|
HC Y SET ANTE/RETRO
|
Facility
|
IP
|
$42.08
|
|
| Hospital Charge Code |
27000661
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$27.35 |
| Max. Negotiated Rate |
$42.08 |
| Rate for Payer: Aetna Commercial |
$37.87
|
| Rate for Payer: ASR ASR |
$40.82
|
| Rate for Payer: ASR Commercial |
$40.82
|
| Rate for Payer: BCBS Trust/PPO |
$34.29
|
| Rate for Payer: BCN Commercial |
$32.62
|
| Rate for Payer: Cash Price |
$33.66
|
| Rate for Payer: Cofinity Commercial |
$39.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.66
|
| Rate for Payer: Healthscope Commercial |
$42.08
|
| Rate for Payer: Healthscope Whirlpool |
$40.82
|
| Rate for Payer: Mclaren Commercial |
$37.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.77
|
| Rate for Payer: Nomi Health Commercial |
$34.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.03
|
|
|
HC YTTRIUM 90 MICROSPHERES
|
Facility
|
IP
|
$50,779.51
|
|
|
Service Code
|
HCPCS C2616
|
| Hospital Charge Code |
27800106
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$33,006.68 |
| Max. Negotiated Rate |
$50,779.51 |
| Rate for Payer: Aetna Commercial |
$45,701.56
|
| Rate for Payer: ASR ASR |
$49,256.12
|
| Rate for Payer: ASR Commercial |
$49,256.12
|
| Rate for Payer: BCBS Trust/PPO |
$41,380.22
|
| Rate for Payer: BCN Commercial |
$39,369.35
|
| Rate for Payer: Cash Price |
$40,623.61
|
| Rate for Payer: Cofinity Commercial |
$47,732.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40,623.61
|
| Rate for Payer: Healthscope Commercial |
$50,779.51
|
| Rate for Payer: Healthscope Whirlpool |
$49,256.12
|
| Rate for Payer: Mclaren Commercial |
$45,701.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43,162.58
|
| Rate for Payer: Nomi Health Commercial |
$41,639.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33,006.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44,685.97
|
|
|
HC YTTRIUM 90 MICROSPHERES
|
Facility
|
OP
|
$50,779.51
|
|
|
Service Code
|
HCPCS C2616
|
| Hospital Charge Code |
27800106
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,182.51 |
| Max. Negotiated Rate |
$50,779.51 |
| Rate for Payer: Aetna Commercial |
$45,701.56
|
| Rate for Payer: Aetna Medicare |
$17,131.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21,414.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21,414.44
|
| Rate for Payer: ASR ASR |
$49,256.12
|
| Rate for Payer: ASR Commercial |
$49,256.12
|
| Rate for Payer: BCBS Complete |
$9,641.64
|
| Rate for Payer: BCBS MAPPO |
$17,131.55
|
| Rate for Payer: BCBS Trust/PPO |
$41,583.34
|
| Rate for Payer: BCN Commercial |
$39,369.35
|
| Rate for Payer: BCN Medicare Advantage |
$17,131.55
|
| Rate for Payer: Cash Price |
$40,623.61
|
| Rate for Payer: Cash Price |
$40,623.61
|
| Rate for Payer: Cofinity Commercial |
$47,732.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40,623.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,131.55
|
| Rate for Payer: Healthscope Commercial |
$50,779.51
|
| Rate for Payer: Healthscope Whirlpool |
$49,256.12
|
| Rate for Payer: Humana Choice PPO Medicare |
$17,131.55
|
| Rate for Payer: Mclaren Commercial |
$45,701.56
|
| Rate for Payer: Mclaren Medicaid |
$9,182.51
|
| Rate for Payer: Mclaren Medicare |
$17,131.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17,988.13
|
| Rate for Payer: Meridian Medicaid |
$9,641.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19,701.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43,162.58
|
| Rate for Payer: Nomi Health Commercial |
$41,639.20
|
| Rate for Payer: PACE Medicare |
$16,274.97
|
| Rate for Payer: PACE SWMI |
$17,131.55
|
| Rate for Payer: PHP Commercial |
$18,844.70
|
| Rate for Payer: PHP Medicaid |
$9,182.51
|
| Rate for Payer: PHP Medicare Advantage |
$17,131.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,182.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33,006.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44,493.01
|
| Rate for Payer: Priority Health Medicare |
$17,131.55
|
| Rate for Payer: Priority Health Narrow Network |
$35,596.44
|
| Rate for Payer: Railroad Medicare Medicare |
$17,131.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44,685.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$17,131.55
|
| Rate for Payer: UHC Exchange |
$26,553.90
|
| Rate for Payer: UHC Medicare Advantage |
$17,131.55
|
| Rate for Payer: UHCCP DNSP |
$17,131.55
|
| Rate for Payer: UHCCP Medicaid |
$9,182.51
|
| Rate for Payer: VA VA |
$17,131.55
|
|
|
HC Y VENOUS BICAVAL
|
Facility
|
IP
|
$41.82
|
|
| Hospital Charge Code |
27000279
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$27.18 |
| Max. Negotiated Rate |
$41.82 |
| Rate for Payer: Aetna Commercial |
$37.64
|
| Rate for Payer: ASR ASR |
$40.57
|
| Rate for Payer: ASR Commercial |
$40.57
|
| Rate for Payer: BCBS Trust/PPO |
$34.08
|
| Rate for Payer: BCN Commercial |
$32.42
|
| Rate for Payer: Cash Price |
$33.46
|
| Rate for Payer: Cofinity Commercial |
$39.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.46
|
| Rate for Payer: Healthscope Commercial |
$41.82
|
| Rate for Payer: Healthscope Whirlpool |
$40.57
|
| Rate for Payer: Mclaren Commercial |
$37.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.55
|
| Rate for Payer: Nomi Health Commercial |
$34.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$36.80
|
|
|
HC Y VENOUS BICAVAL
|
Facility
|
OP
|
$41.82
|
|
| Hospital Charge Code |
27000279
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$16.73 |
| Max. Negotiated Rate |
$41.82 |
| Rate for Payer: Aetna Commercial |
$37.64
|
| Rate for Payer: Aetna Medicare |
$20.91
|
| Rate for Payer: ASR ASR |
$40.57
|
| Rate for Payer: ASR Commercial |
$40.57
|
| Rate for Payer: BCBS Complete |
$16.73
|
| Rate for Payer: BCBS Trust/PPO |
$34.25
|
| Rate for Payer: BCN Commercial |
$32.42
|
| Rate for Payer: Cash Price |
$33.46
|
| Rate for Payer: Cofinity Commercial |
$39.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.46
|
| Rate for Payer: Healthscope Commercial |
$41.82
|
| Rate for Payer: Healthscope Whirlpool |
$40.57
|
| Rate for Payer: Mclaren Commercial |
$37.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.55
|
| Rate for Payer: Nomi Health Commercial |
$34.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$36.64
|
| Rate for Payer: Priority Health Narrow Network |
$29.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$36.80
|
|
|
HC Z ACCESS DEVICE
|
Facility
|
OP
|
$204.86
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200082
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$81.94 |
| Max. Negotiated Rate |
$204.86 |
| Rate for Payer: Aetna Commercial |
$184.37
|
| Rate for Payer: Aetna Medicare |
$102.43
|
| Rate for Payer: ASR ASR |
$198.71
|
| Rate for Payer: ASR Commercial |
$198.71
|
| Rate for Payer: BCBS Complete |
$81.94
|
| Rate for Payer: BCBS Trust/PPO |
$167.76
|
| Rate for Payer: BCN Commercial |
$158.83
|
| Rate for Payer: Cash Price |
$163.89
|
| Rate for Payer: Cofinity Commercial |
$192.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.89
|
| Rate for Payer: Healthscope Commercial |
$204.86
|
| Rate for Payer: Healthscope Whirlpool |
$198.71
|
| Rate for Payer: Mclaren Commercial |
$184.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$174.13
|
| Rate for Payer: Nomi Health Commercial |
$167.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$179.50
|
| Rate for Payer: Priority Health Narrow Network |
$143.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$180.28
|
|
|
HC Z ACCESS DEVICE
|
Facility
|
IP
|
$204.86
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200082
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$133.16 |
| Max. Negotiated Rate |
$204.86 |
| Rate for Payer: Aetna Commercial |
$184.37
|
| Rate for Payer: ASR ASR |
$198.71
|
| Rate for Payer: ASR Commercial |
$198.71
|
| Rate for Payer: BCBS Trust/PPO |
$166.94
|
| Rate for Payer: BCN Commercial |
$158.83
|
| Rate for Payer: Cash Price |
$163.89
|
| Rate for Payer: Cofinity Commercial |
$192.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.89
|
| Rate for Payer: Healthscope Commercial |
$204.86
|
| Rate for Payer: Healthscope Whirlpool |
$198.71
|
| Rate for Payer: Mclaren Commercial |
$184.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$174.13
|
| Rate for Payer: Nomi Health Commercial |
$167.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$180.28
|
|
|
HC Z ACCUNET PROTECTIVE SYSTEM
|
Facility
|
OP
|
$6,366.11
|
|
|
Service Code
|
HCPCS C1884
|
| Hospital Charge Code |
27800037
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,546.44 |
| Max. Negotiated Rate |
$6,366.11 |
| Rate for Payer: Aetna Commercial |
$5,729.50
|
| Rate for Payer: Aetna Medicare |
$3,183.06
|
| Rate for Payer: ASR ASR |
$6,175.13
|
| Rate for Payer: ASR Commercial |
$6,175.13
|
| Rate for Payer: BCBS Complete |
$2,546.44
|
| Rate for Payer: BCBS Trust/PPO |
$5,213.21
|
| Rate for Payer: BCN Commercial |
$4,935.65
|
| Rate for Payer: Cash Price |
$5,092.89
|
| Rate for Payer: Cofinity Commercial |
$5,984.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,092.89
|
| Rate for Payer: Healthscope Commercial |
$6,366.11
|
| Rate for Payer: Healthscope Whirlpool |
$6,175.13
|
| Rate for Payer: Mclaren Commercial |
$5,729.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,411.19
|
| Rate for Payer: Nomi Health Commercial |
$5,220.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,137.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,577.99
|
| Rate for Payer: Priority Health Narrow Network |
$4,462.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,602.18
|
|
|
HC Z ACCUNET PROTECTIVE SYSTEM
|
Facility
|
IP
|
$6,366.11
|
|
|
Service Code
|
HCPCS C1884
|
| Hospital Charge Code |
27800037
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,137.97 |
| Max. Negotiated Rate |
$6,366.11 |
| Rate for Payer: Aetna Commercial |
$5,729.50
|
| Rate for Payer: ASR ASR |
$6,175.13
|
| Rate for Payer: ASR Commercial |
$6,175.13
|
| Rate for Payer: BCBS Trust/PPO |
$5,187.74
|
| Rate for Payer: BCN Commercial |
$4,935.65
|
| Rate for Payer: Cash Price |
$5,092.89
|
| Rate for Payer: Cofinity Commercial |
$5,984.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,092.89
|
| Rate for Payer: Healthscope Commercial |
$6,366.11
|
| Rate for Payer: Healthscope Whirlpool |
$6,175.13
|
| Rate for Payer: Mclaren Commercial |
$5,729.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,411.19
|
| Rate for Payer: Nomi Health Commercial |
$5,220.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,137.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,602.18
|
|
|
HC Z ARTHROCENTESIS SMALL JOINT BIL
|
Facility
|
IP
|
$437.63
|
|
|
Service Code
|
CPT 20600
|
| Hospital Charge Code |
36100023
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$284.46 |
| Max. Negotiated Rate |
$437.63 |
| Rate for Payer: Aetna Commercial |
$393.87
|
| Rate for Payer: ASR ASR |
$424.50
|
| Rate for Payer: ASR Commercial |
$424.50
|
| Rate for Payer: BCBS Trust/PPO |
$356.62
|
| Rate for Payer: BCN Commercial |
$339.29
|
| Rate for Payer: Cash Price |
$350.10
|
| Rate for Payer: Cofinity Commercial |
$411.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.10
|
| Rate for Payer: Healthscope Commercial |
$437.63
|
| Rate for Payer: Healthscope Whirlpool |
$424.50
|
| Rate for Payer: Mclaren Commercial |
$393.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$371.99
|
| Rate for Payer: Nomi Health Commercial |
$358.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$385.11
|
|
|
HC Z ARTHROCENTESIS SMALL JOINT BIL
|
Facility
|
OP
|
$437.63
|
|
|
Service Code
|
CPT 20600
|
| Hospital Charge Code |
36100023
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$155.02 |
| Max. Negotiated Rate |
$448.29 |
| Rate for Payer: Aetna Commercial |
$393.87
|
| Rate for Payer: Aetna Medicare |
$289.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$361.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$361.52
|
| Rate for Payer: ASR ASR |
$424.50
|
| Rate for Payer: ASR Commercial |
$424.50
|
| Rate for Payer: BCBS Complete |
$162.77
|
| Rate for Payer: BCBS MAPPO |
$289.22
|
| Rate for Payer: BCBS Trust/PPO |
$358.38
|
| Rate for Payer: BCN Commercial |
$339.29
|
| Rate for Payer: BCN Medicare Advantage |
$289.22
|
| Rate for Payer: Cash Price |
$350.10
|
| Rate for Payer: Cash Price |
$350.10
|
| Rate for Payer: Cofinity Commercial |
$411.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$289.22
|
| Rate for Payer: Healthscope Commercial |
$437.63
|
| Rate for Payer: Healthscope Whirlpool |
$424.50
|
| Rate for Payer: Humana Choice PPO Medicare |
$289.22
|
| Rate for Payer: Mclaren Commercial |
$393.87
|
| Rate for Payer: Mclaren Medicaid |
$155.02
|
| Rate for Payer: Mclaren Medicare |
$289.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$303.68
|
| Rate for Payer: Meridian Medicaid |
$162.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$332.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$371.99
|
| Rate for Payer: Nomi Health Commercial |
$358.86
|
| Rate for Payer: PACE Medicare |
$274.76
|
| Rate for Payer: PACE SWMI |
$289.22
|
| Rate for Payer: PHP Commercial |
$318.14
|
| Rate for Payer: PHP Medicaid |
$155.02
|
| Rate for Payer: PHP Medicare Advantage |
$289.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$155.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$404.07
|
| Rate for Payer: Priority Health Medicare |
$289.22
|
| Rate for Payer: Priority Health Narrow Network |
$323.26
|
| Rate for Payer: Railroad Medicare Medicare |
$289.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$385.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$289.22
|
| Rate for Payer: UHC Exchange |
$448.29
|
| Rate for Payer: UHC Medicare Advantage |
$289.22
|
| Rate for Payer: UHCCP DNSP |
$289.22
|
| Rate for Payer: UHCCP Medicaid |
$155.02
|
| Rate for Payer: VA VA |
$289.22
|
|
|
HC ZB002 CX ID GI PANEL 12-25 TARGETS
|
Facility
|
IP
|
$692.70
|
|
|
Service Code
|
CPT 87507
|
| Hospital Charge Code |
30600280
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$450.26 |
| Max. Negotiated Rate |
$692.70 |
| Rate for Payer: Aetna Commercial |
$623.43
|
| Rate for Payer: ASR ASR |
$671.92
|
| Rate for Payer: ASR Commercial |
$671.92
|
| Rate for Payer: BCBS Trust/PPO |
$564.48
|
| Rate for Payer: BCN Commercial |
$537.05
|
| Rate for Payer: Cash Price |
$554.16
|
| Rate for Payer: Cofinity Commercial |
$651.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$554.16
|
| Rate for Payer: Healthscope Commercial |
$692.70
|
| Rate for Payer: Healthscope Whirlpool |
$671.92
|
| Rate for Payer: Mclaren Commercial |
$623.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$588.80
|
| Rate for Payer: Nomi Health Commercial |
$568.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$450.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$609.58
|
|
|
HC ZB002 CX ID GI PANEL 12-25 TARGETS
|
Facility
|
OP
|
$692.70
|
|
|
Service Code
|
CPT 87507
|
| Hospital Charge Code |
30600280
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$223.39 |
| Max. Negotiated Rate |
$692.70 |
| Rate for Payer: Aetna Commercial |
$623.43
|
| Rate for Payer: Aetna Medicare |
$416.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$520.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$520.98
|
| Rate for Payer: ASR ASR |
$671.92
|
| Rate for Payer: ASR Commercial |
$671.92
|
| Rate for Payer: BCBS Complete |
$234.56
|
| Rate for Payer: BCBS MAPPO |
$416.78
|
| Rate for Payer: BCBS Trust/PPO |
$567.25
|
| Rate for Payer: BCN Commercial |
$537.05
|
| Rate for Payer: BCN Medicare Advantage |
$416.78
|
| Rate for Payer: Cash Price |
$554.16
|
| Rate for Payer: Cash Price |
$554.16
|
| Rate for Payer: Cofinity Commercial |
$651.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$554.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$416.78
|
| Rate for Payer: Healthscope Commercial |
$692.70
|
| Rate for Payer: Healthscope Whirlpool |
$671.92
|
| Rate for Payer: Humana Choice PPO Medicare |
$416.78
|
| Rate for Payer: Mclaren Commercial |
$623.43
|
| Rate for Payer: Mclaren Medicaid |
$223.39
|
| Rate for Payer: Mclaren Medicare |
$416.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$437.62
|
| Rate for Payer: Meridian Medicaid |
$234.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$479.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$588.80
|
| Rate for Payer: Nomi Health Commercial |
$568.01
|
| Rate for Payer: PACE Medicare |
$395.94
|
| Rate for Payer: PACE SWMI |
$416.78
|
| Rate for Payer: PHP Commercial |
$458.46
|
| Rate for Payer: PHP Medicaid |
$223.39
|
| Rate for Payer: PHP Medicare Advantage |
$416.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$223.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$450.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$606.94
|
| Rate for Payer: Priority Health Medicare |
$416.78
|
| Rate for Payer: Priority Health Narrow Network |
$485.58
|
| Rate for Payer: Railroad Medicare Medicare |
$416.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$609.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$416.78
|
| Rate for Payer: UHC Exchange |
$646.01
|
| Rate for Payer: UHC Medicare Advantage |
$416.78
|
| Rate for Payer: UHCCP DNSP |
$416.78
|
| Rate for Payer: UHCCP Medicaid |
$223.39
|
| Rate for Payer: VA VA |
$416.78
|
|
|
HC ZB5CG RESPIRATORY VIRAL PANEL 12-25 TARGETS
|
Facility
|
OP
|
$622.69
|
|
|
Service Code
|
CPT 87633
|
| Hospital Charge Code |
30600205
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$646.01 |
| Rate for Payer: Aetna Commercial |
$560.42
|
| Rate for Payer: Aetna Medicare |
$416.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$520.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$520.98
|
| Rate for Payer: ASR ASR |
$604.01
|
| Rate for Payer: ASR Commercial |
$604.01
|
| Rate for Payer: BCBS Complete |
$234.56
|
| Rate for Payer: BCBS MAPPO |
$416.78
|
| Rate for Payer: BCBS Trust/PPO |
$509.92
|
| Rate for Payer: BCN Commercial |
$482.77
|
| Rate for Payer: BCN Medicare Advantage |
$416.78
|
| Rate for Payer: Cash Price |
$498.15
|
| Rate for Payer: Cash Price |
$498.15
|
| Rate for Payer: Cofinity Commercial |
$585.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$498.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$416.78
|
| Rate for Payer: Healthscope Commercial |
$622.69
|
| Rate for Payer: Healthscope Whirlpool |
$604.01
|
| Rate for Payer: Humana Choice PPO Medicare |
$416.78
|
| Rate for Payer: Mclaren Commercial |
$560.42
|
| Rate for Payer: Mclaren Medicaid |
$223.39
|
| Rate for Payer: Mclaren Medicare |
$416.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$437.62
|
| Rate for Payer: Meridian Medicaid |
$234.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$479.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$529.29
|
| Rate for Payer: Nomi Health Commercial |
$510.61
|
| Rate for Payer: PACE Medicare |
$395.94
|
| Rate for Payer: PACE SWMI |
$416.78
|
| Rate for Payer: PHP Commercial |
$458.46
|
| Rate for Payer: PHP Medicaid |
$223.39
|
| Rate for Payer: PHP Medicare Advantage |
$416.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$223.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$404.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$0.01
|
| Rate for Payer: Priority Health Medicare |
$416.78
|
| Rate for Payer: Priority Health Narrow Network |
$0.01
|
| Rate for Payer: Railroad Medicare Medicare |
$416.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$547.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$416.78
|
| Rate for Payer: UHC Exchange |
$646.01
|
| Rate for Payer: UHC Medicare Advantage |
$416.78
|
| Rate for Payer: UHCCP DNSP |
$416.78
|
| Rate for Payer: UHCCP Medicaid |
$223.39
|
| Rate for Payer: VA VA |
$416.78
|
|
|
HC ZB5CG RESPIRATORY VIRAL PANEL 12-25 TARGETS
|
Facility
|
IP
|
$622.69
|
|
|
Service Code
|
CPT 87633
|
| Hospital Charge Code |
30600205
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$404.75 |
| Max. Negotiated Rate |
$622.69 |
| Rate for Payer: Aetna Commercial |
$560.42
|
| Rate for Payer: ASR ASR |
$604.01
|
| Rate for Payer: ASR Commercial |
$604.01
|
| Rate for Payer: BCBS Trust/PPO |
$507.43
|
| Rate for Payer: BCN Commercial |
$482.77
|
| Rate for Payer: Cash Price |
$498.15
|
| Rate for Payer: Cofinity Commercial |
$585.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$498.15
|
| Rate for Payer: Healthscope Commercial |
$622.69
|
| Rate for Payer: Healthscope Whirlpool |
$604.01
|
| Rate for Payer: Mclaren Commercial |
$560.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$529.29
|
| Rate for Payer: Nomi Health Commercial |
$510.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$404.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$547.97
|
|
|
HC ZB774 FACTOR II (2) & FACTOR V LEIDEN MUTATION
|
Facility
|
IP
|
$110.28
|
|
|
Service Code
|
CPT 81240
|
| Hospital Charge Code |
30100514
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$71.68 |
| Max. Negotiated Rate |
$110.28 |
| Rate for Payer: Aetna Commercial |
$99.25
|
| Rate for Payer: ASR ASR |
$106.97
|
| Rate for Payer: ASR Commercial |
$106.97
|
| Rate for Payer: BCBS Trust/PPO |
$89.87
|
| Rate for Payer: BCN Commercial |
$85.50
|
| Rate for Payer: Cash Price |
$88.22
|
| Rate for Payer: Cofinity Commercial |
$103.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.22
|
| Rate for Payer: Healthscope Commercial |
$110.28
|
| Rate for Payer: Healthscope Whirlpool |
$106.97
|
| Rate for Payer: Mclaren Commercial |
$99.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.74
|
| Rate for Payer: Nomi Health Commercial |
$90.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$97.05
|
|
|
HC ZB774 FACTOR II (2) & FACTOR V LEIDEN MUTATION
|
Facility
|
OP
|
$110.28
|
|
|
Service Code
|
CPT 81240
|
| Hospital Charge Code |
30100514
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$35.21 |
| Max. Negotiated Rate |
$110.28 |
| Rate for Payer: Aetna Commercial |
$99.25
|
| Rate for Payer: Aetna Medicare |
$65.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$82.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$82.11
|
| Rate for Payer: ASR ASR |
$106.97
|
| Rate for Payer: ASR Commercial |
$106.97
|
| Rate for Payer: BCBS Complete |
$36.97
|
| Rate for Payer: BCBS MAPPO |
$65.69
|
| Rate for Payer: BCBS Trust/PPO |
$90.31
|
| Rate for Payer: BCN Commercial |
$85.50
|
| Rate for Payer: BCN Medicare Advantage |
$65.69
|
| Rate for Payer: Cash Price |
$88.22
|
| Rate for Payer: Cash Price |
$88.22
|
| Rate for Payer: Cofinity Commercial |
$103.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.69
|
| Rate for Payer: Healthscope Commercial |
$110.28
|
| Rate for Payer: Healthscope Whirlpool |
$106.97
|
| Rate for Payer: Humana Choice PPO Medicare |
$65.69
|
| Rate for Payer: Mclaren Commercial |
$99.25
|
| Rate for Payer: Mclaren Medicaid |
$35.21
|
| Rate for Payer: Mclaren Medicare |
$65.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$68.97
|
| Rate for Payer: Meridian Medicaid |
$36.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$75.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.74
|
| Rate for Payer: Nomi Health Commercial |
$90.43
|
| Rate for Payer: PACE Medicare |
$62.41
|
| Rate for Payer: PACE SWMI |
$65.69
|
| Rate for Payer: PHP Commercial |
$72.26
|
| Rate for Payer: PHP Medicaid |
$35.21
|
| Rate for Payer: PHP Medicare Advantage |
$65.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$52.39
|
| Rate for Payer: Priority Health Medicare |
$65.69
|
| Rate for Payer: Priority Health Narrow Network |
$41.91
|
| Rate for Payer: Railroad Medicare Medicare |
$65.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$97.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$65.69
|
| Rate for Payer: UHC Exchange |
$101.82
|
| Rate for Payer: UHC Medicare Advantage |
$65.69
|
| Rate for Payer: UHCCP DNSP |
$65.69
|
| Rate for Payer: UHCCP Medicaid |
$35.21
|
| Rate for Payer: VA VA |
$65.69
|
|
|
HC ZB774 FACTOR II (2) & FACTOR V LEIDEN MUTATION CMPT
|
Facility
|
IP
|
$120.02
|
|
|
Service Code
|
CPT 81241
|
| Hospital Charge Code |
30100515
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$78.01 |
| Max. Negotiated Rate |
$120.02 |
| Rate for Payer: Aetna Commercial |
$108.02
|
| Rate for Payer: ASR ASR |
$116.42
|
| Rate for Payer: ASR Commercial |
$116.42
|
| Rate for Payer: BCBS Trust/PPO |
$97.80
|
| Rate for Payer: BCN Commercial |
$93.05
|
| Rate for Payer: Cash Price |
$96.02
|
| Rate for Payer: Cofinity Commercial |
$112.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.02
|
| Rate for Payer: Healthscope Commercial |
$120.02
|
| Rate for Payer: Healthscope Whirlpool |
$116.42
|
| Rate for Payer: Mclaren Commercial |
$108.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$102.02
|
| Rate for Payer: Nomi Health Commercial |
$98.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$78.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$105.62
|
|
|
HC ZB774 FACTOR II (2) & FACTOR V LEIDEN MUTATION CMPT
|
Facility
|
OP
|
$120.02
|
|
|
Service Code
|
CPT 81241
|
| Hospital Charge Code |
30100515
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$38.07 |
| Max. Negotiated Rate |
$120.02 |
| Rate for Payer: Aetna Commercial |
$108.02
|
| Rate for Payer: Aetna Medicare |
$73.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$91.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$91.71
|
| Rate for Payer: ASR ASR |
$116.42
|
| Rate for Payer: ASR Commercial |
$116.42
|
| Rate for Payer: BCBS Complete |
$41.29
|
| Rate for Payer: BCBS MAPPO |
$73.37
|
| Rate for Payer: BCBS Trust/PPO |
$98.28
|
| Rate for Payer: BCN Commercial |
$93.05
|
| Rate for Payer: BCN Medicare Advantage |
$73.37
|
| Rate for Payer: Cash Price |
$96.02
|
| Rate for Payer: Cash Price |
$96.02
|
| Rate for Payer: Cofinity Commercial |
$112.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$73.37
|
| Rate for Payer: Healthscope Commercial |
$120.02
|
| Rate for Payer: Healthscope Whirlpool |
$116.42
|
| Rate for Payer: Humana Choice PPO Medicare |
$73.37
|
| Rate for Payer: Mclaren Commercial |
$108.02
|
| Rate for Payer: Mclaren Medicaid |
$39.33
|
| Rate for Payer: Mclaren Medicare |
$73.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$77.04
|
| Rate for Payer: Meridian Medicaid |
$41.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$84.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$102.02
|
| Rate for Payer: Nomi Health Commercial |
$98.42
|
| Rate for Payer: PACE Medicare |
$69.70
|
| Rate for Payer: PACE SWMI |
$73.37
|
| Rate for Payer: PHP Commercial |
$80.71
|
| Rate for Payer: PHP Medicaid |
$39.33
|
| Rate for Payer: PHP Medicare Advantage |
$73.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$39.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$78.01
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$47.59
|
| Rate for Payer: Priority Health Medicare |
$73.37
|
| Rate for Payer: Priority Health Narrow Network |
$38.07
|
| Rate for Payer: Railroad Medicare Medicare |
$73.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$105.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$73.37
|
| Rate for Payer: UHC Exchange |
$113.72
|
| Rate for Payer: UHC Medicare Advantage |
$73.37
|
| Rate for Payer: UHCCP DNSP |
$73.37
|
| Rate for Payer: UHCCP Medicaid |
$39.33
|
| Rate for Payer: VA VA |
$73.37
|
|
|
HC Z EMBOLIZATION COILS
|
Facility
|
IP
|
$4,097.89
|
|
| Hospital Charge Code |
27800045
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,663.63 |
| Max. Negotiated Rate |
$4,097.89 |
| Rate for Payer: Aetna Commercial |
$3,688.10
|
| Rate for Payer: ASR ASR |
$3,974.95
|
| Rate for Payer: ASR Commercial |
$3,974.95
|
| Rate for Payer: BCBS Trust/PPO |
$3,339.37
|
| Rate for Payer: BCN Commercial |
$3,177.09
|
| Rate for Payer: Cash Price |
$3,278.31
|
| Rate for Payer: Cofinity Commercial |
$3,852.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,278.31
|
| Rate for Payer: Healthscope Commercial |
$4,097.89
|
| Rate for Payer: Healthscope Whirlpool |
$3,974.95
|
| Rate for Payer: Mclaren Commercial |
$3,688.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,483.21
|
| Rate for Payer: Nomi Health Commercial |
$3,360.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,663.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,606.14
|
|
|
HC Z EMBOLIZATION COILS
|
Facility
|
OP
|
$4,097.89
|
|
| Hospital Charge Code |
27800045
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,639.16 |
| Max. Negotiated Rate |
$4,097.89 |
| Rate for Payer: Aetna Commercial |
$3,688.10
|
| Rate for Payer: Aetna Medicare |
$2,048.94
|
| Rate for Payer: ASR ASR |
$3,974.95
|
| Rate for Payer: ASR Commercial |
$3,974.95
|
| Rate for Payer: BCBS Complete |
$1,639.16
|
| Rate for Payer: BCBS Trust/PPO |
$3,355.76
|
| Rate for Payer: BCN Commercial |
$3,177.09
|
| Rate for Payer: Cash Price |
$3,278.31
|
| Rate for Payer: Cofinity Commercial |
$3,852.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,278.31
|
| Rate for Payer: Healthscope Commercial |
$4,097.89
|
| Rate for Payer: Healthscope Whirlpool |
$3,974.95
|
| Rate for Payer: Mclaren Commercial |
$3,688.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,483.21
|
| Rate for Payer: Nomi Health Commercial |
$3,360.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,663.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,590.57
|
| Rate for Payer: Priority Health Narrow Network |
$2,872.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,606.14
|
|
|
HC Z ENTERPRISE DEVICE
|
Facility
|
IP
|
$7,692.24
|
|
| Hospital Charge Code |
27800047
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,999.96 |
| Max. Negotiated Rate |
$7,692.24 |
| Rate for Payer: Aetna Commercial |
$6,923.02
|
| Rate for Payer: ASR ASR |
$7,461.47
|
| Rate for Payer: ASR Commercial |
$7,461.47
|
| Rate for Payer: BCBS Trust/PPO |
$6,268.41
|
| Rate for Payer: BCN Commercial |
$5,963.79
|
| Rate for Payer: Cash Price |
$6,153.79
|
| Rate for Payer: Cofinity Commercial |
$7,230.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,153.79
|
| Rate for Payer: Healthscope Commercial |
$7,692.24
|
| Rate for Payer: Healthscope Whirlpool |
$7,461.47
|
| Rate for Payer: Mclaren Commercial |
$6,923.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,538.40
|
| Rate for Payer: Nomi Health Commercial |
$6,307.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,999.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,769.17
|
|
|
HC Z ENTERPRISE DEVICE
|
Facility
|
OP
|
$7,692.24
|
|
| Hospital Charge Code |
27800047
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,076.90 |
| Max. Negotiated Rate |
$7,692.24 |
| Rate for Payer: Aetna Commercial |
$6,923.02
|
| Rate for Payer: Aetna Medicare |
$3,846.12
|
| Rate for Payer: ASR ASR |
$7,461.47
|
| Rate for Payer: ASR Commercial |
$7,461.47
|
| Rate for Payer: BCBS Complete |
$3,076.90
|
| Rate for Payer: BCBS Trust/PPO |
$6,299.18
|
| Rate for Payer: BCN Commercial |
$5,963.79
|
| Rate for Payer: Cash Price |
$6,153.79
|
| Rate for Payer: Cofinity Commercial |
$7,230.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,153.79
|
| Rate for Payer: Healthscope Commercial |
$7,692.24
|
| Rate for Payer: Healthscope Whirlpool |
$7,461.47
|
| Rate for Payer: Mclaren Commercial |
$6,923.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,538.40
|
| Rate for Payer: Nomi Health Commercial |
$6,307.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,999.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,739.94
|
| Rate for Payer: Priority Health Narrow Network |
$5,392.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,769.17
|
|
|
HC ZEVALIN IN-III PER STUDY
|
Facility
|
OP
|
$2,229.12
|
|
|
Service Code
|
HCPCS A9542
|
| Hospital Charge Code |
34300025
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$427.74 |
| Max. Negotiated Rate |
$3,570.00 |
| Rate for Payer: Aetna Commercial |
$2,006.21
|
| Rate for Payer: Aetna Medicare |
$798.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$997.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$997.52
|
| Rate for Payer: ASR ASR |
$2,162.25
|
| Rate for Payer: ASR Commercial |
$2,162.25
|
| Rate for Payer: BCBS Complete |
$449.13
|
| Rate for Payer: BCBS MAPPO |
$798.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,825.43
|
| Rate for Payer: BCN Commercial |
$1,728.24
|
| Rate for Payer: BCN Medicare Advantage |
$798.02
|
| Rate for Payer: Cash Price |
$1,783.30
|
| Rate for Payer: Cash Price |
$1,783.30
|
| Rate for Payer: Cofinity Commercial |
$2,095.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,783.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$798.02
|
| Rate for Payer: Healthscope Commercial |
$2,229.12
|
| Rate for Payer: Healthscope Whirlpool |
$2,162.25
|
| Rate for Payer: Humana Choice PPO Medicare |
$798.02
|
| Rate for Payer: Mclaren Commercial |
$2,006.21
|
| Rate for Payer: Mclaren Medicaid |
$427.74
|
| Rate for Payer: Mclaren Medicare |
$798.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$837.92
|
| Rate for Payer: Meridian Medicaid |
$449.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$917.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,894.75
|
| Rate for Payer: Nomi Health Commercial |
$1,827.88
|
| Rate for Payer: PACE Medicare |
$758.12
|
| Rate for Payer: PACE SWMI |
$798.02
|
| Rate for Payer: PHP Commercial |
$877.82
|
| Rate for Payer: PHP Medicaid |
$427.74
|
| Rate for Payer: PHP Medicare Advantage |
$798.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$427.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,448.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,570.00
|
| Rate for Payer: Priority Health Medicare |
$798.02
|
| Rate for Payer: Priority Health Narrow Network |
$2,856.00
|
| Rate for Payer: Railroad Medicare Medicare |
$798.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,961.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$798.02
|
| Rate for Payer: UHC Exchange |
$1,236.93
|
| Rate for Payer: UHC Medicare Advantage |
$798.02
|
| Rate for Payer: UHCCP DNSP |
$798.02
|
| Rate for Payer: UHCCP Medicaid |
$427.74
|
| Rate for Payer: VA VA |
$798.02
|
|
|
HC ZEVALIN IN-III PER STUDY
|
Facility
|
IP
|
$2,229.12
|
|
|
Service Code
|
HCPCS A9542
|
| Hospital Charge Code |
34300025
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$1,448.93 |
| Max. Negotiated Rate |
$2,229.12 |
| Rate for Payer: Aetna Commercial |
$2,006.21
|
| Rate for Payer: ASR ASR |
$2,162.25
|
| Rate for Payer: ASR Commercial |
$2,162.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,816.51
|
| Rate for Payer: BCN Commercial |
$1,728.24
|
| Rate for Payer: Cash Price |
$1,783.30
|
| Rate for Payer: Cofinity Commercial |
$2,095.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,783.30
|
| Rate for Payer: Healthscope Commercial |
$2,229.12
|
| Rate for Payer: Healthscope Whirlpool |
$2,162.25
|
| Rate for Payer: Mclaren Commercial |
$2,006.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,894.75
|
| Rate for Payer: Nomi Health Commercial |
$1,827.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,448.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,961.63
|
|
