|
HC BETA 2 GP1 AB IGA
|
Facility
|
IP
|
$35.70
|
|
|
Service Code
|
CPT 86146
|
| Hospital Charge Code |
30200143
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$24.99 |
| Max. Negotiated Rate |
$35.70 |
| Rate for Payer: Aetna Commercial |
$32.13
|
| Rate for Payer: ASR ASR |
$34.63
|
| Rate for Payer: BCBS Trust/PPO |
$27.68
|
| Rate for Payer: BCN Commercial |
$27.68
|
| Rate for Payer: Cash Price |
$28.56
|
| Rate for Payer: Cofinity Commercial |
$33.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.56
|
| Rate for Payer: Healthscope Commercial |
$35.70
|
| Rate for Payer: Healthscope Whirlpool |
$34.63
|
| Rate for Payer: Mclaren Commercial |
$32.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$30.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$31.42
|
|
|
HC BETA 2 GP1 AB IGA
|
Facility
|
OP
|
$35.70
|
|
|
Service Code
|
CPT 86146
|
| Hospital Charge Code |
30200143
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.92 |
| Max. Negotiated Rate |
$35.70 |
| Rate for Payer: Aetna Commercial |
$32.13
|
| Rate for Payer: Aetna Medicare |
$25.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.81
|
| Rate for Payer: ASR ASR |
$34.63
|
| Rate for Payer: BCBS Complete |
$14.62
|
| Rate for Payer: BCBS MAPPO |
$25.45
|
| Rate for Payer: BCBS Trust/PPO |
$27.68
|
| Rate for Payer: BCN Commercial |
$27.68
|
| Rate for Payer: BCN Medicare Advantage |
$25.45
|
| Rate for Payer: Cash Price |
$28.56
|
| Rate for Payer: Cash Price |
$28.56
|
| Rate for Payer: Cofinity Commercial |
$33.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.45
|
| Rate for Payer: Healthscope Commercial |
$35.70
|
| Rate for Payer: Healthscope Whirlpool |
$34.63
|
| Rate for Payer: Humana Choice PPO Medicare |
$25.45
|
| Rate for Payer: Mclaren Commercial |
$32.13
|
| Rate for Payer: Mclaren Medicaid |
$13.92
|
| Rate for Payer: Mclaren Medicare |
$25.45
|
| Rate for Payer: Meridian Medicaid |
$14.62
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$26.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$30.34
|
| Rate for Payer: PACE Medicare |
$24.18
|
| Rate for Payer: PACE SWMI |
$25.45
|
| Rate for Payer: PHP Commercial |
$28.00
|
| Rate for Payer: PHP Medicaid |
$13.92
|
| Rate for Payer: PHP Medicare Advantage |
$25.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$32.49
|
| Rate for Payer: Priority Health Medicare |
$25.45
|
| Rate for Payer: Priority Health Narrow Network |
$25.35
|
| Rate for Payer: Railroad Medicare Medicare |
$25.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$31.42
|
| Rate for Payer: UHC Medicare Advantage |
$26.21
|
| Rate for Payer: VA VA |
$25.45
|
|
|
HC BETA 2 GP1 AB IGG
|
Facility
|
IP
|
$42.35
|
|
|
Service Code
|
CPT 86146
|
| Hospital Charge Code |
30200142
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$29.64 |
| Max. Negotiated Rate |
$42.35 |
| Rate for Payer: Aetna Commercial |
$38.12
|
| Rate for Payer: ASR ASR |
$41.08
|
| Rate for Payer: BCBS Trust/PPO |
$32.83
|
| Rate for Payer: BCN Commercial |
$32.83
|
| Rate for Payer: Cash Price |
$33.88
|
| Rate for Payer: Cofinity Commercial |
$39.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.88
|
| Rate for Payer: Healthscope Commercial |
$42.35
|
| Rate for Payer: Healthscope Whirlpool |
$41.08
|
| Rate for Payer: Mclaren Commercial |
$38.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$36.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.27
|
|
|
HC BETA 2 GP1 AB IGG
|
Facility
|
OP
|
$42.35
|
|
|
Service Code
|
CPT 86146
|
| Hospital Charge Code |
30200142
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.92 |
| Max. Negotiated Rate |
$42.35 |
| Rate for Payer: Aetna Commercial |
$38.12
|
| Rate for Payer: Aetna Medicare |
$25.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.81
|
| Rate for Payer: ASR ASR |
$41.08
|
| Rate for Payer: BCBS Complete |
$14.62
|
| Rate for Payer: BCBS MAPPO |
$25.45
|
| Rate for Payer: BCBS Trust/PPO |
$32.83
|
| Rate for Payer: BCN Commercial |
$32.83
|
| Rate for Payer: BCN Medicare Advantage |
$25.45
|
| Rate for Payer: Cash Price |
$33.88
|
| Rate for Payer: Cash Price |
$33.88
|
| Rate for Payer: Cofinity Commercial |
$39.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.45
|
| Rate for Payer: Healthscope Commercial |
$42.35
|
| Rate for Payer: Healthscope Whirlpool |
$41.08
|
| Rate for Payer: Humana Choice PPO Medicare |
$25.45
|
| Rate for Payer: Mclaren Commercial |
$38.12
|
| Rate for Payer: Mclaren Medicaid |
$13.92
|
| Rate for Payer: Mclaren Medicare |
$25.45
|
| Rate for Payer: Meridian Medicaid |
$14.62
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$26.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$36.00
|
| Rate for Payer: PACE Medicare |
$24.18
|
| Rate for Payer: PACE SWMI |
$25.45
|
| Rate for Payer: PHP Commercial |
$28.00
|
| Rate for Payer: PHP Medicaid |
$13.92
|
| Rate for Payer: PHP Medicare Advantage |
$25.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$38.54
|
| Rate for Payer: Priority Health Medicare |
$25.45
|
| Rate for Payer: Priority Health Narrow Network |
$30.07
|
| Rate for Payer: Railroad Medicare Medicare |
$25.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.27
|
| Rate for Payer: UHC Medicare Advantage |
$26.21
|
| Rate for Payer: VA VA |
$25.45
|
|
|
HC BETA 2 GP1 AB IGM
|
Facility
|
OP
|
$50.39
|
|
|
Service Code
|
CPT 86146
|
| Hospital Charge Code |
30200141
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.92 |
| Max. Negotiated Rate |
$50.39 |
| Rate for Payer: Aetna Commercial |
$45.35
|
| Rate for Payer: Aetna Medicare |
$25.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.81
|
| Rate for Payer: ASR ASR |
$48.88
|
| Rate for Payer: BCBS Complete |
$14.62
|
| Rate for Payer: BCBS MAPPO |
$25.45
|
| Rate for Payer: BCBS Trust/PPO |
$39.07
|
| Rate for Payer: BCN Commercial |
$39.07
|
| Rate for Payer: BCN Medicare Advantage |
$25.45
|
| Rate for Payer: Cash Price |
$40.31
|
| Rate for Payer: Cash Price |
$40.31
|
| Rate for Payer: Cofinity Commercial |
$47.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.45
|
| Rate for Payer: Healthscope Commercial |
$50.39
|
| Rate for Payer: Healthscope Whirlpool |
$48.88
|
| Rate for Payer: Humana Choice PPO Medicare |
$25.45
|
| Rate for Payer: Mclaren Commercial |
$45.35
|
| Rate for Payer: Mclaren Medicaid |
$13.92
|
| Rate for Payer: Mclaren Medicare |
$25.45
|
| Rate for Payer: Meridian Medicaid |
$14.62
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$26.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.83
|
| Rate for Payer: PACE Medicare |
$24.18
|
| Rate for Payer: PACE SWMI |
$25.45
|
| Rate for Payer: PHP Commercial |
$28.00
|
| Rate for Payer: PHP Medicaid |
$13.92
|
| Rate for Payer: PHP Medicare Advantage |
$25.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45.85
|
| Rate for Payer: Priority Health Medicare |
$25.45
|
| Rate for Payer: Priority Health Narrow Network |
$35.78
|
| Rate for Payer: Railroad Medicare Medicare |
$25.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.34
|
| Rate for Payer: UHC Medicare Advantage |
$26.21
|
| Rate for Payer: VA VA |
$25.45
|
|
|
HC BETA 2 GP1 AB IGM
|
Facility
|
IP
|
$50.39
|
|
|
Service Code
|
CPT 86146
|
| Hospital Charge Code |
30200141
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$35.27 |
| Max. Negotiated Rate |
$50.39 |
| Rate for Payer: Aetna Commercial |
$45.35
|
| Rate for Payer: ASR ASR |
$48.88
|
| Rate for Payer: BCBS Trust/PPO |
$39.07
|
| Rate for Payer: BCN Commercial |
$39.07
|
| Rate for Payer: Cash Price |
$40.31
|
| Rate for Payer: Cofinity Commercial |
$47.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.31
|
| Rate for Payer: Healthscope Commercial |
$50.39
|
| Rate for Payer: Healthscope Whirlpool |
$48.88
|
| Rate for Payer: Mclaren Commercial |
$45.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.34
|
|
|
HC BETA-2 MICROGLOBULIN
|
Facility
|
IP
|
$41.82
|
|
|
Service Code
|
CPT 82232
|
| Hospital Charge Code |
30100115
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$29.27 |
| Max. Negotiated Rate |
$41.82 |
| Rate for Payer: Aetna Commercial |
$37.64
|
| Rate for Payer: ASR ASR |
$40.57
|
| Rate for Payer: BCBS Trust/PPO |
$32.42
|
| 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 Multiplan/Beech St/PHCS |
$35.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$36.80
|
|
|
HC BETA-2 MICROGLOBULIN
|
Facility
|
OP
|
$41.82
|
|
|
Service Code
|
CPT 82232
|
| Hospital Charge Code |
30100115
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.85 |
| Max. Negotiated Rate |
$47.21 |
| Rate for Payer: Aetna Commercial |
$37.64
|
| Rate for Payer: Aetna Medicare |
$16.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.22
|
| Rate for Payer: ASR ASR |
$40.57
|
| Rate for Payer: BCBS Complete |
$9.29
|
| Rate for Payer: BCBS MAPPO |
$16.18
|
| Rate for Payer: BCBS Trust/PPO |
$32.42
|
| Rate for Payer: BCN Commercial |
$32.42
|
| Rate for Payer: BCN Medicare Advantage |
$16.18
|
| Rate for Payer: Cash Price |
$33.46
|
| 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: Health Alliance Plan Medicare Advantage |
$16.18
|
| Rate for Payer: Healthscope Commercial |
$41.82
|
| Rate for Payer: Healthscope Whirlpool |
$40.57
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.18
|
| Rate for Payer: Mclaren Commercial |
$37.64
|
| Rate for Payer: Mclaren Medicaid |
$8.85
|
| Rate for Payer: Mclaren Medicare |
$16.18
|
| Rate for Payer: Meridian Medicaid |
$9.29
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$35.55
|
| Rate for Payer: PACE Medicare |
$15.37
|
| Rate for Payer: PACE SWMI |
$16.18
|
| Rate for Payer: PHP Commercial |
$17.80
|
| Rate for Payer: PHP Medicaid |
$8.85
|
| Rate for Payer: PHP Medicare Advantage |
$16.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$47.21
|
| Rate for Payer: Priority Health Medicare |
$16.18
|
| Rate for Payer: Priority Health Narrow Network |
$37.77
|
| Rate for Payer: Railroad Medicare Medicare |
$16.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$36.80
|
| Rate for Payer: UHC Medicare Advantage |
$16.67
|
| Rate for Payer: VA VA |
$16.18
|
|
|
HC BETA HYDROXY BUTYRATE KETONE
|
Facility
|
OP
|
$27.85
|
|
|
Service Code
|
CPT 82010
|
| Hospital Charge Code |
30100068
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.47 |
| Max. Negotiated Rate |
$27.85 |
| Rate for Payer: Aetna Commercial |
$25.06
|
| Rate for Payer: Aetna Medicare |
$8.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.21
|
| Rate for Payer: ASR ASR |
$27.01
|
| Rate for Payer: BCBS Complete |
$4.69
|
| Rate for Payer: BCBS MAPPO |
$8.17
|
| Rate for Payer: BCBS Trust/PPO |
$21.59
|
| Rate for Payer: BCN Commercial |
$21.59
|
| Rate for Payer: BCN Medicare Advantage |
$8.17
|
| Rate for Payer: Cash Price |
$22.28
|
| Rate for Payer: Cash Price |
$22.28
|
| Rate for Payer: Cofinity Commercial |
$26.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.17
|
| Rate for Payer: Healthscope Commercial |
$27.85
|
| Rate for Payer: Healthscope Whirlpool |
$27.01
|
| Rate for Payer: Humana Choice PPO Medicare |
$8.17
|
| Rate for Payer: Mclaren Commercial |
$25.06
|
| Rate for Payer: Mclaren Medicaid |
$4.47
|
| Rate for Payer: Mclaren Medicare |
$8.17
|
| Rate for Payer: Meridian Medicaid |
$4.69
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$23.67
|
| Rate for Payer: PACE Medicare |
$7.76
|
| Rate for Payer: PACE SWMI |
$8.17
|
| Rate for Payer: PHP Commercial |
$8.99
|
| Rate for Payer: PHP Medicaid |
$4.47
|
| Rate for Payer: PHP Medicare Advantage |
$8.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$23.09
|
| Rate for Payer: Priority Health Medicare |
$8.17
|
| Rate for Payer: Priority Health Narrow Network |
$18.47
|
| Rate for Payer: Railroad Medicare Medicare |
$8.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$24.51
|
| Rate for Payer: UHC Medicare Advantage |
$8.42
|
| Rate for Payer: VA VA |
$8.17
|
|
|
HC BETA HYDROXY BUTYRATE KETONE
|
Facility
|
IP
|
$27.85
|
|
|
Service Code
|
CPT 82010
|
| Hospital Charge Code |
30100068
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.50 |
| Max. Negotiated Rate |
$27.85 |
| Rate for Payer: Aetna Commercial |
$25.06
|
| Rate for Payer: ASR ASR |
$27.01
|
| Rate for Payer: BCBS Trust/PPO |
$21.59
|
| Rate for Payer: BCN Commercial |
$21.59
|
| Rate for Payer: Cash Price |
$22.28
|
| Rate for Payer: Cofinity Commercial |
$26.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.28
|
| Rate for Payer: Healthscope Commercial |
$27.85
|
| Rate for Payer: Healthscope Whirlpool |
$27.01
|
| Rate for Payer: Mclaren Commercial |
$25.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$23.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$24.51
|
|
|
HC BILATERAL INJECT CARPAL TUNNEL
|
Facility
|
IP
|
$600.76
|
|
|
Service Code
|
CPT 20526
|
| Hospital Charge Code |
76100242
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$420.53 |
| Max. Negotiated Rate |
$600.76 |
| Rate for Payer: Aetna Commercial |
$540.68
|
| Rate for Payer: ASR ASR |
$582.74
|
| Rate for Payer: BCBS Trust/PPO |
$465.77
|
| Rate for Payer: BCN Commercial |
$465.77
|
| Rate for Payer: Cash Price |
$480.61
|
| Rate for Payer: Cofinity Commercial |
$564.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$480.61
|
| Rate for Payer: Healthscope Commercial |
$600.76
|
| Rate for Payer: Healthscope Whirlpool |
$582.74
|
| Rate for Payer: Mclaren Commercial |
$540.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$510.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$420.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$528.67
|
|
|
HC BILATERAL INJECT CARPAL TUNNEL
|
Facility
|
OP
|
$600.76
|
|
|
Service Code
|
CPT 20526
|
| Hospital Charge Code |
76100242
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$144.01 |
| Max. Negotiated Rate |
$600.76 |
| Rate for Payer: Aetna Commercial |
$540.68
|
| Rate for Payer: Aetna Medicare |
$263.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$329.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$329.09
|
| Rate for Payer: ASR ASR |
$582.74
|
| Rate for Payer: BCBS Complete |
$151.22
|
| Rate for Payer: BCBS MAPPO |
$263.27
|
| Rate for Payer: BCBS Trust/PPO |
$465.77
|
| Rate for Payer: BCN Commercial |
$465.77
|
| Rate for Payer: BCN Medicare Advantage |
$263.27
|
| Rate for Payer: Cash Price |
$480.61
|
| Rate for Payer: Cash Price |
$480.61
|
| Rate for Payer: Cofinity Commercial |
$564.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$480.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$263.27
|
| Rate for Payer: Healthscope Commercial |
$600.76
|
| Rate for Payer: Healthscope Whirlpool |
$582.74
|
| Rate for Payer: Humana Choice PPO Medicare |
$263.27
|
| Rate for Payer: Mclaren Commercial |
$540.68
|
| Rate for Payer: Mclaren Medicaid |
$144.01
|
| Rate for Payer: Mclaren Medicare |
$263.27
|
| Rate for Payer: Meridian Medicaid |
$151.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$276.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$302.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$510.65
|
| Rate for Payer: PACE Medicare |
$250.11
|
| Rate for Payer: PACE SWMI |
$263.27
|
| Rate for Payer: PHP Commercial |
$289.60
|
| Rate for Payer: PHP Medicaid |
$144.01
|
| Rate for Payer: PHP Medicare Advantage |
$263.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$144.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$420.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$546.69
|
| Rate for Payer: Priority Health Medicare |
$263.27
|
| Rate for Payer: Priority Health Narrow Network |
$426.54
|
| Rate for Payer: Railroad Medicare Medicare |
$263.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$528.67
|
| Rate for Payer: UHC Medicare Advantage |
$271.17
|
| Rate for Payer: VA VA |
$263.27
|
|
|
HC BILATERAL MULTILAYER COMP DSG BK
|
Facility
|
OP
|
$724.00
|
|
|
Service Code
|
CPT 29581
|
| Hospital Charge Code |
76100048
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$76.61 |
| Max. Negotiated Rate |
$724.00 |
| Rate for Payer: Aetna Commercial |
$651.60
|
| Rate for Payer: Aetna Medicare |
$140.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$175.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$175.08
|
| Rate for Payer: ASR ASR |
$702.28
|
| Rate for Payer: BCBS Complete |
$80.45
|
| Rate for Payer: BCBS MAPPO |
$140.06
|
| Rate for Payer: BCBS Trust/PPO |
$561.32
|
| Rate for Payer: BCN Commercial |
$561.32
|
| Rate for Payer: BCN Medicare Advantage |
$140.06
|
| Rate for Payer: Cash Price |
$579.20
|
| Rate for Payer: Cash Price |
$579.20
|
| Rate for Payer: Cofinity Commercial |
$680.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$579.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.06
|
| Rate for Payer: Healthscope Commercial |
$724.00
|
| Rate for Payer: Healthscope Whirlpool |
$702.28
|
| Rate for Payer: Humana Choice PPO Medicare |
$140.06
|
| Rate for Payer: Mclaren Commercial |
$651.60
|
| Rate for Payer: Mclaren Medicaid |
$76.61
|
| Rate for Payer: Mclaren Medicare |
$140.06
|
| Rate for Payer: Meridian Medicaid |
$80.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$147.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$161.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$615.40
|
| Rate for Payer: PACE Medicare |
$133.06
|
| Rate for Payer: PACE SWMI |
$140.06
|
| Rate for Payer: PHP Commercial |
$154.07
|
| Rate for Payer: PHP Medicaid |
$76.61
|
| Rate for Payer: PHP Medicare Advantage |
$140.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$506.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$658.84
|
| Rate for Payer: Priority Health Medicare |
$140.06
|
| Rate for Payer: Priority Health Narrow Network |
$514.04
|
| Rate for Payer: Railroad Medicare Medicare |
$140.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$637.12
|
| Rate for Payer: UHC Medicare Advantage |
$144.26
|
| Rate for Payer: VA VA |
$140.06
|
|
|
HC BILATERAL MULTILAYER COMP DSG BK
|
Facility
|
IP
|
$724.00
|
|
|
Service Code
|
CPT 29581
|
| Hospital Charge Code |
76100048
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$506.80 |
| Max. Negotiated Rate |
$724.00 |
| Rate for Payer: Aetna Commercial |
$651.60
|
| Rate for Payer: ASR ASR |
$702.28
|
| Rate for Payer: BCBS Trust/PPO |
$561.32
|
| Rate for Payer: BCN Commercial |
$561.32
|
| Rate for Payer: Cash Price |
$579.20
|
| Rate for Payer: Cofinity Commercial |
$680.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$579.20
|
| Rate for Payer: Healthscope Commercial |
$724.00
|
| Rate for Payer: Healthscope Whirlpool |
$702.28
|
| Rate for Payer: Mclaren Commercial |
$651.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$615.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$506.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$637.12
|
|
|
HC BILATERAL TOMOSYNTHESIS
|
Facility
|
IP
|
$106.25
|
|
|
Service Code
|
CPT 77062
|
| Hospital Charge Code |
32000300
|
|
Hospital Revenue Code
|
401
|
| Min. Negotiated Rate |
$74.38 |
| Max. Negotiated Rate |
$106.25 |
| Rate for Payer: Aetna Commercial |
$95.62
|
| Rate for Payer: ASR ASR |
$103.06
|
| Rate for Payer: BCBS Trust/PPO |
$82.38
|
| Rate for Payer: BCN Commercial |
$82.38
|
| Rate for Payer: Cash Price |
$85.00
|
| Rate for Payer: Cofinity Commercial |
$99.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.00
|
| Rate for Payer: Healthscope Commercial |
$106.25
|
| Rate for Payer: Healthscope Whirlpool |
$103.06
|
| Rate for Payer: Mclaren Commercial |
$95.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$90.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$93.50
|
|
|
HC BILATERAL TOMOSYNTHESIS
|
Facility
|
OP
|
$106.25
|
|
|
Service Code
|
CPT 77062
|
| Hospital Charge Code |
32000300
|
|
Hospital Revenue Code
|
401
|
| Min. Negotiated Rate |
$42.50 |
| Max. Negotiated Rate |
$106.25 |
| Rate for Payer: Aetna Commercial |
$95.62
|
| Rate for Payer: ASR ASR |
$103.06
|
| Rate for Payer: BCBS Complete |
$42.50
|
| Rate for Payer: BCBS Trust/PPO |
$82.38
|
| Rate for Payer: BCN Commercial |
$82.38
|
| Rate for Payer: Cash Price |
$85.00
|
| Rate for Payer: Cofinity Commercial |
$99.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.00
|
| Rate for Payer: Healthscope Commercial |
$106.25
|
| Rate for Payer: Healthscope Whirlpool |
$103.06
|
| Rate for Payer: Mclaren Commercial |
$95.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$90.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$96.69
|
| Rate for Payer: Priority Health Narrow Network |
$75.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$93.50
|
|
|
HC BILATERAL UNNA BOOT
|
Facility
|
OP
|
$448.00
|
|
|
Service Code
|
CPT 29580
|
| Hospital Charge Code |
76100047
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$76.61 |
| Max. Negotiated Rate |
$448.00 |
| Rate for Payer: Aetna Commercial |
$403.20
|
| Rate for Payer: Aetna Medicare |
$140.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$175.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$175.08
|
| Rate for Payer: ASR ASR |
$434.56
|
| Rate for Payer: BCBS Complete |
$80.45
|
| Rate for Payer: BCBS MAPPO |
$140.06
|
| Rate for Payer: BCBS Trust/PPO |
$347.33
|
| Rate for Payer: BCN Commercial |
$347.33
|
| Rate for Payer: BCN Medicare Advantage |
$140.06
|
| Rate for Payer: Cash Price |
$358.40
|
| Rate for Payer: Cash Price |
$358.40
|
| Rate for Payer: Cofinity Commercial |
$421.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$358.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.06
|
| Rate for Payer: Healthscope Commercial |
$448.00
|
| Rate for Payer: Healthscope Whirlpool |
$434.56
|
| Rate for Payer: Humana Choice PPO Medicare |
$140.06
|
| Rate for Payer: Mclaren Commercial |
$403.20
|
| Rate for Payer: Mclaren Medicaid |
$76.61
|
| Rate for Payer: Mclaren Medicare |
$140.06
|
| Rate for Payer: Meridian Medicaid |
$80.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$147.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$161.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$380.80
|
| Rate for Payer: PACE Medicare |
$133.06
|
| Rate for Payer: PACE SWMI |
$140.06
|
| Rate for Payer: PHP Commercial |
$154.07
|
| Rate for Payer: PHP Medicaid |
$76.61
|
| Rate for Payer: PHP Medicare Advantage |
$140.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$313.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$158.03
|
| Rate for Payer: Priority Health Medicare |
$140.06
|
| Rate for Payer: Priority Health Narrow Network |
$126.42
|
| Rate for Payer: Railroad Medicare Medicare |
$140.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$394.24
|
| Rate for Payer: UHC Medicare Advantage |
$144.26
|
| Rate for Payer: VA VA |
$140.06
|
|
|
HC BILATERAL UNNA BOOT
|
Facility
|
IP
|
$448.00
|
|
|
Service Code
|
CPT 29580
|
| Hospital Charge Code |
76100047
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$313.60 |
| Max. Negotiated Rate |
$448.00 |
| Rate for Payer: Aetna Commercial |
$403.20
|
| Rate for Payer: ASR ASR |
$434.56
|
| Rate for Payer: BCBS Trust/PPO |
$347.33
|
| Rate for Payer: BCN Commercial |
$347.33
|
| Rate for Payer: Cash Price |
$358.40
|
| Rate for Payer: Cofinity Commercial |
$421.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$358.40
|
| Rate for Payer: Healthscope Commercial |
$448.00
|
| Rate for Payer: Healthscope Whirlpool |
$434.56
|
| Rate for Payer: Mclaren Commercial |
$403.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$380.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$313.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$394.24
|
|
|
HC BILAT PERC IMPLANT NEUROSTIM ELTRD,SACRAL NERVE W/IMAG
|
Facility
|
OP
|
$14,199.46
|
|
|
Service Code
|
CPT 64561
|
| Hospital Charge Code |
76100261
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,325.31 |
| Max. Negotiated Rate |
$14,199.46 |
| Rate for Payer: Aetna Commercial |
$12,779.51
|
| Rate for Payer: Aetna Medicare |
$6,079.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,598.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,598.96
|
| Rate for Payer: ASR ASR |
$13,773.48
|
| Rate for Payer: BCBS Complete |
$3,491.88
|
| Rate for Payer: BCBS MAPPO |
$6,079.17
|
| Rate for Payer: BCBS Trust/PPO |
$11,008.84
|
| Rate for Payer: BCN Commercial |
$11,008.84
|
| Rate for Payer: BCN Medicare Advantage |
$6,079.17
|
| Rate for Payer: Cash Price |
$11,359.57
|
| Rate for Payer: Cash Price |
$11,359.57
|
| Rate for Payer: Cofinity Commercial |
$13,347.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,359.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,079.17
|
| Rate for Payer: Healthscope Commercial |
$14,199.46
|
| Rate for Payer: Healthscope Whirlpool |
$13,773.48
|
| Rate for Payer: Humana Choice PPO Medicare |
$6,079.17
|
| Rate for Payer: Mclaren Commercial |
$12,779.51
|
| Rate for Payer: Mclaren Medicaid |
$3,325.31
|
| Rate for Payer: Mclaren Medicare |
$6,079.17
|
| Rate for Payer: Meridian Medicaid |
$3,491.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6,383.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,991.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$12,069.54
|
| Rate for Payer: PACE Medicare |
$5,775.21
|
| Rate for Payer: PACE SWMI |
$6,079.17
|
| Rate for Payer: PHP Commercial |
$6,687.09
|
| Rate for Payer: PHP Medicaid |
$3,325.31
|
| Rate for Payer: PHP Medicare Advantage |
$6,079.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,325.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,939.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12,921.51
|
| Rate for Payer: Priority Health Medicare |
$6,079.17
|
| Rate for Payer: Priority Health Narrow Network |
$10,081.62
|
| Rate for Payer: Railroad Medicare Medicare |
$6,079.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12,495.52
|
| Rate for Payer: UHC Medicare Advantage |
$6,261.55
|
| Rate for Payer: VA VA |
$6,079.17
|
|
|
HC BILAT PERC IMPLANT NEUROSTIM ELTRD,SACRAL NERVE W/IMAG
|
Facility
|
IP
|
$14,199.46
|
|
|
Service Code
|
CPT 64561
|
| Hospital Charge Code |
76100261
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$9,939.62 |
| Max. Negotiated Rate |
$14,199.46 |
| Rate for Payer: Aetna Commercial |
$12,779.51
|
| Rate for Payer: ASR ASR |
$13,773.48
|
| Rate for Payer: BCBS Trust/PPO |
$11,008.84
|
| Rate for Payer: BCN Commercial |
$11,008.84
|
| Rate for Payer: Cash Price |
$11,359.57
|
| Rate for Payer: Cofinity Commercial |
$13,347.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,359.57
|
| Rate for Payer: Healthscope Commercial |
$14,199.46
|
| Rate for Payer: Healthscope Whirlpool |
$13,773.48
|
| Rate for Payer: Mclaren Commercial |
$12,779.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$12,069.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,939.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12,495.52
|
|
|
HC BIL COMPLEX MULTILAYER COMP DSG
|
Facility
|
IP
|
$890.00
|
|
|
Service Code
|
CPT 29581
|
| Hospital Charge Code |
76100072
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$623.00 |
| Max. Negotiated Rate |
$890.00 |
| Rate for Payer: Aetna Commercial |
$801.00
|
| Rate for Payer: ASR ASR |
$863.30
|
| Rate for Payer: BCBS Trust/PPO |
$690.02
|
| Rate for Payer: BCN Commercial |
$690.02
|
| Rate for Payer: Cash Price |
$712.00
|
| Rate for Payer: Cofinity Commercial |
$836.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$712.00
|
| Rate for Payer: Healthscope Commercial |
$890.00
|
| Rate for Payer: Healthscope Whirlpool |
$863.30
|
| Rate for Payer: Mclaren Commercial |
$801.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$756.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$623.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$783.20
|
|
|
HC BIL COMPLEX MULTILAYER COMP DSG
|
Facility
|
OP
|
$890.00
|
|
|
Service Code
|
CPT 29581
|
| Hospital Charge Code |
76100072
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$76.61 |
| Max. Negotiated Rate |
$890.00 |
| Rate for Payer: Aetna Commercial |
$801.00
|
| Rate for Payer: Aetna Medicare |
$140.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$175.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$175.08
|
| Rate for Payer: ASR ASR |
$863.30
|
| Rate for Payer: BCBS Complete |
$80.45
|
| Rate for Payer: BCBS MAPPO |
$140.06
|
| Rate for Payer: BCBS Trust/PPO |
$690.02
|
| Rate for Payer: BCN Commercial |
$690.02
|
| Rate for Payer: BCN Medicare Advantage |
$140.06
|
| Rate for Payer: Cash Price |
$712.00
|
| Rate for Payer: Cash Price |
$712.00
|
| Rate for Payer: Cofinity Commercial |
$836.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$712.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.06
|
| Rate for Payer: Healthscope Commercial |
$890.00
|
| Rate for Payer: Healthscope Whirlpool |
$863.30
|
| Rate for Payer: Humana Choice PPO Medicare |
$140.06
|
| Rate for Payer: Mclaren Commercial |
$801.00
|
| Rate for Payer: Mclaren Medicaid |
$76.61
|
| Rate for Payer: Mclaren Medicare |
$140.06
|
| Rate for Payer: Meridian Medicaid |
$80.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$147.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$161.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$756.50
|
| Rate for Payer: PACE Medicare |
$133.06
|
| Rate for Payer: PACE SWMI |
$140.06
|
| Rate for Payer: PHP Commercial |
$154.07
|
| Rate for Payer: PHP Medicaid |
$76.61
|
| Rate for Payer: PHP Medicare Advantage |
$140.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$623.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$809.90
|
| Rate for Payer: Priority Health Medicare |
$140.06
|
| Rate for Payer: Priority Health Narrow Network |
$631.90
|
| Rate for Payer: Railroad Medicare Medicare |
$140.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$783.20
|
| Rate for Payer: UHC Medicare Advantage |
$144.26
|
| Rate for Payer: VA VA |
$140.06
|
|
|
HC BIL DIAG BONE MARROW ASP
|
Facility
|
IP
|
$3,187.50
|
|
|
Service Code
|
CPT 38220
|
| Hospital Charge Code |
76100292
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,231.25 |
| Max. Negotiated Rate |
$3,187.50 |
| Rate for Payer: Aetna Commercial |
$2,868.75
|
| Rate for Payer: ASR ASR |
$3,091.88
|
| Rate for Payer: BCBS Trust/PPO |
$2,471.27
|
| Rate for Payer: BCN Commercial |
$2,471.27
|
| Rate for Payer: Cash Price |
$2,550.00
|
| Rate for Payer: Cofinity Commercial |
$2,996.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,550.00
|
| Rate for Payer: Healthscope Commercial |
$3,187.50
|
| Rate for Payer: Healthscope Whirlpool |
$3,091.88
|
| Rate for Payer: Mclaren Commercial |
$2,868.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,709.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,231.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,805.00
|
|
|
HC BIL DIAG BONE MARROW ASP
|
Facility
|
OP
|
$3,187.50
|
|
|
Service Code
|
CPT 38220
|
| Hospital Charge Code |
76100292
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$788.30 |
| Max. Negotiated Rate |
$3,187.50 |
| Rate for Payer: Aetna Commercial |
$2,868.75
|
| Rate for Payer: Aetna Medicare |
$1,441.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,801.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,801.41
|
| Rate for Payer: ASR ASR |
$3,091.88
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$2,471.27
|
| Rate for Payer: BCN Commercial |
$2,471.27
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$2,550.00
|
| Rate for Payer: Cash Price |
$2,550.00
|
| Rate for Payer: Cofinity Commercial |
$2,996.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,550.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$3,187.50
|
| Rate for Payer: Healthscope Whirlpool |
$3,091.88
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,441.13
|
| Rate for Payer: Mclaren Commercial |
$2,868.75
|
| Rate for Payer: Mclaren Medicaid |
$788.30
|
| Rate for Payer: Mclaren Medicare |
$1,441.13
|
| Rate for Payer: Meridian Medicaid |
$827.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,513.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,657.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,709.38
|
| Rate for Payer: PACE Medicare |
$1,369.07
|
| Rate for Payer: PACE SWMI |
$1,441.13
|
| Rate for Payer: PHP Commercial |
$1,585.24
|
| Rate for Payer: PHP Medicaid |
$788.30
|
| Rate for Payer: PHP Medicare Advantage |
$1,441.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$788.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,231.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,900.62
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$2,263.12
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,805.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: VA VA |
$1,441.13
|
|
|
HC BIL DIAG BONE MARROW ASP AND BX
|
Facility
|
IP
|
$3,035.52
|
|
|
Service Code
|
CPT 38222
|
| Hospital Charge Code |
76100294
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,124.86 |
| Max. Negotiated Rate |
$3,035.52 |
| Rate for Payer: Aetna Commercial |
$2,731.97
|
| Rate for Payer: ASR ASR |
$2,944.45
|
| Rate for Payer: BCBS Trust/PPO |
$2,353.44
|
| Rate for Payer: BCN Commercial |
$2,353.44
|
| Rate for Payer: Cash Price |
$2,428.42
|
| Rate for Payer: Cofinity Commercial |
$2,853.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,428.42
|
| Rate for Payer: Healthscope Commercial |
$3,035.52
|
| Rate for Payer: Healthscope Whirlpool |
$2,944.45
|
| Rate for Payer: Mclaren Commercial |
$2,731.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,580.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,124.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,671.26
|
|
