|
HC US ELASTOGRAPHY EA ADDL LESION
|
Facility
|
OP
|
$31.21
|
|
|
Service Code
|
CPT 76983
|
| Hospital Charge Code |
40200076
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$12.48 |
| Max. Negotiated Rate |
$31.21 |
| Rate for Payer: Aetna Commercial |
$28.09
|
| Rate for Payer: Aetna Medicare |
$15.61
|
| Rate for Payer: ASR ASR |
$30.27
|
| Rate for Payer: ASR Commercial |
$30.27
|
| Rate for Payer: BCBS Complete |
$12.48
|
| Rate for Payer: BCBS Trust/PPO |
$25.56
|
| Rate for Payer: BCN Commercial |
$24.20
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cofinity Commercial |
$29.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.97
|
| Rate for Payer: Healthscope Commercial |
$31.21
|
| Rate for Payer: Healthscope Whirlpool |
$30.27
|
| Rate for Payer: Mclaren Commercial |
$28.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.53
|
| Rate for Payer: Nomi Health Commercial |
$25.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$27.35
|
| Rate for Payer: Priority Health Narrow Network |
$21.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.46
|
|
|
HC US ELASTOGRAPHY EA ADDL TARGET LESION
|
Facility
|
OP
|
$210.00
|
|
|
Service Code
|
CPT 76983
|
| Hospital Charge Code |
40200083
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$84.00 |
| Max. Negotiated Rate |
$210.00 |
| Rate for Payer: Aetna Commercial |
$189.00
|
| Rate for Payer: Aetna Medicare |
$105.00
|
| Rate for Payer: ASR ASR |
$203.70
|
| Rate for Payer: ASR Commercial |
$203.70
|
| Rate for Payer: BCBS Complete |
$84.00
|
| Rate for Payer: BCBS Trust/PPO |
$171.97
|
| Rate for Payer: BCN Commercial |
$162.81
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cofinity Commercial |
$197.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$168.00
|
| Rate for Payer: Healthscope Commercial |
$210.00
|
| Rate for Payer: Healthscope Whirlpool |
$203.70
|
| Rate for Payer: Mclaren Commercial |
$189.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$178.50
|
| Rate for Payer: Nomi Health Commercial |
$172.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$136.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$184.00
|
| Rate for Payer: Priority Health Narrow Network |
$147.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$184.80
|
|
|
HC US ELASTOGRAPHY EA ADDL TARGET LESION
|
Facility
|
IP
|
$210.00
|
|
|
Service Code
|
CPT 76983
|
| Hospital Charge Code |
40200083
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$136.50 |
| Max. Negotiated Rate |
$210.00 |
| Rate for Payer: Aetna Commercial |
$189.00
|
| Rate for Payer: ASR ASR |
$203.70
|
| Rate for Payer: ASR Commercial |
$203.70
|
| Rate for Payer: BCBS Trust/PPO |
$171.13
|
| Rate for Payer: BCN Commercial |
$162.81
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cofinity Commercial |
$197.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$168.00
|
| Rate for Payer: Healthscope Commercial |
$210.00
|
| Rate for Payer: Healthscope Whirlpool |
$203.70
|
| Rate for Payer: Mclaren Commercial |
$189.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$178.50
|
| Rate for Payer: Nomi Health Commercial |
$172.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$136.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$184.80
|
|
|
HC US ELASTOGRAPHY ORGAN
|
Facility
|
IP
|
$244.80
|
|
|
Service Code
|
CPT 76981
|
| Hospital Charge Code |
40200074
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$159.12 |
| Max. Negotiated Rate |
$244.80 |
| Rate for Payer: Aetna Commercial |
$220.32
|
| Rate for Payer: ASR ASR |
$237.46
|
| Rate for Payer: ASR Commercial |
$237.46
|
| Rate for Payer: BCBS Trust/PPO |
$199.49
|
| Rate for Payer: BCN Commercial |
$189.79
|
| Rate for Payer: Cash Price |
$195.84
|
| Rate for Payer: Cofinity Commercial |
$230.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.84
|
| Rate for Payer: Healthscope Commercial |
$244.80
|
| Rate for Payer: Healthscope Whirlpool |
$237.46
|
| Rate for Payer: Mclaren Commercial |
$220.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$208.08
|
| Rate for Payer: Nomi Health Commercial |
$200.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$159.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$215.42
|
|
|
HC US ELASTOGRAPHY ORGAN
|
Facility
|
OP
|
$244.80
|
|
|
Service Code
|
CPT 76981
|
| Hospital Charge Code |
40200074
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$244.80 |
| Rate for Payer: Aetna Commercial |
$220.32
|
| Rate for Payer: Aetna Medicare |
$103.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.64
|
| Rate for Payer: ASR ASR |
$237.46
|
| Rate for Payer: ASR Commercial |
$237.46
|
| Rate for Payer: BCBS Complete |
$58.37
|
| Rate for Payer: BCBS MAPPO |
$103.71
|
| Rate for Payer: BCBS Trust/PPO |
$200.47
|
| Rate for Payer: BCN Commercial |
$189.79
|
| Rate for Payer: BCN Medicare Advantage |
$103.71
|
| Rate for Payer: Cash Price |
$195.84
|
| Rate for Payer: Cash Price |
$195.84
|
| Rate for Payer: Cofinity Commercial |
$230.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.71
|
| Rate for Payer: Healthscope Commercial |
$244.80
|
| Rate for Payer: Healthscope Whirlpool |
$237.46
|
| Rate for Payer: Humana Choice PPO Medicare |
$103.71
|
| Rate for Payer: Mclaren Commercial |
$220.32
|
| Rate for Payer: Mclaren Medicaid |
$55.59
|
| Rate for Payer: Mclaren Medicare |
$103.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.90
|
| Rate for Payer: Meridian Medicaid |
$58.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$208.08
|
| Rate for Payer: Nomi Health Commercial |
$200.74
|
| Rate for Payer: PACE Medicare |
$98.52
|
| Rate for Payer: PACE SWMI |
$103.71
|
| Rate for Payer: PHP Commercial |
$114.08
|
| Rate for Payer: PHP Medicaid |
$55.59
|
| Rate for Payer: PHP Medicare Advantage |
$103.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$159.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$214.49
|
| Rate for Payer: Priority Health Medicare |
$103.71
|
| Rate for Payer: Priority Health Narrow Network |
$171.60
|
| Rate for Payer: Railroad Medicare Medicare |
$103.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$215.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.71
|
| Rate for Payer: UHC Exchange |
$160.75
|
| Rate for Payer: UHC Medicare Advantage |
$103.71
|
| Rate for Payer: UHCCP DNSP |
$103.71
|
| Rate for Payer: UHCCP Medicaid |
$55.59
|
| Rate for Payer: VA VA |
$103.71
|
|
|
HC USE OF SPEECH DEVICE SERVICE
|
Facility
|
OP
|
$473.16
|
|
|
Service Code
|
CPT 92609
|
| Hospital Charge Code |
44000003
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$189.26 |
| Max. Negotiated Rate |
$473.16 |
| Rate for Payer: Aetna Commercial |
$425.84
|
| Rate for Payer: Aetna Medicare |
$236.58
|
| Rate for Payer: ASR ASR |
$458.97
|
| Rate for Payer: ASR Commercial |
$458.97
|
| Rate for Payer: BCBS Complete |
$189.26
|
| Rate for Payer: BCBS Trust/PPO |
$387.47
|
| Rate for Payer: BCN Commercial |
$366.84
|
| Rate for Payer: Cash Price |
$378.53
|
| Rate for Payer: Cofinity Commercial |
$444.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$378.53
|
| Rate for Payer: Healthscope Commercial |
$473.16
|
| Rate for Payer: Healthscope Whirlpool |
$458.97
|
| Rate for Payer: Mclaren Commercial |
$425.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$402.19
|
| Rate for Payer: Nomi Health Commercial |
$387.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$307.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$414.58
|
| Rate for Payer: Priority Health Narrow Network |
$331.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$416.38
|
|
|
HC USE OF SPEECH DEVICE SERVICE
|
Facility
|
IP
|
$473.16
|
|
|
Service Code
|
CPT 92609
|
| Hospital Charge Code |
44000003
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$307.55 |
| Max. Negotiated Rate |
$473.16 |
| Rate for Payer: Aetna Commercial |
$425.84
|
| Rate for Payer: ASR ASR |
$458.97
|
| Rate for Payer: ASR Commercial |
$458.97
|
| Rate for Payer: BCBS Trust/PPO |
$385.58
|
| Rate for Payer: BCN Commercial |
$366.84
|
| Rate for Payer: Cash Price |
$378.53
|
| Rate for Payer: Cofinity Commercial |
$444.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$378.53
|
| Rate for Payer: Healthscope Commercial |
$473.16
|
| Rate for Payer: Healthscope Whirlpool |
$458.97
|
| Rate for Payer: Mclaren Commercial |
$425.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$402.19
|
| Rate for Payer: Nomi Health Commercial |
$387.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$307.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$416.38
|
|
|
HC US EXTREMITY NONVASC LTD
|
Facility
|
IP
|
$687.01
|
|
|
Service Code
|
CPT 76882
|
| Hospital Charge Code |
40200038
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$446.56 |
| Max. Negotiated Rate |
$687.01 |
| Rate for Payer: Aetna Commercial |
$618.31
|
| Rate for Payer: ASR ASR |
$666.40
|
| Rate for Payer: ASR Commercial |
$666.40
|
| Rate for Payer: BCBS Trust/PPO |
$559.84
|
| Rate for Payer: BCN Commercial |
$532.64
|
| Rate for Payer: Cash Price |
$549.61
|
| Rate for Payer: Cofinity Commercial |
$645.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$549.61
|
| Rate for Payer: Healthscope Commercial |
$687.01
|
| Rate for Payer: Healthscope Whirlpool |
$666.40
|
| Rate for Payer: Mclaren Commercial |
$618.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$583.96
|
| Rate for Payer: Nomi Health Commercial |
$563.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$446.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$604.57
|
|
|
HC US EXTREMITY NONVASC LTD
|
Facility
|
OP
|
$687.01
|
|
|
Service Code
|
CPT 76882
|
| Hospital Charge Code |
40200038
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$687.01 |
| Rate for Payer: Aetna Commercial |
$618.31
|
| Rate for Payer: Aetna Medicare |
$103.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.64
|
| Rate for Payer: ASR ASR |
$666.40
|
| Rate for Payer: ASR Commercial |
$666.40
|
| Rate for Payer: BCBS Complete |
$58.37
|
| Rate for Payer: BCBS MAPPO |
$103.71
|
| Rate for Payer: BCBS Trust/PPO |
$562.59
|
| Rate for Payer: BCN Commercial |
$532.64
|
| Rate for Payer: BCN Medicare Advantage |
$103.71
|
| Rate for Payer: Cash Price |
$549.61
|
| Rate for Payer: Cash Price |
$549.61
|
| Rate for Payer: Cofinity Commercial |
$645.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$549.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.71
|
| Rate for Payer: Healthscope Commercial |
$687.01
|
| Rate for Payer: Healthscope Whirlpool |
$666.40
|
| Rate for Payer: Humana Choice PPO Medicare |
$103.71
|
| Rate for Payer: Mclaren Commercial |
$618.31
|
| Rate for Payer: Mclaren Medicaid |
$55.59
|
| Rate for Payer: Mclaren Medicare |
$103.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.90
|
| Rate for Payer: Meridian Medicaid |
$58.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$583.96
|
| Rate for Payer: Nomi Health Commercial |
$563.35
|
| Rate for Payer: PACE Medicare |
$98.52
|
| Rate for Payer: PACE SWMI |
$103.71
|
| Rate for Payer: PHP Commercial |
$114.08
|
| Rate for Payer: PHP Medicaid |
$55.59
|
| Rate for Payer: PHP Medicare Advantage |
$103.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$446.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$601.96
|
| Rate for Payer: Priority Health Medicare |
$103.71
|
| Rate for Payer: Priority Health Narrow Network |
$481.59
|
| Rate for Payer: Railroad Medicare Medicare |
$103.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$604.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.71
|
| Rate for Payer: UHC Exchange |
$160.75
|
| Rate for Payer: UHC Medicare Advantage |
$103.71
|
| Rate for Payer: UHCCP DNSP |
$103.71
|
| Rate for Payer: UHCCP Medicaid |
$55.59
|
| Rate for Payer: VA VA |
$103.71
|
|
|
HC US EXTREMITY NONVASCULAR COMP
|
Facility
|
IP
|
$687.01
|
|
|
Service Code
|
CPT 76881
|
| Hospital Charge Code |
40200037
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$446.56 |
| Max. Negotiated Rate |
$687.01 |
| Rate for Payer: Aetna Commercial |
$618.31
|
| Rate for Payer: ASR ASR |
$666.40
|
| Rate for Payer: ASR Commercial |
$666.40
|
| Rate for Payer: BCBS Trust/PPO |
$559.84
|
| Rate for Payer: BCN Commercial |
$532.64
|
| Rate for Payer: Cash Price |
$549.61
|
| Rate for Payer: Cofinity Commercial |
$645.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$549.61
|
| Rate for Payer: Healthscope Commercial |
$687.01
|
| Rate for Payer: Healthscope Whirlpool |
$666.40
|
| Rate for Payer: Mclaren Commercial |
$618.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$583.96
|
| Rate for Payer: Nomi Health Commercial |
$563.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$446.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$604.57
|
|
|
HC US EXTREMITY NONVASCULAR COMP
|
Facility
|
OP
|
$687.01
|
|
|
Service Code
|
CPT 76881
|
| Hospital Charge Code |
40200037
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$687.01 |
| Rate for Payer: Aetna Commercial |
$618.31
|
| Rate for Payer: Aetna Medicare |
$103.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.64
|
| Rate for Payer: ASR ASR |
$666.40
|
| Rate for Payer: ASR Commercial |
$666.40
|
| Rate for Payer: BCBS Complete |
$58.37
|
| Rate for Payer: BCBS MAPPO |
$103.71
|
| Rate for Payer: BCBS Trust/PPO |
$562.59
|
| Rate for Payer: BCN Commercial |
$532.64
|
| Rate for Payer: BCN Medicare Advantage |
$103.71
|
| Rate for Payer: Cash Price |
$549.61
|
| Rate for Payer: Cash Price |
$549.61
|
| Rate for Payer: Cofinity Commercial |
$645.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$549.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.71
|
| Rate for Payer: Healthscope Commercial |
$687.01
|
| Rate for Payer: Healthscope Whirlpool |
$666.40
|
| Rate for Payer: Humana Choice PPO Medicare |
$103.71
|
| Rate for Payer: Mclaren Commercial |
$618.31
|
| Rate for Payer: Mclaren Medicaid |
$55.59
|
| Rate for Payer: Mclaren Medicare |
$103.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.90
|
| Rate for Payer: Meridian Medicaid |
$58.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$583.96
|
| Rate for Payer: Nomi Health Commercial |
$563.35
|
| Rate for Payer: PACE Medicare |
$98.52
|
| Rate for Payer: PACE SWMI |
$103.71
|
| Rate for Payer: PHP Commercial |
$114.08
|
| Rate for Payer: PHP Medicaid |
$55.59
|
| Rate for Payer: PHP Medicare Advantage |
$103.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$446.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$601.96
|
| Rate for Payer: Priority Health Medicare |
$103.71
|
| Rate for Payer: Priority Health Narrow Network |
$481.59
|
| Rate for Payer: Railroad Medicare Medicare |
$103.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$604.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.71
|
| Rate for Payer: UHC Exchange |
$160.75
|
| Rate for Payer: UHC Medicare Advantage |
$103.71
|
| Rate for Payer: UHCCP DNSP |
$103.71
|
| Rate for Payer: UHCCP Medicaid |
$55.59
|
| Rate for Payer: VA VA |
$103.71
|
|
|
HC US EYE B MODE
|
Facility
|
OP
|
$1,212.48
|
|
|
Service Code
|
CPT 76512
|
| Hospital Charge Code |
40200004
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$1,212.48 |
| Rate for Payer: Aetna Commercial |
$1,091.23
|
| Rate for Payer: Aetna Medicare |
$103.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.64
|
| Rate for Payer: ASR ASR |
$1,176.11
|
| Rate for Payer: ASR Commercial |
$1,176.11
|
| Rate for Payer: BCBS Complete |
$58.37
|
| Rate for Payer: BCBS MAPPO |
$103.71
|
| Rate for Payer: BCBS Trust/PPO |
$992.90
|
| Rate for Payer: BCN Commercial |
$940.04
|
| Rate for Payer: BCN Medicare Advantage |
$103.71
|
| Rate for Payer: Cash Price |
$969.98
|
| Rate for Payer: Cash Price |
$969.98
|
| Rate for Payer: Cofinity Commercial |
$1,139.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$969.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.71
|
| Rate for Payer: Healthscope Commercial |
$1,212.48
|
| Rate for Payer: Healthscope Whirlpool |
$1,176.11
|
| Rate for Payer: Humana Choice PPO Medicare |
$103.71
|
| Rate for Payer: Mclaren Commercial |
$1,091.23
|
| Rate for Payer: Mclaren Medicaid |
$55.59
|
| Rate for Payer: Mclaren Medicare |
$103.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.90
|
| Rate for Payer: Meridian Medicaid |
$58.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,030.61
|
| Rate for Payer: Nomi Health Commercial |
$994.23
|
| Rate for Payer: PACE Medicare |
$98.52
|
| Rate for Payer: PACE SWMI |
$103.71
|
| Rate for Payer: PHP Commercial |
$114.08
|
| Rate for Payer: PHP Medicaid |
$55.59
|
| Rate for Payer: PHP Medicare Advantage |
$103.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$788.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,062.37
|
| Rate for Payer: Priority Health Medicare |
$103.71
|
| Rate for Payer: Priority Health Narrow Network |
$849.95
|
| Rate for Payer: Railroad Medicare Medicare |
$103.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,066.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.71
|
| Rate for Payer: UHC Exchange |
$160.75
|
| Rate for Payer: UHC Medicare Advantage |
$103.71
|
| Rate for Payer: UHCCP DNSP |
$103.71
|
| Rate for Payer: UHCCP Medicaid |
$55.59
|
| Rate for Payer: VA VA |
$103.71
|
|
|
HC US EYE B MODE
|
Facility
|
IP
|
$1,212.48
|
|
|
Service Code
|
CPT 76512
|
| Hospital Charge Code |
40200004
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$788.11 |
| Max. Negotiated Rate |
$1,212.48 |
| Rate for Payer: Aetna Commercial |
$1,091.23
|
| Rate for Payer: ASR ASR |
$1,176.11
|
| Rate for Payer: ASR Commercial |
$1,176.11
|
| Rate for Payer: BCBS Trust/PPO |
$988.05
|
| Rate for Payer: BCN Commercial |
$940.04
|
| Rate for Payer: Cash Price |
$969.98
|
| Rate for Payer: Cofinity Commercial |
$1,139.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$969.98
|
| Rate for Payer: Healthscope Commercial |
$1,212.48
|
| Rate for Payer: Healthscope Whirlpool |
$1,176.11
|
| Rate for Payer: Mclaren Commercial |
$1,091.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,030.61
|
| Rate for Payer: Nomi Health Commercial |
$994.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$788.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,066.98
|
|
|
HC US EYE B MODE BILAT
|
Facility
|
IP
|
$2,425.09
|
|
|
Service Code
|
CPT 76512
|
| Hospital Charge Code |
40200005
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$1,576.31 |
| Max. Negotiated Rate |
$2,425.09 |
| Rate for Payer: Aetna Commercial |
$2,182.58
|
| Rate for Payer: ASR ASR |
$2,352.34
|
| Rate for Payer: ASR Commercial |
$2,352.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,976.21
|
| Rate for Payer: BCN Commercial |
$1,880.17
|
| Rate for Payer: Cash Price |
$1,940.07
|
| Rate for Payer: Cofinity Commercial |
$2,279.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,940.07
|
| Rate for Payer: Healthscope Commercial |
$2,425.09
|
| Rate for Payer: Healthscope Whirlpool |
$2,352.34
|
| Rate for Payer: Mclaren Commercial |
$2,182.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,061.33
|
| Rate for Payer: Nomi Health Commercial |
$1,988.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,576.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,134.08
|
|
|
HC US EYE B MODE BILAT
|
Facility
|
OP
|
$2,425.09
|
|
|
Service Code
|
CPT 76512
|
| Hospital Charge Code |
40200005
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$2,425.09 |
| Rate for Payer: Aetna Commercial |
$2,182.58
|
| Rate for Payer: Aetna Medicare |
$103.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.64
|
| Rate for Payer: ASR ASR |
$2,352.34
|
| Rate for Payer: ASR Commercial |
$2,352.34
|
| Rate for Payer: BCBS Complete |
$58.37
|
| Rate for Payer: BCBS MAPPO |
$103.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,985.91
|
| Rate for Payer: BCN Commercial |
$1,880.17
|
| Rate for Payer: BCN Medicare Advantage |
$103.71
|
| Rate for Payer: Cash Price |
$1,940.07
|
| Rate for Payer: Cash Price |
$1,940.07
|
| Rate for Payer: Cofinity Commercial |
$2,279.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,940.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.71
|
| Rate for Payer: Healthscope Commercial |
$2,425.09
|
| Rate for Payer: Healthscope Whirlpool |
$2,352.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$103.71
|
| Rate for Payer: Mclaren Commercial |
$2,182.58
|
| Rate for Payer: Mclaren Medicaid |
$55.59
|
| Rate for Payer: Mclaren Medicare |
$103.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.90
|
| Rate for Payer: Meridian Medicaid |
$58.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,061.33
|
| Rate for Payer: Nomi Health Commercial |
$1,988.57
|
| Rate for Payer: PACE Medicare |
$98.52
|
| Rate for Payer: PACE SWMI |
$103.71
|
| Rate for Payer: PHP Commercial |
$114.08
|
| Rate for Payer: PHP Medicaid |
$55.59
|
| Rate for Payer: PHP Medicare Advantage |
$103.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,576.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,124.86
|
| Rate for Payer: Priority Health Medicare |
$103.71
|
| Rate for Payer: Priority Health Narrow Network |
$1,699.99
|
| Rate for Payer: Railroad Medicare Medicare |
$103.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,134.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.71
|
| Rate for Payer: UHC Exchange |
$160.75
|
| Rate for Payer: UHC Medicare Advantage |
$103.71
|
| Rate for Payer: UHCCP DNSP |
$103.71
|
| Rate for Payer: UHCCP Medicaid |
$55.59
|
| Rate for Payer: VA VA |
$103.71
|
|
|
HC US FETAL FLUID DRAIN INCL GUID
|
Facility
|
OP
|
$862.48
|
|
|
Service Code
|
CPT 59074
|
| Hospital Charge Code |
36100088
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$159.02 |
| Max. Negotiated Rate |
$862.48 |
| Rate for Payer: Aetna Commercial |
$776.23
|
| Rate for Payer: Aetna Medicare |
$296.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$370.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$370.84
|
| Rate for Payer: ASR ASR |
$836.61
|
| Rate for Payer: ASR Commercial |
$836.61
|
| Rate for Payer: BCBS Complete |
$166.97
|
| Rate for Payer: BCBS MAPPO |
$296.67
|
| Rate for Payer: BCBS Trust/PPO |
$706.28
|
| Rate for Payer: BCN Commercial |
$668.68
|
| Rate for Payer: BCN Medicare Advantage |
$296.67
|
| Rate for Payer: Cash Price |
$689.98
|
| Rate for Payer: Cash Price |
$689.98
|
| Rate for Payer: Cofinity Commercial |
$810.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$689.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$296.67
|
| Rate for Payer: Healthscope Commercial |
$862.48
|
| Rate for Payer: Healthscope Whirlpool |
$836.61
|
| Rate for Payer: Humana Choice PPO Medicare |
$296.67
|
| Rate for Payer: Mclaren Commercial |
$776.23
|
| Rate for Payer: Mclaren Medicaid |
$159.02
|
| Rate for Payer: Mclaren Medicare |
$296.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$311.50
|
| Rate for Payer: Meridian Medicaid |
$166.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$341.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$733.11
|
| Rate for Payer: Nomi Health Commercial |
$707.23
|
| Rate for Payer: PACE Medicare |
$281.84
|
| Rate for Payer: PACE SWMI |
$296.67
|
| Rate for Payer: PHP Commercial |
$326.34
|
| Rate for Payer: PHP Medicaid |
$159.02
|
| Rate for Payer: PHP Medicare Advantage |
$296.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$159.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$560.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$755.70
|
| Rate for Payer: Priority Health Medicare |
$296.67
|
| Rate for Payer: Priority Health Narrow Network |
$604.60
|
| Rate for Payer: Railroad Medicare Medicare |
$296.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$758.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$296.67
|
| Rate for Payer: UHC Exchange |
$459.84
|
| Rate for Payer: UHC Medicare Advantage |
$296.67
|
| Rate for Payer: UHCCP DNSP |
$296.67
|
| Rate for Payer: UHCCP Medicaid |
$159.02
|
| Rate for Payer: VA VA |
$296.67
|
|
|
HC US FETAL FLUID DRAIN INCL GUID
|
Facility
|
IP
|
$862.48
|
|
|
Service Code
|
CPT 59074
|
| Hospital Charge Code |
36100088
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$560.61 |
| Max. Negotiated Rate |
$862.48 |
| Rate for Payer: Aetna Commercial |
$776.23
|
| Rate for Payer: ASR ASR |
$836.61
|
| Rate for Payer: ASR Commercial |
$836.61
|
| Rate for Payer: BCBS Trust/PPO |
$702.83
|
| Rate for Payer: BCN Commercial |
$668.68
|
| Rate for Payer: Cash Price |
$689.98
|
| Rate for Payer: Cofinity Commercial |
$810.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$689.98
|
| Rate for Payer: Healthscope Commercial |
$862.48
|
| Rate for Payer: Healthscope Whirlpool |
$836.61
|
| Rate for Payer: Mclaren Commercial |
$776.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$733.11
|
| Rate for Payer: Nomi Health Commercial |
$707.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$560.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$758.98
|
|
|
HC US FETAL MCA DOPPLER VELOCIMETREY
|
Facility
|
IP
|
$291.84
|
|
|
Service Code
|
CPT 76821
|
| Hospital Charge Code |
40200029
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$189.70 |
| Max. Negotiated Rate |
$291.84 |
| Rate for Payer: Aetna Commercial |
$262.66
|
| Rate for Payer: ASR ASR |
$283.08
|
| Rate for Payer: ASR Commercial |
$283.08
|
| Rate for Payer: BCBS Trust/PPO |
$237.82
|
| Rate for Payer: BCN Commercial |
$226.26
|
| Rate for Payer: Cash Price |
$233.47
|
| Rate for Payer: Cofinity Commercial |
$274.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$233.47
|
| Rate for Payer: Healthscope Commercial |
$291.84
|
| Rate for Payer: Healthscope Whirlpool |
$283.08
|
| Rate for Payer: Mclaren Commercial |
$262.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$248.06
|
| Rate for Payer: Nomi Health Commercial |
$239.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$256.82
|
|
|
HC US FETAL MCA DOPPLER VELOCIMETREY
|
Facility
|
OP
|
$291.84
|
|
|
Service Code
|
CPT 76821
|
| Hospital Charge Code |
40200029
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$291.84 |
| Rate for Payer: Aetna Commercial |
$262.66
|
| Rate for Payer: Aetna Medicare |
$103.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.64
|
| Rate for Payer: ASR ASR |
$283.08
|
| Rate for Payer: ASR Commercial |
$283.08
|
| Rate for Payer: BCBS Complete |
$58.37
|
| Rate for Payer: BCBS MAPPO |
$103.71
|
| Rate for Payer: BCBS Trust/PPO |
$238.99
|
| Rate for Payer: BCN Commercial |
$226.26
|
| Rate for Payer: BCN Medicare Advantage |
$103.71
|
| Rate for Payer: Cash Price |
$233.47
|
| Rate for Payer: Cash Price |
$233.47
|
| Rate for Payer: Cofinity Commercial |
$274.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$233.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.71
|
| Rate for Payer: Healthscope Commercial |
$291.84
|
| Rate for Payer: Healthscope Whirlpool |
$283.08
|
| Rate for Payer: Humana Choice PPO Medicare |
$103.71
|
| Rate for Payer: Mclaren Commercial |
$262.66
|
| Rate for Payer: Mclaren Medicaid |
$55.59
|
| Rate for Payer: Mclaren Medicare |
$103.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.90
|
| Rate for Payer: Meridian Medicaid |
$58.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$248.06
|
| Rate for Payer: Nomi Health Commercial |
$239.31
|
| Rate for Payer: PACE Medicare |
$98.52
|
| Rate for Payer: PACE SWMI |
$103.71
|
| Rate for Payer: PHP Commercial |
$114.08
|
| Rate for Payer: PHP Medicaid |
$55.59
|
| Rate for Payer: PHP Medicare Advantage |
$103.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$255.71
|
| Rate for Payer: Priority Health Medicare |
$103.71
|
| Rate for Payer: Priority Health Narrow Network |
$204.58
|
| Rate for Payer: Railroad Medicare Medicare |
$103.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$256.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.71
|
| Rate for Payer: UHC Exchange |
$160.75
|
| Rate for Payer: UHC Medicare Advantage |
$103.71
|
| Rate for Payer: UHCCP DNSP |
$103.71
|
| Rate for Payer: UHCCP Medicaid |
$55.59
|
| Rate for Payer: VA VA |
$103.71
|
|
|
HC US FETAL UMBILICAL ART DOPPLER
|
Facility
|
IP
|
$291.84
|
|
|
Service Code
|
CPT 76820
|
| Hospital Charge Code |
40200028
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$189.70 |
| Max. Negotiated Rate |
$291.84 |
| Rate for Payer: Aetna Commercial |
$262.66
|
| Rate for Payer: ASR ASR |
$283.08
|
| Rate for Payer: ASR Commercial |
$283.08
|
| Rate for Payer: BCBS Trust/PPO |
$237.82
|
| Rate for Payer: BCN Commercial |
$226.26
|
| Rate for Payer: Cash Price |
$233.47
|
| Rate for Payer: Cofinity Commercial |
$274.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$233.47
|
| Rate for Payer: Healthscope Commercial |
$291.84
|
| Rate for Payer: Healthscope Whirlpool |
$283.08
|
| Rate for Payer: Mclaren Commercial |
$262.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$248.06
|
| Rate for Payer: Nomi Health Commercial |
$239.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$256.82
|
|
|
HC US FETAL UMBILICAL ART DOPPLER
|
Facility
|
OP
|
$291.84
|
|
|
Service Code
|
CPT 76820
|
| Hospital Charge Code |
40200028
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$291.84 |
| Rate for Payer: Aetna Commercial |
$262.66
|
| Rate for Payer: Aetna Medicare |
$103.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.64
|
| Rate for Payer: ASR ASR |
$283.08
|
| Rate for Payer: ASR Commercial |
$283.08
|
| Rate for Payer: BCBS Complete |
$58.37
|
| Rate for Payer: BCBS MAPPO |
$103.71
|
| Rate for Payer: BCBS Trust/PPO |
$238.99
|
| Rate for Payer: BCN Commercial |
$226.26
|
| Rate for Payer: BCN Medicare Advantage |
$103.71
|
| Rate for Payer: Cash Price |
$233.47
|
| Rate for Payer: Cash Price |
$233.47
|
| Rate for Payer: Cofinity Commercial |
$274.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$233.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.71
|
| Rate for Payer: Healthscope Commercial |
$291.84
|
| Rate for Payer: Healthscope Whirlpool |
$283.08
|
| Rate for Payer: Humana Choice PPO Medicare |
$103.71
|
| Rate for Payer: Mclaren Commercial |
$262.66
|
| Rate for Payer: Mclaren Medicaid |
$55.59
|
| Rate for Payer: Mclaren Medicare |
$103.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.90
|
| Rate for Payer: Meridian Medicaid |
$58.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$248.06
|
| Rate for Payer: Nomi Health Commercial |
$239.31
|
| Rate for Payer: PACE Medicare |
$98.52
|
| Rate for Payer: PACE SWMI |
$103.71
|
| Rate for Payer: PHP Commercial |
$114.08
|
| Rate for Payer: PHP Medicaid |
$55.59
|
| Rate for Payer: PHP Medicare Advantage |
$103.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$255.71
|
| Rate for Payer: Priority Health Medicare |
$103.71
|
| Rate for Payer: Priority Health Narrow Network |
$204.58
|
| Rate for Payer: Railroad Medicare Medicare |
$103.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$256.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.71
|
| Rate for Payer: UHC Exchange |
$160.75
|
| Rate for Payer: UHC Medicare Advantage |
$103.71
|
| Rate for Payer: UHCCP DNSP |
$103.71
|
| Rate for Payer: UHCCP Medicaid |
$55.59
|
| Rate for Payer: VA VA |
$103.71
|
|
|
HC US GUIDED INTERSTITIAL THERAPY
|
Facility
|
IP
|
$413.36
|
|
|
Service Code
|
CPT 76965
|
| Hospital Charge Code |
40200063
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$268.68 |
| Max. Negotiated Rate |
$413.36 |
| Rate for Payer: Aetna Commercial |
$372.02
|
| Rate for Payer: ASR ASR |
$400.96
|
| Rate for Payer: ASR Commercial |
$400.96
|
| Rate for Payer: BCBS Trust/PPO |
$336.85
|
| Rate for Payer: BCN Commercial |
$320.48
|
| Rate for Payer: Cash Price |
$330.69
|
| Rate for Payer: Cofinity Commercial |
$388.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$330.69
|
| Rate for Payer: Healthscope Commercial |
$413.36
|
| Rate for Payer: Healthscope Whirlpool |
$400.96
|
| Rate for Payer: Mclaren Commercial |
$372.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$351.36
|
| Rate for Payer: Nomi Health Commercial |
$338.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$268.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$363.76
|
|
|
HC US GUIDED INTERSTITIAL THERAPY
|
Facility
|
OP
|
$413.36
|
|
|
Service Code
|
CPT 76965
|
| Hospital Charge Code |
40200063
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$165.34 |
| Max. Negotiated Rate |
$413.36 |
| Rate for Payer: Aetna Commercial |
$372.02
|
| Rate for Payer: Aetna Medicare |
$206.68
|
| Rate for Payer: ASR ASR |
$400.96
|
| Rate for Payer: ASR Commercial |
$400.96
|
| Rate for Payer: BCBS Complete |
$165.34
|
| Rate for Payer: BCBS Trust/PPO |
$338.50
|
| Rate for Payer: BCN Commercial |
$320.48
|
| Rate for Payer: Cash Price |
$330.69
|
| Rate for Payer: Cofinity Commercial |
$388.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$330.69
|
| Rate for Payer: Healthscope Commercial |
$413.36
|
| Rate for Payer: Healthscope Whirlpool |
$400.96
|
| Rate for Payer: Mclaren Commercial |
$372.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$351.36
|
| Rate for Payer: Nomi Health Commercial |
$338.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$268.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$362.19
|
| Rate for Payer: Priority Health Narrow Network |
$289.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$363.76
|
|
|
HC US GUIDE FOR NEEDLE PLACEMENT
|
Facility
|
OP
|
$643.95
|
|
|
Service Code
|
CPT 76942
|
| Hospital Charge Code |
40200045
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$257.58 |
| Max. Negotiated Rate |
$643.95 |
| Rate for Payer: Aetna Commercial |
$579.55
|
| Rate for Payer: Aetna Medicare |
$321.98
|
| Rate for Payer: ASR ASR |
$624.63
|
| Rate for Payer: ASR Commercial |
$624.63
|
| Rate for Payer: BCBS Complete |
$257.58
|
| Rate for Payer: BCBS Trust/PPO |
$527.33
|
| Rate for Payer: BCN Commercial |
$499.25
|
| Rate for Payer: Cash Price |
$515.16
|
| Rate for Payer: Cofinity Commercial |
$605.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$515.16
|
| Rate for Payer: Healthscope Commercial |
$643.95
|
| Rate for Payer: Healthscope Whirlpool |
$624.63
|
| Rate for Payer: Mclaren Commercial |
$579.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$547.36
|
| Rate for Payer: Nomi Health Commercial |
$528.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$418.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$564.23
|
| Rate for Payer: Priority Health Narrow Network |
$451.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$566.68
|
|
|
HC US GUIDE FOR NEEDLE PLACEMENT
|
Facility
|
IP
|
$643.95
|
|
|
Service Code
|
CPT 76942
|
| Hospital Charge Code |
40200045
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$418.57 |
| Max. Negotiated Rate |
$643.95 |
| Rate for Payer: Aetna Commercial |
$579.55
|
| Rate for Payer: ASR ASR |
$624.63
|
| Rate for Payer: ASR Commercial |
$624.63
|
| Rate for Payer: BCBS Trust/PPO |
$524.75
|
| Rate for Payer: BCN Commercial |
$499.25
|
| Rate for Payer: Cash Price |
$515.16
|
| Rate for Payer: Cofinity Commercial |
$605.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$515.16
|
| Rate for Payer: Healthscope Commercial |
$643.95
|
| Rate for Payer: Healthscope Whirlpool |
$624.63
|
| Rate for Payer: Mclaren Commercial |
$579.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$547.36
|
| Rate for Payer: Nomi Health Commercial |
$528.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$418.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$566.68
|
|
