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Service Code HCPCS J2919
Hospital Charge Code 119451
Hospital Revenue Code 636
Min. Negotiated Rate $0.11
Max. Negotiated Rate $35.31
Rate for Payer: Aetna Commercial $31.78
Rate for Payer: Aetna Medicare $0.21
Rate for Payer: Allen County Amish Medical Aid Commercial $0.26
Rate for Payer: Amish Plain Church Group Commercial $0.26
Rate for Payer: ASR ASR $34.25
Rate for Payer: ASR Commercial $34.25
Rate for Payer: BCBS Complete $0.12
Rate for Payer: BCBS MAPPO $0.21
Rate for Payer: BCBS Trust/PPO $28.92
Rate for Payer: BCN Commercial $27.38
Rate for Payer: BCN Medicare Advantage $0.21
Rate for Payer: Cash Price $28.25
Rate for Payer: Cash Price $28.25
Rate for Payer: Cofinity Commercial $33.19
Rate for Payer: Encore Health Key Benefits Commercial $28.25
Rate for Payer: Health Alliance Plan Medicare Advantage $0.21
Rate for Payer: Healthscope Commercial $35.31
Rate for Payer: Healthscope Whirlpool $34.25
Rate for Payer: Humana Choice PPO Medicare $0.21
Rate for Payer: Mclaren Commercial $31.78
Rate for Payer: Mclaren Medicaid $0.11
Rate for Payer: Mclaren Medicare $0.21
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage $0.22
Rate for Payer: Meridian Medicaid $0.12
Rate for Payer: MI Amish Medical Board Commercial $0.24
Rate for Payer: Multiplan/Beech St/PHCS Commercial $30.01
Rate for Payer: Nomi Health Commercial $28.95
Rate for Payer: PACE Medicare $0.20
Rate for Payer: PACE SWMI $0.21
Rate for Payer: PHP Commercial $0.23
Rate for Payer: PHP Medicaid $0.11
Rate for Payer: PHP Medicare Advantage $0.21
Rate for Payer: Priority Health Choice Medicaid $0.11
Rate for Payer: Priority Health Cigna Priority Health $22.95
Rate for Payer: Priority Health HMO/PPO/Tiered Network $30.94
Rate for Payer: Priority Health Medicare $0.21
Rate for Payer: Priority Health Narrow Network $24.75
Rate for Payer: Railroad Medicare Medicare $0.21
Rate for Payer: UHC All Payor (Choice/PPO) + Core $31.07
Rate for Payer: UHC Dual Complete DSNP $0.21
Rate for Payer: UHC Exchange $0.33
Rate for Payer: UHC Medicare Advantage $0.21
Rate for Payer: UHCCP DNSP $0.21
Rate for Payer: UHCCP Medicaid $0.11
Rate for Payer: VA VA $0.21
Service Code HCPCS J2919
Hospital Charge Code 119450
Hospital Revenue Code 636
Min. Negotiated Rate $14.42
Max. Negotiated Rate $22.19
Rate for Payer: Aetna Commercial $19.97
Rate for Payer: ASR ASR $21.52
Rate for Payer: ASR Commercial $21.52
Rate for Payer: BCBS Trust/PPO $18.08
Rate for Payer: BCN Commercial $17.20
Rate for Payer: Cash Price $17.75
Rate for Payer: Cofinity Commercial $20.86
Rate for Payer: Encore Health Key Benefits Commercial $17.75
Rate for Payer: Healthscope Commercial $22.19
Rate for Payer: Healthscope Whirlpool $21.52
Rate for Payer: Mclaren Commercial $19.97
Rate for Payer: Multiplan/Beech St/PHCS Commercial $18.86
Rate for Payer: Nomi Health Commercial $18.20
Rate for Payer: Priority Health Cigna Priority Health $14.42
Rate for Payer: UHC All Payor (Choice/PPO) + Core $19.53
Service Code HCPCS J2919
Hospital Charge Code 119450
Hospital Revenue Code 636
Min. Negotiated Rate $0.11
Max. Negotiated Rate $22.19
Rate for Payer: Aetna Commercial $19.97
Rate for Payer: Aetna Medicare $0.21
Rate for Payer: Allen County Amish Medical Aid Commercial $0.26
Rate for Payer: Amish Plain Church Group Commercial $0.26
Rate for Payer: ASR ASR $21.52
Rate for Payer: ASR Commercial $21.52
Rate for Payer: BCBS Complete $0.12
Rate for Payer: BCBS MAPPO $0.21
Rate for Payer: BCBS Trust/PPO $18.17
Rate for Payer: BCN Commercial $17.20
Rate for Payer: BCN Medicare Advantage $0.21
Rate for Payer: Cash Price $17.75
Rate for Payer: Cash Price $17.75
Rate for Payer: Cofinity Commercial $20.86
Rate for Payer: Encore Health Key Benefits Commercial $17.75
Rate for Payer: Health Alliance Plan Medicare Advantage $0.21
Rate for Payer: Healthscope Commercial $22.19
Rate for Payer: Healthscope Whirlpool $21.52
Rate for Payer: Humana Choice PPO Medicare $0.21
Rate for Payer: Mclaren Commercial $19.97
Rate for Payer: Mclaren Medicaid $0.11
Rate for Payer: Mclaren Medicare $0.21
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage $0.22
Rate for Payer: Meridian Medicaid $0.12
Rate for Payer: MI Amish Medical Board Commercial $0.24
Rate for Payer: Multiplan/Beech St/PHCS Commercial $18.86
Rate for Payer: Nomi Health Commercial $18.20
Rate for Payer: PACE Medicare $0.20
Rate for Payer: PACE SWMI $0.21
Rate for Payer: PHP Commercial $0.23
Rate for Payer: PHP Medicaid $0.11
Rate for Payer: PHP Medicare Advantage $0.21
Rate for Payer: Priority Health Choice Medicaid $0.11
Rate for Payer: Priority Health Cigna Priority Health $14.42
Rate for Payer: Priority Health HMO/PPO/Tiered Network $19.44
Rate for Payer: Priority Health Medicare $0.21
Rate for Payer: Priority Health Narrow Network $15.56
Rate for Payer: Railroad Medicare Medicare $0.21
Rate for Payer: UHC All Payor (Choice/PPO) + Core $19.53
Rate for Payer: UHC Dual Complete DSNP $0.21
Rate for Payer: UHC Exchange $0.33
Rate for Payer: UHC Medicare Advantage $0.21
Rate for Payer: UHCCP DNSP $0.21
Rate for Payer: UHCCP Medicaid $0.11
Rate for Payer: VA VA $0.21
Service Code NDC 60687063111
Hospital Charge Code 5005
Hospital Revenue Code 637
Min. Negotiated Rate $1.70
Max. Negotiated Rate $2.62
Rate for Payer: Aetna Commercial $2.36
Rate for Payer: ASR ASR $2.54
Rate for Payer: ASR Commercial $2.54
Rate for Payer: BCBS Trust/PPO $2.14
Rate for Payer: BCN Commercial $2.03
Rate for Payer: Cash Price $2.09
Rate for Payer: Cofinity Commercial $2.46
Rate for Payer: Encore Health Key Benefits Commercial $2.10
Rate for Payer: Healthscope Commercial $2.62
Rate for Payer: Healthscope Whirlpool $2.54
Rate for Payer: Mclaren Commercial $2.36
Rate for Payer: Multiplan/Beech St/PHCS Commercial $2.23
Rate for Payer: Nomi Health Commercial $2.15
Rate for Payer: Priority Health Cigna Priority Health $1.70
Rate for Payer: UHC All Payor (Choice/PPO) + Core $2.31
Service Code NDC 60687063111
Hospital Charge Code 5005
Hospital Revenue Code 637
Min. Negotiated Rate $1.05
Max. Negotiated Rate $2.62
Rate for Payer: Aetna Commercial $2.36
Rate for Payer: Aetna Medicare $1.31
Rate for Payer: ASR ASR $2.54
Rate for Payer: ASR Commercial $2.54
Rate for Payer: BCBS Complete $1.05
Rate for Payer: BCBS Trust/PPO $2.15
Rate for Payer: BCN Commercial $2.03
Rate for Payer: Cash Price $2.09
Rate for Payer: Cofinity Commercial $2.46
Rate for Payer: Encore Health Key Benefits Commercial $2.10
Rate for Payer: Healthscope Commercial $2.62
Rate for Payer: Healthscope Whirlpool $2.54
Rate for Payer: Mclaren Commercial $2.36
Rate for Payer: Multiplan/Beech St/PHCS Commercial $2.23
Rate for Payer: Nomi Health Commercial $2.15
Rate for Payer: Priority Health Cigna Priority Health $1.70
Rate for Payer: Priority Health HMO/PPO/Tiered Network $2.30
Rate for Payer: Priority Health Narrow Network $1.84
Rate for Payer: UHC All Payor (Choice/PPO) + Core $2.31
Service Code NDC 68084067611
Hospital Charge Code 5005
Hospital Revenue Code 637
Min. Negotiated Rate $1.00
Max. Negotiated Rate $2.50
Rate for Payer: Aetna Commercial $2.25
Rate for Payer: Aetna Medicare $1.25
Rate for Payer: ASR ASR $2.42
Rate for Payer: ASR Commercial $2.42
Rate for Payer: BCBS Complete $1.00
Rate for Payer: BCBS Trust/PPO $2.05
Rate for Payer: BCN Commercial $1.94
Rate for Payer: Cash Price $2.00
Rate for Payer: Cofinity Commercial $2.35
Rate for Payer: Encore Health Key Benefits Commercial $2.00
Rate for Payer: Healthscope Commercial $2.50
Rate for Payer: Healthscope Whirlpool $2.42
Rate for Payer: Mclaren Commercial $2.25
Rate for Payer: Multiplan/Beech St/PHCS Commercial $2.12
Rate for Payer: Nomi Health Commercial $2.05
Rate for Payer: Priority Health Cigna Priority Health $1.62
Rate for Payer: Priority Health HMO/PPO/Tiered Network $2.19
Rate for Payer: Priority Health Narrow Network $1.75
Rate for Payer: UHC All Payor (Choice/PPO) + Core $2.20
Service Code NDC 68084067601
Hospital Charge Code 5005
Hospital Revenue Code 637
Min. Negotiated Rate $99.84
Max. Negotiated Rate $249.60
Rate for Payer: Aetna Commercial $224.64
Rate for Payer: Aetna Medicare $124.80
Rate for Payer: ASR ASR $242.11
Rate for Payer: ASR Commercial $242.11
Rate for Payer: BCBS Complete $99.84
Rate for Payer: BCBS Trust/PPO $204.40
Rate for Payer: BCN Commercial $193.51
Rate for Payer: Cash Price $199.68
Rate for Payer: Cofinity Commercial $234.62
Rate for Payer: Encore Health Key Benefits Commercial $199.68
Rate for Payer: Healthscope Commercial $249.60
Rate for Payer: Healthscope Whirlpool $242.11
Rate for Payer: Mclaren Commercial $224.64
Rate for Payer: Multiplan/Beech St/PHCS Commercial $212.16
Rate for Payer: Nomi Health Commercial $204.67
Rate for Payer: Priority Health Cigna Priority Health $162.24
Rate for Payer: Priority Health HMO/PPO/Tiered Network $218.70
Rate for Payer: Priority Health Narrow Network $174.97
Rate for Payer: UHC All Payor (Choice/PPO) + Core $219.65
Service Code NDC 68084067601
Hospital Charge Code 5005
Hospital Revenue Code 637
Min. Negotiated Rate $162.24
Max. Negotiated Rate $249.60
Rate for Payer: Aetna Commercial $224.64
Rate for Payer: ASR ASR $242.11
Rate for Payer: ASR Commercial $242.11
Rate for Payer: BCBS Trust/PPO $203.40
Rate for Payer: BCN Commercial $193.51
Rate for Payer: Cash Price $199.68
Rate for Payer: Cofinity Commercial $234.62
Rate for Payer: Encore Health Key Benefits Commercial $199.68
Rate for Payer: Healthscope Commercial $249.60
Rate for Payer: Healthscope Whirlpool $242.11
Rate for Payer: Mclaren Commercial $224.64
Rate for Payer: Multiplan/Beech St/PHCS Commercial $212.16
Rate for Payer: Nomi Health Commercial $204.67
Rate for Payer: Priority Health Cigna Priority Health $162.24
Rate for Payer: UHC All Payor (Choice/PPO) + Core $219.65
Service Code NDC 60687063101
Hospital Charge Code 5005
Hospital Revenue Code 637
Min. Negotiated Rate $104.64
Max. Negotiated Rate $261.60
Rate for Payer: Aetna Commercial $235.44
Rate for Payer: Aetna Medicare $130.80
Rate for Payer: ASR ASR $253.75
Rate for Payer: ASR Commercial $253.75
Rate for Payer: BCBS Complete $104.64
Rate for Payer: BCBS Trust/PPO $214.22
Rate for Payer: BCN Commercial $202.82
Rate for Payer: Cash Price $209.28
Rate for Payer: Cofinity Commercial $245.90
Rate for Payer: Encore Health Key Benefits Commercial $209.28
Rate for Payer: Healthscope Commercial $261.60
Rate for Payer: Healthscope Whirlpool $253.75
Rate for Payer: Mclaren Commercial $235.44
Rate for Payer: Multiplan/Beech St/PHCS Commercial $222.36
Rate for Payer: Nomi Health Commercial $214.51
Rate for Payer: Priority Health Cigna Priority Health $170.04
Rate for Payer: Priority Health HMO/PPO/Tiered Network $229.21
Rate for Payer: Priority Health Narrow Network $183.38
Rate for Payer: UHC All Payor (Choice/PPO) + Core $230.21
Service Code NDC 60687063101
Hospital Charge Code 5005
Hospital Revenue Code 637
Min. Negotiated Rate $170.04
Max. Negotiated Rate $261.60
Rate for Payer: Aetna Commercial $235.44
Rate for Payer: ASR ASR $253.75
Rate for Payer: ASR Commercial $253.75
Rate for Payer: BCBS Trust/PPO $213.18
Rate for Payer: BCN Commercial $202.82
Rate for Payer: Cash Price $209.28
Rate for Payer: Cofinity Commercial $245.90
Rate for Payer: Encore Health Key Benefits Commercial $209.28
Rate for Payer: Healthscope Commercial $261.60
Rate for Payer: Healthscope Whirlpool $253.75
Rate for Payer: Mclaren Commercial $235.44
Rate for Payer: Multiplan/Beech St/PHCS Commercial $222.36
Rate for Payer: Nomi Health Commercial $214.51
Rate for Payer: Priority Health Cigna Priority Health $170.04
Rate for Payer: UHC All Payor (Choice/PPO) + Core $230.21
Service Code NDC 68084067611
Hospital Charge Code 5005
Hospital Revenue Code 637
Min. Negotiated Rate $1.62
Max. Negotiated Rate $2.50
Rate for Payer: Aetna Commercial $2.25
Rate for Payer: ASR ASR $2.42
Rate for Payer: ASR Commercial $2.42
Rate for Payer: BCBS Trust/PPO $2.04
Rate for Payer: BCN Commercial $1.94
Rate for Payer: Cash Price $2.00
Rate for Payer: Cofinity Commercial $2.35
Rate for Payer: Encore Health Key Benefits Commercial $2.00
Rate for Payer: Healthscope Commercial $2.50
Rate for Payer: Healthscope Whirlpool $2.42
Rate for Payer: Mclaren Commercial $2.25
Rate for Payer: Multiplan/Beech St/PHCS Commercial $2.12
Rate for Payer: Nomi Health Commercial $2.05
Rate for Payer: Priority Health Cigna Priority Health $1.62
Rate for Payer: UHC All Payor (Choice/PPO) + Core $2.20
Service Code HCPCS J2765
Hospital Charge Code 5002
Hospital Revenue Code 636
Min. Negotiated Rate $10.87
Max. Negotiated Rate $16.73
Rate for Payer: Aetna Commercial $15.06
Rate for Payer: Aetna Commercial $13.63
Rate for Payer: Aetna Commercial $15.14
Rate for Payer: Aetna Commercial $9.84
Rate for Payer: ASR ASR $10.60
Rate for Payer: ASR ASR $16.23
Rate for Payer: ASR ASR $14.69
Rate for Payer: ASR ASR $16.32
Rate for Payer: ASR Commercial $16.23
Rate for Payer: ASR Commercial $16.32
Rate for Payer: ASR Commercial $14.69
Rate for Payer: ASR Commercial $10.60
Rate for Payer: BCBS Trust/PPO $13.71
Rate for Payer: BCBS Trust/PPO $8.91
Rate for Payer: BCBS Trust/PPO $12.34
Rate for Payer: BCBS Trust/PPO $13.63
Rate for Payer: BCN Commercial $13.04
Rate for Payer: BCN Commercial $8.47
Rate for Payer: BCN Commercial $12.97
Rate for Payer: BCN Commercial $11.74
Rate for Payer: Cash Price $12.11
Rate for Payer: Cash Price $8.75
Rate for Payer: Cash Price $13.46
Rate for Payer: Cash Price $13.39
Rate for Payer: Cofinity Commercial $15.73
Rate for Payer: Cofinity Commercial $14.23
Rate for Payer: Cofinity Commercial $15.81
Rate for Payer: Cofinity Commercial $10.27
Rate for Payer: Encore Health Key Benefits Commercial $13.46
Rate for Payer: Encore Health Key Benefits Commercial $8.74
Rate for Payer: Encore Health Key Benefits Commercial $12.11
Rate for Payer: Encore Health Key Benefits Commercial $13.38
Rate for Payer: Healthscope Commercial $15.14
Rate for Payer: Healthscope Commercial $10.93
Rate for Payer: Healthscope Commercial $16.73
Rate for Payer: Healthscope Commercial $16.82
Rate for Payer: Healthscope Whirlpool $16.32
Rate for Payer: Healthscope Whirlpool $14.69
Rate for Payer: Healthscope Whirlpool $16.23
Rate for Payer: Healthscope Whirlpool $10.60
Rate for Payer: Mclaren Commercial $15.06
Rate for Payer: Mclaren Commercial $15.14
Rate for Payer: Mclaren Commercial $13.63
Rate for Payer: Mclaren Commercial $9.84
Rate for Payer: Multiplan/Beech St/PHCS Commercial $12.87
Rate for Payer: Multiplan/Beech St/PHCS Commercial $14.22
Rate for Payer: Multiplan/Beech St/PHCS Commercial $14.30
Rate for Payer: Multiplan/Beech St/PHCS Commercial $9.29
Rate for Payer: Nomi Health Commercial $8.96
Rate for Payer: Nomi Health Commercial $13.79
Rate for Payer: Nomi Health Commercial $13.72
Rate for Payer: Nomi Health Commercial $12.41
Rate for Payer: Priority Health Cigna Priority Health $7.10
Rate for Payer: Priority Health Cigna Priority Health $9.84
Rate for Payer: Priority Health Cigna Priority Health $10.87
Rate for Payer: Priority Health Cigna Priority Health $10.93
Rate for Payer: UHC All Payor (Choice/PPO) + Core $13.32
Rate for Payer: UHC All Payor (Choice/PPO) + Core $14.80
Rate for Payer: UHC All Payor (Choice/PPO) + Core $14.72
Rate for Payer: UHC All Payor (Choice/PPO) + Core $9.62
Service Code HCPCS J2765
Hospital Charge Code 5002
Hospital Revenue Code 636
Min. Negotiated Rate $6.06
Max. Negotiated Rate $15.14
Rate for Payer: Aetna Commercial $13.63
Rate for Payer: Aetna Commercial $15.14
Rate for Payer: Aetna Commercial $9.84
Rate for Payer: Aetna Commercial $15.06
Rate for Payer: Aetna Medicare $8.41
Rate for Payer: Aetna Medicare $7.57
Rate for Payer: Aetna Medicare $8.37
Rate for Payer: Aetna Medicare $5.46
Rate for Payer: ASR ASR $16.23
Rate for Payer: ASR ASR $10.60
Rate for Payer: ASR ASR $16.32
Rate for Payer: ASR ASR $14.69
Rate for Payer: ASR Commercial $14.69
Rate for Payer: ASR Commercial $16.23
Rate for Payer: ASR Commercial $16.32
Rate for Payer: ASR Commercial $10.60
Rate for Payer: BCBS Complete $4.37
Rate for Payer: BCBS Complete $6.73
Rate for Payer: BCBS Complete $6.69
Rate for Payer: BCBS Complete $6.06
Rate for Payer: BCBS Trust/PPO $12.40
Rate for Payer: BCBS Trust/PPO $13.77
Rate for Payer: BCBS Trust/PPO $8.95
Rate for Payer: BCBS Trust/PPO $13.70
Rate for Payer: BCN Commercial $13.04
Rate for Payer: BCN Commercial $11.74
Rate for Payer: BCN Commercial $8.47
Rate for Payer: BCN Commercial $12.97
Rate for Payer: Cash Price $12.11
Rate for Payer: Cash Price $8.75
Rate for Payer: Cash Price $13.39
Rate for Payer: Cash Price $13.46
Rate for Payer: Cofinity Commercial $10.27
Rate for Payer: Cofinity Commercial $14.23
Rate for Payer: Cofinity Commercial $15.73
Rate for Payer: Cofinity Commercial $15.81
Rate for Payer: Encore Health Key Benefits Commercial $8.74
Rate for Payer: Encore Health Key Benefits Commercial $13.46
Rate for Payer: Encore Health Key Benefits Commercial $13.38
Rate for Payer: Encore Health Key Benefits Commercial $12.11
Rate for Payer: Healthscope Commercial $16.73
Rate for Payer: Healthscope Commercial $10.93
Rate for Payer: Healthscope Commercial $15.14
Rate for Payer: Healthscope Commercial $16.82
Rate for Payer: Healthscope Whirlpool $16.32
Rate for Payer: Healthscope Whirlpool $16.23
Rate for Payer: Healthscope Whirlpool $14.69
Rate for Payer: Healthscope Whirlpool $10.60
Rate for Payer: Mclaren Commercial $9.84
Rate for Payer: Mclaren Commercial $13.63
Rate for Payer: Mclaren Commercial $15.06
Rate for Payer: Mclaren Commercial $15.14
Rate for Payer: Multiplan/Beech St/PHCS Commercial $9.29
Rate for Payer: Multiplan/Beech St/PHCS Commercial $14.30
Rate for Payer: Multiplan/Beech St/PHCS Commercial $12.87
Rate for Payer: Multiplan/Beech St/PHCS Commercial $14.22
Rate for Payer: Nomi Health Commercial $13.72
Rate for Payer: Nomi Health Commercial $12.41
Rate for Payer: Nomi Health Commercial $13.79
Rate for Payer: Nomi Health Commercial $8.96
Rate for Payer: Priority Health Cigna Priority Health $9.84
Rate for Payer: Priority Health Cigna Priority Health $10.87
Rate for Payer: Priority Health Cigna Priority Health $10.93
Rate for Payer: Priority Health Cigna Priority Health $7.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network $14.66
Rate for Payer: Priority Health HMO/PPO/Tiered Network $14.74
Rate for Payer: Priority Health HMO/PPO/Tiered Network $13.27
Rate for Payer: Priority Health HMO/PPO/Tiered Network $9.58
Rate for Payer: Priority Health Narrow Network $11.73
Rate for Payer: Priority Health Narrow Network $10.61
Rate for Payer: Priority Health Narrow Network $11.79
Rate for Payer: Priority Health Narrow Network $7.66
Rate for Payer: UHC All Payor (Choice/PPO) + Core $9.62
Rate for Payer: UHC All Payor (Choice/PPO) + Core $14.72
Rate for Payer: UHC All Payor (Choice/PPO) + Core $14.80
Rate for Payer: UHC All Payor (Choice/PPO) + Core $13.32
Service Code NDC 00185005501
Hospital Charge Code 10588
Hospital Revenue Code 637
Min. Negotiated Rate $120.58
Max. Negotiated Rate $301.44
Rate for Payer: Aetna Commercial $271.30
Rate for Payer: Aetna Medicare $150.72
Rate for Payer: ASR ASR $292.40
Rate for Payer: ASR Commercial $292.40
Rate for Payer: BCBS Complete $120.58
Rate for Payer: BCBS Trust/PPO $246.85
Rate for Payer: BCN Commercial $233.71
Rate for Payer: Cash Price $241.15
Rate for Payer: Cofinity Commercial $283.35
Rate for Payer: Encore Health Key Benefits Commercial $241.15
Rate for Payer: Healthscope Commercial $301.44
Rate for Payer: Healthscope Whirlpool $292.40
Rate for Payer: Mclaren Commercial $271.30
Rate for Payer: Multiplan/Beech St/PHCS Commercial $256.22
Rate for Payer: Nomi Health Commercial $247.18
Rate for Payer: Priority Health Cigna Priority Health $195.94
Rate for Payer: Priority Health HMO/PPO/Tiered Network $264.12
Rate for Payer: Priority Health Narrow Network $211.31
Rate for Payer: UHC All Payor (Choice/PPO) + Core $265.27
Service Code NDC 00185005501
Hospital Charge Code 10588
Hospital Revenue Code 637
Min. Negotiated Rate $195.94
Max. Negotiated Rate $301.44
Rate for Payer: Aetna Commercial $271.30
Rate for Payer: ASR ASR $292.40
Rate for Payer: ASR Commercial $292.40
Rate for Payer: BCBS Trust/PPO $245.64
Rate for Payer: BCN Commercial $233.71
Rate for Payer: Cash Price $241.15
Rate for Payer: Cofinity Commercial $283.35
Rate for Payer: Encore Health Key Benefits Commercial $241.15
Rate for Payer: Healthscope Commercial $301.44
Rate for Payer: Healthscope Whirlpool $292.40
Rate for Payer: Mclaren Commercial $271.30
Rate for Payer: Multiplan/Beech St/PHCS Commercial $256.22
Rate for Payer: Nomi Health Commercial $247.18
Rate for Payer: Priority Health Cigna Priority Health $195.94
Rate for Payer: UHC All Payor (Choice/PPO) + Core $265.27
Service Code NDC 51079002401
Hospital Charge Code 10588
Hospital Revenue Code 637
Min. Negotiated Rate $7.11
Max. Negotiated Rate $10.94
Rate for Payer: Aetna Commercial $9.85
Rate for Payer: ASR ASR $10.61
Rate for Payer: ASR Commercial $10.61
Rate for Payer: BCBS Trust/PPO $8.92
Rate for Payer: BCN Commercial $8.48
Rate for Payer: Cash Price $8.75
Rate for Payer: Cofinity Commercial $10.28
Rate for Payer: Encore Health Key Benefits Commercial $8.75
Rate for Payer: Healthscope Commercial $10.94
Rate for Payer: Healthscope Whirlpool $10.61
Rate for Payer: Mclaren Commercial $9.85
Rate for Payer: Multiplan/Beech St/PHCS Commercial $9.30
Rate for Payer: Nomi Health Commercial $8.97
Rate for Payer: Priority Health Cigna Priority Health $7.11
Rate for Payer: UHC All Payor (Choice/PPO) + Core $9.63
Service Code NDC 51079002401
Hospital Charge Code 10588
Hospital Revenue Code 637
Min. Negotiated Rate $4.38
Max. Negotiated Rate $10.94
Rate for Payer: Aetna Commercial $9.85
Rate for Payer: Aetna Medicare $5.47
Rate for Payer: ASR ASR $10.61
Rate for Payer: ASR Commercial $10.61
Rate for Payer: BCBS Complete $4.38
Rate for Payer: BCBS Trust/PPO $8.96
Rate for Payer: BCN Commercial $8.48
Rate for Payer: Cash Price $8.75
Rate for Payer: Cofinity Commercial $10.28
Rate for Payer: Encore Health Key Benefits Commercial $8.75
Rate for Payer: Healthscope Commercial $10.94
Rate for Payer: Healthscope Whirlpool $10.61
Rate for Payer: Mclaren Commercial $9.85
Rate for Payer: Multiplan/Beech St/PHCS Commercial $9.30
Rate for Payer: Nomi Health Commercial $8.97
Rate for Payer: Priority Health Cigna Priority Health $7.11
Rate for Payer: Priority Health HMO/PPO/Tiered Network $9.59
Rate for Payer: Priority Health Narrow Network $7.67
Rate for Payer: UHC All Payor (Choice/PPO) + Core $9.63
Service Code NDC 50742061510
Hospital Charge Code 29858
Hospital Revenue Code 637
Min. Negotiated Rate $1,558.05
Max. Negotiated Rate $2,397.00
Rate for Payer: Aetna Commercial $2,157.30
Rate for Payer: ASR ASR $2,325.09
Rate for Payer: ASR Commercial $2,325.09
Rate for Payer: BCBS Trust/PPO $1,953.32
Rate for Payer: BCN Commercial $1,858.39
Rate for Payer: Cash Price $1,917.60
Rate for Payer: Cofinity Commercial $2,253.18
Rate for Payer: Encore Health Key Benefits Commercial $1,917.60
Rate for Payer: Healthscope Commercial $2,397.00
Rate for Payer: Healthscope Whirlpool $2,325.09
Rate for Payer: Mclaren Commercial $2,157.30
Rate for Payer: Multiplan/Beech St/PHCS Commercial $2,037.45
Rate for Payer: Nomi Health Commercial $1,965.54
Rate for Payer: Priority Health Cigna Priority Health $1,558.05
Rate for Payer: UHC All Payor (Choice/PPO) + Core $2,109.36
Service Code NDC 70436020201
Hospital Charge Code 29858
Hospital Revenue Code 637
Min. Negotiated Rate $61.10
Max. Negotiated Rate $152.75
Rate for Payer: Aetna Commercial $137.47
Rate for Payer: Aetna Medicare $76.38
Rate for Payer: ASR ASR $148.17
Rate for Payer: ASR Commercial $148.17
Rate for Payer: BCBS Complete $61.10
Rate for Payer: BCBS Trust/PPO $125.09
Rate for Payer: BCN Commercial $118.43
Rate for Payer: Cash Price $122.20
Rate for Payer: Cofinity Commercial $143.59
Rate for Payer: Encore Health Key Benefits Commercial $122.20
Rate for Payer: Healthscope Commercial $152.75
Rate for Payer: Healthscope Whirlpool $148.17
Rate for Payer: Mclaren Commercial $137.47
Rate for Payer: Multiplan/Beech St/PHCS Commercial $129.84
Rate for Payer: Nomi Health Commercial $125.25
Rate for Payer: Priority Health Cigna Priority Health $99.29
Rate for Payer: Priority Health HMO/PPO/Tiered Network $133.84
Rate for Payer: Priority Health Narrow Network $107.08
Rate for Payer: UHC All Payor (Choice/PPO) + Core $134.42
Service Code NDC 00904632261
Hospital Charge Code 29858
Hospital Revenue Code 637
Min. Negotiated Rate $241.44
Max. Negotiated Rate $371.45
Rate for Payer: Aetna Commercial $334.31
Rate for Payer: ASR ASR $360.31
Rate for Payer: ASR Commercial $360.31
Rate for Payer: BCBS Trust/PPO $302.69
Rate for Payer: BCN Commercial $287.99
Rate for Payer: Cash Price $297.16
Rate for Payer: Cofinity Commercial $349.16
Rate for Payer: Encore Health Key Benefits Commercial $297.16
Rate for Payer: Healthscope Commercial $371.45
Rate for Payer: Healthscope Whirlpool $360.31
Rate for Payer: Mclaren Commercial $334.31
Rate for Payer: Multiplan/Beech St/PHCS Commercial $315.73
Rate for Payer: Nomi Health Commercial $304.59
Rate for Payer: Priority Health Cigna Priority Health $241.44
Rate for Payer: UHC All Payor (Choice/PPO) + Core $326.88
Service Code NDC 70436020201
Hospital Charge Code 29858
Hospital Revenue Code 637
Min. Negotiated Rate $99.29
Max. Negotiated Rate $152.75
Rate for Payer: Aetna Commercial $137.47
Rate for Payer: ASR ASR $148.17
Rate for Payer: ASR Commercial $148.17
Rate for Payer: BCBS Trust/PPO $124.48
Rate for Payer: BCN Commercial $118.43
Rate for Payer: Cash Price $122.20
Rate for Payer: Cofinity Commercial $143.59
Rate for Payer: Encore Health Key Benefits Commercial $122.20
Rate for Payer: Healthscope Commercial $152.75
Rate for Payer: Healthscope Whirlpool $148.17
Rate for Payer: Mclaren Commercial $137.47
Rate for Payer: Multiplan/Beech St/PHCS Commercial $129.84
Rate for Payer: Nomi Health Commercial $125.25
Rate for Payer: Priority Health Cigna Priority Health $99.29
Rate for Payer: UHC All Payor (Choice/PPO) + Core $134.42
Service Code NDC 50742061510
Hospital Charge Code 29858
Hospital Revenue Code 637
Min. Negotiated Rate $958.80
Max. Negotiated Rate $2,397.00
Rate for Payer: Aetna Commercial $2,157.30
Rate for Payer: Aetna Medicare $1,198.50
Rate for Payer: ASR ASR $2,325.09
Rate for Payer: ASR Commercial $2,325.09
Rate for Payer: BCBS Complete $958.80
Rate for Payer: BCBS Trust/PPO $1,962.90
Rate for Payer: BCN Commercial $1,858.39
Rate for Payer: Cash Price $1,917.60
Rate for Payer: Cofinity Commercial $2,253.18
Rate for Payer: Encore Health Key Benefits Commercial $1,917.60
Rate for Payer: Healthscope Commercial $2,397.00
Rate for Payer: Healthscope Whirlpool $2,325.09
Rate for Payer: Mclaren Commercial $2,157.30
Rate for Payer: Multiplan/Beech St/PHCS Commercial $2,037.45
Rate for Payer: Nomi Health Commercial $1,965.54
Rate for Payer: Priority Health Cigna Priority Health $1,558.05
Rate for Payer: Priority Health HMO/PPO/Tiered Network $2,100.25
Rate for Payer: Priority Health Narrow Network $1,680.30
Rate for Payer: UHC All Payor (Choice/PPO) + Core $2,109.36
Service Code NDC 00904632261
Hospital Charge Code 29858
Hospital Revenue Code 637
Min. Negotiated Rate $148.58
Max. Negotiated Rate $371.45
Rate for Payer: Aetna Commercial $334.31
Rate for Payer: Aetna Medicare $185.72
Rate for Payer: ASR ASR $360.31
Rate for Payer: ASR Commercial $360.31
Rate for Payer: BCBS Complete $148.58
Rate for Payer: BCBS Trust/PPO $304.18
Rate for Payer: BCN Commercial $287.99
Rate for Payer: Cash Price $297.16
Rate for Payer: Cofinity Commercial $349.16
Rate for Payer: Encore Health Key Benefits Commercial $297.16
Rate for Payer: Healthscope Commercial $371.45
Rate for Payer: Healthscope Whirlpool $360.31
Rate for Payer: Mclaren Commercial $334.31
Rate for Payer: Multiplan/Beech St/PHCS Commercial $315.73
Rate for Payer: Nomi Health Commercial $304.59
Rate for Payer: Priority Health Cigna Priority Health $241.44
Rate for Payer: Priority Health HMO/PPO/Tiered Network $325.46
Rate for Payer: Priority Health Narrow Network $260.39
Rate for Payer: UHC All Payor (Choice/PPO) + Core $326.88
Service Code NDC 51079017020
Hospital Charge Code 30070
Hospital Revenue Code 637
Min. Negotiated Rate $267.38
Max. Negotiated Rate $411.35
Rate for Payer: Aetna Commercial $370.21
Rate for Payer: ASR ASR $399.01
Rate for Payer: ASR Commercial $399.01
Rate for Payer: BCBS Trust/PPO $335.21
Rate for Payer: BCN Commercial $318.92
Rate for Payer: Cash Price $329.08
Rate for Payer: Cofinity Commercial $386.67
Rate for Payer: Encore Health Key Benefits Commercial $329.08
Rate for Payer: Healthscope Commercial $411.35
Rate for Payer: Healthscope Whirlpool $399.01
Rate for Payer: Mclaren Commercial $370.21
Rate for Payer: Multiplan/Beech St/PHCS Commercial $349.65
Rate for Payer: Nomi Health Commercial $337.31
Rate for Payer: Priority Health Cigna Priority Health $267.38
Rate for Payer: UHC All Payor (Choice/PPO) + Core $361.99
Service Code NDC 00904632361
Hospital Charge Code 30070
Hospital Revenue Code 637
Min. Negotiated Rate $148.96
Max. Negotiated Rate $372.40
Rate for Payer: Aetna Commercial $335.16
Rate for Payer: Aetna Medicare $186.20
Rate for Payer: ASR ASR $361.23
Rate for Payer: ASR Commercial $361.23
Rate for Payer: BCBS Complete $148.96
Rate for Payer: BCBS Trust/PPO $304.96
Rate for Payer: BCN Commercial $288.72
Rate for Payer: Cash Price $297.92
Rate for Payer: Cofinity Commercial $350.06
Rate for Payer: Encore Health Key Benefits Commercial $297.92
Rate for Payer: Healthscope Commercial $372.40
Rate for Payer: Healthscope Whirlpool $361.23
Rate for Payer: Mclaren Commercial $335.16
Rate for Payer: Multiplan/Beech St/PHCS Commercial $316.54
Rate for Payer: Nomi Health Commercial $305.37
Rate for Payer: Priority Health Cigna Priority Health $242.06
Rate for Payer: Priority Health HMO/PPO/Tiered Network $326.30
Rate for Payer: Priority Health Narrow Network $261.05
Rate for Payer: UHC All Payor (Choice/PPO) + Core $327.71