|
HC VEEG 2-12 HR UNMONITORED
|
Facility
|
OP
|
$1,959.46
|
|
|
Service Code
|
CPT 95711
|
| Hospital Charge Code |
74000026
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$163.53 |
| Max. Negotiated Rate |
$1,959.46 |
| Rate for Payer: Aetna Commercial |
$1,763.51
|
| Rate for Payer: Aetna Medicare |
$305.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$381.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$381.38
|
| Rate for Payer: ASR ASR |
$1,900.68
|
| Rate for Payer: ASR Commercial |
$1,900.68
|
| Rate for Payer: BCBS Complete |
$171.71
|
| Rate for Payer: BCBS MAPPO |
$305.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,604.60
|
| Rate for Payer: BCN Commercial |
$1,519.17
|
| Rate for Payer: BCN Medicare Advantage |
$305.10
|
| Rate for Payer: Cash Price |
$1,567.57
|
| Rate for Payer: Cash Price |
$1,567.57
|
| Rate for Payer: Cofinity Commercial |
$1,841.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,567.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.10
|
| Rate for Payer: Healthscope Commercial |
$1,959.46
|
| Rate for Payer: Healthscope Whirlpool |
$1,900.68
|
| Rate for Payer: Humana Choice PPO Medicare |
$305.10
|
| Rate for Payer: Mclaren Commercial |
$1,763.51
|
| Rate for Payer: Mclaren Medicaid |
$163.53
|
| Rate for Payer: Mclaren Medicare |
$305.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$320.36
|
| Rate for Payer: Meridian Medicaid |
$171.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$350.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,665.54
|
| Rate for Payer: Nomi Health Commercial |
$1,606.76
|
| Rate for Payer: PACE Medicare |
$289.84
|
| Rate for Payer: PACE SWMI |
$305.10
|
| Rate for Payer: PHP Commercial |
$335.61
|
| Rate for Payer: PHP Medicaid |
$163.53
|
| Rate for Payer: PHP Medicare Advantage |
$305.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$163.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,273.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$289.73
|
| Rate for Payer: Priority Health Medicare |
$305.10
|
| Rate for Payer: Priority Health Narrow Network |
$231.78
|
| Rate for Payer: Railroad Medicare Medicare |
$305.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,724.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$305.10
|
| Rate for Payer: UHC Exchange |
$472.90
|
| Rate for Payer: UHC Medicare Advantage |
$305.10
|
| Rate for Payer: UHCCP DNSP |
$305.10
|
| Rate for Payer: UHCCP Medicaid |
$163.53
|
| Rate for Payer: VA VA |
$305.10
|
|
|
HC VEEG 2-12 HR UNMONITORED
|
Facility
|
IP
|
$1,959.46
|
|
|
Service Code
|
CPT 95711
|
| Hospital Charge Code |
74000026
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$1,273.65 |
| Max. Negotiated Rate |
$1,959.46 |
| Rate for Payer: Aetna Commercial |
$1,763.51
|
| Rate for Payer: ASR ASR |
$1,900.68
|
| Rate for Payer: ASR Commercial |
$1,900.68
|
| Rate for Payer: BCBS Trust/PPO |
$1,596.76
|
| Rate for Payer: BCN Commercial |
$1,519.17
|
| Rate for Payer: Cash Price |
$1,567.57
|
| Rate for Payer: Cofinity Commercial |
$1,841.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,567.57
|
| Rate for Payer: Healthscope Commercial |
$1,959.46
|
| Rate for Payer: Healthscope Whirlpool |
$1,900.68
|
| Rate for Payer: Mclaren Commercial |
$1,763.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,665.54
|
| Rate for Payer: Nomi Health Commercial |
$1,606.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,273.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,724.32
|
|
|
HC VEEG EA 12-26 HR CONT MNTR
|
Facility
|
OP
|
$4,552.18
|
|
|
Service Code
|
CPT 95716
|
| Hospital Charge Code |
74000025
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$534.30 |
| Max. Negotiated Rate |
$4,552.18 |
| Rate for Payer: Aetna Commercial |
$4,096.96
|
| Rate for Payer: Aetna Medicare |
$996.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,246.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,246.02
|
| Rate for Payer: ASR ASR |
$4,415.61
|
| Rate for Payer: ASR Commercial |
$4,415.61
|
| Rate for Payer: BCBS Complete |
$561.01
|
| Rate for Payer: BCBS MAPPO |
$996.82
|
| Rate for Payer: BCBS Trust/PPO |
$3,727.78
|
| Rate for Payer: BCN Commercial |
$3,529.31
|
| Rate for Payer: BCN Medicare Advantage |
$996.82
|
| Rate for Payer: Cash Price |
$3,641.74
|
| Rate for Payer: Cash Price |
$3,641.74
|
| Rate for Payer: Cofinity Commercial |
$4,279.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,641.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$996.82
|
| Rate for Payer: Healthscope Commercial |
$4,552.18
|
| Rate for Payer: Healthscope Whirlpool |
$4,415.61
|
| Rate for Payer: Humana Choice PPO Medicare |
$996.82
|
| Rate for Payer: Mclaren Commercial |
$4,096.96
|
| Rate for Payer: Mclaren Medicaid |
$534.30
|
| Rate for Payer: Mclaren Medicare |
$996.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,046.66
|
| Rate for Payer: Meridian Medicaid |
$561.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,146.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,869.35
|
| Rate for Payer: Nomi Health Commercial |
$3,732.79
|
| Rate for Payer: PACE Medicare |
$946.98
|
| Rate for Payer: PACE SWMI |
$996.82
|
| Rate for Payer: PHP Commercial |
$1,096.50
|
| Rate for Payer: PHP Medicaid |
$534.30
|
| Rate for Payer: PHP Medicare Advantage |
$996.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$534.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,958.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,040.53
|
| Rate for Payer: Priority Health Medicare |
$996.82
|
| Rate for Payer: Priority Health Narrow Network |
$832.42
|
| Rate for Payer: Railroad Medicare Medicare |
$996.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,005.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$996.82
|
| Rate for Payer: UHC Exchange |
$1,545.07
|
| Rate for Payer: UHC Medicare Advantage |
$996.82
|
| Rate for Payer: UHCCP DNSP |
$996.82
|
| Rate for Payer: UHCCP Medicaid |
$534.30
|
| Rate for Payer: VA VA |
$996.82
|
|
|
HC VEEG EA 12-26 HR CONT MNTR
|
Facility
|
IP
|
$4,552.18
|
|
|
Service Code
|
CPT 95716
|
| Hospital Charge Code |
74000025
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$2,958.92 |
| Max. Negotiated Rate |
$4,552.18 |
| Rate for Payer: Aetna Commercial |
$4,096.96
|
| Rate for Payer: ASR ASR |
$4,415.61
|
| Rate for Payer: ASR Commercial |
$4,415.61
|
| Rate for Payer: BCBS Trust/PPO |
$3,709.57
|
| Rate for Payer: BCN Commercial |
$3,529.31
|
| Rate for Payer: Cash Price |
$3,641.74
|
| Rate for Payer: Cofinity Commercial |
$4,279.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,641.74
|
| Rate for Payer: Healthscope Commercial |
$4,552.18
|
| Rate for Payer: Healthscope Whirlpool |
$4,415.61
|
| Rate for Payer: Mclaren Commercial |
$4,096.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,869.35
|
| Rate for Payer: Nomi Health Commercial |
$3,732.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,958.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,005.92
|
|
|
HC VEEG EA 12-26 HR INTMT MNTR
|
Facility
|
IP
|
$2,421.79
|
|
|
Service Code
|
CPT 95715
|
| Hospital Charge Code |
74000024
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$1,574.16 |
| Max. Negotiated Rate |
$2,421.79 |
| Rate for Payer: Aetna Commercial |
$2,179.61
|
| Rate for Payer: ASR ASR |
$2,349.14
|
| Rate for Payer: ASR Commercial |
$2,349.14
|
| Rate for Payer: BCBS Trust/PPO |
$1,973.52
|
| Rate for Payer: BCN Commercial |
$1,877.61
|
| Rate for Payer: Cash Price |
$1,937.43
|
| Rate for Payer: Cofinity Commercial |
$2,276.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,937.43
|
| Rate for Payer: Healthscope Commercial |
$2,421.79
|
| Rate for Payer: Healthscope Whirlpool |
$2,349.14
|
| Rate for Payer: Mclaren Commercial |
$2,179.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,058.52
|
| Rate for Payer: Nomi Health Commercial |
$1,985.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,574.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,131.18
|
|
|
HC VEEG EA 12-26 HR INTMT MNTR
|
Facility
|
OP
|
$2,421.79
|
|
|
Service Code
|
CPT 95715
|
| Hospital Charge Code |
74000024
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$278.65 |
| Max. Negotiated Rate |
$2,421.79 |
| Rate for Payer: Aetna Commercial |
$2,179.61
|
| Rate for Payer: Aetna Medicare |
$519.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$649.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$649.84
|
| Rate for Payer: ASR ASR |
$2,349.14
|
| Rate for Payer: ASR Commercial |
$2,349.14
|
| Rate for Payer: BCBS Complete |
$292.58
|
| Rate for Payer: BCBS MAPPO |
$519.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,983.20
|
| Rate for Payer: BCN Commercial |
$1,877.61
|
| Rate for Payer: BCN Medicare Advantage |
$519.87
|
| Rate for Payer: Cash Price |
$1,937.43
|
| Rate for Payer: Cash Price |
$1,937.43
|
| Rate for Payer: Cofinity Commercial |
$2,276.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,937.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$519.87
|
| Rate for Payer: Healthscope Commercial |
$2,421.79
|
| Rate for Payer: Healthscope Whirlpool |
$2,349.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$519.87
|
| Rate for Payer: Mclaren Commercial |
$2,179.61
|
| Rate for Payer: Mclaren Medicaid |
$278.65
|
| Rate for Payer: Mclaren Medicare |
$519.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$545.86
|
| Rate for Payer: Meridian Medicaid |
$292.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$597.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,058.52
|
| Rate for Payer: Nomi Health Commercial |
$1,985.87
|
| Rate for Payer: PACE Medicare |
$493.88
|
| Rate for Payer: PACE SWMI |
$519.87
|
| Rate for Payer: PHP Commercial |
$571.86
|
| Rate for Payer: PHP Medicaid |
$278.65
|
| Rate for Payer: PHP Medicare Advantage |
$519.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$278.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,574.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$555.91
|
| Rate for Payer: Priority Health Medicare |
$519.87
|
| Rate for Payer: Priority Health Narrow Network |
$444.73
|
| Rate for Payer: Railroad Medicare Medicare |
$519.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,131.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$519.87
|
| Rate for Payer: UHC Exchange |
$805.80
|
| Rate for Payer: UHC Medicare Advantage |
$519.87
|
| Rate for Payer: UHCCP DNSP |
$519.87
|
| Rate for Payer: UHCCP Medicaid |
$278.65
|
| Rate for Payer: VA VA |
$519.87
|
|
|
HC VEIN MAPPING BILATERAL LOWER
|
Facility
|
OP
|
$1,408.69
|
|
|
Service Code
|
CPT 93970
|
| Hospital Charge Code |
92100024
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$126.94 |
| Max. Negotiated Rate |
$1,408.69 |
| Rate for Payer: Aetna Commercial |
$1,267.82
|
| Rate for Payer: Aetna Medicare |
$236.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$296.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$296.04
|
| Rate for Payer: ASR ASR |
$1,366.43
|
| Rate for Payer: ASR Commercial |
$1,366.43
|
| Rate for Payer: BCBS Complete |
$133.29
|
| Rate for Payer: BCBS MAPPO |
$236.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,153.58
|
| Rate for Payer: BCN Commercial |
$1,092.16
|
| Rate for Payer: BCN Medicare Advantage |
$236.83
|
| Rate for Payer: Cash Price |
$1,126.95
|
| Rate for Payer: Cash Price |
$1,126.95
|
| Rate for Payer: Cofinity Commercial |
$1,324.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,126.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.83
|
| Rate for Payer: Healthscope Commercial |
$1,408.69
|
| Rate for Payer: Healthscope Whirlpool |
$1,366.43
|
| Rate for Payer: Humana Choice PPO Medicare |
$236.83
|
| Rate for Payer: Mclaren Commercial |
$1,267.82
|
| Rate for Payer: Mclaren Medicaid |
$126.94
|
| Rate for Payer: Mclaren Medicare |
$236.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$248.67
|
| Rate for Payer: Meridian Medicaid |
$133.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$272.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,197.39
|
| Rate for Payer: Nomi Health Commercial |
$1,155.13
|
| Rate for Payer: PACE Medicare |
$224.99
|
| Rate for Payer: PACE SWMI |
$236.83
|
| Rate for Payer: PHP Commercial |
$260.51
|
| Rate for Payer: PHP Medicaid |
$126.94
|
| Rate for Payer: PHP Medicare Advantage |
$236.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$915.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,060.13
|
| Rate for Payer: Priority Health Medicare |
$236.83
|
| Rate for Payer: Priority Health Narrow Network |
$848.10
|
| Rate for Payer: Railroad Medicare Medicare |
$236.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,239.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$236.83
|
| Rate for Payer: UHC Exchange |
$367.09
|
| Rate for Payer: UHC Medicare Advantage |
$236.83
|
| Rate for Payer: UHCCP DNSP |
$236.83
|
| Rate for Payer: UHCCP Medicaid |
$126.94
|
| Rate for Payer: VA VA |
$236.83
|
|
|
HC VEIN MAPPING BILATERAL LOWER
|
Facility
|
IP
|
$1,408.69
|
|
|
Service Code
|
CPT 93970
|
| Hospital Charge Code |
92100024
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$915.65 |
| Max. Negotiated Rate |
$1,408.69 |
| Rate for Payer: Aetna Commercial |
$1,267.82
|
| Rate for Payer: ASR ASR |
$1,366.43
|
| Rate for Payer: ASR Commercial |
$1,366.43
|
| Rate for Payer: BCBS Trust/PPO |
$1,147.94
|
| Rate for Payer: BCN Commercial |
$1,092.16
|
| Rate for Payer: Cash Price |
$1,126.95
|
| Rate for Payer: Cofinity Commercial |
$1,324.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,126.95
|
| Rate for Payer: Healthscope Commercial |
$1,408.69
|
| Rate for Payer: Healthscope Whirlpool |
$1,366.43
|
| Rate for Payer: Mclaren Commercial |
$1,267.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,197.39
|
| Rate for Payer: Nomi Health Commercial |
$1,155.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$915.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,239.65
|
|
|
HC VEIN MAPPING BILATERAL UPPER
|
Facility
|
OP
|
$1,408.69
|
|
|
Service Code
|
CPT 93970
|
| Hospital Charge Code |
92100025
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$126.94 |
| Max. Negotiated Rate |
$1,408.69 |
| Rate for Payer: Aetna Commercial |
$1,267.82
|
| Rate for Payer: Aetna Medicare |
$236.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$296.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$296.04
|
| Rate for Payer: ASR ASR |
$1,366.43
|
| Rate for Payer: ASR Commercial |
$1,366.43
|
| Rate for Payer: BCBS Complete |
$133.29
|
| Rate for Payer: BCBS MAPPO |
$236.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,153.58
|
| Rate for Payer: BCN Commercial |
$1,092.16
|
| Rate for Payer: BCN Medicare Advantage |
$236.83
|
| Rate for Payer: Cash Price |
$1,126.95
|
| Rate for Payer: Cash Price |
$1,126.95
|
| Rate for Payer: Cofinity Commercial |
$1,324.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,126.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.83
|
| Rate for Payer: Healthscope Commercial |
$1,408.69
|
| Rate for Payer: Healthscope Whirlpool |
$1,366.43
|
| Rate for Payer: Humana Choice PPO Medicare |
$236.83
|
| Rate for Payer: Mclaren Commercial |
$1,267.82
|
| Rate for Payer: Mclaren Medicaid |
$126.94
|
| Rate for Payer: Mclaren Medicare |
$236.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$248.67
|
| Rate for Payer: Meridian Medicaid |
$133.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$272.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,197.39
|
| Rate for Payer: Nomi Health Commercial |
$1,155.13
|
| Rate for Payer: PACE Medicare |
$224.99
|
| Rate for Payer: PACE SWMI |
$236.83
|
| Rate for Payer: PHP Commercial |
$260.51
|
| Rate for Payer: PHP Medicaid |
$126.94
|
| Rate for Payer: PHP Medicare Advantage |
$236.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$915.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,060.13
|
| Rate for Payer: Priority Health Medicare |
$236.83
|
| Rate for Payer: Priority Health Narrow Network |
$848.10
|
| Rate for Payer: Railroad Medicare Medicare |
$236.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,239.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$236.83
|
| Rate for Payer: UHC Exchange |
$367.09
|
| Rate for Payer: UHC Medicare Advantage |
$236.83
|
| Rate for Payer: UHCCP DNSP |
$236.83
|
| Rate for Payer: UHCCP Medicaid |
$126.94
|
| Rate for Payer: VA VA |
$236.83
|
|
|
HC VEIN MAPPING BILATERAL UPPER
|
Facility
|
IP
|
$1,408.69
|
|
|
Service Code
|
CPT 93970
|
| Hospital Charge Code |
92100025
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$915.65 |
| Max. Negotiated Rate |
$1,408.69 |
| Rate for Payer: Aetna Commercial |
$1,267.82
|
| Rate for Payer: ASR ASR |
$1,366.43
|
| Rate for Payer: ASR Commercial |
$1,366.43
|
| Rate for Payer: BCBS Trust/PPO |
$1,147.94
|
| Rate for Payer: BCN Commercial |
$1,092.16
|
| Rate for Payer: Cash Price |
$1,126.95
|
| Rate for Payer: Cofinity Commercial |
$1,324.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,126.95
|
| Rate for Payer: Healthscope Commercial |
$1,408.69
|
| Rate for Payer: Healthscope Whirlpool |
$1,366.43
|
| Rate for Payer: Mclaren Commercial |
$1,267.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,197.39
|
| Rate for Payer: Nomi Health Commercial |
$1,155.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$915.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,239.65
|
|
|
HC VEIN MAPPING UNILAT LOWER EXTREMITY (R OR L)
|
Facility
|
IP
|
$867.63
|
|
|
Service Code
|
CPT 93971
|
| Hospital Charge Code |
92100011
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$563.96 |
| Max. Negotiated Rate |
$867.63 |
| Rate for Payer: Aetna Commercial |
$780.87
|
| Rate for Payer: ASR ASR |
$841.60
|
| Rate for Payer: ASR Commercial |
$841.60
|
| Rate for Payer: BCBS Trust/PPO |
$707.03
|
| Rate for Payer: BCN Commercial |
$672.67
|
| Rate for Payer: Cash Price |
$694.10
|
| Rate for Payer: Cofinity Commercial |
$815.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$694.10
|
| Rate for Payer: Healthscope Commercial |
$867.63
|
| Rate for Payer: Healthscope Whirlpool |
$841.60
|
| Rate for Payer: Mclaren Commercial |
$780.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$737.49
|
| Rate for Payer: Nomi Health Commercial |
$711.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$563.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$763.51
|
|
|
HC VEIN MAPPING UNILAT LOWER EXTREMITY (R OR L)
|
Facility
|
OP
|
$867.63
|
|
|
Service Code
|
CPT 93971
|
| Hospital Charge Code |
92100011
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$55.85 |
| Max. Negotiated Rate |
$867.63 |
| Rate for Payer: Aetna Commercial |
$780.87
|
| Rate for Payer: Aetna Medicare |
$104.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.24
|
| Rate for Payer: ASR ASR |
$841.60
|
| Rate for Payer: ASR Commercial |
$841.60
|
| Rate for Payer: BCBS Complete |
$58.64
|
| Rate for Payer: BCBS MAPPO |
$104.19
|
| Rate for Payer: BCBS Trust/PPO |
$710.50
|
| Rate for Payer: BCN Commercial |
$672.67
|
| Rate for Payer: BCN Medicare Advantage |
$104.19
|
| Rate for Payer: Cash Price |
$694.10
|
| Rate for Payer: Cash Price |
$694.10
|
| Rate for Payer: Cofinity Commercial |
$815.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$694.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.19
|
| Rate for Payer: Healthscope Commercial |
$867.63
|
| Rate for Payer: Healthscope Whirlpool |
$841.60
|
| Rate for Payer: Humana Choice PPO Medicare |
$104.19
|
| Rate for Payer: Mclaren Commercial |
$780.87
|
| Rate for Payer: Mclaren Medicaid |
$55.85
|
| Rate for Payer: Mclaren Medicare |
$104.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.40
|
| Rate for Payer: Meridian Medicaid |
$58.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$737.49
|
| Rate for Payer: Nomi Health Commercial |
$711.46
|
| Rate for Payer: PACE Medicare |
$98.98
|
| Rate for Payer: PACE SWMI |
$104.19
|
| Rate for Payer: PHP Commercial |
$114.61
|
| Rate for Payer: PHP Medicaid |
$55.85
|
| Rate for Payer: PHP Medicare Advantage |
$104.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$563.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$682.41
|
| Rate for Payer: Priority Health Medicare |
$104.19
|
| Rate for Payer: Priority Health Narrow Network |
$545.93
|
| Rate for Payer: Railroad Medicare Medicare |
$104.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$763.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$104.19
|
| Rate for Payer: UHC Exchange |
$161.49
|
| Rate for Payer: UHC Medicare Advantage |
$104.19
|
| Rate for Payer: UHCCP DNSP |
$104.19
|
| Rate for Payer: UHCCP Medicaid |
$55.85
|
| Rate for Payer: VA VA |
$104.19
|
|
|
HC VEIN MAPPING UNILAT UPPER EXTREMITY (R OR L)
|
Facility
|
OP
|
$867.63
|
|
|
Service Code
|
CPT 93971
|
| Hospital Charge Code |
92100029
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$55.85 |
| Max. Negotiated Rate |
$867.63 |
| Rate for Payer: Aetna Commercial |
$780.87
|
| Rate for Payer: Aetna Medicare |
$104.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.24
|
| Rate for Payer: ASR ASR |
$841.60
|
| Rate for Payer: ASR Commercial |
$841.60
|
| Rate for Payer: BCBS Complete |
$58.64
|
| Rate for Payer: BCBS MAPPO |
$104.19
|
| Rate for Payer: BCBS Trust/PPO |
$710.50
|
| Rate for Payer: BCN Commercial |
$672.67
|
| Rate for Payer: BCN Medicare Advantage |
$104.19
|
| Rate for Payer: Cash Price |
$694.10
|
| Rate for Payer: Cash Price |
$694.10
|
| Rate for Payer: Cofinity Commercial |
$815.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$694.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.19
|
| Rate for Payer: Healthscope Commercial |
$867.63
|
| Rate for Payer: Healthscope Whirlpool |
$841.60
|
| Rate for Payer: Humana Choice PPO Medicare |
$104.19
|
| Rate for Payer: Mclaren Commercial |
$780.87
|
| Rate for Payer: Mclaren Medicaid |
$55.85
|
| Rate for Payer: Mclaren Medicare |
$104.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.40
|
| Rate for Payer: Meridian Medicaid |
$58.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$737.49
|
| Rate for Payer: Nomi Health Commercial |
$711.46
|
| Rate for Payer: PACE Medicare |
$98.98
|
| Rate for Payer: PACE SWMI |
$104.19
|
| Rate for Payer: PHP Commercial |
$114.61
|
| Rate for Payer: PHP Medicaid |
$55.85
|
| Rate for Payer: PHP Medicare Advantage |
$104.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$563.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$682.41
|
| Rate for Payer: Priority Health Medicare |
$104.19
|
| Rate for Payer: Priority Health Narrow Network |
$545.93
|
| Rate for Payer: Railroad Medicare Medicare |
$104.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$763.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$104.19
|
| Rate for Payer: UHC Exchange |
$161.49
|
| Rate for Payer: UHC Medicare Advantage |
$104.19
|
| Rate for Payer: UHCCP DNSP |
$104.19
|
| Rate for Payer: UHCCP Medicaid |
$55.85
|
| Rate for Payer: VA VA |
$104.19
|
|
|
HC VEIN MAPPING UNILAT UPPER EXTREMITY (R OR L)
|
Facility
|
IP
|
$867.63
|
|
|
Service Code
|
CPT 93971
|
| Hospital Charge Code |
92100029
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$563.96 |
| Max. Negotiated Rate |
$867.63 |
| Rate for Payer: Aetna Commercial |
$780.87
|
| Rate for Payer: ASR ASR |
$841.60
|
| Rate for Payer: ASR Commercial |
$841.60
|
| Rate for Payer: BCBS Trust/PPO |
$707.03
|
| Rate for Payer: BCN Commercial |
$672.67
|
| Rate for Payer: Cash Price |
$694.10
|
| Rate for Payer: Cofinity Commercial |
$815.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$694.10
|
| Rate for Payer: Healthscope Commercial |
$867.63
|
| Rate for Payer: Healthscope Whirlpool |
$841.60
|
| Rate for Payer: Mclaren Commercial |
$780.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$737.49
|
| Rate for Payer: Nomi Health Commercial |
$711.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$563.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$763.51
|
|
|
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 |
$965.18 |
| Max. Negotiated Rate |
$2,412.96 |
| Rate for Payer: Aetna Commercial |
$2,171.66
|
| Rate for Payer: Aetna Medicare |
$1,206.48
|
| Rate for Payer: ASR ASR |
$2,340.57
|
| Rate for Payer: ASR Commercial |
$2,340.57
|
| Rate for Payer: BCBS Complete |
$965.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,975.97
|
| Rate for Payer: BCN Commercial |
$1,870.77
|
| 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 |
$2,412.96
|
| Rate for Payer: Healthscope Whirlpool |
$2,340.57
|
| 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: Priority Health Cigna Priority Health |
$1,568.42
|
| Rate for Payer: 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 5
|
Facility
|
IP
|
$2,412.96
|
|
|
Service Code
|
HCPCS C1880
|
| Hospital Charge Code |
27800093
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,568.42 |
| 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: ASR Commercial |
$2,340.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,966.32
|
| Rate for Payer: BCN Commercial |
$1,870.77
|
| 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 |
$2,412.96
|
| Rate for Payer: Healthscope Whirlpool |
$2,340.57
|
| 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: Priority Health Cigna Priority Health |
$1,568.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,123.40
|
|
|
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 |
$1,916.50 |
| 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: ASR Commercial |
$2,860.01
|
| Rate for Payer: BCBS Trust/PPO |
$2,402.70
|
| Rate for Payer: BCN Commercial |
$2,285.94
|
| 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 |
$2,948.46
|
| Rate for Payer: Healthscope Whirlpool |
$2,860.01
|
| 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: Priority Health Cigna Priority Health |
$1,916.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,594.64
|
|
|
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 |
$1,179.38 |
| Max. Negotiated Rate |
$2,948.46 |
| Rate for Payer: Aetna Commercial |
$2,653.61
|
| Rate for Payer: Aetna Medicare |
$1,474.23
|
| Rate for Payer: ASR ASR |
$2,860.01
|
| Rate for Payer: ASR Commercial |
$2,860.01
|
| Rate for Payer: BCBS Complete |
$1,179.38
|
| Rate for Payer: BCBS Trust/PPO |
$2,414.49
|
| Rate for Payer: BCN Commercial |
$2,285.94
|
| 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 |
$2,948.46
|
| Rate for Payer: Healthscope Whirlpool |
$2,860.01
|
| 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: Priority Health Cigna Priority Health |
$1,916.50
|
| Rate for Payer: 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 VEN ADDL VEIN INTRAOP
|
Facility
|
OP
|
$408.07
|
|
| Hospital Charge Code |
36000051
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$163.23 |
| Max. Negotiated Rate |
$408.07 |
| Rate for Payer: Aetna Commercial |
$367.26
|
| Rate for Payer: Aetna Medicare |
$204.04
|
| Rate for Payer: ASR ASR |
$395.83
|
| Rate for Payer: ASR Commercial |
$395.83
|
| Rate for Payer: BCBS Complete |
$163.23
|
| Rate for Payer: BCBS Trust/PPO |
$334.17
|
| Rate for Payer: BCN Commercial |
$316.38
|
| Rate for Payer: Cash Price |
$326.46
|
| Rate for Payer: Cofinity Commercial |
$383.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$326.46
|
| Rate for Payer: Healthscope Commercial |
$408.07
|
| Rate for Payer: Healthscope Whirlpool |
$395.83
|
| Rate for Payer: Mclaren Commercial |
$367.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$346.86
|
| Rate for Payer: Nomi Health Commercial |
$334.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$357.55
|
| Rate for Payer: Priority Health Narrow Network |
$286.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$359.10
|
|
|
HC VEN ADDL VEIN INTRAOP
|
Facility
|
IP
|
$408.07
|
|
| Hospital Charge Code |
36000051
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$265.25 |
| Max. Negotiated Rate |
$408.07 |
| Rate for Payer: Aetna Commercial |
$367.26
|
| Rate for Payer: ASR ASR |
$395.83
|
| Rate for Payer: ASR Commercial |
$395.83
|
| Rate for Payer: BCBS Trust/PPO |
$332.54
|
| Rate for Payer: BCN Commercial |
$316.38
|
| Rate for Payer: Cash Price |
$326.46
|
| Rate for Payer: Cofinity Commercial |
$383.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$326.46
|
| Rate for Payer: Healthscope Commercial |
$408.07
|
| Rate for Payer: Healthscope Whirlpool |
$395.83
|
| Rate for Payer: Mclaren Commercial |
$367.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$346.86
|
| Rate for Payer: Nomi Health Commercial |
$334.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$359.10
|
|
|
HC VENIPUNCT BY PHYS/QHP 3/> YRS
|
Facility
|
IP
|
$45.90
|
|
|
Service Code
|
CPT 36410
|
| Hospital Charge Code |
45000105
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$29.84 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$41.31
|
| Rate for Payer: ASR ASR |
$44.52
|
| Rate for Payer: ASR Commercial |
$44.52
|
| Rate for Payer: BCBS Trust/PPO |
$37.40
|
| Rate for Payer: BCN Commercial |
$35.59
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cofinity Commercial |
$43.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.72
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Healthscope Whirlpool |
$44.52
|
| Rate for Payer: Mclaren Commercial |
$41.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.02
|
| Rate for Payer: Nomi Health Commercial |
$37.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.39
|
|
|
HC VENIPUNCT BY PHYS/QHP 3/> YRS
|
Facility
|
OP
|
$45.90
|
|
|
Service Code
|
CPT 36410
|
| Hospital Charge Code |
45000105
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$18.36 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$41.31
|
| Rate for Payer: Aetna Medicare |
$22.95
|
| Rate for Payer: ASR ASR |
$44.52
|
| Rate for Payer: ASR Commercial |
$44.52
|
| Rate for Payer: BCBS Complete |
$18.36
|
| Rate for Payer: BCBS Trust/PPO |
$37.59
|
| Rate for Payer: BCN Commercial |
$35.59
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cofinity Commercial |
$43.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.72
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Healthscope Whirlpool |
$44.52
|
| Rate for Payer: Mclaren Commercial |
$41.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.02
|
| Rate for Payer: Nomi Health Commercial |
$37.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$35.14
|
| Rate for Payer: Priority Health Narrow Network |
$28.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.39
|
|
|
HC VENOGRAM ADRENAL
|
Facility
|
OP
|
$8,817.94
|
|
|
Service Code
|
CPT 75840
|
| Hospital Charge Code |
32000334
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,652.95 |
| Max. Negotiated Rate |
$8,817.94 |
| Rate for Payer: Aetna Commercial |
$7,936.15
|
| Rate for Payer: Aetna Medicare |
$3,083.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,854.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,854.82
|
| Rate for Payer: ASR ASR |
$8,553.40
|
| Rate for Payer: ASR Commercial |
$8,553.40
|
| Rate for Payer: BCBS Complete |
$1,735.60
|
| Rate for Payer: BCBS MAPPO |
$3,083.86
|
| Rate for Payer: BCBS Trust/PPO |
$7,221.01
|
| Rate for Payer: BCN Commercial |
$6,836.55
|
| Rate for Payer: BCN Medicare Advantage |
$3,083.86
|
| Rate for Payer: Cash Price |
$7,054.35
|
| Rate for Payer: Cash Price |
$7,054.35
|
| Rate for Payer: Cofinity Commercial |
$8,288.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,054.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,083.86
|
| Rate for Payer: Healthscope Commercial |
$8,817.94
|
| Rate for Payer: Healthscope Whirlpool |
$8,553.40
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,083.86
|
| Rate for Payer: Mclaren Commercial |
$7,936.15
|
| Rate for Payer: Mclaren Medicaid |
$1,652.95
|
| Rate for Payer: Mclaren Medicare |
$3,083.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,238.05
|
| Rate for Payer: Meridian Medicaid |
$1,735.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,546.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,495.25
|
| Rate for Payer: Nomi Health Commercial |
$7,230.71
|
| Rate for Payer: PACE Medicare |
$2,929.67
|
| Rate for Payer: PACE SWMI |
$3,083.86
|
| Rate for Payer: PHP Commercial |
$3,392.25
|
| Rate for Payer: PHP Medicaid |
$1,652.95
|
| Rate for Payer: PHP Medicare Advantage |
$3,083.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,652.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,731.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,726.28
|
| Rate for Payer: Priority Health Medicare |
$3,083.86
|
| Rate for Payer: Priority Health Narrow Network |
$6,181.38
|
| Rate for Payer: Railroad Medicare Medicare |
$3,083.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,759.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,083.86
|
| Rate for Payer: UHC Exchange |
$4,779.98
|
| Rate for Payer: UHC Medicare Advantage |
$3,083.86
|
| Rate for Payer: UHCCP DNSP |
$3,083.86
|
| Rate for Payer: UHCCP Medicaid |
$1,652.95
|
| Rate for Payer: VA VA |
$3,083.86
|
|
|
HC VENOGRAM ADRENAL
|
Facility
|
IP
|
$8,817.94
|
|
|
Service Code
|
CPT 75840
|
| Hospital Charge Code |
32000334
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$5,731.66 |
| Max. Negotiated Rate |
$8,817.94 |
| Rate for Payer: Aetna Commercial |
$7,936.15
|
| Rate for Payer: ASR ASR |
$8,553.40
|
| Rate for Payer: ASR Commercial |
$8,553.40
|
| Rate for Payer: BCBS Trust/PPO |
$7,185.74
|
| Rate for Payer: BCN Commercial |
$6,836.55
|
| Rate for Payer: Cash Price |
$7,054.35
|
| Rate for Payer: Cofinity Commercial |
$8,288.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,054.35
|
| Rate for Payer: Healthscope Commercial |
$8,817.94
|
| Rate for Payer: Healthscope Whirlpool |
$8,553.40
|
| Rate for Payer: Mclaren Commercial |
$7,936.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,495.25
|
| Rate for Payer: Nomi Health Commercial |
$7,230.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,731.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,759.79
|
|
|
HC VENOGRAM INTERNAL JUGULAR
|
Facility
|
OP
|
$5,018.21
|
|
|
Service Code
|
CPT 75860
|
| Hospital Charge Code |
32000319
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,652.95 |
| Max. Negotiated Rate |
$5,018.21 |
| Rate for Payer: Aetna Commercial |
$4,516.39
|
| Rate for Payer: Aetna Medicare |
$3,083.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,854.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,854.82
|
| Rate for Payer: ASR ASR |
$4,867.66
|
| Rate for Payer: ASR Commercial |
$4,867.66
|
| Rate for Payer: BCBS Complete |
$1,735.60
|
| Rate for Payer: BCBS MAPPO |
$3,083.86
|
| Rate for Payer: BCBS Trust/PPO |
$4,109.41
|
| Rate for Payer: BCN Commercial |
$3,890.62
|
| Rate for Payer: BCN Medicare Advantage |
$3,083.86
|
| Rate for Payer: Cash Price |
$4,014.57
|
| Rate for Payer: Cash Price |
$4,014.57
|
| Rate for Payer: Cofinity Commercial |
$4,717.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,014.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,083.86
|
| Rate for Payer: Healthscope Commercial |
$5,018.21
|
| Rate for Payer: Healthscope Whirlpool |
$4,867.66
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,083.86
|
| Rate for Payer: Mclaren Commercial |
$4,516.39
|
| Rate for Payer: Mclaren Medicaid |
$1,652.95
|
| Rate for Payer: Mclaren Medicare |
$3,083.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,238.05
|
| Rate for Payer: Meridian Medicaid |
$1,735.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,546.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,265.48
|
| Rate for Payer: Nomi Health Commercial |
$4,114.93
|
| Rate for Payer: PACE Medicare |
$2,929.67
|
| Rate for Payer: PACE SWMI |
$3,083.86
|
| Rate for Payer: PHP Commercial |
$3,392.25
|
| Rate for Payer: PHP Medicaid |
$1,652.95
|
| Rate for Payer: PHP Medicare Advantage |
$3,083.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,652.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,261.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,396.96
|
| Rate for Payer: Priority Health Medicare |
$3,083.86
|
| Rate for Payer: Priority Health Narrow Network |
$3,517.77
|
| Rate for Payer: Railroad Medicare Medicare |
$3,083.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,416.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,083.86
|
| Rate for Payer: UHC Exchange |
$4,779.98
|
| Rate for Payer: UHC Medicare Advantage |
$3,083.86
|
| Rate for Payer: UHCCP DNSP |
$3,083.86
|
| Rate for Payer: UHCCP Medicaid |
$1,652.95
|
| Rate for Payer: VA VA |
$3,083.86
|
|
