|
APRA7-12
|
Facility
|
OP
|
$3.26
|
|
| Hospital Charge Code |
3102657
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.28 |
| Max. Negotiated Rate |
$2.77 |
| Rate for Payer: Cash Price |
$2.12
|
| Rate for Payer: Community Health Alliance Commercial |
$2.77
|
| Rate for Payer: Priority Health Commercial |
$2.28
|
| Rate for Payer: Priority Health PPO |
$2.28
|
|
|
APRA7-13
|
Facility
|
OP
|
$3.26
|
|
| Hospital Charge Code |
3102658
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.28 |
| Max. Negotiated Rate |
$2.77 |
| Rate for Payer: Cash Price |
$2.12
|
| Rate for Payer: Community Health Alliance Commercial |
$2.77
|
| Rate for Payer: Priority Health Commercial |
$2.28
|
| Rate for Payer: Priority Health PPO |
$2.28
|
|
|
APRA7-14
|
Facility
|
OP
|
$3.26
|
|
| Hospital Charge Code |
3102659
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.28 |
| Max. Negotiated Rate |
$2.77 |
| Rate for Payer: Cash Price |
$2.12
|
| Rate for Payer: Community Health Alliance Commercial |
$2.77
|
| Rate for Payer: Priority Health Commercial |
$2.28
|
| Rate for Payer: Priority Health PPO |
$2.28
|
|
|
APRA7-15
|
Facility
|
OP
|
$3.26
|
|
| Hospital Charge Code |
3102660
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.28 |
| Max. Negotiated Rate |
$2.77 |
| Rate for Payer: Cash Price |
$2.12
|
| Rate for Payer: Community Health Alliance Commercial |
$2.77
|
| Rate for Payer: Priority Health Commercial |
$2.28
|
| Rate for Payer: Priority Health PPO |
$2.28
|
|
|
APRA7-16
|
Facility
|
OP
|
$3.26
|
|
| Hospital Charge Code |
3102661
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.28 |
| Max. Negotiated Rate |
$2.77 |
| Rate for Payer: Cash Price |
$2.12
|
| Rate for Payer: Community Health Alliance Commercial |
$2.77
|
| Rate for Payer: Priority Health Commercial |
$2.28
|
| Rate for Payer: Priority Health PPO |
$2.28
|
|
|
APRA7-17
|
Facility
|
OP
|
$3.26
|
|
| Hospital Charge Code |
3102662
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.28 |
| Max. Negotiated Rate |
$2.77 |
| Rate for Payer: Cash Price |
$2.12
|
| Rate for Payer: Community Health Alliance Commercial |
$2.77
|
| Rate for Payer: Priority Health Commercial |
$2.28
|
| Rate for Payer: Priority Health PPO |
$2.28
|
|
|
APRA7-18
|
Facility
|
OP
|
$3.26
|
|
| Hospital Charge Code |
3102663
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.28 |
| Max. Negotiated Rate |
$2.77 |
| Rate for Payer: Cash Price |
$2.12
|
| Rate for Payer: Community Health Alliance Commercial |
$2.77
|
| Rate for Payer: Priority Health Commercial |
$2.28
|
| Rate for Payer: Priority Health PPO |
$2.28
|
|
|
APRA7-19
|
Facility
|
OP
|
$3.26
|
|
| Hospital Charge Code |
3102664
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.28 |
| Max. Negotiated Rate |
$2.77 |
| Rate for Payer: Cash Price |
$2.12
|
| Rate for Payer: Community Health Alliance Commercial |
$2.77
|
| Rate for Payer: Priority Health Commercial |
$2.28
|
| Rate for Payer: Priority Health PPO |
$2.28
|
|
|
APRA7-2
|
Facility
|
OP
|
$3.26
|
|
| Hospital Charge Code |
3102647
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.28 |
| Max. Negotiated Rate |
$2.77 |
| Rate for Payer: Cash Price |
$2.12
|
| Rate for Payer: Community Health Alliance Commercial |
$2.77
|
| Rate for Payer: Priority Health Commercial |
$2.28
|
| Rate for Payer: Priority Health PPO |
$2.28
|
|
|
APRA7-20
|
Facility
|
OP
|
$3.26
|
|
| Hospital Charge Code |
3102665
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.28 |
| Max. Negotiated Rate |
$2.77 |
| Rate for Payer: Cash Price |
$2.12
|
| Rate for Payer: Community Health Alliance Commercial |
$2.77
|
| Rate for Payer: Priority Health Commercial |
$2.28
|
| Rate for Payer: Priority Health PPO |
$2.28
|
|
|
APRA7-21
|
Facility
|
OP
|
$3.26
|
|
| Hospital Charge Code |
3102666
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.28 |
| Max. Negotiated Rate |
$2.77 |
| Rate for Payer: Cash Price |
$2.12
|
| Rate for Payer: Community Health Alliance Commercial |
$2.77
|
| Rate for Payer: Priority Health Commercial |
$2.28
|
| Rate for Payer: Priority Health PPO |
$2.28
|
|
|
APRA7-22
|
Facility
|
OP
|
$3.26
|
|
| Hospital Charge Code |
3102667
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.28 |
| Max. Negotiated Rate |
$2.77 |
| Rate for Payer: Cash Price |
$2.12
|
| Rate for Payer: Community Health Alliance Commercial |
$2.77
|
| Rate for Payer: Priority Health Commercial |
$2.28
|
| Rate for Payer: Priority Health PPO |
$2.28
|
|
|
APRA7-23
|
Facility
|
OP
|
$3.26
|
|
| Hospital Charge Code |
3102668
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.28 |
| Max. Negotiated Rate |
$2.77 |
| Rate for Payer: Cash Price |
$2.12
|
| Rate for Payer: Community Health Alliance Commercial |
$2.77
|
| Rate for Payer: Priority Health Commercial |
$2.28
|
| Rate for Payer: Priority Health PPO |
$2.28
|
|
|
APRA7-24
|
Facility
|
OP
|
$3.26
|
|
| Hospital Charge Code |
3102669
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.28 |
| Max. Negotiated Rate |
$2.77 |
| Rate for Payer: Cash Price |
$2.12
|
| Rate for Payer: Community Health Alliance Commercial |
$2.77
|
| Rate for Payer: Priority Health Commercial |
$2.28
|
| Rate for Payer: Priority Health PPO |
$2.28
|
|
|
APRA7-3
|
Facility
|
OP
|
$3.26
|
|
| Hospital Charge Code |
3102648
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.28 |
| Max. Negotiated Rate |
$2.77 |
| Rate for Payer: Cash Price |
$2.12
|
| Rate for Payer: Community Health Alliance Commercial |
$2.77
|
| Rate for Payer: Priority Health Commercial |
$2.28
|
| Rate for Payer: Priority Health PPO |
$2.28
|
|
|
APRA7-4
|
Facility
|
OP
|
$3.26
|
|
| Hospital Charge Code |
3102649
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.28 |
| Max. Negotiated Rate |
$2.77 |
| Rate for Payer: Cash Price |
$2.12
|
| Rate for Payer: Community Health Alliance Commercial |
$2.77
|
| Rate for Payer: Priority Health Commercial |
$2.28
|
| Rate for Payer: Priority Health PPO |
$2.28
|
|
|
APRA7-5
|
Facility
|
OP
|
$3.26
|
|
| Hospital Charge Code |
3102650
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.28 |
| Max. Negotiated Rate |
$2.77 |
| Rate for Payer: Cash Price |
$2.12
|
| Rate for Payer: Community Health Alliance Commercial |
$2.77
|
| Rate for Payer: Priority Health Commercial |
$2.28
|
| Rate for Payer: Priority Health PPO |
$2.28
|
|
|
APRA7-6
|
Facility
|
OP
|
$3.26
|
|
| Hospital Charge Code |
3102651
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.28 |
| Max. Negotiated Rate |
$2.77 |
| Rate for Payer: Cash Price |
$2.12
|
| Rate for Payer: Community Health Alliance Commercial |
$2.77
|
| Rate for Payer: Priority Health Commercial |
$2.28
|
| Rate for Payer: Priority Health PPO |
$2.28
|
|
|
APRA7-7
|
Facility
|
OP
|
$3.26
|
|
| Hospital Charge Code |
3102652
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.28 |
| Max. Negotiated Rate |
$2.77 |
| Rate for Payer: Cash Price |
$2.12
|
| Rate for Payer: Community Health Alliance Commercial |
$2.77
|
| Rate for Payer: Priority Health Commercial |
$2.28
|
| Rate for Payer: Priority Health PPO |
$2.28
|
|
|
APRA7-8
|
Facility
|
OP
|
$3.26
|
|
| Hospital Charge Code |
3102653
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.28 |
| Max. Negotiated Rate |
$2.77 |
| Rate for Payer: Cash Price |
$2.12
|
| Rate for Payer: Community Health Alliance Commercial |
$2.77
|
| Rate for Payer: Priority Health Commercial |
$2.28
|
| Rate for Payer: Priority Health PPO |
$2.28
|
|
|
APRA7-9
|
Facility
|
OP
|
$3.26
|
|
| Hospital Charge Code |
3102654
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.28 |
| Max. Negotiated Rate |
$2.77 |
| Rate for Payer: Cash Price |
$2.12
|
| Rate for Payer: Community Health Alliance Commercial |
$2.77
|
| Rate for Payer: Priority Health Commercial |
$2.28
|
| Rate for Payer: Priority Health PPO |
$2.28
|
|
|
APT DOWNEY TEST
|
Facility
|
OP
|
$97.00
|
|
| Hospital Charge Code |
3006927
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$67.90 |
| Max. Negotiated Rate |
$82.45 |
| Rate for Payer: Cash Price |
$63.05
|
| Rate for Payer: Community Health Alliance Commercial |
$82.45
|
| Rate for Payer: Priority Health Commercial |
$67.90
|
| Rate for Payer: Priority Health PPO |
$67.90
|
|
|
AQUA-2
|
Facility
|
OP
|
$187.50
|
|
| Hospital Charge Code |
3102355
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$131.25 |
| Max. Negotiated Rate |
$159.38 |
| Rate for Payer: Cash Price |
$121.88
|
| Rate for Payer: Community Health Alliance Commercial |
$159.38
|
| Rate for Payer: Priority Health Commercial |
$131.25
|
| Rate for Payer: Priority Health PPO |
$131.25
|
|
|
AQUAPORIN-4 RECEPTOR AB IgGIFA
|
Facility
|
OP
|
$300.00
|
|
| Hospital Charge Code |
3101324
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$210.00 |
| Max. Negotiated Rate |
$255.00 |
| Rate for Payer: Cash Price |
$195.00
|
| Rate for Payer: Community Health Alliance Commercial |
$255.00
|
| Rate for Payer: Priority Health Commercial |
$210.00
|
| Rate for Payer: Priority Health PPO |
$210.00
|
|
|
AQUATIC THERAPY EA 15 MINS
|
Facility
|
OP
|
$103.00
|
|
| Hospital Charge Code |
4200093
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$72.10 |
| Max. Negotiated Rate |
$87.55 |
| Rate for Payer: Cash Price |
$66.95
|
| Rate for Payer: Community Health Alliance Commercial |
$87.55
|
| Rate for Payer: Priority Health Commercial |
$72.10
|
| Rate for Payer: Priority Health PPO |
$72.10
|
|