Payer: UHC Medicaid |
$1,686.93
|
| Rate for Payer: UHCCP DNSP |
$3,225.49
|
| Rate for Payer: UHCCP Medicaid |
$1,686.93
|
| Rate for Payer: VA VA |
$3,225.49
|
|
|
HC VULVECTOMY SIMPLE PARTIAL
|
Facility
|
IP
|
$8,104.44
|
|
|
Service Code
|
CPT 56620
|
| Hospital Charge Code |
36100618
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$6,078.33 |
| Max. Negotiated Rate |
$8,104.44 |
| Rate for Payer: Aetna Commercial |
$7,294.00
|
| Rate for Payer: ASR ASR |
$7,861.31
|
| Rate for Payer: BCBS Trust/PPO |
$6,655.37
|
| Rate for Payer: BCN Commercial |
$6,655.37
|
| Rate for Payer: Cash Price |
$6,483.55
|
| Rate for Payer: Cofinity Commercial |
$7,618.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,483.55
|
| Rate for Payer: Healthscope Commercial |
$7,861.31
|
| Rate for Payer: Healthscope Whirlpool |
$8,104.44
|
| Rate for Payer: Mclaren Commercial |
$7,294.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,888.77
|
| Rate for Payer: Nomi Health Commercial |
$6,645.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,078.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,131.91
|
|
|
HC WALNUT IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200065
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.43 |
| Max. Negotiated Rate |
$25.90 |
| Rate for Payer: Aetna Commercial |
$23.31
|
| Rate for Payer: ASR ASR |
$25.12
|
| Rate for Payer: BCBS Trust/PPO |
$21.27
|
| Rate for Payer: BCN Commercial |
$21.27
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$24.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$25.12
|
| Rate for Payer: Healthscope Whirlpool |
$25.90
|
| Rate for Payer: Mclaren Commercial |
$23.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.79
|
|
|
HC WALNUT IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200065
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$25.90 |
| Rate for Payer: Aetna Commercial |
$23.31
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: ASR ASR |
$25.12
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$21.35
|
| Rate for Payer: BCN Commercial |
$21.35
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$24.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$25.12
|
| Rate for Payer: Healthscope Whirlpool |
$25.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$23.31
|
| Rate for Payer: Mclaren Medicaid |
$5.22
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$5.74
|
| Rate for Payer: PHP Medicaid |
$2.80
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$22.69
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$18.16
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP DNSP |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC WALNUT TREE IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200116
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$25.90 |
| Rate for Payer: Aetna Commercial |
$23.31
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: ASR ASR |
$25.12
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$21.35
|
| Rate for Payer: BCN Commercial |
$21.35
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$24.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$25.12
|
| Rate for Payer: Healthscope Whirlpool |
$25.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$23.31
|
| Rate for Payer: Mclaren Medicaid |
$5.22
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$5.74
|
| Rate for Payer: PHP Medicaid |
$2.80
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$22.69
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$18.16
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP DNSP |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC WALNUT TREE IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200116
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.43 |
| Max. Negotiated Rate |
$25.90 |
| Rate for Payer: Aetna Commercial |
$23.31
|
| Rate for Payer: ASR ASR |
$25.12
|
| Rate for Payer: BCBS Trust/PPO |
$21.27
|
| Rate for Payer: BCN Commercial |
$21.27
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$24.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$25.12
|
| Rate for Payer: Healthscope Whirlpool |
$25.90
|
| Rate for Payer: Mclaren Commercial |
$23.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.79
|
|
|
HC WASHED RED BLOOD CELLS
|
Facility
|
IP
|
$846.31
|
|
|
Service Code
|
HCPCS P9022
|
| Hospital Charge Code |
39000073
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$634.73 |
| Max. Negotiated Rate |
$846.31 |
| Rate for Payer: Aetna Commercial |
$761.68
|
| Rate for Payer: ASR ASR |
$820.92
|
| Rate for Payer: BCBS Trust/PPO |
$694.99
|
| Rate for Payer: BCN Commercial |
$694.99
|
| Rate for Payer: Cash Price |
$677.05
|
| Rate for Payer: Cofinity Commercial |
$795.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$677.05
|
| Rate for Payer: Healthscope Commercial |
$820.92
|
| Rate for Payer: Healthscope Whirlpool |
$846.31
|
| Rate for Payer: Mclaren Commercial |
$761.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$719.36
|
| Rate for Payer: Nomi Health Commercial |
$693.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$634.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$744.75
|
|
|
HC WASHED RED BLOOD CELLS
|
Facility
|
OP
|
$846.31
|
|
|
Service Code
|
HCPCS P9022
|
| Hospital Charge Code |
39000073
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$188.00 |
| Max. Negotiated Rate |
$846.31 |
| Rate for Payer: Aetna Commercial |
$761.68
|
| Rate for Payer: Aetna Medicare |
$359.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$449.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$449.34
|
| Rate for Payer: ASR ASR |
$820.92
|
| Rate for Payer: BCBS Complete |
$197.42
|
| Rate for Payer: BCBS MAPPO |
$359.47
|
| Rate for Payer: BCBS Trust/PPO |
$697.78
|
| Rate for Payer: BCN Commercial |
$697.78
|
| Rate for Payer: BCN Medicare Advantage |
$359.47
|
| Rate for Payer: Cash Price |
$677.05
|
| Rate for Payer: Cash Price |
$677.05
|
| Rate for Payer: Cofinity Commercial |
$795.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$677.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$359.47
|
| Rate for Payer: Healthscope Commercial |
$820.92
|
| Rate for Payer: Healthscope Whirlpool |
$846.31
|
| Rate for Payer: Humana Choice PPO Medicare |
$359.47
|
| Rate for Payer: Mclaren Commercial |
$761.68
|
| Rate for Payer: Mclaren Medicaid |
$359.47
|
| Rate for Payer: Mclaren Medicare |
$359.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$377.44
|
| Rate for Payer: Meridian Medicaid |
$197.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$413.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$395.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$719.36
|
| Rate for Payer: Nomi Health Commercial |
$693.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$634.73
|
| Rate for Payer: PACE Medicare |
$341.50
|
| Rate for Payer: PACE SWMI |
$359.47
|
| Rate for Payer: PHP Commercial |
$395.42
|
| Rate for Payer: PHP Medicaid |
$192.68
|
| Rate for Payer: PHP Medicare Advantage |
$359.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$188.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$633.47
|
| Rate for Payer: Priority Health Medicare |
$359.47
|
| Rate for Payer: Priority Health Narrow Network |
$506.77
|
| Rate for Payer: Railroad Medicare Medicare |
$359.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$744.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$359.47
|
| Rate for Payer: UHC Exchange |
$557.18
|
| Rate for Payer: UHC Medicaid |
$188.00
|
| Rate for Payer: UHCCP DNSP |
$359.47
|
| Rate for Payer: UHCCP Medicaid |
$188.00
|
| Rate for Payer: VA VA |
$359.47
|
|
|
HC WBC BUFFY COAT
|
Facility
|
OP
|
$47.24
|
|
|
Service Code
|
CPT 85009
|
| Hospital Charge Code |
30500004
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.65 |
| Max. Negotiated Rate |
$47.24 |
| Rate for Payer: Aetna Commercial |
$42.52
|
| Rate for Payer: Aetna Medicare |
$5.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.34
|
| Rate for Payer: ASR ASR |
$45.82
|
| Rate for Payer: BCBS Complete |
$2.78
|
| Rate for Payer: BCBS MAPPO |
$5.07
|
| Rate for Payer: BCBS Trust/PPO |
$38.95
|
| Rate for Payer: BCN Commercial |
$38.95
|
| Rate for Payer: BCN Medicare Advantage |
$5.07
|
| Rate for Payer: Cash Price |
$37.79
|
| Rate for Payer: Cash Price |
$37.79
|
| Rate for Payer: Cofinity Commercial |
$44.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.07
|
| Rate for Payer: Healthscope Commercial |
$45.82
|
| Rate for Payer: Healthscope Whirlpool |
$47.24
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.07
|
| Rate for Payer: Mclaren Commercial |
$42.52
|
| Rate for Payer: Mclaren Medicaid |
$5.07
|
| Rate for Payer: Mclaren Medicare |
$5.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.32
|
| Rate for Payer: Meridian Medicaid |
$2.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.15
|
| Rate for Payer: Nomi Health Commercial |
$38.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.43
|
| Rate for Payer: PACE Medicare |
$4.82
|
| Rate for Payer: PACE SWMI |
$5.07
|
| Rate for Payer: PHP Commercial |
$5.58
|
| Rate for Payer: PHP Medicaid |
$2.72
|
| Rate for Payer: PHP Medicare Advantage |
$5.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$41.39
|
| Rate for Payer: Priority Health Medicare |
$5.07
|
| Rate for Payer: Priority Health Narrow Network |
$33.12
|
| Rate for Payer: Railroad Medicare Medicare |
$5.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$41.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.07
|
| Rate for Payer: UHC Exchange |
$7.86
|
| Rate for Payer: UHC Medicaid |
$2.65
|
| Rate for Payer: UHCCP DNSP |
$5.07
|
| Rate for Payer: UHCCP Medicaid |
$2.65
|
| Rate for Payer: VA VA |
$5.07
|
|
|
HC WBC BUFFY COAT
|
Facility
|
IP
|
$47.24
|
|
|
Service Code
|
CPT 85009
|
| Hospital Charge Code |
30500004
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$35.43 |
| Max. Negotiated Rate |
$47.24 |
| Rate for Payer: Aetna Commercial |
$42.52
|
| Rate for Payer: ASR ASR |
$45.82
|
| Rate for Payer: BCBS Trust/PPO |
$38.79
|
| Rate for Payer: BCN Commercial |
$38.79
|
| Rate for Payer: Cash Price |
$37.79
|
| Rate for Payer: Cofinity Commercial |
$44.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.79
|
| Rate for Payer: Healthscope Commercial |
$45.82
|
| Rate for Payer: Healthscope Whirlpool |
$47.24
|
| Rate for Payer: Mclaren Commercial |
$42.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.15
|
| Rate for Payer: Nomi Health Commercial |
$38.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$41.57
|
|
|
HC WBC COUNT
|
Facility
|
IP
|
$27.59
|
|
|
Service Code
|
CPT 85048
|
| Hospital Charge Code |
30500011
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$20.69 |
| Max. Negotiated Rate |
$27.59 |
| Rate for Payer: Aetna Commercial |
$24.83
|
| Rate for Payer: ASR ASR |
$26.76
|
| Rate for Payer: BCBS Trust/PPO |
$22.66
|
| Rate for Payer: BCN Commercial |
$22.66
|
| Rate for Payer: Cash Price |
$22.07
|
| Rate for Payer: Cofinity Commercial |
$25.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.07
|
| Rate for Payer: Healthscope Commercial |
$26.76
|
| Rate for Payer: Healthscope Whirlpool |
$27.59
|
| Rate for Payer: Mclaren Commercial |
$24.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.45
|
| Rate for Payer: Nomi Health Commercial |
$22.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$24.28
|
|
|
HC WBC COUNT
|
Facility
|
OP
|
$27.59
|
|
|
Service Code
|
CPT 85048
|
| Hospital Charge Code |
30500011
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$1.33 |
| Max. Negotiated Rate |
$27.59 |
| Rate for Payer: Aetna Commercial |
$24.83
|
| Rate for Payer: Aetna Medicare |
$2.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.17
|
| Rate for Payer: ASR ASR |
$26.76
|
| Rate for Payer: BCBS Complete |
$1.39
|
| Rate for Payer: BCBS MAPPO |
$2.54
|
| Rate for Payer: BCBS Trust/PPO |
$22.75
|
| Rate for Payer: BCN Commercial |
$22.75
|
| Rate for Payer: BCN Medicare Advantage |
$2.54
|
| Rate for Payer: Cash Price |
$22.07
|
| Rate for Payer: Cash Price |
$22.07
|
| Rate for Payer: Cofinity Commercial |
$25.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.54
|
| Rate for Payer: Healthscope Commercial |
$26.76
|
| Rate for Payer: Healthscope Whirlpool |
$27.59
|
| Rate for Payer: Humana Choice PPO Medicare |
$2.54
|
| Rate for Payer: Mclaren Commercial |
$24.83
|
| Rate for Payer: Mclaren Medicaid |
$2.54
|
| Rate for Payer: Mclaren Medicare |
$2.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.67
|
| Rate for Payer: Meridian Medicaid |
$1.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$2.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.45
|
| Rate for Payer: Nomi Health Commercial |
$22.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.69
|
| Rate for Payer: PACE Medicare |
$2.41
|
| Rate for Payer: PACE SWMI |
$2.54
|
| Rate for Payer: PHP Commercial |
$2.79
|
| Rate for Payer: PHP Medicaid |
$1.36
|
| Rate for Payer: PHP Medicare Advantage |
$2.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$23.60
|
| Rate for Payer: Priority Health Medicare |
$2.54
|
| Rate for Payer: Priority Health Narrow Network |
$18.88
|
| Rate for Payer: Railroad Medicare Medicare |
$2.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$24.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2.54
|
| Rate for Payer: UHC Exchange |
$3.94
|
| Rate for Payer: UHC Medicaid |
$1.33
|
| Rate for Payer: UHCCP DNSP |
$2.54
|
| Rate for Payer: UHCCP Medicaid |
$1.33
|
| Rate for Payer: VA VA |
$2.54
|
|
|
HC WC EVAL JOB SITE ANALYSIS EACH 30 MIN
|
Facility
|
IP
|
$224.62
|
|
| Hospital Charge Code |
42000045
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$168.47 |
| Max. Negotiated Rate |
$224.62 |
| Rate for Payer: Aetna Commercial |
$202.16
|
| Rate for Payer: ASR ASR |
$217.88
|
| Rate for Payer: BCBS Trust/PPO |
$184.46
|
| Rate for Payer: BCN Commercial |
$184.46
|
| Rate for Payer: Cash Price |
$179.70
|
| Rate for Payer: Cofinity Commercial |
$211.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$179.70
|
| Rate for Payer: Healthscope Commercial |
$217.88
|
| Rate for Payer: Healthscope Whirlpool |
$224.62
|
| Rate for Payer: Mclaren Commercial |
$202.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$190.93
|
| Rate for Payer: Nomi Health Commercial |
$184.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$168.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$197.67
|
|
