|
HC ZEVALIN Y-90 PER STUDY
|
Facility
|
IP
|
$61,963.39
|
|
|
Service Code
|
HCPCS A9543
|
| Hospital Charge Code |
34400006
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$40,276.20 |
| Max. Negotiated Rate |
$61,963.39 |
| Rate for Payer: Aetna Commercial |
$55,767.05
|
| Rate for Payer: ASR ASR |
$60,104.49
|
| Rate for Payer: ASR Commercial |
$60,104.49
|
| Rate for Payer: BCBS Trust/PPO |
$50,493.97
|
| Rate for Payer: BCN Commercial |
$48,040.22
|
| Rate for Payer: Cash Price |
$49,570.71
|
| Rate for Payer: Cofinity Commercial |
$58,245.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49,570.71
|
| Rate for Payer: Healthscope Commercial |
$61,963.39
|
| Rate for Payer: Healthscope Whirlpool |
$60,104.49
|
| Rate for Payer: Mclaren Commercial |
$55,767.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52,668.88
|
| Rate for Payer: Nomi Health Commercial |
$50,809.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40,276.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$54,527.78
|
|
|
HC ZEVALIN Y-90 PER STUDY
|
Facility
|
OP
|
$61,963.39
|
|
|
Service Code
|
HCPCS A9543
|
| Hospital Charge Code |
34400006
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$30,457.96 |
| Max. Negotiated Rate |
$88,078.05 |
| Rate for Payer: Aetna Commercial |
$55,767.05
|
| Rate for Payer: Aetna Medicare |
$56,824.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$71,030.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$71,030.69
|
| Rate for Payer: ASR ASR |
$60,104.49
|
| Rate for Payer: ASR Commercial |
$60,104.49
|
| Rate for Payer: BCBS Complete |
$31,980.86
|
| Rate for Payer: BCBS MAPPO |
$56,824.55
|
| Rate for Payer: BCBS Trust/PPO |
$50,741.82
|
| Rate for Payer: BCN Commercial |
$48,040.22
|
| Rate for Payer: BCN Medicare Advantage |
$56,824.55
|
| Rate for Payer: Cash Price |
$49,570.71
|
| Rate for Payer: Cash Price |
$49,570.71
|
| Rate for Payer: Cofinity Commercial |
$58,245.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49,570.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$56,824.55
|
| Rate for Payer: Healthscope Commercial |
$61,963.39
|
| Rate for Payer: Healthscope Whirlpool |
$60,104.49
|
| Rate for Payer: Humana Choice PPO Medicare |
$56,824.55
|
| Rate for Payer: Mclaren Commercial |
$55,767.05
|
| Rate for Payer: Mclaren Medicaid |
$30,457.96
|
| Rate for Payer: Mclaren Medicare |
$56,824.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$59,665.78
|
| Rate for Payer: Meridian Medicaid |
$31,980.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$65,348.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52,668.88
|
| Rate for Payer: Nomi Health Commercial |
$50,809.98
|
| Rate for Payer: PACE Medicare |
$53,983.32
|
| Rate for Payer: PACE SWMI |
$56,824.55
|
| Rate for Payer: PHP Commercial |
$62,507.00
|
| Rate for Payer: PHP Medicaid |
$30,457.96
|
| Rate for Payer: PHP Medicare Advantage |
$56,824.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$30,457.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40,276.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$68,140.74
|
| Rate for Payer: Priority Health Medicare |
$56,824.55
|
| Rate for Payer: Priority Health Narrow Network |
$54,512.59
|
| Rate for Payer: Railroad Medicare Medicare |
$56,824.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$54,527.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$56,824.55
|
| Rate for Payer: UHC Exchange |
$88,078.05
|
| Rate for Payer: UHC Medicare Advantage |
$56,824.55
|
| Rate for Payer: UHCCP DNSP |
$56,824.55
|
| Rate for Payer: UHCCP Medicaid |
$30,457.96
|
| Rate for Payer: VA VA |
$56,824.55
|
|
|
HC Z G J TUBE
|
Facility
|
IP
|
$1,530.89
|
|
| Hospital Charge Code |
27800048
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$995.08 |
| Max. Negotiated Rate |
$1,530.89 |
| Rate for Payer: Aetna Commercial |
$1,377.80
|
| Rate for Payer: ASR ASR |
$1,484.96
|
| Rate for Payer: ASR Commercial |
$1,484.96
|
| Rate for Payer: BCBS Trust/PPO |
$1,247.52
|
| Rate for Payer: BCN Commercial |
$1,186.90
|
| Rate for Payer: Cash Price |
$1,224.71
|
| Rate for Payer: Cofinity Commercial |
$1,439.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,224.71
|
| Rate for Payer: Healthscope Commercial |
$1,530.89
|
| Rate for Payer: Healthscope Whirlpool |
$1,484.96
|
| Rate for Payer: Mclaren Commercial |
$1,377.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,301.26
|
| Rate for Payer: Nomi Health Commercial |
$1,255.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$995.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,347.18
|
|
|
HC Z G J TUBE
|
Facility
|
OP
|
$1,530.89
|
|
| Hospital Charge Code |
27800048
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$612.36 |
| Max. Negotiated Rate |
$1,530.89 |
| Rate for Payer: Aetna Commercial |
$1,377.80
|
| Rate for Payer: Aetna Medicare |
$765.44
|
| Rate for Payer: ASR ASR |
$1,484.96
|
| Rate for Payer: ASR Commercial |
$1,484.96
|
| Rate for Payer: BCBS Complete |
$612.36
|
| Rate for Payer: BCBS Trust/PPO |
$1,253.65
|
| Rate for Payer: BCN Commercial |
$1,186.90
|
| Rate for Payer: Cash Price |
$1,224.71
|
| Rate for Payer: Cofinity Commercial |
$1,439.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,224.71
|
| Rate for Payer: Healthscope Commercial |
$1,530.89
|
| Rate for Payer: Healthscope Whirlpool |
$1,484.96
|
| Rate for Payer: Mclaren Commercial |
$1,377.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,301.26
|
| Rate for Payer: Nomi Health Commercial |
$1,255.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$995.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,341.37
|
| Rate for Payer: Priority Health Narrow Network |
$1,073.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,347.18
|
|
|
HC Z HEMODIALYSIS ANGIODYNAMIC
|
Facility
|
IP
|
$1,223.34
|
|
|
Service Code
|
HCPCS C1881
|
| Hospital Charge Code |
27200087
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$795.17 |
| Max. Negotiated Rate |
$1,223.34 |
| Rate for Payer: Aetna Commercial |
$1,101.01
|
| Rate for Payer: ASR ASR |
$1,186.64
|
| Rate for Payer: ASR Commercial |
$1,186.64
|
| Rate for Payer: BCBS Trust/PPO |
$996.90
|
| Rate for Payer: BCN Commercial |
$948.46
|
| Rate for Payer: Cash Price |
$978.67
|
| Rate for Payer: Cofinity Commercial |
$1,149.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$978.67
|
| Rate for Payer: Healthscope Commercial |
$1,223.34
|
| Rate for Payer: Healthscope Whirlpool |
$1,186.64
|
| Rate for Payer: Mclaren Commercial |
$1,101.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,039.84
|
| Rate for Payer: Nomi Health Commercial |
$1,003.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$795.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,076.54
|
|
|
HC Z HEMODIALYSIS ANGIODYNAMIC
|
Facility
|
OP
|
$1,223.34
|
|
|
Service Code
|
HCPCS C1881
|
| Hospital Charge Code |
27200087
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$489.34 |
| Max. Negotiated Rate |
$1,223.34 |
| Rate for Payer: Aetna Commercial |
$1,101.01
|
| Rate for Payer: Aetna Medicare |
$611.67
|
| Rate for Payer: ASR ASR |
$1,186.64
|
| Rate for Payer: ASR Commercial |
$1,186.64
|
| Rate for Payer: BCBS Complete |
$489.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,001.79
|
| Rate for Payer: BCN Commercial |
$948.46
|
| Rate for Payer: Cash Price |
$978.67
|
| Rate for Payer: Cofinity Commercial |
$1,149.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$978.67
|
| Rate for Payer: Healthscope Commercial |
$1,223.34
|
| Rate for Payer: Healthscope Whirlpool |
$1,186.64
|
| Rate for Payer: Mclaren Commercial |
$1,101.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,039.84
|
| Rate for Payer: Nomi Health Commercial |
$1,003.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$795.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,071.89
|
| Rate for Payer: Priority Health Narrow Network |
$857.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,076.54
|
|
|
HC Z HEMODIALYSIS BARD
|
Facility
|
IP
|
$1,583.13
|
|
|
Service Code
|
HCPCS C1881
|
| Hospital Charge Code |
27200088
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,029.03 |
| Max. Negotiated Rate |
$1,583.13 |
| Rate for Payer: Aetna Commercial |
$1,424.82
|
| Rate for Payer: ASR ASR |
$1,535.64
|
| Rate for Payer: ASR Commercial |
$1,535.64
|
| Rate for Payer: BCBS Trust/PPO |
$1,290.09
|
| Rate for Payer: BCN Commercial |
$1,227.40
|
| Rate for Payer: Cash Price |
$1,266.50
|
| Rate for Payer: Cofinity Commercial |
$1,488.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,266.50
|
| Rate for Payer: Healthscope Commercial |
$1,583.13
|
| Rate for Payer: Healthscope Whirlpool |
$1,535.64
|
| Rate for Payer: Mclaren Commercial |
$1,424.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,345.66
|
| Rate for Payer: Nomi Health Commercial |
$1,298.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,029.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,393.15
|
|
|
HC Z HEMODIALYSIS BARD
|
Facility
|
OP
|
$1,583.13
|
|
|
Service Code
|
HCPCS C1881
|
| Hospital Charge Code |
27200088
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$633.25 |
| Max. Negotiated Rate |
$1,583.13 |
| Rate for Payer: Aetna Commercial |
$1,424.82
|
| Rate for Payer: Aetna Medicare |
$791.56
|
| Rate for Payer: ASR ASR |
$1,535.64
|
| Rate for Payer: ASR Commercial |
$1,535.64
|
| Rate for Payer: BCBS Complete |
$633.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,296.43
|
| Rate for Payer: BCN Commercial |
$1,227.40
|
| Rate for Payer: Cash Price |
$1,266.50
|
| Rate for Payer: Cofinity Commercial |
$1,488.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,266.50
|
| Rate for Payer: Healthscope Commercial |
$1,583.13
|
| Rate for Payer: Healthscope Whirlpool |
$1,535.64
|
| Rate for Payer: Mclaren Commercial |
$1,424.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,345.66
|
| Rate for Payer: Nomi Health Commercial |
$1,298.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,029.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,387.14
|
| Rate for Payer: Priority Health Narrow Network |
$1,109.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,393.15
|
|
|
HC Z HYPERGLIDE OCCL BALLOON C
|
Facility
|
IP
|
$2,218.93
|
|
|
Service Code
|
HCPCS C2628
|
| Hospital Charge Code |
27200089
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,442.30 |
| Max. Negotiated Rate |
$2,218.93 |
| Rate for Payer: Aetna Commercial |
$1,997.04
|
| Rate for Payer: ASR ASR |
$2,152.36
|
| Rate for Payer: ASR Commercial |
$2,152.36
|
| Rate for Payer: BCBS Trust/PPO |
$1,808.21
|
| Rate for Payer: BCN Commercial |
$1,720.34
|
| Rate for Payer: Cash Price |
$1,775.14
|
| Rate for Payer: Cofinity Commercial |
$2,085.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,775.14
|
| Rate for Payer: Healthscope Commercial |
$2,218.93
|
| Rate for Payer: Healthscope Whirlpool |
$2,152.36
|
| Rate for Payer: Mclaren Commercial |
$1,997.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,886.09
|
| Rate for Payer: Nomi Health Commercial |
$1,819.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,442.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,952.66
|
|
|
HC Z HYPERGLIDE OCCL BALLOON C
|
Facility
|
OP
|
$2,218.93
|
|
|
Service Code
|
HCPCS C2628
|
| Hospital Charge Code |
27200089
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$887.57 |
| Max. Negotiated Rate |
$2,218.93 |
| Rate for Payer: Aetna Commercial |
$1,997.04
|
| Rate for Payer: Aetna Medicare |
$1,109.46
|
| Rate for Payer: ASR ASR |
$2,152.36
|
| Rate for Payer: ASR Commercial |
$2,152.36
|
| Rate for Payer: BCBS Complete |
$887.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,817.08
|
| Rate for Payer: BCN Commercial |
$1,720.34
|
| Rate for Payer: Cash Price |
$1,775.14
|
| Rate for Payer: Cofinity Commercial |
$2,085.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,775.14
|
| Rate for Payer: Healthscope Commercial |
$2,218.93
|
| Rate for Payer: Healthscope Whirlpool |
$2,152.36
|
| Rate for Payer: Mclaren Commercial |
$1,997.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,886.09
|
| Rate for Payer: Nomi Health Commercial |
$1,819.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,442.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,944.23
|
| Rate for Payer: Priority Health Narrow Network |
$1,555.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,952.66
|
|
|
HC ZIKA VIRUS MAC ELISA IGM
|
Facility
|
IP
|
$187.68
|
|
|
Service Code
|
CPT 86794
|
| Hospital Charge Code |
30000148
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$121.99 |
| Max. Negotiated Rate |
$187.68 |
| Rate for Payer: Aetna Commercial |
$168.91
|
| Rate for Payer: ASR ASR |
$182.05
|
| Rate for Payer: ASR Commercial |
$182.05
|
| Rate for Payer: BCBS Trust/PPO |
$152.94
|
| Rate for Payer: BCN Commercial |
$145.51
|
| Rate for Payer: Cash Price |
$150.14
|
| Rate for Payer: Cofinity Commercial |
$176.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$150.14
|
| Rate for Payer: Healthscope Commercial |
$187.68
|
| Rate for Payer: Healthscope Whirlpool |
$182.05
|
| Rate for Payer: Mclaren Commercial |
$168.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$159.53
|
| Rate for Payer: Nomi Health Commercial |
$153.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$165.16
|
|
|
HC ZIKA VIRUS MAC ELISA IGM
|
Facility
|
OP
|
$187.68
|
|
|
Service Code
|
CPT 86794
|
| Hospital Charge Code |
30000148
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.03 |
| Max. Negotiated Rate |
$187.68 |
| Rate for Payer: Aetna Commercial |
$168.91
|
| Rate for Payer: Aetna Medicare |
$16.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.06
|
| Rate for Payer: ASR ASR |
$182.05
|
| Rate for Payer: ASR Commercial |
$182.05
|
| Rate for Payer: BCBS Complete |
$9.48
|
| Rate for Payer: BCBS MAPPO |
$16.85
|
| Rate for Payer: BCBS Trust/PPO |
$153.69
|
| Rate for Payer: BCN Commercial |
$145.51
|
| Rate for Payer: BCN Medicare Advantage |
$16.85
|
| Rate for Payer: Cash Price |
$150.14
|
| Rate for Payer: Cash Price |
$150.14
|
| Rate for Payer: Cofinity Commercial |
$176.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$150.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.85
|
| Rate for Payer: Healthscope Commercial |
$187.68
|
| Rate for Payer: Healthscope Whirlpool |
$182.05
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.85
|
| Rate for Payer: Mclaren Commercial |
$168.91
|
| Rate for Payer: Mclaren Medicaid |
$9.03
|
| Rate for Payer: Mclaren Medicare |
$16.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.69
|
| Rate for Payer: Meridian Medicaid |
$9.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$159.53
|
| Rate for Payer: Nomi Health Commercial |
$153.90
|
| Rate for Payer: PACE Medicare |
$16.01
|
| Rate for Payer: PACE SWMI |
$16.85
|
| Rate for Payer: PHP Commercial |
$18.54
|
| Rate for Payer: PHP Medicaid |
$9.03
|
| Rate for Payer: PHP Medicare Advantage |
$16.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20.88
|
| Rate for Payer: Priority Health Medicare |
$16.85
|
| Rate for Payer: Priority Health Narrow Network |
$16.70
|
| Rate for Payer: Railroad Medicare Medicare |
$16.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$165.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.85
|
| Rate for Payer: UHC Exchange |
$26.12
|
| Rate for Payer: UHC Medicare Advantage |
$16.85
|
| Rate for Payer: UHCCP DNSP |
$16.85
|
| Rate for Payer: UHCCP Medicaid |
$9.03
|
| Rate for Payer: VA VA |
$16.85
|
|
|
HC ZIKA VIRUS, PCR, SERUM
|
Facility
|
IP
|
$260.10
|
|
|
Service Code
|
CPT 87662
|
| Hospital Charge Code |
30000150
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$169.06 |
| Max. Negotiated Rate |
$260.10 |
| Rate for Payer: Aetna Commercial |
$234.09
|
| Rate for Payer: ASR ASR |
$252.30
|
| Rate for Payer: ASR Commercial |
$252.30
|
| Rate for Payer: BCBS Trust/PPO |
$211.96
|
| Rate for Payer: BCN Commercial |
$201.66
|
| Rate for Payer: Cash Price |
$208.08
|
| Rate for Payer: Cofinity Commercial |
$244.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.08
|
| Rate for Payer: Healthscope Commercial |
$260.10
|
| Rate for Payer: Healthscope Whirlpool |
$252.30
|
| Rate for Payer: Mclaren Commercial |
$234.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.08
|
| Rate for Payer: Nomi Health Commercial |
$213.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$228.89
|
|
|
HC ZIKA VIRUS, PCR, SERUM
|
Facility
|
OP
|
$260.10
|
|
|
Service Code
|
CPT 87662
|
| Hospital Charge Code |
30000150
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$27.50 |
| Max. Negotiated Rate |
$260.10 |
| Rate for Payer: Aetna Commercial |
$234.09
|
| Rate for Payer: Aetna Medicare |
$51.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$64.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$64.14
|
| Rate for Payer: ASR ASR |
$252.30
|
| Rate for Payer: ASR Commercial |
$252.30
|
| Rate for Payer: BCBS Complete |
$28.88
|
| Rate for Payer: BCBS MAPPO |
$51.31
|
| Rate for Payer: BCBS Trust/PPO |
$213.00
|
| Rate for Payer: BCN Commercial |
$201.66
|
| Rate for Payer: BCN Medicare Advantage |
$51.31
|
| Rate for Payer: Cash Price |
$208.08
|
| Rate for Payer: Cash Price |
$208.08
|
| Rate for Payer: Cofinity Commercial |
$244.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.31
|
| Rate for Payer: Healthscope Commercial |
$260.10
|
| Rate for Payer: Healthscope Whirlpool |
$252.30
|
| Rate for Payer: Humana Choice PPO Medicare |
$51.31
|
| Rate for Payer: Mclaren Commercial |
$234.09
|
| Rate for Payer: Mclaren Medicaid |
$27.50
|
| Rate for Payer: Mclaren Medicare |
$51.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.88
|
| Rate for Payer: Meridian Medicaid |
$28.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.08
|
| Rate for Payer: Nomi Health Commercial |
$213.28
|
| Rate for Payer: PACE Medicare |
$48.74
|
| Rate for Payer: PACE SWMI |
$51.31
|
| Rate for Payer: PHP Commercial |
$56.44
|
| Rate for Payer: PHP Medicaid |
$27.50
|
| Rate for Payer: PHP Medicare Advantage |
$51.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$80.59
|
| Rate for Payer: Priority Health Medicare |
$51.31
|
| Rate for Payer: Priority Health Narrow Network |
$64.47
|
| Rate for Payer: Railroad Medicare Medicare |
$51.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$228.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$51.31
|
| Rate for Payer: UHC Exchange |
$79.53
|
| Rate for Payer: UHC Medicare Advantage |
$51.31
|
| Rate for Payer: UHCCP DNSP |
$51.31
|
| Rate for Payer: UHCCP Medicaid |
$27.50
|
| Rate for Payer: VA VA |
$51.31
|
|
|
HC ZIKA VIRUS, PCR, URINE
|
Facility
|
IP
|
$260.10
|
|
|
Service Code
|
CPT 87662
|
| Hospital Charge Code |
30000151
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$169.06 |
| Max. Negotiated Rate |
$260.10 |
| Rate for Payer: Aetna Commercial |
$234.09
|
| Rate for Payer: ASR ASR |
$252.30
|
| Rate for Payer: ASR Commercial |
$252.30
|
| Rate for Payer: BCBS Trust/PPO |
$211.96
|
| Rate for Payer: BCN Commercial |
$201.66
|
| Rate for Payer: Cash Price |
$208.08
|
| Rate for Payer: Cofinity Commercial |
$244.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.08
|
| Rate for Payer: Healthscope Commercial |
$260.10
|
| Rate for Payer: Healthscope Whirlpool |
$252.30
|
| Rate for Payer: Mclaren Commercial |
$234.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.08
|
| Rate for Payer: Nomi Health Commercial |
$213.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$228.89
|
|
|
HC ZIKA VIRUS, PCR, URINE
|
Facility
|
OP
|
$260.10
|
|
|
Service Code
|
CPT 87662
|
| Hospital Charge Code |
30000151
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$27.50 |
| Max. Negotiated Rate |
$260.10 |
| Rate for Payer: Aetna Commercial |
$234.09
|
| Rate for Payer: Aetna Medicare |
$51.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$64.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$64.14
|
| Rate for Payer: ASR ASR |
$252.30
|
| Rate for Payer: ASR Commercial |
$252.30
|
| Rate for Payer: BCBS Complete |
$28.88
|
| Rate for Payer: BCBS MAPPO |
$51.31
|
| Rate for Payer: BCBS Trust/PPO |
$213.00
|
| Rate for Payer: BCN Commercial |
$201.66
|
| Rate for Payer: BCN Medicare Advantage |
$51.31
|
| Rate for Payer: Cash Price |
$208.08
|
| Rate for Payer: Cash Price |
$208.08
|
| Rate for Payer: Cofinity Commercial |
$244.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.31
|
| Rate for Payer: Healthscope Commercial |
$260.10
|
| Rate for Payer: Healthscope Whirlpool |
$252.30
|
| Rate for Payer: Humana Choice PPO Medicare |
$51.31
|
| Rate for Payer: Mclaren Commercial |
$234.09
|
| Rate for Payer: Mclaren Medicaid |
$27.50
|
| Rate for Payer: Mclaren Medicare |
$51.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.88
|
| Rate for Payer: Meridian Medicaid |
$28.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.08
|
| Rate for Payer: Nomi Health Commercial |
$213.28
|
| Rate for Payer: PACE Medicare |
$48.74
|
| Rate for Payer: PACE SWMI |
$51.31
|
| Rate for Payer: PHP Commercial |
$56.44
|
| Rate for Payer: PHP Medicaid |
$27.50
|
| Rate for Payer: PHP Medicare Advantage |
$51.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$80.59
|
| Rate for Payer: Priority Health Medicare |
$51.31
|
| Rate for Payer: Priority Health Narrow Network |
$64.47
|
| Rate for Payer: Railroad Medicare Medicare |
$51.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$228.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$51.31
|
| Rate for Payer: UHC Exchange |
$79.53
|
| Rate for Payer: UHC Medicare Advantage |
$51.31
|
| Rate for Payer: UHCCP DNSP |
$51.31
|
| Rate for Payer: UHCCP Medicaid |
$27.50
|
| Rate for Payer: VA VA |
$51.31
|
|
|
HC Z IMPLANTABLE PORT
|
Facility
|
OP
|
$3,098.41
|
|
|
Service Code
|
HCPCS C1788
|
| Hospital Charge Code |
27800039
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,239.36 |
| Max. Negotiated Rate |
$3,098.41 |
| Rate for Payer: Aetna Commercial |
$2,788.57
|
| Rate for Payer: Aetna Medicare |
$1,549.20
|
| Rate for Payer: ASR ASR |
$3,005.46
|
| Rate for Payer: ASR Commercial |
$3,005.46
|
| Rate for Payer: BCBS Complete |
$1,239.36
|
| Rate for Payer: BCBS Trust/PPO |
$2,537.29
|
| Rate for Payer: BCN Commercial |
$2,402.20
|
| Rate for Payer: Cash Price |
$2,478.73
|
| Rate for Payer: Cofinity Commercial |
$2,912.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,478.73
|
| Rate for Payer: Healthscope Commercial |
$3,098.41
|
| Rate for Payer: Healthscope Whirlpool |
$3,005.46
|
| Rate for Payer: Mclaren Commercial |
$2,788.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,633.65
|
| Rate for Payer: Nomi Health Commercial |
$2,540.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,013.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,714.83
|
| Rate for Payer: Priority Health Narrow Network |
$2,171.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,726.60
|
|
|
HC Z IMPLANTABLE PORT
|
Facility
|
IP
|
$3,098.41
|
|
|
Service Code
|
HCPCS C1788
|
| Hospital Charge Code |
27800039
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,013.97 |
| Max. Negotiated Rate |
$3,098.41 |
| Rate for Payer: Aetna Commercial |
$2,788.57
|
| Rate for Payer: ASR ASR |
$3,005.46
|
| Rate for Payer: ASR Commercial |
$3,005.46
|
| Rate for Payer: BCBS Trust/PPO |
$2,524.89
|
| Rate for Payer: BCN Commercial |
$2,402.20
|
| Rate for Payer: Cash Price |
$2,478.73
|
| Rate for Payer: Cofinity Commercial |
$2,912.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,478.73
|
| Rate for Payer: Healthscope Commercial |
$3,098.41
|
| Rate for Payer: Healthscope Whirlpool |
$3,005.46
|
| Rate for Payer: Mclaren Commercial |
$2,788.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,633.65
|
| Rate for Payer: Nomi Health Commercial |
$2,540.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,013.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,726.60
|
|
|
HC ZINC LEVEL
|
Facility
|
OP
|
$49.98
|
|
|
Service Code
|
CPT 84630
|
| Hospital Charge Code |
30100462
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.11 |
| Max. Negotiated Rate |
$51.62 |
| Rate for Payer: Aetna Commercial |
$44.98
|
| Rate for Payer: Aetna Medicare |
$11.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.24
|
| Rate for Payer: ASR ASR |
$48.48
|
| Rate for Payer: ASR Commercial |
$48.48
|
| Rate for Payer: BCBS Complete |
$6.41
|
| Rate for Payer: BCBS MAPPO |
$11.39
|
| Rate for Payer: BCBS Trust/PPO |
$40.93
|
| Rate for Payer: BCN Commercial |
$38.75
|
| Rate for Payer: BCN Medicare Advantage |
$11.39
|
| Rate for Payer: Cash Price |
$39.98
|
| Rate for Payer: Cash Price |
$39.98
|
| Rate for Payer: Cofinity Commercial |
$46.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.39
|
| Rate for Payer: Healthscope Commercial |
$49.98
|
| Rate for Payer: Healthscope Whirlpool |
$48.48
|
| Rate for Payer: Humana Choice PPO Medicare |
$11.39
|
| Rate for Payer: Mclaren Commercial |
$44.98
|
| Rate for Payer: Mclaren Medicaid |
$6.11
|
| Rate for Payer: Mclaren Medicare |
$11.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.96
|
| Rate for Payer: Meridian Medicaid |
$6.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.48
|
| Rate for Payer: Nomi Health Commercial |
$40.98
|
| Rate for Payer: PACE Medicare |
$10.82
|
| Rate for Payer: PACE SWMI |
$11.39
|
| Rate for Payer: PHP Commercial |
$12.53
|
| Rate for Payer: PHP Medicaid |
$6.11
|
| Rate for Payer: PHP Medicare Advantage |
$11.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.49
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$51.62
|
| Rate for Payer: Priority Health Medicare |
$11.39
|
| Rate for Payer: Priority Health Narrow Network |
$41.30
|
| Rate for Payer: Railroad Medicare Medicare |
$11.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$43.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.39
|
| Rate for Payer: UHC Exchange |
$17.65
|
| Rate for Payer: UHC Medicare Advantage |
$11.39
|
| Rate for Payer: UHCCP DNSP |
$11.39
|
| Rate for Payer: UHCCP Medicaid |
$6.11
|
| Rate for Payer: VA VA |
$11.39
|
|
|
HC ZINC LEVEL
|
Facility
|
IP
|
$49.98
|
|
|
Service Code
|
CPT 84630
|
| Hospital Charge Code |
30100462
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$32.49 |
| Max. Negotiated Rate |
$49.98 |
| Rate for Payer: Aetna Commercial |
$44.98
|
| Rate for Payer: ASR ASR |
$48.48
|
| Rate for Payer: ASR Commercial |
$48.48
|
| Rate for Payer: BCBS Trust/PPO |
$40.73
|
| Rate for Payer: BCN Commercial |
$38.75
|
| Rate for Payer: Cash Price |
$39.98
|
| Rate for Payer: Cofinity Commercial |
$46.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.98
|
| Rate for Payer: Healthscope Commercial |
$49.98
|
| Rate for Payer: Healthscope Whirlpool |
$48.48
|
| Rate for Payer: Mclaren Commercial |
$44.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.48
|
| Rate for Payer: Nomi Health Commercial |
$40.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$43.98
|
|
|
HC ZINC TRANSPORTER T8
|
Facility
|
IP
|
$450.00
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
30200514
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$292.50 |
| Max. Negotiated Rate |
$450.00 |
| Rate for Payer: Aetna Commercial |
$405.00
|
| Rate for Payer: ASR ASR |
$436.50
|
| Rate for Payer: ASR Commercial |
$436.50
|
| Rate for Payer: BCBS Trust/PPO |
$366.70
|
| Rate for Payer: BCN Commercial |
$348.88
|
| Rate for Payer: Cash Price |
$360.00
|
| Rate for Payer: Cofinity Commercial |
$423.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$360.00
|
| Rate for Payer: Healthscope Commercial |
$450.00
|
| Rate for Payer: Healthscope Whirlpool |
$436.50
|
| Rate for Payer: Mclaren Commercial |
$405.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$382.50
|
| Rate for Payer: Nomi Health Commercial |
$369.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$292.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$396.00
|
|
|
HC ZINC TRANSPORTER T8
|
Facility
|
OP
|
$450.00
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
30200514
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.63 |
| Max. Negotiated Rate |
$450.00 |
| Rate for Payer: Aetna Commercial |
$405.00
|
| Rate for Payer: Aetna Medicare |
$23.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.46
|
| Rate for Payer: ASR ASR |
$436.50
|
| Rate for Payer: ASR Commercial |
$436.50
|
| Rate for Payer: BCBS Complete |
$13.27
|
| Rate for Payer: BCBS MAPPO |
$23.57
|
| Rate for Payer: BCBS Trust/PPO |
$368.50
|
| Rate for Payer: BCN Commercial |
$348.88
|
| Rate for Payer: BCN Medicare Advantage |
$23.57
|
| Rate for Payer: Cash Price |
$360.00
|
| Rate for Payer: Cash Price |
$360.00
|
| Rate for Payer: Cofinity Commercial |
$423.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$360.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.57
|
| Rate for Payer: Healthscope Commercial |
$450.00
|
| Rate for Payer: Healthscope Whirlpool |
$436.50
|
| Rate for Payer: Humana Choice PPO Medicare |
$23.57
|
| Rate for Payer: Mclaren Commercial |
$405.00
|
| Rate for Payer: Mclaren Medicaid |
$12.63
|
| Rate for Payer: Mclaren Medicare |
$23.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.75
|
| Rate for Payer: Meridian Medicaid |
$13.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$382.50
|
| Rate for Payer: Nomi Health Commercial |
$369.00
|
| Rate for Payer: PACE Medicare |
$22.39
|
| Rate for Payer: PACE SWMI |
$23.57
|
| Rate for Payer: PHP Commercial |
$25.93
|
| Rate for Payer: PHP Medicaid |
$12.63
|
| Rate for Payer: PHP Medicare Advantage |
$23.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$292.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$394.29
|
| Rate for Payer: Priority Health Medicare |
$23.57
|
| Rate for Payer: Priority Health Narrow Network |
$315.45
|
| Rate for Payer: Railroad Medicare Medicare |
$23.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$396.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.57
|
| Rate for Payer: UHC Exchange |
$36.53
|
| Rate for Payer: UHC Medicare Advantage |
$23.57
|
| Rate for Payer: UHCCP DNSP |
$23.57
|
| Rate for Payer: UHCCP Medicaid |
$12.63
|
| Rate for Payer: VA VA |
$23.57
|
|
|
HC ZINC URINE
|
Facility
|
OP
|
$69.97
|
|
|
Service Code
|
CPT 84630
|
| Hospital Charge Code |
30100463
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.11 |
| Max. Negotiated Rate |
$69.97 |
| Rate for Payer: Aetna Commercial |
$62.97
|
| Rate for Payer: Aetna Medicare |
$11.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.24
|
| Rate for Payer: ASR ASR |
$67.87
|
| Rate for Payer: ASR Commercial |
$67.87
|
| Rate for Payer: BCBS Complete |
$6.41
|
| Rate for Payer: BCBS MAPPO |
$11.39
|
| Rate for Payer: BCBS Trust/PPO |
$57.30
|
| Rate for Payer: BCN Commercial |
$54.25
|
| Rate for Payer: BCN Medicare Advantage |
$11.39
|
| Rate for Payer: Cash Price |
$55.98
|
| Rate for Payer: Cash Price |
$55.98
|
| Rate for Payer: Cofinity Commercial |
$65.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.39
|
| Rate for Payer: Healthscope Commercial |
$69.97
|
| Rate for Payer: Healthscope Whirlpool |
$67.87
|
| Rate for Payer: Humana Choice PPO Medicare |
$11.39
|
| Rate for Payer: Mclaren Commercial |
$62.97
|
| Rate for Payer: Mclaren Medicaid |
$6.11
|
| Rate for Payer: Mclaren Medicare |
$11.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.96
|
| Rate for Payer: Meridian Medicaid |
$6.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.47
|
| Rate for Payer: Nomi Health Commercial |
$57.38
|
| Rate for Payer: PACE Medicare |
$10.82
|
| Rate for Payer: PACE SWMI |
$11.39
|
| Rate for Payer: PHP Commercial |
$12.53
|
| Rate for Payer: PHP Medicaid |
$6.11
|
| Rate for Payer: PHP Medicare Advantage |
$11.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$51.62
|
| Rate for Payer: Priority Health Medicare |
$11.39
|
| Rate for Payer: Priority Health Narrow Network |
$41.30
|
| Rate for Payer: Railroad Medicare Medicare |
$11.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$61.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.39
|
| Rate for Payer: UHC Exchange |
$17.65
|
| Rate for Payer: UHC Medicare Advantage |
$11.39
|
| Rate for Payer: UHCCP DNSP |
$11.39
|
| Rate for Payer: UHCCP Medicaid |
$6.11
|
| Rate for Payer: VA VA |
$11.39
|
|
|
HC ZINC URINE
|
Facility
|
IP
|
$69.97
|
|
|
Service Code
|
CPT 84630
|
| Hospital Charge Code |
30100463
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$45.48 |
| Max. Negotiated Rate |
$69.97 |
| Rate for Payer: Aetna Commercial |
$62.97
|
| Rate for Payer: ASR ASR |
$67.87
|
| Rate for Payer: ASR Commercial |
$67.87
|
| Rate for Payer: BCBS Trust/PPO |
$57.02
|
| Rate for Payer: BCN Commercial |
$54.25
|
| Rate for Payer: Cash Price |
$55.98
|
| Rate for Payer: Cofinity Commercial |
$65.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.98
|
| Rate for Payer: Healthscope Commercial |
$69.97
|
| Rate for Payer: Healthscope Whirlpool |
$67.87
|
| Rate for Payer: Mclaren Commercial |
$62.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.47
|
| Rate for Payer: Nomi Health Commercial |
$57.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$61.57
|
|
|
HC Z INFUSION WIRE
|
Facility
|
OP
|
$874.85
|
|
| Hospital Charge Code |
62100001
|
|
Hospital Revenue Code
|
621
|
| Min. Negotiated Rate |
$349.94 |
| Max. Negotiated Rate |
$874.85 |
| Rate for Payer: Aetna Commercial |
$787.36
|
| Rate for Payer: Aetna Medicare |
$437.42
|
| Rate for Payer: ASR ASR |
$848.60
|
| Rate for Payer: ASR Commercial |
$848.60
|
| Rate for Payer: BCBS Complete |
$349.94
|
| Rate for Payer: BCBS Trust/PPO |
$716.41
|
| Rate for Payer: BCN Commercial |
$678.27
|
| Rate for Payer: Cash Price |
$699.88
|
| Rate for Payer: Cofinity Commercial |
$822.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$699.88
|
| Rate for Payer: Healthscope Commercial |
$874.85
|
| Rate for Payer: Healthscope Whirlpool |
$848.60
|
| Rate for Payer: Mclaren Commercial |
$787.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$743.62
|
| Rate for Payer: Nomi Health Commercial |
$717.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$568.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$766.54
|
| Rate for Payer: Priority Health Narrow Network |
$613.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$769.87
|
|
