|
HC ABLATION CATHETER (8/10 MM TIP
|
Facility
|
OP
|
$6,030.46
|
|
|
Service Code
|
HCPCS C1733
|
| Hospital Charge Code |
27200009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$5,427.41 |
| Rate for Payer: Aetna Commercial |
$5,125.89
|
| Rate for Payer: Aetna Medicare |
$3,015.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,919.80
|
| Rate for Payer: BCBS Complete |
$2,412.18
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$4,824.37
|
| Rate for Payer: Cash Price |
$4,824.37
|
| Rate for Payer: Cofinity Advantage |
$4,221.32
|
| Rate for Payer: Cofinity Commercial |
$5,186.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,824.37
|
| Rate for Payer: Healthscope Commercial |
$5,427.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,824.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,125.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,522.85
|
| Rate for Payer: PHP Commercial |
$5,125.89
|
| Rate for Payer: Priority Health SBD |
$3,799.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,919.80
|
| Rate for Payer: UHC Core |
$3,141.87
|
| Rate for Payer: UHC Exchange |
$2,369.97
|
|
|
HC ABLATION CATH EXTRAVASC TISSUE
|
Facility
|
OP
|
$7,366.91
|
|
|
Service Code
|
HCPCS C1886
|
| Hospital Charge Code |
27000645
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$6,630.22 |
| Rate for Payer: Aetna Commercial |
$6,261.87
|
| Rate for Payer: Aetna Medicare |
$3,683.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,788.49
|
| Rate for Payer: BCBS Complete |
$2,946.76
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$5,893.53
|
| Rate for Payer: Cash Price |
$5,893.53
|
| Rate for Payer: Cofinity Advantage |
$5,156.84
|
| Rate for Payer: Cofinity Commercial |
$6,335.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,893.53
|
| Rate for Payer: Healthscope Commercial |
$6,630.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,893.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,261.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,525.18
|
| Rate for Payer: PHP Commercial |
$6,261.87
|
| Rate for Payer: Priority Health SBD |
$4,641.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,788.49
|
| Rate for Payer: UHC Core |
$3,838.16
|
| Rate for Payer: UHC Exchange |
$2,895.20
|
|
|
HC ABLATION CATH EXTRAVASC TISSUE
|
Facility
|
IP
|
$7,366.91
|
|
|
Service Code
|
HCPCS C1886
|
| Hospital Charge Code |
27000645
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4,641.15 |
| Max. Negotiated Rate |
$6,630.22 |
| Rate for Payer: Aetna Commercial |
$6,261.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,788.49
|
| Rate for Payer: Cash Price |
$5,893.53
|
| Rate for Payer: Cofinity Advantage |
$5,156.84
|
| Rate for Payer: Cofinity Commercial |
$6,335.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,893.53
|
| Rate for Payer: Healthscope Commercial |
$6,630.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,261.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,525.18
|
| Rate for Payer: PHP Commercial |
$6,261.87
|
| Rate for Payer: Priority Health SBD |
$4,641.15
|
|
|
HC ABLATION CATH NON-CARD ENDOVASC IMPLANT LVL 12
|
Facility
|
OP
|
$1,275.00
|
|
|
Service Code
|
HCPCS C1888
|
| Hospital Charge Code |
27200324
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$501.07 |
| Max. Negotiated Rate |
$1,147.50 |
| Rate for Payer: Aetna Commercial |
$1,083.75
|
| Rate for Payer: Aetna Medicare |
$637.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$828.75
|
| Rate for Payer: BCBS Complete |
$510.00
|
| Rate for Payer: Cash Price |
$1,020.00
|
| Rate for Payer: Cofinity Advantage |
$892.50
|
| Rate for Payer: Cofinity Commercial |
$1,096.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,020.00
|
| Rate for Payer: Healthscope Commercial |
$1,147.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,020.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,083.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$956.25
|
| Rate for Payer: PHP Commercial |
$1,083.75
|
| Rate for Payer: Priority Health SBD |
$803.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$828.75
|
| Rate for Payer: UHC Core |
$664.27
|
| Rate for Payer: UHC Exchange |
$501.07
|
|
|
HC ABLATION CATH NON-CARD ENDOVASC IMPLANT LVL 12
|
Facility
|
IP
|
$1,275.00
|
|
|
Service Code
|
HCPCS C1888
|
| Hospital Charge Code |
27200324
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$803.25 |
| Max. Negotiated Rate |
$1,147.50 |
| Rate for Payer: Aetna Commercial |
$1,083.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$828.75
|
| Rate for Payer: Cash Price |
$1,020.00
|
| Rate for Payer: Cofinity Advantage |
$892.50
|
| Rate for Payer: Cofinity Commercial |
$1,096.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,020.00
|
| Rate for Payer: Healthscope Commercial |
$1,147.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,083.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$956.25
|
| Rate for Payer: PHP Commercial |
$1,083.75
|
| Rate for Payer: Priority Health SBD |
$803.25
|
|
|
HC ABLATION CATH NON CARD ENDOVASC IMPLANT LVL 15
|
Facility
|
OP
|
$1,593.75
|
|
|
Service Code
|
CPT C1888
|
| Hospital Charge Code |
27200358
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$626.34 |
| Max. Negotiated Rate |
$1,434.38 |
| Rate for Payer: Aetna Commercial |
$1,354.69
|
| Rate for Payer: Aetna Medicare |
$796.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,035.94
|
| Rate for Payer: BCBS Complete |
$637.50
|
| Rate for Payer: Cash Price |
$1,275.00
|
| Rate for Payer: Cofinity Advantage |
$1,115.62
|
| Rate for Payer: Cofinity Commercial |
$1,370.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,275.00
|
| Rate for Payer: Healthscope Commercial |
$1,434.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,275.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,354.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,195.31
|
| Rate for Payer: PHP Commercial |
$1,354.69
|
| Rate for Payer: Priority Health SBD |
$1,004.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,035.94
|
| Rate for Payer: UHC Core |
$830.34
|
| Rate for Payer: UHC Exchange |
$626.34
|
|
|
HC ABLATION CATH NON CARD ENDOVASC IMPLANT LVL 15
|
Facility
|
IP
|
$1,593.75
|
|
|
Service Code
|
CPT C1888
|
| Hospital Charge Code |
27200358
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,004.06 |
| Max. Negotiated Rate |
$1,434.38 |
| Rate for Payer: Aetna Commercial |
$1,354.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,035.94
|
| Rate for Payer: Cash Price |
$1,275.00
|
| Rate for Payer: Cofinity Advantage |
$1,115.62
|
| Rate for Payer: Cofinity Commercial |
$1,370.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,275.00
|
| Rate for Payer: Healthscope Commercial |
$1,434.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,354.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,195.31
|
| Rate for Payer: PHP Commercial |
$1,354.69
|
| Rate for Payer: Priority Health SBD |
$1,004.06
|
|
|
HC ABLATION RF LUNG
|
Facility
|
IP
|
$6,137.71
|
|
|
Service Code
|
CPT 32998
|
| Hospital Charge Code |
36100055
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,866.76 |
| Max. Negotiated Rate |
$5,523.94 |
| Rate for Payer: Aetna Commercial |
$5,217.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,989.51
|
| Rate for Payer: Cash Price |
$4,910.17
|
| Rate for Payer: Cofinity Advantage |
$4,296.40
|
| Rate for Payer: Cofinity Commercial |
$5,278.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,910.17
|
| Rate for Payer: Healthscope Commercial |
$5,523.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,217.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,603.28
|
| Rate for Payer: PHP Commercial |
$5,217.05
|
| Rate for Payer: Priority Health SBD |
$3,866.76
|
|
|
HC ABLATION RF LUNG
|
Facility
|
OP
|
$6,137.71
|
|
|
Service Code
|
CPT 32998
|
| Hospital Charge Code |
36100055
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,015.30 |
| Max. Negotiated Rate |
$19,480.40 |
| Rate for Payer: Aetna Commercial |
$5,217.05
|
| Rate for Payer: Aetna Medicare |
$6,264.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,989.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,529.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,529.74
|
| Rate for Payer: BCBS Complete |
$3,308.27
|
| Rate for Payer: BCBS MAPPO |
$6,023.79
|
| Rate for Payer: BCBS Trust/PPO |
$3,015.30
|
| Rate for Payer: BCN Commercial |
$3,015.30
|
| Rate for Payer: BCN Medicare Advantage |
$6,023.79
|
| Rate for Payer: Cash Price |
$4,910.17
|
| Rate for Payer: Cash Price |
$4,910.17
|
| Rate for Payer: Cash Price |
$4,910.17
|
| Rate for Payer: Cofinity Advantage |
$4,296.40
|
| Rate for Payer: Cofinity Commercial |
$5,278.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,910.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,023.79
|
| Rate for Payer: Healthscope Commercial |
$5,523.94
|
| Rate for Payer: Mclaren Medicaid |
$3,150.44
|
| Rate for Payer: Mclaren Medicare |
$6,023.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,324.98
|
| Rate for Payer: Meridian Medicaid |
$6,324.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,927.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$6,626.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,217.05
|
| Rate for Payer: Nomi Health Commercial |
$18,071.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,603.28
|
| Rate for Payer: PACE Medicare |
$5,722.60
|
| Rate for Payer: PACE SWMI |
$6,023.79
|
| Rate for Payer: PHP Commercial |
$5,217.05
|
| Rate for Payer: PHP Medicare Advantage |
$6,023.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,150.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$19,480.40
|
| Rate for Payer: Priority Health Medicare |
$6,023.79
|
| Rate for Payer: Priority Health SBD |
$3,866.76
|
| Rate for Payer: Priority Health Tiered Network |
$15,584.32
|
| Rate for Payer: Railroad Medicare Medicare |
$6,023.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6,023.79
|
| Rate for Payer: UHC Medicaid |
$3,150.44
|
| Rate for Payer: UHCCP Medicaid |
$3,150.44
|
| Rate for Payer: VA VA |
$6,023.79
|
|
|
HC ABLATION VEIN OF MARSHALL
|
Facility
|
OP
|
$9,077.96
|
|
|
Service Code
|
CPT 93799
|
| Hospital Charge Code |
48100122
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$67.05 |
| Max. Negotiated Rate |
$8,170.16 |
| Rate for Payer: Aetna Commercial |
$7,716.27
|
| Rate for Payer: Aetna Medicare |
$133.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,900.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$160.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$160.26
|
| Rate for Payer: BCBS Complete |
$70.41
|
| Rate for Payer: BCBS MAPPO |
$128.21
|
| Rate for Payer: BCBS Trust/PPO |
$434.91
|
| Rate for Payer: BCN Commercial |
$434.91
|
| Rate for Payer: BCN Medicare Advantage |
$128.21
|
| Rate for Payer: Cash Price |
$7,262.37
|
| Rate for Payer: Cash Price |
$7,262.37
|
| Rate for Payer: Cofinity Advantage |
$6,354.57
|
| Rate for Payer: Cofinity Commercial |
$7,807.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,262.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.21
|
| Rate for Payer: Healthscope Commercial |
$8,170.16
|
| Rate for Payer: Mclaren Medicaid |
$67.05
|
| Rate for Payer: Mclaren Medicare |
$128.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$134.62
|
| Rate for Payer: Meridian Medicaid |
$134.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$147.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$141.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,716.27
|
| Rate for Payer: Nomi Health Commercial |
$384.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,808.47
|
| Rate for Payer: PACE Medicare |
$121.80
|
| Rate for Payer: PACE SWMI |
$128.21
|
| Rate for Payer: PHP Commercial |
$7,716.27
|
| Rate for Payer: PHP Medicare Advantage |
$128.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$414.63
|
| Rate for Payer: Priority Health Medicare |
$128.21
|
| Rate for Payer: Priority Health SBD |
$5,719.11
|
| Rate for Payer: Priority Health Tiered Network |
$331.70
|
| Rate for Payer: Railroad Medicare Medicare |
$128.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$128.21
|
| Rate for Payer: UHC Medicaid |
$67.05
|
| Rate for Payer: UHCCP Medicaid |
$67.05
|
| Rate for Payer: VA VA |
$128.21
|
|
|
HC ABLATION VEIN OF MARSHALL
|
Facility
|
IP
|
$9,077.96
|
|
|
Service Code
|
CPT 93799
|
| Hospital Charge Code |
48100122
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,719.11 |
| Max. Negotiated Rate |
$8,170.16 |
| Rate for Payer: Aetna Commercial |
$7,716.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,900.67
|
| Rate for Payer: Cash Price |
$7,262.37
|
| Rate for Payer: Cofinity Advantage |
$6,354.57
|
| Rate for Payer: Cofinity Commercial |
$7,807.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,262.37
|
| Rate for Payer: Healthscope Commercial |
$8,170.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,716.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,808.47
|
| Rate for Payer: PHP Commercial |
$7,716.27
|
| Rate for Payer: Priority Health SBD |
$5,719.11
|
|
|
HC ABLAVAR
|
Facility
|
OP
|
$27.05
|
|
|
Service Code
|
HCPCS A9583
|
| Hospital Charge Code |
63600007
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$10.82 |
| Max. Negotiated Rate |
$26.88 |
| Rate for Payer: Aetna Commercial |
$22.99
|
| Rate for Payer: Aetna Medicare |
$13.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.58
|
| Rate for Payer: BCBS Complete |
$10.82
|
| Rate for Payer: BCBS Trust/PPO |
$26.88
|
| Rate for Payer: BCN Commercial |
$26.88
|
| Rate for Payer: Cash Price |
$21.64
|
| Rate for Payer: Cash Price |
$21.64
|
| Rate for Payer: Cofinity Advantage |
$18.93
|
| Rate for Payer: Cofinity Commercial |
$23.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.64
|
| Rate for Payer: Healthscope Commercial |
$24.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.29
|
| Rate for Payer: PHP Commercial |
$22.99
|
| Rate for Payer: Priority Health SBD |
$17.04
|
|
|
HC ABLAVAR
|
Facility
|
IP
|
$27.05
|
|
|
Service Code
|
HCPCS A9583
|
| Hospital Charge Code |
63600007
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$17.04 |
| Max. Negotiated Rate |
$24.34 |
| Rate for Payer: Aetna Commercial |
$22.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.58
|
| Rate for Payer: Cash Price |
$21.64
|
| Rate for Payer: Cofinity Advantage |
$18.93
|
| Rate for Payer: Cofinity Commercial |
$23.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.64
|
| Rate for Payer: Healthscope Commercial |
$24.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.29
|
| Rate for Payer: PHP Commercial |
$22.99
|
| Rate for Payer: Priority Health SBD |
$17.04
|
|
|
HC ABSCESS DRAINAGE COMPLICATED
|
Facility
|
IP
|
$508.61
|
|
|
Service Code
|
CPT 10061
|
| Hospital Charge Code |
76100037
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$320.42 |
| Max. Negotiated Rate |
$457.75 |
| Rate for Payer: Aetna Commercial |
$432.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$330.60
|
| Rate for Payer: Cash Price |
$406.89
|
| Rate for Payer: Cofinity Advantage |
$356.03
|
| Rate for Payer: Cofinity Commercial |
$437.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$406.89
|
| Rate for Payer: Healthscope Commercial |
$457.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$432.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$381.46
|
| Rate for Payer: PHP Commercial |
$432.32
|
| Rate for Payer: Priority Health SBD |
$320.42
|
|
|
HC ABSCESS DRAINAGE COMPLICATED
|
Facility
|
OP
|
$508.61
|
|
|
Service Code
|
CPT 10061
|
| Hospital Charge Code |
76100037
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$199.88 |
| Max. Negotiated Rate |
$1,309.90 |
| Rate for Payer: Aetna Commercial |
$432.32
|
| Rate for Payer: Aetna Medicare |
$421.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$330.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$506.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$506.31
|
| Rate for Payer: BCBS Complete |
$222.45
|
| Rate for Payer: BCBS MAPPO |
$405.05
|
| Rate for Payer: BCBS Trust/PPO |
$307.60
|
| Rate for Payer: BCN Commercial |
$307.60
|
| Rate for Payer: BCN Medicare Advantage |
$405.05
|
| Rate for Payer: Cash Price |
$406.89
|
| Rate for Payer: Cash Price |
$406.89
|
| Rate for Payer: Cash Price |
$406.89
|
| Rate for Payer: Cofinity Advantage |
$356.03
|
| Rate for Payer: Cofinity Commercial |
$437.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$406.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$405.05
|
| Rate for Payer: Healthscope Commercial |
$457.75
|
| Rate for Payer: Mclaren Medicaid |
$211.84
|
| Rate for Payer: Mclaren Medicare |
$405.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$425.30
|
| Rate for Payer: Meridian Medicaid |
$425.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$465.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$445.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$432.32
|
| Rate for Payer: Nomi Health Commercial |
$1,215.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$381.46
|
| Rate for Payer: PACE Medicare |
$384.80
|
| Rate for Payer: PACE SWMI |
$405.05
|
| Rate for Payer: PHP Commercial |
$432.32
|
| Rate for Payer: PHP Medicare Advantage |
$405.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,309.90
|
| Rate for Payer: Priority Health Medicare |
$405.05
|
| Rate for Payer: Priority Health SBD |
$320.42
|
| Rate for Payer: Priority Health Tiered Network |
$1,047.92
|
| Rate for Payer: Railroad Medicare Medicare |
$405.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$330.60
|
| Rate for Payer: UHC Core |
$264.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$405.05
|
| Rate for Payer: UHC Exchange |
$199.88
|
| Rate for Payer: UHC Medicaid |
$211.84
|
| Rate for Payer: UHCCP Medicaid |
$211.84
|
| Rate for Payer: VA VA |
$405.05
|
|
|
HC ABSCESS DRAINAGE SIMPLE
|
Facility
|
IP
|
$407.83
|
|
|
Service Code
|
CPT 10060
|
| Hospital Charge Code |
36100002
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$256.93 |
| Max. Negotiated Rate |
$367.05 |
| Rate for Payer: Aetna Commercial |
$346.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$265.09
|
| Rate for Payer: Cash Price |
$326.26
|
| Rate for Payer: Cofinity Advantage |
$285.48
|
| Rate for Payer: Cofinity Commercial |
$350.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$326.26
|
| Rate for Payer: Healthscope Commercial |
$367.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$346.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$305.87
|
| Rate for Payer: PHP Commercial |
$346.66
|
| Rate for Payer: Priority Health SBD |
$256.93
|
|
|
HC ABSCESS DRAINAGE SIMPLE
|
Facility
|
OP
|
$407.83
|
|
|
Service Code
|
CPT 10060
|
| Hospital Charge Code |
36100002
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$104.55 |
| Max. Negotiated Rate |
$646.50 |
| Rate for Payer: Aetna Commercial |
$346.66
|
| Rate for Payer: Aetna Medicare |
$207.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$265.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$249.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$249.89
|
| Rate for Payer: BCBS Complete |
$109.79
|
| Rate for Payer: BCBS MAPPO |
$199.91
|
| Rate for Payer: BCBS Trust/PPO |
$193.02
|
| Rate for Payer: BCN Commercial |
$193.02
|
| Rate for Payer: BCN Medicare Advantage |
$199.91
|
| Rate for Payer: Cash Price |
$326.26
|
| Rate for Payer: Cash Price |
$326.26
|
| Rate for Payer: Cash Price |
$326.26
|
| Rate for Payer: Cofinity Advantage |
$285.48
|
| Rate for Payer: Cofinity Commercial |
$350.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$326.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$199.91
|
| Rate for Payer: Healthscope Commercial |
$367.05
|
| Rate for Payer: Mclaren Medicaid |
$104.55
|
| Rate for Payer: Mclaren Medicare |
$199.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$209.91
|
| Rate for Payer: Meridian Medicaid |
$209.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$229.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$219.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$346.66
|
| Rate for Payer: Nomi Health Commercial |
$599.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$305.87
|
| Rate for Payer: PACE Medicare |
$189.91
|
| Rate for Payer: PACE SWMI |
$199.91
|
| Rate for Payer: PHP Commercial |
$346.66
|
| Rate for Payer: PHP Medicare Advantage |
$199.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$646.50
|
| Rate for Payer: Priority Health Medicare |
$199.91
|
| Rate for Payer: Priority Health SBD |
$256.93
|
| Rate for Payer: Priority Health Tiered Network |
$517.20
|
| Rate for Payer: Railroad Medicare Medicare |
$199.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$265.09
|
| Rate for Payer: UHC Core |
$212.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$199.91
|
| Rate for Payer: UHC Exchange |
$160.28
|
| Rate for Payer: UHC Medicaid |
$104.55
|
| Rate for Payer: UHCCP Medicaid |
$104.55
|
| Rate for Payer: VA VA |
$199.91
|
|
|
HC ABSCESS ISHIO/PERIRECTAL
|
Facility
|
OP
|
$1,825.18
|
|
|
Service Code
|
CPT 46040
|
| Hospital Charge Code |
36100196
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$623.59 |
| Max. Negotiated Rate |
$3,855.91 |
| Rate for Payer: Aetna Commercial |
$1,551.40
|
| Rate for Payer: Aetna Medicare |
$1,240.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,186.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,490.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,490.42
|
| Rate for Payer: BCBS Complete |
$654.83
|
| Rate for Payer: BCBS MAPPO |
$1,192.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,532.68
|
| Rate for Payer: BCN Commercial |
$1,532.68
|
| Rate for Payer: BCN Medicare Advantage |
$1,192.34
|
| Rate for Payer: Cash Price |
$1,460.14
|
| Rate for Payer: Cash Price |
$1,460.14
|
| Rate for Payer: Cash Price |
$1,460.14
|
| Rate for Payer: Cofinity Advantage |
$1,277.63
|
| Rate for Payer: Cofinity Commercial |
$1,569.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,460.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,192.34
|
| Rate for Payer: Healthscope Commercial |
$1,642.66
|
| Rate for Payer: Mclaren Medicaid |
$623.59
|
| Rate for Payer: Mclaren Medicare |
$1,192.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,251.96
|
| Rate for Payer: Meridian Medicaid |
$1,251.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,371.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,311.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,551.40
|
| Rate for Payer: Nomi Health Commercial |
$3,577.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,368.88
|
| Rate for Payer: PACE Medicare |
$1,132.72
|
| Rate for Payer: PACE SWMI |
$1,192.34
|
| Rate for Payer: PHP Commercial |
$1,551.40
|
| Rate for Payer: PHP Medicare Advantage |
$1,192.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$623.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,855.91
|
| Rate for Payer: Priority Health Medicare |
$1,192.34
|
| Rate for Payer: Priority Health SBD |
$1,149.86
|
| Rate for Payer: Priority Health Tiered Network |
$3,084.73
|
| Rate for Payer: Railroad Medicare Medicare |
$1,192.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,186.37
|
| Rate for Payer: UHC Core |
$950.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,192.34
|
| Rate for Payer: UHC Exchange |
$717.30
|
| Rate for Payer: UHC Medicaid |
$623.59
|
| Rate for Payer: UHCCP Medicaid |
$623.59
|
| Rate for Payer: VA VA |
$1,192.34
|
|
|
HC ABSCESS ISHIO/PERIRECTAL
|
Facility
|
IP
|
$1,825.18
|
|
|
Service Code
|
CPT 46040
|
| Hospital Charge Code |
36100196
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,149.86 |
| Max. Negotiated Rate |
$1,642.66 |
| Rate for Payer: Aetna Commercial |
$1,551.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,186.37
|
| Rate for Payer: Cash Price |
$1,460.14
|
| Rate for Payer: Cofinity Advantage |
$1,277.63
|
| Rate for Payer: Cofinity Commercial |
$1,569.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,460.14
|
| Rate for Payer: Healthscope Commercial |
$1,642.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,551.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,368.88
|
| Rate for Payer: PHP Commercial |
$1,551.40
|
| Rate for Payer: Priority Health SBD |
$1,149.86
|
|
|
HC ACAPELLA SUPPLY
|
Facility
|
OP
|
$199.90
|
|
| Hospital Charge Code |
27000025
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$78.56 |
| Max. Negotiated Rate |
$179.91 |
| Rate for Payer: Aetna Commercial |
$169.91
|
| Rate for Payer: Aetna Medicare |
$99.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$129.94
|
| Rate for Payer: BCBS Complete |
$79.96
|
| Rate for Payer: Cash Price |
$159.92
|
| Rate for Payer: Cofinity Advantage |
$139.93
|
| Rate for Payer: Cofinity Commercial |
$171.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$159.92
|
| Rate for Payer: Healthscope Commercial |
$179.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$159.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$169.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$149.93
|
| Rate for Payer: PHP Commercial |
$169.91
|
| Rate for Payer: Priority Health SBD |
$125.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$129.94
|
| Rate for Payer: UHC Core |
$104.15
|
| Rate for Payer: UHC Exchange |
$78.56
|
|
|
HC ACAPELLA SUPPLY
|
Facility
|
IP
|
$199.90
|
|
| Hospital Charge Code |
27000025
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$125.94 |
| Max. Negotiated Rate |
$179.91 |
| Rate for Payer: Aetna Commercial |
$169.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$129.94
|
| Rate for Payer: Cash Price |
$159.92
|
| Rate for Payer: Cofinity Advantage |
$139.93
|
| Rate for Payer: Cofinity Commercial |
$171.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$159.92
|
| Rate for Payer: Healthscope Commercial |
$179.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$169.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$149.93
|
| Rate for Payer: PHP Commercial |
$169.91
|
| Rate for Payer: Priority Health SBD |
$125.94
|
|
|
HC ACB APLIGRAF PER SQ CM
|
Facility
|
OP
|
$96.18
|
|
|
Service Code
|
HCPCS Q4101
|
| Hospital Charge Code |
63600031
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$60.59 |
| Max. Negotiated Rate |
$4,833.67 |
| Rate for Payer: Aetna Commercial |
$81.75
|
| Rate for Payer: Aetna Medicare |
$128.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$155.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$155.00
|
| Rate for Payer: BCBS Complete |
$68.10
|
| Rate for Payer: BCBS MAPPO |
$124.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,618.49
|
| Rate for Payer: BCN Commercial |
$4,833.67
|
| Rate for Payer: BCN Medicare Advantage |
$124.00
|
| Rate for Payer: Cash Price |
$76.94
|
| Rate for Payer: Cash Price |
$76.94
|
| Rate for Payer: Cash Price |
$76.94
|
| Rate for Payer: Cofinity Advantage |
$67.33
|
| Rate for Payer: Cofinity Commercial |
$82.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$124.00
|
| Rate for Payer: Healthscope Commercial |
$86.56
|
| Rate for Payer: Mclaren Medicaid |
$64.85
|
| Rate for Payer: Mclaren Medicare |
$124.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$130.20
|
| Rate for Payer: Meridian Medicaid |
$130.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$142.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$136.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.75
|
| Rate for Payer: Nomi Health Commercial |
$372.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$72.14
|
| Rate for Payer: PACE Medicare |
$117.80
|
| Rate for Payer: PACE SWMI |
$124.00
|
| Rate for Payer: PHP Commercial |
$81.75
|
| Rate for Payer: PHP Medicare Advantage |
$124.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$401.00
|
| Rate for Payer: Priority Health Medicare |
$124.00
|
| Rate for Payer: Priority Health SBD |
$60.59
|
| Rate for Payer: Priority Health Tiered Network |
$320.80
|
| Rate for Payer: Railroad Medicare Medicare |
$124.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$209.78
|
| Rate for Payer: UHC Core |
$209.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$124.00
|
| Rate for Payer: UHC Exchange |
$209.78
|
| Rate for Payer: UHC Medicaid |
$64.85
|
| Rate for Payer: UHCCP Medicaid |
$64.85
|
| Rate for Payer: VA VA |
$124.00
|
|
|
HC ACB APLIGRAF PER SQ CM
|
Facility
|
IP
|
$96.18
|
|
|
Service Code
|
HCPCS Q4101
|
| Hospital Charge Code |
63600031
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$60.59 |
| Max. Negotiated Rate |
$86.56 |
| Rate for Payer: Aetna Commercial |
$81.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.52
|
| Rate for Payer: Cash Price |
$76.94
|
| Rate for Payer: Cofinity Advantage |
$67.33
|
| Rate for Payer: Cofinity Commercial |
$82.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.94
|
| Rate for Payer: Healthscope Commercial |
$86.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$72.14
|
| Rate for Payer: PHP Commercial |
$81.75
|
| Rate for Payer: Priority Health SBD |
$60.59
|
|
|
HC ACB ESTABLISHED PT LEVEL 1
|
Facility
|
OP
|
$355.31
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
51000072
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$21.87 |
| Max. Negotiated Rate |
$319.78 |
| Rate for Payer: Aetna Commercial |
$302.01
|
| Rate for Payer: Aetna Medicare |
$177.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$230.95
|
| Rate for Payer: BCBS Complete |
$142.12
|
| Rate for Payer: BCBS Trust/PPO |
$49.51
|
| Rate for Payer: BCCCP Commercial |
$21.87
|
| Rate for Payer: BCN Commercial |
$49.51
|
| Rate for Payer: Cash Price |
$284.25
|
| Rate for Payer: Cash Price |
$284.25
|
| Rate for Payer: Cofinity Advantage |
$248.72
|
| Rate for Payer: Cofinity Commercial |
$305.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$284.25
|
| Rate for Payer: Healthscope Commercial |
$319.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$284.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$302.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$266.48
|
| Rate for Payer: PHP Commercial |
$302.01
|
| Rate for Payer: Priority Health SBD |
$223.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$230.95
|
| Rate for Payer: UHC Core |
$185.12
|
| Rate for Payer: UHC Exchange |
$139.64
|
|
|
HC ACB ESTABLISHED PT LEVEL 1
|
Facility
|
IP
|
$355.31
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
51000072
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$223.85 |
| Max. Negotiated Rate |
$319.78 |
| Rate for Payer: Aetna Commercial |
$302.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$230.95
|
| Rate for Payer: Cash Price |
$284.25
|
| Rate for Payer: Cofinity Advantage |
$248.72
|
| Rate for Payer: Cofinity Commercial |
$305.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$284.25
|
| Rate for Payer: Healthscope Commercial |
$319.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$302.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$266.48
|
| Rate for Payer: PHP Commercial |
$302.01
|
| Rate for Payer: Priority Health SBD |
$223.85
|
|
