|
HC BILL ONLY URINE DRUG SCR MAN
|
Facility
|
OP
|
$44.88
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30000143
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.89 |
| Max. Negotiated Rate |
$44.88 |
| Rate for Payer: Aetna Commercial |
$40.39
|
| Rate for Payer: Aetna Medicare |
$12.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.75
|
| Rate for Payer: ASR ASR |
$43.53
|
| Rate for Payer: BCBS Complete |
$7.24
|
| Rate for Payer: BCBS MAPPO |
$12.60
|
| Rate for Payer: BCBS Trust/PPO |
$34.80
|
| Rate for Payer: BCN Commercial |
$34.80
|
| Rate for Payer: BCN Medicare Advantage |
$12.60
|
| Rate for Payer: Cash Price |
$35.90
|
| Rate for Payer: Cash Price |
$35.90
|
| Rate for Payer: Cofinity Commercial |
$42.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.60
|
| Rate for Payer: Healthscope Commercial |
$44.88
|
| Rate for Payer: Healthscope Whirlpool |
$43.53
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.60
|
| Rate for Payer: Mclaren Commercial |
$40.39
|
| Rate for Payer: Mclaren Medicaid |
$6.89
|
| Rate for Payer: Mclaren Medicare |
$12.60
|
| Rate for Payer: Meridian Medicaid |
$7.24
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$38.15
|
| Rate for Payer: PACE Medicare |
$11.97
|
| Rate for Payer: PACE SWMI |
$12.60
|
| Rate for Payer: PHP Commercial |
$13.86
|
| Rate for Payer: PHP Medicaid |
$6.89
|
| Rate for Payer: PHP Medicare Advantage |
$12.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$40.84
|
| Rate for Payer: Priority Health Medicare |
$12.60
|
| Rate for Payer: Priority Health Narrow Network |
$31.86
|
| Rate for Payer: Railroad Medicare Medicare |
$12.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$39.49
|
| Rate for Payer: UHC Medicare Advantage |
$12.98
|
| Rate for Payer: VA VA |
$12.60
|
|
|
HC BILL ONLY URINE DRUG SCR MAN
|
Facility
|
IP
|
$44.88
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30000143
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$31.42 |
| Max. Negotiated Rate |
$44.88 |
| Rate for Payer: Aetna Commercial |
$40.39
|
| Rate for Payer: ASR ASR |
$43.53
|
| Rate for Payer: BCBS Trust/PPO |
$34.80
|
| Rate for Payer: BCN Commercial |
$34.80
|
| Rate for Payer: Cash Price |
$35.90
|
| Rate for Payer: Cofinity Commercial |
$42.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.90
|
| Rate for Payer: Healthscope Commercial |
$44.88
|
| Rate for Payer: Healthscope Whirlpool |
$43.53
|
| Rate for Payer: Mclaren Commercial |
$40.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$38.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$39.49
|
|
|
HC BINOCULAR MICROSCOPY SEPARATE DX PROCEDURE
|
Facility
|
IP
|
$160.00
|
|
|
Service Code
|
CPT 92504
|
| Hospital Charge Code |
47000003
|
|
Hospital Revenue Code
|
470
|
| Min. Negotiated Rate |
$112.00 |
| Max. Negotiated Rate |
$160.00 |
| Rate for Payer: Aetna Commercial |
$144.00
|
| Rate for Payer: ASR ASR |
$155.20
|
| Rate for Payer: BCBS Trust/PPO |
$124.05
|
| Rate for Payer: BCN Commercial |
$124.05
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cofinity Commercial |
$150.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.00
|
| Rate for Payer: Healthscope Commercial |
$160.00
|
| Rate for Payer: Healthscope Whirlpool |
$155.20
|
| Rate for Payer: Mclaren Commercial |
$144.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$136.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$112.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$140.80
|
|
|
HC BINOCULAR MICROSCOPY SEPARATE DX PROCEDURE
|
Facility
|
OP
|
$160.00
|
|
|
Service Code
|
CPT 92504
|
| Hospital Charge Code |
47000003
|
|
Hospital Revenue Code
|
470
|
| Min. Negotiated Rate |
$64.00 |
| Max. Negotiated Rate |
$160.00 |
| Rate for Payer: Aetna Commercial |
$144.00
|
| Rate for Payer: ASR ASR |
$155.20
|
| Rate for Payer: BCBS Complete |
$64.00
|
| Rate for Payer: BCBS Trust/PPO |
$124.05
|
| Rate for Payer: BCN Commercial |
$124.05
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cofinity Commercial |
$150.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.00
|
| Rate for Payer: Healthscope Commercial |
$160.00
|
| Rate for Payer: Healthscope Whirlpool |
$155.20
|
| Rate for Payer: Mclaren Commercial |
$144.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$136.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$112.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$145.60
|
| Rate for Payer: Priority Health Narrow Network |
$113.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$140.80
|
|
|
HC BIOELECT IMPEDANCE ANALYSIS (BIA) WHOLE BODY
|
Facility
|
IP
|
$31.62
|
|
|
Service Code
|
CPT 0358T
|
| Hospital Charge Code |
92000032
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$22.13 |
| Max. Negotiated Rate |
$31.62 |
| Rate for Payer: Aetna Commercial |
$28.46
|
| Rate for Payer: ASR ASR |
$30.67
|
| Rate for Payer: BCBS Trust/PPO |
$24.51
|
| Rate for Payer: BCN Commercial |
$24.51
|
| Rate for Payer: Cash Price |
$25.30
|
| Rate for Payer: Cofinity Commercial |
$29.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.30
|
| Rate for Payer: Healthscope Commercial |
$31.62
|
| Rate for Payer: Healthscope Whirlpool |
$30.67
|
| Rate for Payer: Mclaren Commercial |
$28.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.83
|
|
|
HC BIOELECT IMPEDANCE ANALYSIS (BIA) WHOLE BODY
|
Facility
|
OP
|
$31.62
|
|
|
Service Code
|
CPT 0358T
|
| Hospital Charge Code |
92000032
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$14.48 |
| Max. Negotiated Rate |
$33.09 |
| Rate for Payer: Aetna Commercial |
$28.46
|
| Rate for Payer: Aetna Medicare |
$26.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.09
|
| Rate for Payer: ASR ASR |
$30.67
|
| Rate for Payer: BCBS Complete |
$15.20
|
| Rate for Payer: BCBS MAPPO |
$26.47
|
| Rate for Payer: BCBS Trust/PPO |
$24.51
|
| Rate for Payer: BCN Commercial |
$24.51
|
| Rate for Payer: BCN Medicare Advantage |
$26.47
|
| Rate for Payer: Cash Price |
$25.30
|
| Rate for Payer: Cash Price |
$25.30
|
| Rate for Payer: Cofinity Commercial |
$29.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.47
|
| Rate for Payer: Healthscope Commercial |
$31.62
|
| Rate for Payer: Healthscope Whirlpool |
$30.67
|
| Rate for Payer: Humana Choice PPO Medicare |
$26.47
|
| Rate for Payer: Mclaren Commercial |
$28.46
|
| Rate for Payer: Mclaren Medicaid |
$14.48
|
| Rate for Payer: Mclaren Medicare |
$26.47
|
| Rate for Payer: Meridian Medicaid |
$15.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$27.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.88
|
| Rate for Payer: PACE Medicare |
$25.15
|
| Rate for Payer: PACE SWMI |
$26.47
|
| Rate for Payer: PHP Commercial |
$29.12
|
| Rate for Payer: PHP Medicaid |
$14.48
|
| Rate for Payer: PHP Medicare Advantage |
$26.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$28.77
|
| Rate for Payer: Priority Health Medicare |
$26.47
|
| Rate for Payer: Priority Health Narrow Network |
$22.45
|
| Rate for Payer: Railroad Medicare Medicare |
$26.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.83
|
| Rate for Payer: UHC Medicare Advantage |
$27.26
|
| Rate for Payer: VA VA |
$26.47
|
|
|
HC BIOPSY ABDOMEN OR RETROPERITONEAL
|
Facility
|
IP
|
$1,653.46
|
|
|
Service Code
|
CPT 49180
|
| Hospital Charge Code |
36100218
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,157.42 |
| Max. Negotiated Rate |
$1,653.46 |
| Rate for Payer: Aetna Commercial |
$1,488.11
|
| Rate for Payer: ASR ASR |
$1,603.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,281.93
|
| Rate for Payer: BCN Commercial |
$1,281.93
|
| Rate for Payer: Cash Price |
$1,322.77
|
| Rate for Payer: Cofinity Commercial |
$1,554.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,322.77
|
| Rate for Payer: Healthscope Commercial |
$1,653.46
|
| Rate for Payer: Healthscope Whirlpool |
$1,603.86
|
| Rate for Payer: Mclaren Commercial |
$1,488.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,405.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,157.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,455.04
|
|
|
HC BIOPSY ABDOMEN OR RETROPERITONEAL
|
Facility
|
OP
|
$1,653.46
|
|
|
Service Code
|
CPT 49180
|
| Hospital Charge Code |
36100218
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$788.30 |
| Max. Negotiated Rate |
$1,801.41 |
| Rate for Payer: Aetna Commercial |
$1,488.11
|
| 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 |
$1,603.86
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,281.93
|
| Rate for Payer: BCN Commercial |
$1,281.93
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$1,322.77
|
| Rate for Payer: Cash Price |
$1,322.77
|
| Rate for Payer: Cofinity Commercial |
$1,554.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,322.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$1,653.46
|
| Rate for Payer: Healthscope Whirlpool |
$1,603.86
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,441.13
|
| Rate for Payer: Mclaren Commercial |
$1,488.11
|
| 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 |
$1,405.44
|
| 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 |
$1,157.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,376.11
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$1,100.89
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,455.04
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: VA VA |
$1,441.13
|
|
|
HC BIOPSY ACCESSION & GROSS
|
Facility
|
IP
|
$8.00
|
|
| Hospital Charge Code |
31000069
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$5.60 |
| Max. Negotiated Rate |
$8.00 |
| Rate for Payer: Aetna Commercial |
$7.20
|
| Rate for Payer: ASR ASR |
$7.76
|
| Rate for Payer: BCBS Trust/PPO |
$6.20
|
| Rate for Payer: BCN Commercial |
$6.20
|
| Rate for Payer: Cash Price |
$6.40
|
| Rate for Payer: Cofinity Commercial |
$7.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.40
|
| Rate for Payer: Healthscope Commercial |
$8.00
|
| Rate for Payer: Healthscope Whirlpool |
$7.76
|
| Rate for Payer: Mclaren Commercial |
$7.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7.04
|
|
|
HC BIOPSY ACCESSION & GROSS
|
Facility
|
OP
|
$8.00
|
|
| Hospital Charge Code |
31000069
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$3.20 |
| Max. Negotiated Rate |
$8.00 |
| Rate for Payer: Aetna Commercial |
$7.20
|
| Rate for Payer: ASR ASR |
$7.76
|
| Rate for Payer: BCBS Complete |
$3.20
|
| Rate for Payer: BCBS Trust/PPO |
$6.20
|
| Rate for Payer: BCN Commercial |
$6.20
|
| Rate for Payer: Cash Price |
$6.40
|
| Rate for Payer: Cofinity Commercial |
$7.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.40
|
| Rate for Payer: Healthscope Commercial |
$8.00
|
| Rate for Payer: Healthscope Whirlpool |
$7.76
|
| Rate for Payer: Mclaren Commercial |
$7.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7.28
|
| Rate for Payer: Priority Health Narrow Network |
$5.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7.04
|
|
|
HC BIOPSY BONE DEEP
|
Facility
|
OP
|
$2,064.25
|
|
|
Service Code
|
CPT 20225
|
| Hospital Charge Code |
36100019
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$788.30 |
| Max. Negotiated Rate |
$2,555.18 |
| Rate for Payer: Aetna Commercial |
$1,857.82
|
| 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 |
$2,002.32
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,600.41
|
| Rate for Payer: BCN Commercial |
$1,600.41
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$1,651.40
|
| Rate for Payer: Cash Price |
$1,651.40
|
| Rate for Payer: Cofinity Commercial |
$1,940.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,651.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$2,064.25
|
| Rate for Payer: Healthscope Whirlpool |
$2,002.32
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,441.13
|
| Rate for Payer: Mclaren Commercial |
$1,857.82
|
| 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 |
$1,754.61
|
| 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 |
$1,444.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,555.18
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$2,044.14
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,816.54
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: VA VA |
$1,441.13
|
|
|
HC BIOPSY BONE DEEP
|
Facility
|
IP
|
$2,064.25
|
|
|
Service Code
|
CPT 20225
|
| Hospital Charge Code |
36100019
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,444.98 |
| Max. Negotiated Rate |
$2,064.25 |
| Rate for Payer: Aetna Commercial |
$1,857.82
|
| Rate for Payer: ASR ASR |
$2,002.32
|
| Rate for Payer: BCBS Trust/PPO |
$1,600.41
|
| Rate for Payer: BCN Commercial |
$1,600.41
|
| Rate for Payer: Cash Price |
$1,651.40
|
| Rate for Payer: Cofinity Commercial |
$1,940.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,651.40
|
| Rate for Payer: Healthscope Commercial |
$2,064.25
|
| Rate for Payer: Healthscope Whirlpool |
$2,002.32
|
| Rate for Payer: Mclaren Commercial |
$1,857.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,754.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,444.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,816.54
|
|
|
HC BIOPSY, BONE, OPEN, DEEP
|
Facility
|
IP
|
$3,547.91
|
|
|
Service Code
|
CPT 20245
|
| Hospital Charge Code |
76100271
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,483.54 |
| Max. Negotiated Rate |
$3,547.91 |
| Rate for Payer: Aetna Commercial |
$3,193.12
|
| Rate for Payer: ASR ASR |
$3,441.47
|
| Rate for Payer: BCBS Trust/PPO |
$2,750.69
|
| Rate for Payer: BCN Commercial |
$2,750.69
|
| Rate for Payer: Cash Price |
$2,838.33
|
| Rate for Payer: Cofinity Commercial |
$3,335.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,838.33
|
| Rate for Payer: Healthscope Commercial |
$3,547.91
|
| Rate for Payer: Healthscope Whirlpool |
$3,441.47
|
| Rate for Payer: Mclaren Commercial |
$3,193.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,015.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,483.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,122.16
|
|
|
HC BIOPSY, BONE, OPEN, DEEP
|
Facility
|
OP
|
$3,547.91
|
|
|
Service Code
|
CPT 20245
|
| Hospital Charge Code |
76100271
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,381.58 |
| Max. Negotiated Rate |
$3,547.91 |
| Rate for Payer: Aetna Commercial |
$3,193.12
|
| Rate for Payer: Aetna Medicare |
$2,525.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,157.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,157.18
|
| Rate for Payer: ASR ASR |
$3,441.47
|
| Rate for Payer: BCBS Complete |
$1,450.79
|
| Rate for Payer: BCBS MAPPO |
$2,525.74
|
| Rate for Payer: BCBS Trust/PPO |
$2,750.69
|
| Rate for Payer: BCN Commercial |
$2,750.69
|
| Rate for Payer: BCN Medicare Advantage |
$2,525.74
|
| Rate for Payer: Cash Price |
$2,838.33
|
| Rate for Payer: Cash Price |
$2,838.33
|
| Rate for Payer: Cofinity Commercial |
$3,335.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,838.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,525.74
|
| Rate for Payer: Healthscope Commercial |
$3,547.91
|
| Rate for Payer: Healthscope Whirlpool |
$3,441.47
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,525.74
|
| Rate for Payer: Mclaren Commercial |
$3,193.12
|
| Rate for Payer: Mclaren Medicaid |
$1,381.58
|
| Rate for Payer: Mclaren Medicare |
$2,525.74
|
| Rate for Payer: Meridian Medicaid |
$1,450.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,652.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,904.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,015.72
|
| Rate for Payer: PACE Medicare |
$2,399.45
|
| Rate for Payer: PACE SWMI |
$2,525.74
|
| Rate for Payer: PHP Commercial |
$2,778.31
|
| Rate for Payer: PHP Medicaid |
$1,381.58
|
| Rate for Payer: PHP Medicare Advantage |
$2,525.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,381.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,483.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,228.60
|
| Rate for Payer: Priority Health Medicare |
$2,525.74
|
| Rate for Payer: Priority Health Narrow Network |
$2,519.02
|
| Rate for Payer: Railroad Medicare Medicare |
$2,525.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,122.16
|
| Rate for Payer: UHC Medicare Advantage |
$2,601.51
|
| Rate for Payer: VA VA |
$2,525.74
|
|
|
HC BIOPSY BONE OPEN; SUPERFICIAL
|
Facility
|
OP
|
$3,075.30
|
|
|
Service Code
|
CPT 20240
|
| Hospital Charge Code |
76100290
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,381.58 |
| Max. Negotiated Rate |
$3,157.18 |
| Rate for Payer: Aetna Commercial |
$2,767.77
|
| Rate for Payer: Aetna Medicare |
$2,525.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,157.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,157.18
|
| Rate for Payer: ASR ASR |
$2,983.04
|
| Rate for Payer: BCBS Complete |
$1,450.79
|
| Rate for Payer: BCBS MAPPO |
$2,525.74
|
| Rate for Payer: BCBS Trust/PPO |
$2,384.28
|
| Rate for Payer: BCN Commercial |
$2,384.28
|
| Rate for Payer: BCN Medicare Advantage |
$2,525.74
|
| Rate for Payer: Cash Price |
$2,460.24
|
| Rate for Payer: Cash Price |
$2,460.24
|
| Rate for Payer: Cofinity Commercial |
$2,890.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,460.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,525.74
|
| Rate for Payer: Healthscope Commercial |
$3,075.30
|
| Rate for Payer: Healthscope Whirlpool |
$2,983.04
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,525.74
|
| Rate for Payer: Mclaren Commercial |
$2,767.77
|
| Rate for Payer: Mclaren Medicaid |
$1,381.58
|
| Rate for Payer: Mclaren Medicare |
$2,525.74
|
| Rate for Payer: Meridian Medicaid |
$1,450.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,652.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,904.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,614.00
|
| Rate for Payer: PACE Medicare |
$2,399.45
|
| Rate for Payer: PACE SWMI |
$2,525.74
|
| Rate for Payer: PHP Commercial |
$2,778.31
|
| Rate for Payer: PHP Medicaid |
$1,381.58
|
| Rate for Payer: PHP Medicare Advantage |
$2,525.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,381.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,152.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,798.52
|
| Rate for Payer: Priority Health Medicare |
$2,525.74
|
| Rate for Payer: Priority Health Narrow Network |
$2,183.46
|
| Rate for Payer: Railroad Medicare Medicare |
$2,525.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,706.26
|
| Rate for Payer: UHC Medicare Advantage |
$2,601.51
|
| Rate for Payer: VA VA |
$2,525.74
|
|
|
HC BIOPSY BONE OPEN; SUPERFICIAL
|
Facility
|
IP
|
$3,075.30
|
|
|
Service Code
|
CPT 20240
|
| Hospital Charge Code |
76100290
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,152.71 |
| Max. Negotiated Rate |
$3,075.30 |
| Rate for Payer: Aetna Commercial |
$2,767.77
|
| Rate for Payer: ASR ASR |
$2,983.04
|
| Rate for Payer: BCBS Trust/PPO |
$2,384.28
|
| Rate for Payer: BCN Commercial |
$2,384.28
|
| Rate for Payer: Cash Price |
$2,460.24
|
| Rate for Payer: Cofinity Commercial |
$2,890.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,460.24
|
| Rate for Payer: Healthscope Commercial |
$3,075.30
|
| Rate for Payer: Healthscope Whirlpool |
$2,983.04
|
| Rate for Payer: Mclaren Commercial |
$2,767.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,614.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,152.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,706.26
|
|
|
HC BIOPSY BONE SUPERFICIAL
|
Facility
|
IP
|
$2,012.98
|
|
|
Service Code
|
CPT 20220
|
| Hospital Charge Code |
36100018
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,409.09 |
| Max. Negotiated Rate |
$2,012.98 |
| Rate for Payer: Aetna Commercial |
$1,811.68
|
| Rate for Payer: ASR ASR |
$1,952.59
|
| Rate for Payer: BCBS Trust/PPO |
$1,560.66
|
| Rate for Payer: BCN Commercial |
$1,560.66
|
| Rate for Payer: Cash Price |
$1,610.38
|
| Rate for Payer: Cofinity Commercial |
$1,892.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,610.38
|
| Rate for Payer: Healthscope Commercial |
$2,012.98
|
| Rate for Payer: Healthscope Whirlpool |
$1,952.59
|
| Rate for Payer: Mclaren Commercial |
$1,811.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,711.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,409.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,771.42
|
|
|
HC BIOPSY BONE SUPERFICIAL
|
Facility
|
OP
|
$2,012.98
|
|
|
Service Code
|
CPT 20220
|
| Hospital Charge Code |
36100018
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$788.30 |
| Max. Negotiated Rate |
$2,012.98 |
| Rate for Payer: Aetna Commercial |
$1,811.68
|
| 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 |
$1,952.59
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,560.66
|
| Rate for Payer: BCN Commercial |
$1,560.66
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$1,610.38
|
| Rate for Payer: Cash Price |
$1,610.38
|
| Rate for Payer: Cofinity Commercial |
$1,892.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,610.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$2,012.98
|
| Rate for Payer: Healthscope Whirlpool |
$1,952.59
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,441.13
|
| Rate for Payer: Mclaren Commercial |
$1,811.68
|
| 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 |
$1,711.03
|
| 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 |
$1,409.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,200.63
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$960.50
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,771.42
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: VA VA |
$1,441.13
|
|
|
HC BIOPSY CERVIX
|
Facility
|
IP
|
$663.00
|
|
|
Service Code
|
CPT 57500
|
| Hospital Charge Code |
76100070
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$464.10 |
| Max. Negotiated Rate |
$663.00 |
| Rate for Payer: Aetna Commercial |
$596.70
|
| Rate for Payer: ASR ASR |
$643.11
|
| Rate for Payer: BCBS Trust/PPO |
$514.02
|
| Rate for Payer: BCN Commercial |
$514.02
|
| Rate for Payer: Cash Price |
$530.40
|
| Rate for Payer: Cofinity Commercial |
$623.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$530.40
|
| Rate for Payer: Healthscope Commercial |
$663.00
|
| Rate for Payer: Healthscope Whirlpool |
$643.11
|
| Rate for Payer: Mclaren Commercial |
$596.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$563.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$464.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$583.44
|
|
|
HC BIOPSY CERVIX
|
Facility
|
OP
|
$663.00
|
|
|
Service Code
|
CPT 57500
|
| Hospital Charge Code |
76100070
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$390.88 |
| Max. Negotiated Rate |
$893.22 |
| Rate for Payer: Aetna Commercial |
$596.70
|
| Rate for Payer: Aetna Medicare |
$714.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$893.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$893.22
|
| Rate for Payer: ASR ASR |
$643.11
|
| Rate for Payer: BCBS Complete |
$410.45
|
| Rate for Payer: BCBS MAPPO |
$714.58
|
| Rate for Payer: BCBS Trust/PPO |
$514.02
|
| Rate for Payer: BCN Commercial |
$514.02
|
| Rate for Payer: BCN Medicare Advantage |
$714.58
|
| Rate for Payer: Cash Price |
$530.40
|
| Rate for Payer: Cash Price |
$530.40
|
| Rate for Payer: Cofinity Commercial |
$623.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$530.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$714.58
|
| Rate for Payer: Healthscope Commercial |
$663.00
|
| Rate for Payer: Healthscope Whirlpool |
$643.11
|
| Rate for Payer: Humana Choice PPO Medicare |
$714.58
|
| Rate for Payer: Mclaren Commercial |
$596.70
|
| Rate for Payer: Mclaren Medicaid |
$390.88
|
| Rate for Payer: Mclaren Medicare |
$714.58
|
| Rate for Payer: Meridian Medicaid |
$410.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$750.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$821.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$563.55
|
| Rate for Payer: PACE Medicare |
$678.85
|
| Rate for Payer: PACE SWMI |
$714.58
|
| Rate for Payer: PHP Commercial |
$786.04
|
| Rate for Payer: PHP Medicaid |
$390.88
|
| Rate for Payer: PHP Medicare Advantage |
$714.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$390.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$464.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$603.33
|
| Rate for Payer: Priority Health Medicare |
$714.58
|
| Rate for Payer: Priority Health Narrow Network |
$470.73
|
| Rate for Payer: Railroad Medicare Medicare |
$714.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$583.44
|
| Rate for Payer: UHC Medicare Advantage |
$736.02
|
| Rate for Payer: VA VA |
$714.58
|
|
|
HC BIOPSY EXTERNAL AUDITORY CANAL
|
Facility
|
IP
|
$3,937.00
|
|
|
Service Code
|
CPT 69105
|
| Hospital Charge Code |
76100480
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,755.90 |
| Max. Negotiated Rate |
$3,937.00 |
| Rate for Payer: Aetna Commercial |
$3,543.30
|
| Rate for Payer: ASR ASR |
$3,818.89
|
| Rate for Payer: BCBS Trust/PPO |
$3,052.36
|
| Rate for Payer: BCN Commercial |
$3,052.36
|
| Rate for Payer: Cash Price |
$3,149.60
|
| Rate for Payer: Cofinity Commercial |
$3,700.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,149.60
|
| Rate for Payer: Healthscope Commercial |
$3,937.00
|
| Rate for Payer: Healthscope Whirlpool |
$3,818.89
|
| Rate for Payer: Mclaren Commercial |
$3,543.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,346.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,755.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,464.56
|
|
|
HC BIOPSY EXTERNAL AUDITORY CANAL
|
Facility
|
OP
|
$3,937.00
|
|
|
Service Code
|
CPT 69105
|
| Hospital Charge Code |
76100480
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$741.50 |
| Max. Negotiated Rate |
$3,937.00 |
| Rate for Payer: Aetna Commercial |
$3,543.30
|
| Rate for Payer: Aetna Medicare |
$1,355.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,694.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,694.48
|
| Rate for Payer: ASR ASR |
$3,818.89
|
| Rate for Payer: BCBS Complete |
$778.65
|
| Rate for Payer: BCBS MAPPO |
$1,355.58
|
| Rate for Payer: BCBS Trust/PPO |
$3,052.36
|
| Rate for Payer: BCN Commercial |
$3,052.36
|
| Rate for Payer: BCN Medicare Advantage |
$1,355.58
|
| Rate for Payer: Cash Price |
$3,149.60
|
| Rate for Payer: Cash Price |
$3,149.60
|
| Rate for Payer: Cofinity Commercial |
$3,700.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,149.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,355.58
|
| Rate for Payer: Healthscope Commercial |
$3,937.00
|
| Rate for Payer: Healthscope Whirlpool |
$3,818.89
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,355.58
|
| Rate for Payer: Mclaren Commercial |
$3,543.30
|
| Rate for Payer: Mclaren Medicaid |
$741.50
|
| Rate for Payer: Mclaren Medicare |
$1,355.58
|
| Rate for Payer: Meridian Medicaid |
$778.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,423.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,558.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,346.45
|
| Rate for Payer: PACE Medicare |
$1,287.80
|
| Rate for Payer: PACE SWMI |
$1,355.58
|
| Rate for Payer: PHP Commercial |
$1,491.14
|
| Rate for Payer: PHP Medicaid |
$741.50
|
| Rate for Payer: PHP Medicare Advantage |
$1,355.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$741.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,755.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,582.67
|
| Rate for Payer: Priority Health Medicare |
$1,355.58
|
| Rate for Payer: Priority Health Narrow Network |
$2,795.27
|
| Rate for Payer: Railroad Medicare Medicare |
$1,355.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,464.56
|
| Rate for Payer: UHC Medicare Advantage |
$1,396.25
|
| Rate for Payer: VA VA |
$1,355.58
|
|
|
HC BIOPSY EXTERNAL EAR
|
Facility
|
IP
|
$383.03
|
|
|
Service Code
|
CPT 69100
|
| Hospital Charge Code |
36100522
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$268.12 |
| Max. Negotiated Rate |
$383.03 |
| Rate for Payer: Aetna Commercial |
$344.73
|
| Rate for Payer: ASR ASR |
$371.54
|
| Rate for Payer: BCBS Trust/PPO |
$296.96
|
| Rate for Payer: BCN Commercial |
$296.96
|
| Rate for Payer: Cash Price |
$306.42
|
| Rate for Payer: Cofinity Commercial |
$360.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$306.42
|
| Rate for Payer: Healthscope Commercial |
$383.03
|
| Rate for Payer: Healthscope Whirlpool |
$371.54
|
| Rate for Payer: Mclaren Commercial |
$344.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$325.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$268.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$337.07
|
|
|
HC BIOPSY EXTERNAL EAR
|
Facility
|
OP
|
$383.03
|
|
|
Service Code
|
CPT 69100
|
| Hospital Charge Code |
36100522
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$118.76 |
| Max. Negotiated Rate |
$663.71 |
| Rate for Payer: Aetna Commercial |
$344.73
|
| Rate for Payer: Aetna Medicare |
$217.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$271.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$271.40
|
| Rate for Payer: ASR ASR |
$371.54
|
| Rate for Payer: BCBS Complete |
$124.71
|
| Rate for Payer: BCBS MAPPO |
$217.12
|
| Rate for Payer: BCBS Trust/PPO |
$296.96
|
| Rate for Payer: BCN Commercial |
$296.96
|
| Rate for Payer: BCN Medicare Advantage |
$217.12
|
| Rate for Payer: Cash Price |
$306.42
|
| Rate for Payer: Cash Price |
$306.42
|
| Rate for Payer: Cofinity Commercial |
$360.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$306.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.12
|
| Rate for Payer: Healthscope Commercial |
$383.03
|
| Rate for Payer: Healthscope Whirlpool |
$371.54
|
| Rate for Payer: Humana Choice PPO Medicare |
$217.12
|
| Rate for Payer: Mclaren Commercial |
$344.73
|
| Rate for Payer: Mclaren Medicaid |
$118.76
|
| Rate for Payer: Mclaren Medicare |
$217.12
|
| Rate for Payer: Meridian Medicaid |
$124.71
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$227.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$249.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$325.58
|
| Rate for Payer: PACE Medicare |
$206.26
|
| Rate for Payer: PACE SWMI |
$217.12
|
| Rate for Payer: PHP Commercial |
$238.83
|
| Rate for Payer: PHP Medicaid |
$118.76
|
| Rate for Payer: PHP Medicare Advantage |
$217.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$118.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$268.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$663.71
|
| Rate for Payer: Priority Health Medicare |
$217.12
|
| Rate for Payer: Priority Health Narrow Network |
$530.97
|
| Rate for Payer: Railroad Medicare Medicare |
$217.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$337.07
|
| Rate for Payer: UHC Medicare Advantage |
$223.63
|
| Rate for Payer: VA VA |
$217.12
|
|
|
HC BIOPSY FLOOR MOUTH
|
Facility
|
IP
|
$4,100.00
|
|
|
Service Code
|
CPT 41108
|
| Hospital Charge Code |
76100464
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,870.00 |
| Max. Negotiated Rate |
$4,100.00 |
| Rate for Payer: Aetna Commercial |
$3,690.00
|
| Rate for Payer: ASR ASR |
$3,977.00
|
| Rate for Payer: BCBS Trust/PPO |
$3,178.73
|
| Rate for Payer: BCN Commercial |
$3,178.73
|
| Rate for Payer: Cash Price |
$3,280.00
|
| Rate for Payer: Cofinity Commercial |
$3,854.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,280.00
|
| Rate for Payer: Healthscope Commercial |
$4,100.00
|
| Rate for Payer: Healthscope Whirlpool |
$3,977.00
|
| Rate for Payer: Mclaren Commercial |
$3,690.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,485.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,870.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,608.00
|
|
