|
HC ARTHROCENTESIS INTERMED JT BIL
|
Facility
|
OP
|
$429.05
|
|
|
Service Code
|
CPT 20605
|
| Hospital Charge Code |
36100025
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$36.02 |
| Max. Negotiated Rate |
$813.49 |
| Rate for Payer: Aetna Commercial |
$364.69
|
| Rate for Payer: Aetna Medicare |
$274.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$278.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$329.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$329.42
|
| Rate for Payer: BCBS Complete |
$151.38
|
| Rate for Payer: BCBS MAPPO |
$263.54
|
| Rate for Payer: BCBS Trust/PPO |
$169.96
|
| Rate for Payer: BCN Medicare Advantage |
$263.54
|
| Rate for Payer: Cash Price |
$343.24
|
| Rate for Payer: Cash Price |
$343.24
|
| Rate for Payer: Cofinity Commercial |
$368.98
|
| Rate for Payer: Cofinity Commercial |
$300.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$263.54
|
| Rate for Payer: Healthscope Commercial |
$386.14
|
| Rate for Payer: Mclaren Medicaid |
$144.16
|
| Rate for Payer: Mclaren Medicare |
$263.54
|
| Rate for Payer: Meridian Medicaid |
$151.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$276.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$303.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$364.69
|
| Rate for Payer: PACE Medicare |
$250.36
|
| Rate for Payer: PACE SWMI |
$263.54
|
| Rate for Payer: PHP Commercial |
$364.69
|
| Rate for Payer: PHP Medicare Advantage |
$263.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$144.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$300.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$813.49
|
| Rate for Payer: Priority Health Medicare |
$263.54
|
| Rate for Payer: Priority Health Narrow Network |
$650.79
|
| Rate for Payer: Priority Health SBD |
$270.30
|
| Rate for Payer: Railroad Medicare Medicare |
$263.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$263.54
|
| Rate for Payer: UHC Exchange |
$36.02
|
| Rate for Payer: UHC Medicare Advantage |
$271.45
|
| Rate for Payer: VA VA |
$263.54
|
|
|
HC ARTHROCENTESIS INTERMED JT BIL
|
Facility
|
IP
|
$429.05
|
|
|
Service Code
|
CPT 20605
|
| Hospital Charge Code |
36100025
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$270.30 |
| Max. Negotiated Rate |
$386.14 |
| Rate for Payer: Aetna Commercial |
$364.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$278.88
|
| Rate for Payer: Cash Price |
$343.24
|
| Rate for Payer: Cofinity Commercial |
$300.34
|
| Rate for Payer: Cofinity Commercial |
$368.98
|
| Rate for Payer: Healthscope Commercial |
$386.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$364.69
|
| Rate for Payer: PHP Commercial |
$364.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$300.34
|
| Rate for Payer: Priority Health SBD |
$270.30
|
|
|
HC ARTHROCENTESIS INTERMED JT BIL W US GUIDE
|
Facility
|
IP
|
$1,434.49
|
|
|
Service Code
|
CPT 20606
|
| Hospital Charge Code |
36100457
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$903.73 |
| Max. Negotiated Rate |
$1,291.04 |
| Rate for Payer: Aetna Commercial |
$1,219.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$932.42
|
| Rate for Payer: Cash Price |
$1,147.59
|
| Rate for Payer: Cofinity Commercial |
$1,004.14
|
| Rate for Payer: Cofinity Commercial |
$1,233.66
|
| Rate for Payer: Healthscope Commercial |
$1,291.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,219.32
|
| Rate for Payer: PHP Commercial |
$1,219.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,004.14
|
| Rate for Payer: Priority Health SBD |
$903.73
|
|
|
HC ARTHROCENTESIS INTERMED JT BIL W US GUIDE
|
Facility
|
OP
|
$1,434.49
|
|
|
Service Code
|
CPT 20606
|
| Hospital Charge Code |
36100457
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$50.75 |
| Max. Negotiated Rate |
$1,977.15 |
| Rate for Payer: Aetna Commercial |
$1,219.32
|
| Rate for Payer: Aetna Medicare |
$639.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$932.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$769.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$769.16
|
| Rate for Payer: BCBS Complete |
$353.45
|
| Rate for Payer: BCBS MAPPO |
$615.33
|
| Rate for Payer: BCBS Trust/PPO |
$402.78
|
| Rate for Payer: BCN Medicare Advantage |
$615.33
|
| Rate for Payer: Cash Price |
$1,147.59
|
| Rate for Payer: Cash Price |
$1,147.59
|
| Rate for Payer: Cofinity Commercial |
$1,233.66
|
| Rate for Payer: Cofinity Commercial |
$1,004.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$615.33
|
| Rate for Payer: Healthscope Commercial |
$1,291.04
|
| Rate for Payer: Mclaren Medicaid |
$336.59
|
| Rate for Payer: Mclaren Medicare |
$615.33
|
| Rate for Payer: Meridian Medicaid |
$353.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$646.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$707.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,219.32
|
| Rate for Payer: PACE Medicare |
$584.56
|
| Rate for Payer: PACE SWMI |
$615.33
|
| Rate for Payer: PHP Commercial |
$1,219.32
|
| Rate for Payer: PHP Medicare Advantage |
$615.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$336.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,004.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,977.15
|
| Rate for Payer: Priority Health Medicare |
$615.33
|
| Rate for Payer: Priority Health Narrow Network |
$1,581.72
|
| Rate for Payer: Priority Health SBD |
$903.73
|
| Rate for Payer: Railroad Medicare Medicare |
$615.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.82
|
| Rate for Payer: UHC Core |
$1,463.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$615.33
|
| Rate for Payer: UHC Exchange |
$50.75
|
| Rate for Payer: UHC Medicare Advantage |
$633.79
|
| Rate for Payer: VA VA |
$615.33
|
|
|
HC ARTHROCENTESIS INTERMED JT W US GUIDE
|
Facility
|
OP
|
$1,063.45
|
|
|
Service Code
|
CPT 20606
|
| Hospital Charge Code |
36100456
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$50.75 |
| Max. Negotiated Rate |
$1,977.15 |
| Rate for Payer: Aetna Commercial |
$903.93
|
| Rate for Payer: Aetna Medicare |
$639.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$691.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$769.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$769.16
|
| Rate for Payer: BCBS Complete |
$353.45
|
| Rate for Payer: BCBS MAPPO |
$615.33
|
| Rate for Payer: BCBS Trust/PPO |
$402.78
|
| Rate for Payer: BCN Medicare Advantage |
$615.33
|
| Rate for Payer: Cash Price |
$850.76
|
| Rate for Payer: Cash Price |
$850.76
|
| Rate for Payer: Cofinity Commercial |
$914.57
|
| Rate for Payer: Cofinity Commercial |
$744.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$615.33
|
| Rate for Payer: Healthscope Commercial |
$957.10
|
| Rate for Payer: Mclaren Medicaid |
$336.59
|
| Rate for Payer: Mclaren Medicare |
$615.33
|
| Rate for Payer: Meridian Medicaid |
$353.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$646.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$707.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$903.93
|
| Rate for Payer: PACE Medicare |
$584.56
|
| Rate for Payer: PACE SWMI |
$615.33
|
| Rate for Payer: PHP Commercial |
$903.93
|
| Rate for Payer: PHP Medicare Advantage |
$615.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$336.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$744.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,977.15
|
| Rate for Payer: Priority Health Medicare |
$615.33
|
| Rate for Payer: Priority Health Narrow Network |
$1,581.72
|
| Rate for Payer: Priority Health SBD |
$669.97
|
| Rate for Payer: Railroad Medicare Medicare |
$615.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$615.33
|
| Rate for Payer: UHC Exchange |
$50.75
|
| Rate for Payer: UHC Medicare Advantage |
$633.79
|
| Rate for Payer: VA VA |
$615.33
|
|
|
HC ARTHROCENTESIS INTERMED JT W US GUIDE
|
Facility
|
IP
|
$1,063.45
|
|
|
Service Code
|
CPT 20606
|
| Hospital Charge Code |
36100456
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$669.97 |
| Max. Negotiated Rate |
$957.10 |
| Rate for Payer: Aetna Commercial |
$903.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$691.24
|
| Rate for Payer: Cash Price |
$850.76
|
| Rate for Payer: Cofinity Commercial |
$744.42
|
| Rate for Payer: Cofinity Commercial |
$914.57
|
| Rate for Payer: Healthscope Commercial |
$957.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$903.93
|
| Rate for Payer: PHP Commercial |
$903.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$744.42
|
| Rate for Payer: Priority Health SBD |
$669.97
|
|
|
HC ARTHROCENTESIS MAJOR JOINT
|
Facility
|
OP
|
$322.73
|
|
|
Service Code
|
CPT 20610
|
| Hospital Charge Code |
36100026
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$44.53 |
| Max. Negotiated Rate |
$813.49 |
| Rate for Payer: Aetna Commercial |
$274.32
|
| Rate for Payer: Aetna Medicare |
$274.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$209.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$329.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$329.42
|
| Rate for Payer: BCBS Complete |
$151.38
|
| Rate for Payer: BCBS MAPPO |
$263.54
|
| Rate for Payer: BCBS Trust/PPO |
$169.96
|
| Rate for Payer: BCN Medicare Advantage |
$263.54
|
| Rate for Payer: Cash Price |
$258.18
|
| Rate for Payer: Cash Price |
$258.18
|
| Rate for Payer: Cofinity Commercial |
$277.55
|
| Rate for Payer: Cofinity Commercial |
$225.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$263.54
|
| Rate for Payer: Healthscope Commercial |
$290.46
|
| Rate for Payer: Mclaren Medicaid |
$144.16
|
| Rate for Payer: Mclaren Medicare |
$263.54
|
| Rate for Payer: Meridian Medicaid |
$151.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$276.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$303.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$274.32
|
| Rate for Payer: PACE Medicare |
$250.36
|
| Rate for Payer: PACE SWMI |
$263.54
|
| Rate for Payer: PHP Commercial |
$274.32
|
| Rate for Payer: PHP Medicare Advantage |
$263.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$144.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$225.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$813.49
|
| Rate for Payer: Priority Health Medicare |
$263.54
|
| Rate for Payer: Priority Health Narrow Network |
$650.79
|
| Rate for Payer: Priority Health SBD |
$203.32
|
| Rate for Payer: Railroad Medicare Medicare |
$263.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$263.54
|
| Rate for Payer: UHC Exchange |
$44.53
|
| Rate for Payer: UHC Medicare Advantage |
$271.45
|
| Rate for Payer: VA VA |
$263.54
|
|
|
HC ARTHROCENTESIS MAJOR JOINT
|
Facility
|
IP
|
$322.73
|
|
|
Service Code
|
CPT 20610
|
| Hospital Charge Code |
36100026
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$203.32 |
| Max. Negotiated Rate |
$290.46 |
| Rate for Payer: Aetna Commercial |
$274.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$209.77
|
| Rate for Payer: Cash Price |
$258.18
|
| Rate for Payer: Cofinity Commercial |
$225.91
|
| Rate for Payer: Cofinity Commercial |
$277.55
|
| Rate for Payer: Healthscope Commercial |
$290.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$274.32
|
| Rate for Payer: PHP Commercial |
$274.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$225.91
|
| Rate for Payer: Priority Health SBD |
$203.32
|
|
|
HC ARTHROCENTESIS MAJOR JOINT BIL
|
Facility
|
OP
|
$413.01
|
|
|
Service Code
|
CPT 20610
|
| Hospital Charge Code |
36100027
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$44.53 |
| Max. Negotiated Rate |
$813.49 |
| Rate for Payer: Aetna Commercial |
$351.06
|
| Rate for Payer: Aetna Medicare |
$274.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$268.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$329.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$329.42
|
| Rate for Payer: BCBS Complete |
$151.38
|
| Rate for Payer: BCBS MAPPO |
$263.54
|
| Rate for Payer: BCBS Trust/PPO |
$169.96
|
| Rate for Payer: BCN Medicare Advantage |
$263.54
|
| Rate for Payer: Cash Price |
$330.41
|
| Rate for Payer: Cash Price |
$330.41
|
| Rate for Payer: Cofinity Commercial |
$289.11
|
| Rate for Payer: Cofinity Commercial |
$355.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$263.54
|
| Rate for Payer: Healthscope Commercial |
$371.71
|
| Rate for Payer: Mclaren Medicaid |
$144.16
|
| Rate for Payer: Mclaren Medicare |
$263.54
|
| Rate for Payer: Meridian Medicaid |
$151.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$276.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$303.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$351.06
|
| Rate for Payer: PACE Medicare |
$250.36
|
| Rate for Payer: PACE SWMI |
$263.54
|
| Rate for Payer: PHP Commercial |
$351.06
|
| Rate for Payer: PHP Medicare Advantage |
$263.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$144.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$289.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$813.49
|
| Rate for Payer: Priority Health Medicare |
$263.54
|
| Rate for Payer: Priority Health Narrow Network |
$650.79
|
| Rate for Payer: Priority Health SBD |
$260.20
|
| Rate for Payer: Railroad Medicare Medicare |
$263.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$263.54
|
| Rate for Payer: UHC Exchange |
$44.53
|
| Rate for Payer: UHC Medicare Advantage |
$271.45
|
| Rate for Payer: VA VA |
$263.54
|
|
|
HC ARTHROCENTESIS MAJOR JOINT BIL
|
Facility
|
IP
|
$413.01
|
|
|
Service Code
|
CPT 20610
|
| Hospital Charge Code |
36100027
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$260.20 |
| Max. Negotiated Rate |
$371.71 |
| Rate for Payer: Aetna Commercial |
$351.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$268.46
|
| Rate for Payer: Cash Price |
$330.41
|
| Rate for Payer: Cofinity Commercial |
$289.11
|
| Rate for Payer: Cofinity Commercial |
$355.19
|
| Rate for Payer: Healthscope Commercial |
$371.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$351.06
|
| Rate for Payer: PHP Commercial |
$351.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$289.11
|
| Rate for Payer: Priority Health SBD |
$260.20
|
|
|
HC ARTHROCENTESIS MAJOR JOINT BIL W US GUIDE
|
Facility
|
OP
|
$1,204.67
|
|
|
Service Code
|
CPT 20611
|
| Hospital Charge Code |
36100455
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$57.63 |
| Max. Negotiated Rate |
$1,084.20 |
| Rate for Payer: Aetna Commercial |
$1,023.97
|
| Rate for Payer: Aetna Medicare |
$274.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$783.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$329.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$329.42
|
| Rate for Payer: BCBS Complete |
$151.38
|
| Rate for Payer: BCBS MAPPO |
$263.54
|
| Rate for Payer: BCBS Trust/PPO |
$169.96
|
| Rate for Payer: BCN Medicare Advantage |
$263.54
|
| Rate for Payer: Cash Price |
$963.74
|
| Rate for Payer: Cash Price |
$963.74
|
| Rate for Payer: Cofinity Commercial |
$843.27
|
| Rate for Payer: Cofinity Commercial |
$1,036.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$263.54
|
| Rate for Payer: Healthscope Commercial |
$1,084.20
|
| Rate for Payer: Mclaren Medicaid |
$144.16
|
| Rate for Payer: Mclaren Medicare |
$263.54
|
| Rate for Payer: Meridian Medicaid |
$151.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$276.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$303.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,023.97
|
| Rate for Payer: PACE Medicare |
$250.36
|
| Rate for Payer: PACE SWMI |
$263.54
|
| Rate for Payer: PHP Commercial |
$1,023.97
|
| Rate for Payer: PHP Medicare Advantage |
$263.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$144.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$843.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$813.49
|
| Rate for Payer: Priority Health Medicare |
$263.54
|
| Rate for Payer: Priority Health Narrow Network |
$650.79
|
| Rate for Payer: Priority Health SBD |
$758.94
|
| Rate for Payer: Railroad Medicare Medicare |
$263.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.39
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$263.54
|
| Rate for Payer: UHC Exchange |
$57.63
|
| Rate for Payer: UHC Medicare Advantage |
$271.45
|
| Rate for Payer: VA VA |
$263.54
|
|
|
HC ARTHROCENTESIS MAJOR JOINT BIL W US GUIDE
|
Facility
|
IP
|
$1,204.67
|
|
|
Service Code
|
CPT 20611
|
| Hospital Charge Code |
36100455
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$758.94 |
| Max. Negotiated Rate |
$1,084.20 |
| Rate for Payer: Aetna Commercial |
$1,023.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$783.04
|
| Rate for Payer: Cash Price |
$963.74
|
| Rate for Payer: Cofinity Commercial |
$1,036.02
|
| Rate for Payer: Cofinity Commercial |
$843.27
|
| Rate for Payer: Healthscope Commercial |
$1,084.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,023.97
|
| Rate for Payer: PHP Commercial |
$1,023.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$843.27
|
| Rate for Payer: Priority Health SBD |
$758.94
|
|
|
HC ARTHROCENTESIS MAJOR JOINT W US GUIDE
|
Facility
|
OP
|
$1,118.72
|
|
|
Service Code
|
CPT 20611
|
| Hospital Charge Code |
36100454
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$57.63 |
| Max. Negotiated Rate |
$1,006.85 |
| Rate for Payer: Aetna Commercial |
$950.91
|
| Rate for Payer: Aetna Medicare |
$274.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$727.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$329.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$329.42
|
| Rate for Payer: BCBS Complete |
$151.38
|
| Rate for Payer: BCBS MAPPO |
$263.54
|
| Rate for Payer: BCBS Trust/PPO |
$169.96
|
| Rate for Payer: BCN Medicare Advantage |
$263.54
|
| Rate for Payer: Cash Price |
$894.98
|
| Rate for Payer: Cash Price |
$894.98
|
| Rate for Payer: Cofinity Commercial |
$962.10
|
| Rate for Payer: Cofinity Commercial |
$783.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$263.54
|
| Rate for Payer: Healthscope Commercial |
$1,006.85
|
| Rate for Payer: Mclaren Medicaid |
$144.16
|
| Rate for Payer: Mclaren Medicare |
$263.54
|
| Rate for Payer: Meridian Medicaid |
$151.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$276.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$303.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$950.91
|
| Rate for Payer: PACE Medicare |
$250.36
|
| Rate for Payer: PACE SWMI |
$263.54
|
| Rate for Payer: PHP Commercial |
$950.91
|
| Rate for Payer: PHP Medicare Advantage |
$263.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$144.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$783.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$813.49
|
| Rate for Payer: Priority Health Medicare |
$263.54
|
| Rate for Payer: Priority Health Narrow Network |
$650.79
|
| Rate for Payer: Priority Health SBD |
$704.79
|
| Rate for Payer: Railroad Medicare Medicare |
$263.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$263.54
|
| Rate for Payer: UHC Exchange |
$57.63
|
| Rate for Payer: UHC Medicare Advantage |
$271.45
|
| Rate for Payer: VA VA |
$263.54
|
|
|
HC ARTHROCENTESIS MAJOR JOINT W US GUIDE
|
Facility
|
IP
|
$1,118.72
|
|
|
Service Code
|
CPT 20611
|
| Hospital Charge Code |
36100454
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$704.79 |
| Max. Negotiated Rate |
$1,006.85 |
| Rate for Payer: Aetna Commercial |
$950.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$727.17
|
| Rate for Payer: Cash Price |
$894.98
|
| Rate for Payer: Cofinity Commercial |
$783.10
|
| Rate for Payer: Cofinity Commercial |
$962.10
|
| Rate for Payer: Healthscope Commercial |
$1,006.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$950.91
|
| Rate for Payer: PHP Commercial |
$950.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$783.10
|
| Rate for Payer: Priority Health SBD |
$704.79
|
|
|
HC ARTHROCENTESIS SMALL JOINT
|
Facility
|
IP
|
$320.14
|
|
|
Service Code
|
CPT 20600
|
| Hospital Charge Code |
36100022
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$201.69 |
| Max. Negotiated Rate |
$288.13 |
| Rate for Payer: Aetna Commercial |
$272.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$208.09
|
| Rate for Payer: Cash Price |
$256.11
|
| Rate for Payer: Cofinity Commercial |
$224.10
|
| Rate for Payer: Cofinity Commercial |
$275.32
|
| Rate for Payer: Healthscope Commercial |
$288.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$272.12
|
| Rate for Payer: PHP Commercial |
$272.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$224.10
|
| Rate for Payer: Priority Health SBD |
$201.69
|
|
|
HC ARTHROCENTESIS SMALL JOINT
|
Facility
|
OP
|
$320.14
|
|
|
Service Code
|
CPT 20600
|
| Hospital Charge Code |
36100022
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$35.04 |
| Max. Negotiated Rate |
$813.49 |
| Rate for Payer: Aetna Commercial |
$272.12
|
| Rate for Payer: Aetna Medicare |
$274.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$208.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$329.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$329.42
|
| Rate for Payer: BCBS Complete |
$151.38
|
| Rate for Payer: BCBS MAPPO |
$263.54
|
| Rate for Payer: BCBS Trust/PPO |
$169.96
|
| Rate for Payer: BCN Medicare Advantage |
$263.54
|
| Rate for Payer: Cash Price |
$256.11
|
| Rate for Payer: Cash Price |
$256.11
|
| Rate for Payer: Cofinity Commercial |
$275.32
|
| Rate for Payer: Cofinity Commercial |
$224.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$263.54
|
| Rate for Payer: Healthscope Commercial |
$288.13
|
| Rate for Payer: Mclaren Medicaid |
$144.16
|
| Rate for Payer: Mclaren Medicare |
$263.54
|
| Rate for Payer: Meridian Medicaid |
$151.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$276.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$303.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$272.12
|
| Rate for Payer: PACE Medicare |
$250.36
|
| Rate for Payer: PACE SWMI |
$263.54
|
| Rate for Payer: PHP Commercial |
$272.12
|
| Rate for Payer: PHP Medicare Advantage |
$263.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$144.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$224.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$813.49
|
| Rate for Payer: Priority Health Medicare |
$263.54
|
| Rate for Payer: Priority Health Narrow Network |
$650.79
|
| Rate for Payer: Priority Health SBD |
$201.69
|
| Rate for Payer: Railroad Medicare Medicare |
$263.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$263.54
|
| Rate for Payer: UHC Exchange |
$35.04
|
| Rate for Payer: UHC Medicare Advantage |
$271.45
|
| Rate for Payer: VA VA |
$263.54
|
|
|
HC ARTHROCENTESIS SMALL JOINT BIL W US GUIDE
|
Facility
|
OP
|
$1,159.24
|
|
|
Service Code
|
CPT 20604
|
| Hospital Charge Code |
36100459
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$44.53 |
| Max. Negotiated Rate |
$1,043.32 |
| Rate for Payer: Aetna Commercial |
$985.35
|
| Rate for Payer: Aetna Medicare |
$274.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$753.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$329.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$329.42
|
| Rate for Payer: BCBS Complete |
$151.38
|
| Rate for Payer: BCBS MAPPO |
$263.54
|
| Rate for Payer: BCBS Trust/PPO |
$169.96
|
| Rate for Payer: BCN Medicare Advantage |
$263.54
|
| Rate for Payer: Cash Price |
$927.39
|
| Rate for Payer: Cash Price |
$927.39
|
| Rate for Payer: Cofinity Commercial |
$811.47
|
| Rate for Payer: Cofinity Commercial |
$996.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$263.54
|
| Rate for Payer: Healthscope Commercial |
$1,043.32
|
| Rate for Payer: Mclaren Medicaid |
$144.16
|
| Rate for Payer: Mclaren Medicare |
$263.54
|
| Rate for Payer: Meridian Medicaid |
$151.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$276.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$303.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$985.35
|
| Rate for Payer: PACE Medicare |
$250.36
|
| Rate for Payer: PACE SWMI |
$263.54
|
| Rate for Payer: PHP Commercial |
$985.35
|
| Rate for Payer: PHP Medicare Advantage |
$263.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$144.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$811.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$813.49
|
| Rate for Payer: Priority Health Medicare |
$263.54
|
| Rate for Payer: Priority Health Narrow Network |
$650.79
|
| Rate for Payer: Priority Health SBD |
$730.32
|
| Rate for Payer: Railroad Medicare Medicare |
$263.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.98
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$263.54
|
| Rate for Payer: UHC Exchange |
$44.53
|
| Rate for Payer: UHC Medicare Advantage |
$271.45
|
| Rate for Payer: VA VA |
$263.54
|
|
|
HC ARTHROCENTESIS SMALL JOINT BIL W US GUIDE
|
Facility
|
IP
|
$1,159.24
|
|
|
Service Code
|
CPT 20604
|
| Hospital Charge Code |
36100459
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$730.32 |
| Max. Negotiated Rate |
$1,043.32 |
| Rate for Payer: Aetna Commercial |
$985.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$753.51
|
| Rate for Payer: Cash Price |
$927.39
|
| Rate for Payer: Cofinity Commercial |
$811.47
|
| Rate for Payer: Cofinity Commercial |
$996.95
|
| Rate for Payer: Healthscope Commercial |
$1,043.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$985.35
|
| Rate for Payer: PHP Commercial |
$985.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$811.47
|
| Rate for Payer: Priority Health SBD |
$730.32
|
|
|
HC ARTHROCENTESIS SMALL JOINT W US GUIDE
|
Facility
|
IP
|
$984.86
|
|
|
Service Code
|
CPT 20604
|
| Hospital Charge Code |
36100458
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$620.46 |
| Max. Negotiated Rate |
$886.37 |
| Rate for Payer: Aetna Commercial |
$837.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$640.16
|
| Rate for Payer: Cash Price |
$787.89
|
| Rate for Payer: Cofinity Commercial |
$846.98
|
| Rate for Payer: Cofinity Commercial |
$689.40
|
| Rate for Payer: Healthscope Commercial |
$886.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$837.13
|
| Rate for Payer: PHP Commercial |
$837.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$689.40
|
| Rate for Payer: Priority Health SBD |
$620.46
|
|
|
HC ARTHROCENTESIS SMALL JOINT W US GUIDE
|
Facility
|
OP
|
$984.86
|
|
|
Service Code
|
CPT 20604
|
| Hospital Charge Code |
36100458
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$44.53 |
| Max. Negotiated Rate |
$886.37 |
| Rate for Payer: Aetna Commercial |
$837.13
|
| Rate for Payer: Aetna Medicare |
$274.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$640.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$329.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$329.42
|
| Rate for Payer: BCBS Complete |
$151.38
|
| Rate for Payer: BCBS MAPPO |
$263.54
|
| Rate for Payer: BCBS Trust/PPO |
$169.96
|
| Rate for Payer: BCN Medicare Advantage |
$263.54
|
| Rate for Payer: Cash Price |
$787.89
|
| Rate for Payer: Cash Price |
$787.89
|
| Rate for Payer: Cofinity Commercial |
$846.98
|
| Rate for Payer: Cofinity Commercial |
$689.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$263.54
|
| Rate for Payer: Healthscope Commercial |
$886.37
|
| Rate for Payer: Mclaren Medicaid |
$144.16
|
| Rate for Payer: Mclaren Medicare |
$263.54
|
| Rate for Payer: Meridian Medicaid |
$151.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$276.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$303.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$837.13
|
| Rate for Payer: PACE Medicare |
$250.36
|
| Rate for Payer: PACE SWMI |
$263.54
|
| Rate for Payer: PHP Commercial |
$837.13
|
| Rate for Payer: PHP Medicare Advantage |
$263.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$144.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$689.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$813.49
|
| Rate for Payer: Priority Health Medicare |
$263.54
|
| Rate for Payer: Priority Health Narrow Network |
$650.79
|
| Rate for Payer: Priority Health SBD |
$620.46
|
| Rate for Payer: Railroad Medicare Medicare |
$263.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.98
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$263.54
|
| Rate for Payer: UHC Exchange |
$44.53
|
| Rate for Payer: UHC Medicare Advantage |
$271.45
|
| Rate for Payer: VA VA |
$263.54
|
|
|
HC ARTHROGRAM SACROILIAC
|
Facility
|
OP
|
$919.32
|
|
|
Service Code
|
CPT 27096
|
| Hospital Charge Code |
36100585
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$80.88 |
| Max. Negotiated Rate |
$878.00 |
| Rate for Payer: Aetna Commercial |
$781.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$597.56
|
| Rate for Payer: BCBS Complete |
$367.73
|
| Rate for Payer: BCBS Trust/PPO |
$428.94
|
| Rate for Payer: Cash Price |
$735.46
|
| Rate for Payer: Cash Price |
$735.46
|
| Rate for Payer: Cofinity Commercial |
$790.62
|
| Rate for Payer: Cofinity Commercial |
$643.52
|
| Rate for Payer: Healthscope Commercial |
$827.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$781.42
|
| Rate for Payer: PHP Commercial |
$781.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$643.52
|
| Rate for Payer: Priority Health SBD |
$579.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88.97
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Exchange |
$80.88
|
|
|
HC ARTHROGRAM SACROILIAC
|
Facility
|
IP
|
$919.32
|
|
|
Service Code
|
CPT 27096
|
| Hospital Charge Code |
36100585
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$579.17 |
| Max. Negotiated Rate |
$827.39 |
| Rate for Payer: Aetna Commercial |
$781.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$597.56
|
| Rate for Payer: Cash Price |
$735.46
|
| Rate for Payer: Cofinity Commercial |
$643.52
|
| Rate for Payer: Cofinity Commercial |
$790.62
|
| Rate for Payer: Healthscope Commercial |
$827.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$781.42
|
| Rate for Payer: PHP Commercial |
$781.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$643.52
|
| Rate for Payer: Priority Health SBD |
$579.17
|
|
|
HC ARTHROGRAM SACROILIAC BIL
|
Facility
|
IP
|
$1,047.85
|
|
|
Service Code
|
CPT 27096
|
| Hospital Charge Code |
36100586
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$660.15 |
| Max. Negotiated Rate |
$943.06 |
| Rate for Payer: Aetna Commercial |
$890.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$681.10
|
| Rate for Payer: Cash Price |
$838.28
|
| Rate for Payer: Cofinity Commercial |
$901.15
|
| Rate for Payer: Cofinity Commercial |
$733.50
|
| Rate for Payer: Healthscope Commercial |
$943.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$890.67
|
| Rate for Payer: PHP Commercial |
$890.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$733.50
|
| Rate for Payer: Priority Health SBD |
$660.15
|
|
|
HC ARTHROGRAM SACROILIAC BIL
|
Facility
|
OP
|
$1,047.85
|
|
|
Service Code
|
CPT 27096
|
| Hospital Charge Code |
36100586
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$80.88 |
| Max. Negotiated Rate |
$943.06 |
| Rate for Payer: Aetna Commercial |
$890.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$681.10
|
| Rate for Payer: BCBS Complete |
$419.14
|
| Rate for Payer: BCBS Trust/PPO |
$428.94
|
| Rate for Payer: Cash Price |
$838.28
|
| Rate for Payer: Cash Price |
$838.28
|
| Rate for Payer: Cofinity Commercial |
$901.15
|
| Rate for Payer: Cofinity Commercial |
$733.50
|
| Rate for Payer: Healthscope Commercial |
$943.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$890.67
|
| Rate for Payer: PHP Commercial |
$890.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$733.50
|
| Rate for Payer: Priority Health SBD |
$660.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88.97
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Exchange |
$80.88
|
|
|
HC ARTHROTOMY W/EXP, DRAIN, REMOVAL FB METACARPOPHALANGEAL JT EACH
|
Facility
|
IP
|
$1,781.24
|
|
|
Service Code
|
CPT 26075
|
| Hospital Charge Code |
76100135
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,122.18 |
| Max. Negotiated Rate |
$1,603.12 |
| Rate for Payer: Aetna Commercial |
$1,514.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,157.81
|
| Rate for Payer: Cash Price |
$1,424.99
|
| Rate for Payer: Cofinity Commercial |
$1,246.87
|
| Rate for Payer: Cofinity Commercial |
$1,531.87
|
| Rate for Payer: Healthscope Commercial |
$1,603.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,514.05
|
| Rate for Payer: PHP Commercial |
$1,514.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,246.87
|
| Rate for Payer: Priority Health SBD |
$1,122.18
|
|
