|
HC ABLATION BY NEUROLYTIC AGENT FACET JT C OR T SNG LVL
|
Facility
|
OP
|
$2,683.22
|
|
|
Service Code
|
CPT 64633
|
| Hospital Charge Code |
36100590
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$202.00 |
| Max. Negotiated Rate |
$6,013.44 |
| Rate for Payer: Aetna Commercial |
$2,280.74
|
| Rate for Payer: Aetna Medicare |
$1,989.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,744.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,391.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,391.60
|
| Rate for Payer: BCBS Complete |
$1,076.79
|
| Rate for Payer: BCBS MAPPO |
$1,913.28
|
| Rate for Payer: BCBS Trust/PPO |
$790.75
|
| Rate for Payer: BCN Commercial |
$790.75
|
| Rate for Payer: BCN Medicare Advantage |
$1,913.28
|
| Rate for Payer: Cash Price |
$2,146.58
|
| Rate for Payer: Cash Price |
$2,146.58
|
| Rate for Payer: Cash Price |
$2,146.58
|
| Rate for Payer: Cofinity Commercial |
$1,878.25
|
| Rate for Payer: Cofinity Commercial |
$2,307.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,878.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,146.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,913.28
|
| Rate for Payer: Healthscope Commercial |
$2,414.90
|
| Rate for Payer: Mclaren Medicaid |
$1,025.52
|
| Rate for Payer: Mclaren Medicare |
$1,913.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,008.94
|
| Rate for Payer: Meridian Medicaid |
$1,076.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,200.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,280.74
|
| Rate for Payer: Nomi Health Commercial |
$4,017.89
|
| Rate for Payer: PACE Medicare |
$1,817.62
|
| Rate for Payer: PACE SWMI |
$1,913.28
|
| Rate for Payer: PHP Commercial |
$2,280.74
|
| Rate for Payer: PHP Medicare Advantage |
$1,913.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,025.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,744.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,013.44
|
| Rate for Payer: Priority Health Medicare |
$1,913.28
|
| Rate for Payer: Priority Health Narrow Network |
$4,810.75
|
| Rate for Payer: Priority Health SBD |
$1,690.43
|
| Rate for Payer: Railroad Medicare Medicare |
$1,913.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$202.00
|
| Rate for Payer: UHC Core |
$4,155.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,913.28
|
| Rate for Payer: UHC Exchange |
$4,450.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,913.28
|
| Rate for Payer: UHCCP Medicaid |
$1,077.18
|
| Rate for Payer: VA VA |
$1,913.28
|
|
|
HC ABLATION BY NEUROLYTIC AGENT FACET JT L OR S EA ADDL JOINT
|
Facility
|
IP
|
$1,092.42
|
|
|
Service Code
|
CPT 64636
|
| Hospital Charge Code |
36100593
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$688.22 |
| Max. Negotiated Rate |
$983.18 |
| Rate for Payer: Aetna Commercial |
$928.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$710.07
|
| Rate for Payer: Cash Price |
$873.94
|
| Rate for Payer: Cofinity Commercial |
$764.69
|
| Rate for Payer: Cofinity Commercial |
$939.48
|
| Rate for Payer: Cofinity Medicare Advantage |
$764.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$873.94
|
| Rate for Payer: Healthscope Commercial |
$983.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$928.56
|
| Rate for Payer: PHP Commercial |
$928.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$710.07
|
| Rate for Payer: Priority Health SBD |
$688.22
|
|
|
HC ABLATION BY NEUROLYTIC AGENT FACET JT L OR S EA ADDL JOINT
|
Facility
|
OP
|
$1,092.42
|
|
|
Service Code
|
CPT 64636
|
| Hospital Charge Code |
36100593
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$61.85 |
| Max. Negotiated Rate |
$983.18 |
| Rate for Payer: Aetna Commercial |
$928.56
|
| Rate for Payer: Aetna Medicare |
$546.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$710.07
|
| Rate for Payer: BCBS Complete |
$436.97
|
| Rate for Payer: BCBS Trust/PPO |
$350.96
|
| Rate for Payer: BCN Commercial |
$350.96
|
| Rate for Payer: Cash Price |
$873.94
|
| Rate for Payer: Cash Price |
$873.94
|
| Rate for Payer: Cash Price |
$873.94
|
| Rate for Payer: Cofinity Commercial |
$764.69
|
| Rate for Payer: Cofinity Commercial |
$939.48
|
| Rate for Payer: Cofinity Medicare Advantage |
$764.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$873.94
|
| Rate for Payer: Healthscope Commercial |
$983.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$928.56
|
| Rate for Payer: PHP Commercial |
$928.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$710.07
|
| Rate for Payer: Priority Health SBD |
$688.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.85
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Exchange |
$940.00
|
|
|
HC ABLATION BY NEUROLYTIC AGENT FACET JT L OR S SNG LVL
|
Facility
|
IP
|
$2,683.22
|
|
|
Service Code
|
CPT 64635
|
| Hospital Charge Code |
36100592
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,690.43 |
| Max. Negotiated Rate |
$2,414.90 |
| Rate for Payer: Aetna Commercial |
$2,280.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,744.09
|
| Rate for Payer: Cash Price |
$2,146.58
|
| Rate for Payer: Cofinity Commercial |
$1,878.25
|
| Rate for Payer: Cofinity Commercial |
$2,307.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,878.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,146.58
|
| Rate for Payer: Healthscope Commercial |
$2,414.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,280.74
|
| Rate for Payer: PHP Commercial |
$2,280.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,744.09
|
| Rate for Payer: Priority Health SBD |
$1,690.43
|
|
|
HC ABLATION BY NEUROLYTIC AGENT FACET JT L OR S SNG LVL
|
Facility
|
OP
|
$2,683.22
|
|
|
Service Code
|
CPT 64635
|
| Hospital Charge Code |
36100592
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$202.33 |
| Max. Negotiated Rate |
$6,013.44 |
| Rate for Payer: Aetna Commercial |
$2,280.74
|
| Rate for Payer: Aetna Medicare |
$1,989.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,744.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,391.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,391.60
|
| Rate for Payer: BCBS Complete |
$1,076.79
|
| Rate for Payer: BCBS MAPPO |
$1,913.28
|
| Rate for Payer: BCBS Trust/PPO |
$885.90
|
| Rate for Payer: BCN Commercial |
$885.90
|
| Rate for Payer: BCN Medicare Advantage |
$1,913.28
|
| Rate for Payer: Cash Price |
$2,146.58
|
| Rate for Payer: Cash Price |
$2,146.58
|
| Rate for Payer: Cash Price |
$2,146.58
|
| Rate for Payer: Cofinity Commercial |
$1,878.25
|
| Rate for Payer: Cofinity Commercial |
$2,307.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,878.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,146.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,913.28
|
| Rate for Payer: Healthscope Commercial |
$2,414.90
|
| Rate for Payer: Mclaren Medicaid |
$1,025.52
|
| Rate for Payer: Mclaren Medicare |
$1,913.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,008.94
|
| Rate for Payer: Meridian Medicaid |
$1,076.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,200.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,280.74
|
| Rate for Payer: Nomi Health Commercial |
$4,017.89
|
| Rate for Payer: PACE Medicare |
$1,817.62
|
| Rate for Payer: PACE SWMI |
$1,913.28
|
| Rate for Payer: PHP Commercial |
$2,280.74
|
| Rate for Payer: PHP Medicare Advantage |
$1,913.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,025.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,744.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,013.44
|
| Rate for Payer: Priority Health Medicare |
$1,913.28
|
| Rate for Payer: Priority Health Narrow Network |
$4,810.75
|
| Rate for Payer: Priority Health SBD |
$1,690.43
|
| Rate for Payer: Railroad Medicare Medicare |
$1,913.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$202.33
|
| Rate for Payer: UHC Core |
$4,155.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,913.28
|
| Rate for Payer: UHC Exchange |
$4,450.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,913.28
|
| Rate for Payer: UHCCP Medicaid |
$1,077.18
|
| Rate for Payer: VA VA |
$1,913.28
|
|
|
HC ABLATION CATHETER
|
Facility
|
IP
|
$4,346.76
|
|
|
Service Code
|
HCPCS C1733
|
| Hospital Charge Code |
27200008
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,738.46 |
| Max. Negotiated Rate |
$3,912.08 |
| Rate for Payer: Aetna Commercial |
$3,694.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,825.39
|
| Rate for Payer: Cash Price |
$3,477.41
|
| Rate for Payer: Cofinity Commercial |
$3,042.73
|
| Rate for Payer: Cofinity Commercial |
$3,738.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,042.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,477.41
|
| Rate for Payer: Healthscope Commercial |
$3,912.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,694.75
|
| Rate for Payer: PHP Commercial |
$3,694.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,825.39
|
| Rate for Payer: Priority Health SBD |
$2,738.46
|
|
|
HC ABLATION CATHETER
|
Facility
|
OP
|
$4,346.76
|
|
|
Service Code
|
HCPCS C1733
|
| Hospital Charge Code |
27200008
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$3,912.08 |
| Rate for Payer: Aetna Commercial |
$3,694.75
|
| Rate for Payer: Aetna Medicare |
$2,173.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,825.39
|
| Rate for Payer: BCBS Complete |
$1,738.70
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$3,477.41
|
| Rate for Payer: Cash Price |
$3,477.41
|
| Rate for Payer: Cofinity Commercial |
$3,042.73
|
| Rate for Payer: Cofinity Commercial |
$3,738.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,042.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,477.41
|
| Rate for Payer: Healthscope Commercial |
$3,912.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,694.75
|
| Rate for Payer: PHP Commercial |
$3,694.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,825.39
|
| Rate for Payer: Priority Health SBD |
$2,738.46
|
|
|
HC ABLATION CATHETER (8/10 MM TIP
|
Facility
|
OP
|
$5,912.22
|
|
|
Service Code
|
HCPCS C1733
|
| Hospital Charge Code |
27200009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$5,321.00 |
| Rate for Payer: Aetna Commercial |
$5,025.39
|
| Rate for Payer: Aetna Medicare |
$2,956.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,842.94
|
| Rate for Payer: BCBS Complete |
$2,364.89
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$4,729.78
|
| Rate for Payer: Cash Price |
$4,729.78
|
| Rate for Payer: Cofinity Commercial |
$4,138.55
|
| Rate for Payer: Cofinity Commercial |
$5,084.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,138.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,729.78
|
| Rate for Payer: Healthscope Commercial |
$5,321.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,025.39
|
| Rate for Payer: PHP Commercial |
$5,025.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,842.94
|
| Rate for Payer: Priority Health SBD |
$3,724.70
|
|
|
HC ABLATION CATHETER (8/10 MM TIP
|
Facility
|
IP
|
$5,912.22
|
|
|
Service Code
|
HCPCS C1733
|
| Hospital Charge Code |
27200009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,724.70 |
| Max. Negotiated Rate |
$5,321.00 |
| Rate for Payer: Aetna Commercial |
$5,025.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,842.94
|
| Rate for Payer: Cash Price |
$4,729.78
|
| Rate for Payer: Cofinity Commercial |
$4,138.55
|
| Rate for Payer: Cofinity Commercial |
$5,084.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,138.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,729.78
|
| Rate for Payer: Healthscope Commercial |
$5,321.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,025.39
|
| Rate for Payer: PHP Commercial |
$5,025.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,842.94
|
| Rate for Payer: Priority Health SBD |
$3,724.70
|
|
|
HC ABLATION CATH EXTRAVASC TISSUE
|
Facility
|
IP
|
$7,222.46
|
|
|
Service Code
|
HCPCS C1886
|
| Hospital Charge Code |
27000645
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4,550.15 |
| Max. Negotiated Rate |
$6,500.21 |
| Rate for Payer: Aetna Commercial |
$6,139.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,694.60
|
| Rate for Payer: Cash Price |
$5,777.97
|
| Rate for Payer: Cofinity Commercial |
$5,055.72
|
| Rate for Payer: Cofinity Commercial |
$6,211.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,055.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,777.97
|
| Rate for Payer: Healthscope Commercial |
$6,500.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,139.09
|
| Rate for Payer: PHP Commercial |
$6,139.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,694.60
|
| Rate for Payer: Priority Health SBD |
$4,550.15
|
|
|
HC ABLATION CATH EXTRAVASC TISSUE
|
Facility
|
OP
|
$7,222.46
|
|
|
Service Code
|
HCPCS C1886
|
| Hospital Charge Code |
27000645
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$6,500.21 |
| Rate for Payer: Aetna Commercial |
$6,139.09
|
| Rate for Payer: Aetna Medicare |
$3,611.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,694.60
|
| Rate for Payer: BCBS Complete |
$2,888.98
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$5,777.97
|
| Rate for Payer: Cash Price |
$5,777.97
|
| Rate for Payer: Cofinity Commercial |
$5,055.72
|
| Rate for Payer: Cofinity Commercial |
$6,211.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,055.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,777.97
|
| Rate for Payer: Healthscope Commercial |
$6,500.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,139.09
|
| Rate for Payer: PHP Commercial |
$6,139.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,694.60
|
| Rate for Payer: Priority Health SBD |
$4,550.15
|
|
|
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 |
$510.00 |
| 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 Commercial |
$1,096.50
|
| Rate for Payer: Cofinity Commercial |
$892.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$892.50
|
| 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: PHP Commercial |
$1,083.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$828.75
|
| Rate for Payer: Priority Health SBD |
$803.25
|
|
|
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 Commercial |
$1,096.50
|
| Rate for Payer: Cofinity Commercial |
$892.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$892.50
|
| 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: PHP Commercial |
$1,083.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$828.75
|
| Rate for Payer: Priority Health SBD |
$803.25
|
|
|
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 Commercial |
$1,115.62
|
| Rate for Payer: Cofinity Commercial |
$1,370.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,115.62
|
| 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: PHP Commercial |
$1,354.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,035.94
|
| Rate for Payer: Priority Health SBD |
$1,004.06
|
|
|
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 |
$637.50 |
| 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 Commercial |
$1,115.62
|
| Rate for Payer: Cofinity Commercial |
$1,370.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,115.62
|
| 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: PHP Commercial |
$1,354.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,035.94
|
| Rate for Payer: Priority Health SBD |
$1,004.06
|
|
|
HC ABLATION RF LUNG
|
Facility
|
IP
|
$6,017.36
|
|
|
Service Code
|
CPT 32998
|
| Hospital Charge Code |
36100055
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,790.94 |
| Max. Negotiated Rate |
$5,415.62 |
| Rate for Payer: Aetna Commercial |
$5,114.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,911.28
|
| Rate for Payer: Cash Price |
$4,813.89
|
| Rate for Payer: Cofinity Commercial |
$4,212.15
|
| Rate for Payer: Cofinity Commercial |
$5,174.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,212.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,813.89
|
| Rate for Payer: Healthscope Commercial |
$5,415.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,114.76
|
| Rate for Payer: PHP Commercial |
$5,114.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,911.28
|
| Rate for Payer: Priority Health SBD |
$3,790.94
|
|
|
HC ABLATION RF LUNG
|
Facility
|
OP
|
$6,017.36
|
|
|
Service Code
|
CPT 32998
|
| Hospital Charge Code |
36100055
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$457.78 |
| Max. Negotiated Rate |
$17,966.53 |
| Rate for Payer: Aetna Commercial |
$5,114.76
|
| Rate for Payer: Aetna Medicare |
$5,945.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,911.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,145.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,145.49
|
| Rate for Payer: BCBS Complete |
$3,217.18
|
| Rate for Payer: BCBS MAPPO |
$5,716.39
|
| Rate for Payer: BCBS Trust/PPO |
$2,354.09
|
| Rate for Payer: BCN Commercial |
$2,354.09
|
| Rate for Payer: BCN Medicare Advantage |
$5,716.39
|
| Rate for Payer: Cash Price |
$4,813.89
|
| Rate for Payer: Cash Price |
$4,813.89
|
| Rate for Payer: Cash Price |
$4,813.89
|
| Rate for Payer: Cofinity Commercial |
$4,212.15
|
| Rate for Payer: Cofinity Commercial |
$5,174.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,212.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,813.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,716.39
|
| Rate for Payer: Healthscope Commercial |
$5,415.62
|
| Rate for Payer: Mclaren Medicaid |
$3,063.99
|
| Rate for Payer: Mclaren Medicare |
$5,716.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,002.21
|
| Rate for Payer: Meridian Medicaid |
$3,217.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,573.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,114.76
|
| Rate for Payer: Nomi Health Commercial |
$12,004.42
|
| Rate for Payer: PACE Medicare |
$5,430.57
|
| Rate for Payer: PACE SWMI |
$5,716.39
|
| Rate for Payer: PHP Commercial |
$5,114.76
|
| Rate for Payer: PHP Medicare Advantage |
$5,716.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,063.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,911.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17,966.53
|
| Rate for Payer: Priority Health Medicare |
$5,716.39
|
| Rate for Payer: Priority Health Narrow Network |
$14,373.22
|
| Rate for Payer: Priority Health SBD |
$3,790.94
|
| Rate for Payer: Railroad Medicare Medicare |
$5,716.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$457.78
|
| Rate for Payer: UHC Core |
$7,632.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,716.39
|
| Rate for Payer: UHC Exchange |
$8,174.00
|
| Rate for Payer: UHC Medicare Advantage |
$5,716.39
|
| Rate for Payer: UHCCP Medicaid |
$3,218.33
|
| Rate for Payer: VA VA |
$5,716.39
|
|
|
HC ABLATION VEIN OF MARSHALL
|
Facility
|
OP
|
$8,899.96
|
|
|
Service Code
|
CPT 93799
|
| Hospital Charge Code |
48100122
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$82.17 |
| Max. Negotiated Rate |
$8,009.96 |
| Rate for Payer: Aetna Commercial |
$7,564.97
|
| Rate for Payer: Aetna Medicare |
$159.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,784.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$191.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$191.62
|
| Rate for Payer: BCBS Complete |
$86.28
|
| Rate for Payer: BCBS MAPPO |
$153.30
|
| Rate for Payer: BCBS Trust/PPO |
$412.63
|
| Rate for Payer: BCN Commercial |
$412.63
|
| Rate for Payer: BCN Medicare Advantage |
$153.30
|
| Rate for Payer: Cash Price |
$7,119.97
|
| Rate for Payer: Cash Price |
$7,119.97
|
| Rate for Payer: Cash Price |
$7,119.97
|
| Rate for Payer: Cofinity Commercial |
$6,229.97
|
| Rate for Payer: Cofinity Commercial |
$7,653.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$6,229.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,119.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.30
|
| Rate for Payer: Healthscope Commercial |
$8,009.96
|
| Rate for Payer: Mclaren Medicaid |
$82.17
|
| Rate for Payer: Mclaren Medicare |
$153.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.96
|
| Rate for Payer: Meridian Medicaid |
$86.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$176.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,564.97
|
| Rate for Payer: Nomi Health Commercial |
$459.90
|
| Rate for Payer: PACE Medicare |
$145.64
|
| Rate for Payer: PACE SWMI |
$153.30
|
| Rate for Payer: PHP Commercial |
$7,564.97
|
| Rate for Payer: PHP Medicare Advantage |
$153.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,784.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$481.80
|
| Rate for Payer: Priority Health Medicare |
$153.30
|
| Rate for Payer: Priority Health Narrow Network |
$385.44
|
| Rate for Payer: Priority Health SBD |
$5,606.97
|
| Rate for Payer: Railroad Medicare Medicare |
$153.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$431.52
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.30
|
| Rate for Payer: UHC Exchange |
$940.00
|
| Rate for Payer: UHC Medicare Advantage |
$153.30
|
| Rate for Payer: UHCCP Medicaid |
$86.31
|
| Rate for Payer: VA VA |
$153.30
|
|
|
HC ABLATION VEIN OF MARSHALL
|
Facility
|
IP
|
$8,899.96
|
|
|
Service Code
|
CPT 93799
|
| Hospital Charge Code |
48100122
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,606.97 |
| Max. Negotiated Rate |
$8,009.96 |
| Rate for Payer: Aetna Commercial |
$7,564.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,784.97
|
| Rate for Payer: Cash Price |
$7,119.97
|
| Rate for Payer: Cofinity Commercial |
$6,229.97
|
| Rate for Payer: Cofinity Commercial |
$7,653.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$6,229.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,119.97
|
| Rate for Payer: Healthscope Commercial |
$8,009.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,564.97
|
| Rate for Payer: PHP Commercial |
$7,564.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,784.97
|
| Rate for Payer: Priority Health SBD |
$5,606.97
|
|
|
HC ABLAVAR
|
Facility
|
IP
|
$26.52
|
|
|
Service Code
|
HCPCS A9583
|
| Hospital Charge Code |
63600007
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$16.71 |
| Max. Negotiated Rate |
$23.87 |
| Rate for Payer: Aetna Commercial |
$22.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.24
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Commercial |
$18.56
|
| Rate for Payer: Cofinity Commercial |
$22.81
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Healthscope Commercial |
$23.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.54
|
| Rate for Payer: PHP Commercial |
$22.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.24
|
| Rate for Payer: Priority Health SBD |
$16.71
|
|
|
HC ABLAVAR
|
Facility
|
OP
|
$26.52
|
|
|
Service Code
|
HCPCS A9583
|
| Hospital Charge Code |
63600007
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$10.61 |
| Max. Negotiated Rate |
$23.87 |
| Rate for Payer: Aetna Commercial |
$22.54
|
| Rate for Payer: Aetna Medicare |
$13.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.24
|
| Rate for Payer: BCBS Complete |
$10.61
|
| Rate for Payer: BCBS Trust/PPO |
$22.32
|
| Rate for Payer: BCN Commercial |
$22.32
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Commercial |
$18.56
|
| Rate for Payer: Cofinity Commercial |
$22.81
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Healthscope Commercial |
$23.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.54
|
| Rate for Payer: PHP Commercial |
$22.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.24
|
| Rate for Payer: Priority Health SBD |
$16.71
|
|
|
HC ABSCESS DRAINAGE COMPLICATED
|
Facility
|
OP
|
$498.64
|
|
|
Service Code
|
CPT 10061
|
| Hospital Charge Code |
76100037
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$193.31 |
| Max. Negotiated Rate |
$1,230.33 |
| Rate for Payer: Aetna Commercial |
$423.84
|
| Rate for Payer: Aetna Medicare |
$407.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$324.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$489.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$489.31
|
| Rate for Payer: BCBS Complete |
$220.31
|
| Rate for Payer: BCBS MAPPO |
$391.45
|
| Rate for Payer: BCBS Trust/PPO |
$240.15
|
| Rate for Payer: BCN Commercial |
$240.15
|
| Rate for Payer: BCN Medicare Advantage |
$391.45
|
| Rate for Payer: Cash Price |
$398.91
|
| Rate for Payer: Cash Price |
$398.91
|
| Rate for Payer: Cash Price |
$398.91
|
| Rate for Payer: Cofinity Commercial |
$428.83
|
| Rate for Payer: Cofinity Commercial |
$349.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$349.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$398.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$391.45
|
| Rate for Payer: Healthscope Commercial |
$448.78
|
| Rate for Payer: Mclaren Medicaid |
$209.82
|
| Rate for Payer: Mclaren Medicare |
$391.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$411.02
|
| Rate for Payer: Meridian Medicaid |
$220.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$450.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$423.84
|
| Rate for Payer: Nomi Health Commercial |
$822.04
|
| Rate for Payer: PACE Medicare |
$371.88
|
| Rate for Payer: PACE SWMI |
$391.45
|
| Rate for Payer: PHP Commercial |
$423.84
|
| Rate for Payer: PHP Medicare Advantage |
$391.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$209.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$324.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,230.33
|
| Rate for Payer: Priority Health Medicare |
$391.45
|
| Rate for Payer: Priority Health Narrow Network |
$984.26
|
| Rate for Payer: Priority Health SBD |
$314.14
|
| Rate for Payer: Railroad Medicare Medicare |
$391.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$193.31
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$391.45
|
| Rate for Payer: UHC Medicare Advantage |
$391.45
|
| Rate for Payer: UHCCP Medicaid |
$220.39
|
| Rate for Payer: VA VA |
$391.45
|
|
|
HC ABSCESS DRAINAGE COMPLICATED
|
Facility
|
IP
|
$498.64
|
|
|
Service Code
|
CPT 10061
|
| Hospital Charge Code |
76100037
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$314.14 |
| Max. Negotiated Rate |
$448.78 |
| Rate for Payer: Aetna Commercial |
$423.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$324.12
|
| Rate for Payer: Cash Price |
$398.91
|
| Rate for Payer: Cofinity Commercial |
$349.05
|
| Rate for Payer: Cofinity Commercial |
$428.83
|
| Rate for Payer: Cofinity Medicare Advantage |
$349.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$398.91
|
| Rate for Payer: Healthscope Commercial |
$448.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$423.84
|
| Rate for Payer: PHP Commercial |
$423.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$324.12
|
| Rate for Payer: Priority Health SBD |
$314.14
|
|
|
HC ABSCESS DRAINAGE SIMPLE
|
Facility
|
OP
|
$399.83
|
|
|
Service Code
|
CPT 10060
|
| Hospital Charge Code |
36100002
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$104.35 |
| Max. Negotiated Rate |
$878.00 |
| Rate for Payer: Aetna Commercial |
$339.86
|
| Rate for Payer: Aetna Medicare |
$202.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$259.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$243.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$243.35
|
| Rate for Payer: BCBS Complete |
$109.57
|
| Rate for Payer: BCBS MAPPO |
$194.68
|
| Rate for Payer: BCBS Trust/PPO |
$150.70
|
| Rate for Payer: BCN Commercial |
$150.70
|
| Rate for Payer: BCN Medicare Advantage |
$194.68
|
| Rate for Payer: Cash Price |
$319.86
|
| Rate for Payer: Cash Price |
$319.86
|
| Rate for Payer: Cash Price |
$319.86
|
| Rate for Payer: Cofinity Commercial |
$279.88
|
| Rate for Payer: Cofinity Commercial |
$343.85
|
| Rate for Payer: Cofinity Medicare Advantage |
$279.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$319.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$194.68
|
| Rate for Payer: Healthscope Commercial |
$359.85
|
| Rate for Payer: Mclaren Medicaid |
$104.35
|
| Rate for Payer: Mclaren Medicare |
$194.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$204.41
|
| Rate for Payer: Meridian Medicaid |
$109.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$223.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$339.86
|
| Rate for Payer: Nomi Health Commercial |
$408.83
|
| Rate for Payer: PACE Medicare |
$184.95
|
| Rate for Payer: PACE SWMI |
$194.68
|
| Rate for Payer: PHP Commercial |
$339.86
|
| Rate for Payer: PHP Medicare Advantage |
$194.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$259.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$611.90
|
| Rate for Payer: Priority Health Medicare |
$194.68
|
| Rate for Payer: Priority Health Narrow Network |
$489.52
|
| Rate for Payer: Priority Health SBD |
$251.89
|
| Rate for Payer: Railroad Medicare Medicare |
$194.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$110.79
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$194.68
|
| Rate for Payer: UHC Medicare Advantage |
$194.68
|
| Rate for Payer: UHCCP Medicaid |
$109.60
|
| Rate for Payer: VA VA |
$194.68
|
|
|
HC ABSCESS DRAINAGE SIMPLE
|
Facility
|
IP
|
$399.83
|
|
|
Service Code
|
CPT 10060
|
| Hospital Charge Code |
36100002
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$251.89 |
| Max. Negotiated Rate |
$359.85 |
| Rate for Payer: Aetna Commercial |
$339.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$259.89
|
| Rate for Payer: Cash Price |
$319.86
|
| Rate for Payer: Cofinity Commercial |
$279.88
|
| Rate for Payer: Cofinity Commercial |
$343.85
|
| Rate for Payer: Cofinity Medicare Advantage |
$279.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$319.86
|
| Rate for Payer: Healthscope Commercial |
$359.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$339.86
|
| Rate for Payer: PHP Commercial |
$339.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$259.89
|
| Rate for Payer: Priority Health SBD |
$251.89
|
|
